Claim settlements

My claim has been accepted, but my insurer has offered to settle my claim. Can I settle my accepted claim?

Yes. On an accepted claim, you can enter into a claims disposition agreement (CDA), a legal agreement in which, in return for an agreed-upon amount of money, you give up your right to the following:

• Present and future time-loss benefits
• Present and future permanent partial disability awards
• Monthly payments for permanent total disability
• Vocational assistance benefits
• Survivor's benefits

However, you cannot release your right to medical benefits or eligibility for the Preferred Worker Program. All claim disposition agreements are reviewed by the Workers’ Compensation Board, which approves or disapproves the agreement.

My insurer has offered to settle my denied claim. Can I settle a denied claim?

Yes. When you disagree with the insurer about whether you have a valid workers’ compensation claim, you and the insurer may resolve the dispute by agreeing to a disputed claims settlement (DCS). When you settle your claim, you agree to give up all rights to future benefits for the denied medical conditions. Medical bills received by the insurer only before the settlement agreement are included in the DCS and are not routinely paid in full. Medical providers can bill you for unpaid services, so find out what your obligations will be before you agree to a settlement.

Once a claims disposition agreement (CDA) or a disputed claims settlement (DCS) is approved, how long does the insurer have to issue a payment?

CDA – The insurer must issue payment no later than the 14th day after the board or administrative law judge (ALJ) mails or distributes notice of its approval of the agreement to the parties (e.g., worker, insurer), unless otherwise stated in the agreement.

DCS – Generally, the settlement specifies a time frame for issuing payment (e.g., 30 days). If the insurer has not issued payment within a reasonable time frame, you can submit a written request to the insurer for payment.

We encourage legal representation when settling your workers’ compensation claim. See Need legal advice.