By Karissa Hearn, Client Development Manager
As of November 1st, Senate Bill 1332 will allow for Arizona full and final workers’ compensation settlements. This new law allows future medical claims to be settled full and final, meaning they cannot be re-opened or changed in any way. Prior to this change, injured workers reserved the right to re-open claims for added medical treatment if the injury worsened or required additional care.
All settlements must be approved by the ICA, Industrial Commission of Arizona. For the ICA’s approval, the settlement agreement must include signatures from the carrier, employer, and the employee or their representative. It also must include a description of the employee’s medical conditions at the time of the agreement and an accurate depiction of all anticipated future medical costs and treatments.
Once there is an agreement containing all of this information, the ICA will then review and consider whether the settlement is in the best interest of the employee based on the stability of the injury and the permanency of the injury.
The injured parties also must take reasonable steps to consider and protect the interests of Medicare, Medicaid, and the United States Department of Veterans Affairs to ensure that those entities will step in and pay for the medical expenses due to the injury if the MSA funds were to run out and were spent properly.
Additionally, the new law indicates that the employee must attest that he or she is able to handle the settlement funds and, if appropriate has intentions to deposit the funds into a separate administered account.
What does this change mean for settlements in Arizona, how do you settle workers’ compensation cases that have future medical care needs, and what are the best practices to protect the injured worker and other parties to the settlement?
These changes are sure to cause confusion in Arizona, as many parties involved in a settlement in Arizona have never fully settled future medical care without the ability to reopen. So what are the important things to consider? We’ve provided our best practices and thoughts:
- Ensure that an analysis to allocate accurate amount of future medical is completed. The analysis can include non-Medicare future medical treatment projections or an MSA. Projecting future medical care is critical to ensuring that the injured worker will have adequate future medical care for the rest of their life after settlement
- Involve a Medicare Set Aside professional administrator as early as possible to handle medical cost projections, Medicare set asides, or any other future medical allocation. A professional administrator can help you walk the injured party through the settlement process, answering any questions they may have
- Professional administration and self-administration tools should be offered on all workers’ compensation settlements as a means of ensuring support for the injured party, generating savings on pharmacy, provider, or medical equipment, and supporting mandatory reporting compliance with Medicare after settlement
- Utilize settlement advisors or structured settlement brokers that can help you form the best plan to settle cases quickly and effectively while utilizing annuities to save money on the case and create a guaranteed stream of income
- Ensure that the injured worker is being appropriately informed of the pros and cons of settling the care full and final. The injured worker must understand that they are giving up future rights to reopen medical care and the parties to the settlement (attorneys, claims handlers, and judges) must ensure that the injured worker is aware of the resources that can assist them post-settlement, including a company to analyze the future medical, a professional administration company, and a structured broker. These partners can help ensure the injured worker is receiving adequate funds (through an MSA), financing those funds appropriately (through a structured settlement annuity), and spending the funds appropriately and effectively post-settlement (with a professional administration company).
At Ametros, we provide tools and resources to help injured workers navigate healthcare after they settle their workers’ compensation case. We understand that one of the main concerns with the new change in law in Arizona is who will support the injured workers with their medical care after settlement. We have helped thousands of cases settle across the country, and our team of Care Advocates have helped injured workers save money and protect their government benefits. Our Settlement Advisors can provide you with a free settlement consultation to plan the best course of action for your case. We are always happy to answer any questions you may have about what settling future medical means for you and how to navigate this new change in Arizona’s law.
Want to find out more about Ametros and how we can help you Settle Well?
Industrial Commission of Arizona:
- This goes directly to the Industrial Commission of Arizona’s website, where the actual cases are being sent to get approval for the Arizona final settlements. This specific page has a list of frequently asked questions about the “Final Settlement of Future Undisputed Supportive Medical Maintenance Benefits.”
- This would be a good resource to answer questions like “What payments remain the responsibility of the employer or carrier?” or “What must be filed with a final supportive care settlement agreement?”
Arizona Injury Law group-
- This is the Arizona Injury Law Group, who are attorneys exclusively dedicated to representing injured workers. Their website has information on workers’ compensation cases and they strive to educate and guide their clients to help make this process more seamless.
- This specific page goes to a specific article, “What is a Final Supportive Care Settlement?” to answer questions like “What should be included in the agreement?” and “What other obligations does the employer have after the settlement?”
Lovitt & touché-Insurance Broker
- Lovitt & Touche is one of the largest independent insurance brokerages in the Unites States.
- This specific page goes to an article explaining the changes in workers’ compensation cases for full and final settlements. It explains the actual bill (Senate Bill 1332) and what it means. It breaks up each of the sections in the bill, explaining them in more understanding terms and what it means for the injured workers that it could affect.
Legiscan- shows the actual changed to Bill 1332-