The Claimant and the Insurer have the ability to reach an agreement in a case with respect to permanent partial disability benefits (PPD). There are three ways that the Claimant may receive PPD benefits: (1) following a hearing and an order granting PPD from the Commission (which is treated the same as a Stipulation); (2) a Stipulation; or (3) a Settlement. There are important differences between a Settlement and Stipulation that a claimant should consider prior to entering into any agreement with the insurer.
When the parties stipulate to a PPD award, the claimant and insurer are agreeing that:
- The claimant is disabled;
- The claimant will receive a specific PPD award;
- There is no need for a hearing on this matter;
- The claimant may reopen their claim within 5 years; and
- The claimant is entitled to reasonable medical treatment for the injury for the remainder of their life.
When the parties reach a Settlement regarding a PPD award, the claimant and insurer are agreeing that:
- The claimant is disabled;
- The claimant will receive a specific PPD award;
- There is no need for a hearing in the matter;
- The claimant may not reopen their claim in the future for any reason; and
- The claimant may not receive any future medical treatment for the injury unless its specifically addressed in the Settlement Agreement.
It is very important for the claimant to realize that when they settle a case instead of entering into a Stipulation, they are waiving any future rights they may be entitled to under workers’ compensation law, unless those rights and benefits are expressly provided for in the Settlement Agreement.
All Stipulations and Settlement Agreements will be reviewed and approved by the Commission. In fact, any Stipulation or Settlement Agreement is not enforceable until the Commission provides approval. Settlement Agreements are more strictly scrutinized by the Commission because of the rights the claimant is usually giving up.