Greetings,
(Just one last follow up from my last two Tips on splitting indemnity during a week. If you would like a copy of the memo from the Division which shows how they calculate it, please email me at mindek@eraclides.com! You can find those Tips on our website www.eraclides.com)
Over the last few weeks I have received a few referrals to handle the settlement document portion for an unrepresented (pro se) claimant, so I thought it would be a good time for a reminder on a few issues.
- When negotiating with the claimant, yes get a favorable settlement, but not one that appears to be taking advantage of the claimant. For the settlement to be approved, the JCC holds a hearing to make sure the settlement is in the claimant’s “best interests” and they will find a way to deny a settlement if it appears grossly unfair to the claimant.
- Make sure to explain to the claimant that this settles the entire claim, medical and indemnity, but if they owe any child support that will be taken out of the settlement, with a cap of 50% of the settlement at most going to child support.
- If the claim is a total denial, either from the beginning or total denial after some benefits were paid, the claimant does not need to be at MMI for the settlement to be approved. However, if the claim is accepted, the claimant must be at MMI and the impairment benefits must be paid separately from the settlement (see the Q rule below)
- Explain the process to the claimant, and that realistically it will take at least 4-6 weeks to get it approved if all goes smoothly, and you then have 2 weeks to issue the check. My office has to draft the settlement documents including a medical summary and send to the claimant to be notarized and signed. The claimant then needs to send them back to my office, we then send to the JCC and get a hearing scheduled. We also have to submit a letter signed off on by the authorized treater confirming the claimant is at MMI and that the amount of the settlement allocated to medical is enough to cover the claimant’s future medical treatment for the compensable injury (see the Q rules below). We do not need this letter if it’s a total denial.
The JCC’s will not schedule a hearing until they have everything.
- And lastly, each carrier has different rules as to whether an adjuster can or cannot discuss anything regarding a General Release and Resignation. Please be certain to follow your carrier’s rules on this, but if it is not brought up at all at the time of the settlement negotiations/acceptance it is not part of the deal. A proposed safe way to handle this may be to tell the claimant there will also be a discussion with my office regarding their employer and employment issues (if that is permissible with the carrier).
As always, please let me know if you have any questions. I actually have a washout hearing today on one of these 😊.
60Q-6.123. SETTLEMENTS UNDER SECTION 440.20(11), FLORIDA STATUTES
3. A summary or payout sheet indicating total indemnity and medical benefits previously paid, including impairment income benefits;
11. For settlements under section 440.20(11)(b), F.S., the required notice to the employer, a maximum medical improvement report establishing the date of overall physical maximum medical improvement and psychiatric maximum medical improvement if the latter applies, permanent impairment rating, information concerning the need for future medical care and an estimate of the cost of future medical care, or an explanation as to why an estimate cannot be reasonably obtained, and other essential medical information.
Be sure to check our website for upcoming FL, GA and TN webinars and events. https://eraclides.com/events/
I’ll be teaching an upcoming FL 4 hr ethics and law on 6/24/25.
Register here:
https://us02web.zoom.us/meeting/register/LgV8OvZaQHSFpi1u_XWi9w
Save the date for our firm’s 10th annual Tampa CEU extravaganza, July 25th!
Sincerely,
Morgan Indek | Managing Partner