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Have you ever settled a case for a substantial sum only to see the claimant’s obituary in the newspaper a few weeks later? What steps can you take to come up to speed on the claimant’s health status before you settle?

When settling a case involving injuries to a specific body part, it is often easy to focus on that body part exclusively without looking too deeply into the claimant’s overall health status. This could be a serious mistake. The parties’ expectations about the claimant’s life expectancy often dictate the value of a settlement. It is therefore wise to get detailed information to help estimate what that life expectancy may be.

One method an insurer might use is to refuse to settle unless the claimant fills out a pre-settlement questionnaire which would include questions about any conditions the employee is suffering from. They could take this a step further and demand the production of all primary care medical records to verify the claimant’s health status. Insurers could even require a full pre-settlement IME with lab work. Whichever method they chose, insurers should be aware that more information is better when it comes to settlement.

Please follow the link to a recent decision by the Kennebec County Superior Court involving an important issue in workers’ compensation. Justice Jabar’s decision invalidates a June 2008 Board Rule which retroactively lowered the permanent impairment threshold under Section 213 to 11.8% as of January 1, 2006. The Court determined that it was error for the Board’s actuary to consider cases with 0% permanent impairment ratings in determining the 2006 threshold. It should be noted that the actuary’s original determination, which did not consider cases with 0% permanent impairment, would have set permanent impairment at 12.5%.

View complete text of Maine State Chamber of Commerce and Workers’ Compensation Coordinating Council v. Workers’ Compensation Board, State of Maine, et al.