Do your TTD and Medical benefits continue before a settlement is approved?

A reader of my blog contacted me because he had a question about the settlement of his Illinois workers’ compensation case.  To be clear, his claim is not being handled by my office or anyone that I recommend in my state wide network of attorneys.  But like many readers, he contacted me because he knows I will answer questions.

The gist of his complaint is that his case was settled in July and it is now October and he still hasn’t been paid the settlement.  Before he agreed to settle, he was receiving TTD benefits and had occasional medical treatment that is no longer being paid.

First off, I question why he would settle his case if he was still receiving medical care and being paid for being off of work.  If he is, then the settlement contracts should be for a larger dollar amount and there needs to be some built in protection for his medical costs.  If he was my client, I would want to know that he has a suitable job waiting for him that he can work and will not cause a big wage loss.  In the alternative, I’d want to know that this is really best for him.  For example, some clients have moved out of state to be closer to family with the settlement they’ve received.

So it’s unusual to settle in this type of situation, but not unheard of if the dollar amount is fair and in your best interests, not that of your lawyer or the insurance company.

But if you are going to settle a case while you are getting paid, you should insist that a clause be inserted in to the contract that will require the insurance company to pay you up until the approval date by an arbitrator.  This will protect you if there are delays and will motivate the insurance company attorney to act fast.

We typically use this type of clause when we’ve gone to trial on a case and won and have a client that is receiving weekly benefits for something like a wage differential or permanent disability.  Typically what happens is someone in the insurance company after a year or two has gone by will contact your lawyer and ask to settle the case outright.  They don’t always do that after the trial, but eventually an underwriter comes in and wants to get the case off their books so they agree to settle for a fair amount.

When that happens, we’ll insist that the weekly benefit checks be continued until the contract is approved.   Otherwise you are likely going to lose out on a few thousand dollars while some paper pushers are dotting their I’s and crossing their T’s.  That’s their problem, not yours and you shouldn’t suffer as a result.

What’s insane about the question from this reader is that I can’t imagine any circumstance where the insurance company wouldn’t have agreed to continue TTD benefits has his attorney asked for it.  They have no leverage in this situation because if the settlement goes away, they still are paying TTD.

My guess is that the attorney didn’t want to risk losing a settlement so instead of acting in the best interests of his client, he acted in his own best interests.  Which is rather sad.