Workmans comp required to make pain and suffereing settlements?

[firemanup]

What is the name of your state? Iowa

On the job injury, workmans comp pays for medical bills and time off, and then pays a disability benefit for pain and suffering. This happened twice.

Now in past years when the employer has gone to self insurance, that pain and suffering payment has disappeared.

Is this payment required through workman's comp..? When a company, this case a municipality goes to self insurance, can they get around it?

I don't know if this makes sense but i'm trying to be brief like this forum suggests..any questions i'll try to answer.

Jason

 

[Beth3]

I'm not aware that any State's WC reg's require pay for "pain and suffering." Disability benefits are paid for lost wages, i.e. if you break your leg on the job and can't work for two months, you'll receive temporary total disability pay for those two months. If you are left with some degree of permanent impairment, you are eligible to receive a permanent partial disability payment at the end of healing. I think you're confused - I seriously doubt you've ever received any payments from your employer's WC carrier for pain and suffering.

Self-funding is only a funding mechanism for paying claims and related costs. The employer is paying WC expenses out of their own coffers (undoubtedly via a WC administrator) rather than purchasing insurance. An employer typically has to go through considerable financial scruitiny by the State before they will approve an employer self-funding their WC insurance. Self-funding would have absolutely no impact on what benefits are paid.

If you have been off work due to an alledged WC injury and aren't receiving temporary total disability payments, it's due to some other reason.

 

[firemanup]

Thanks for the info Beth.

The first case was an employee that received a laceration to the lip while in the course of her duties. WC came back with a $600+ settlement for the injury, maybe the scar is considered a permanent partial disability?

Second case employee injures knee on the job, while recovering pay continues as normal. A surgery later and months of rehab he is back to work without an noticeable permanent disability, he's working as a firefighter. He received a $3500 check from WC as a settlement on the injury.

Now we have people going out on injuries, again they receive normal pay during their leave of absence to recover. Then they come back and there are no more "settlement" checks coming in to them. ie back injury, two months to recover, normal pay during that time, then come back to work and everything continues like nothing ever happened.

I don't understand where the first two cases are any different than the last, unless they somehow decided on the first two that there was some type of permanent disability??

Thank you

 

[Beth3]

Yes, a scar would be a disfigurement that would entitle the employee to a PPD settlement. In the second case, the doctor's final reports may have indicated some slight permanent impairment or the possiblity of one in the future due to the injury (arthritic knee, for example), so a PPD settlement was made and the claim closed. Neither of those have anything to do with pain and suffering.

The mere fact that someone had a work injury doesn't remotely mean they're entitled to a PPD settlement. If the employee's physical condition is "whole" following treatment and recuperation, they're not entitled to anything more than having their lost time and medical bills paid.

I suspect you're comparing apples and oranges. PPD settlements do not happen in the majority of WC claims.

 

[firemanup]

Beth,

I think you're on the money with the explanations, thank you for your time..

Jason

 

[Beth3]

You're very welcome. My work here is done.