Think Like a Mediator to Settle Your Workers’ Compensation Claim

Workers compensation attorneys know that for our clients, the best claim is a settled claim.  With that in mind, I reached out to Teddy Snyder, who specializes in workers’ compensation mediation, for some simple tips on how attorneys and claims professionals can maximize their chances of success at mediation.  The following text comes from a story originally published in Teddy’s WCMediator News  entitled “How to Write a Workers Compensation Mediation Brief”

Why do so many advocates stumble when it comes to preparing for mediation? Perhaps the most important thing a lawyer can do to prepare for mediation is to write a brief. Done properly, the process forces the writer to focus and get ready to negotiate. But many people do it wrong, mostly by providing irrelevant and obsolete information and not providing the data necessary to evaluate the claim. This problem is so common, I now instruct parties in my confirmation letter what to include.

The brief doesn’t have to be fancy. I don’t care if there’s a caption. An email message is fine. What would be helpful would be sub-headings for the categories shown below.

Transmit the brief at least 7 days in advance of the mediation. This helps everyone prepare, including the mediator. Your brief may prompt a request for a document. Showing up with your brief at mediation wastes participants’ time and money as the mediator reads the brief. Late preparation can raise new questions and sometimes leads to adjournment and a second session to allow time for everyone to get answers.

Claims professionals, you know the mediation is coming up. Ask your lawyer to provide you a copy of the brief at the same time it is sent to the mediator. This assures you and your advocate are on the same page. You can also monitor the timeliness of the preparation.

Facts

The brief should briefly (that’s why it’s called a brief) recite facts such as the dates of injury, affected body parts, and the injured worker’s date of birth.

Indemnity

State specifically if indemnity is open. If it is open, what do you think is the correct percentage and dollar amount? If less than 100%, what are the Permanent Disability Advances to date? At what rate are they being paid? Is there any argument about apportionment, overpayments or retro? Do the parties agree on the DOI? If parties disagree on an issue, spell out your position. What does the other party say?

Medical

Copies of narrative medical reports from the last two years will be very helpful as well as a print-out of medical expense payments for that period.

Medicare Status

Is there a current (within the last year) MSA? If so, attach a copy to your brief. If the injured worker is a Medicare enrollee or is at least 62 1/2 years old, get a current MSA report and attach it to your brief. If you are not obtaining an MSA because the injured worker is undocumented or is otherwise ineligible for Medicare, say so in your brief. If you have obtained CMS approval, provide a copy.

Other Issues

Are there any other issues to be resolved? Mediations are most successful when parties are able to prepare for negotiation and do not encounter surprise issues.

Confidentiality

Indicate if the brief is confidential or is being shared with the other party. You may choose to create two briefs, one for exchange and one confidential.

This Blogger’s Closing Thoughts

Remember that although settling a workers’ compensation claim might seem like a zero-sum game, it doesn’t have to be.  Be creative, and think about things like a structured settlement (which increases the amount received by the injured worker without increasing costs to the company) and how a resignation might add value to the settlement for the company.  From the Medicare set aside angle, make sure that before going into the mediation process you know what conditional payments are outstanding, and determine whether the company will consider an indemnity-only settlement. Most importantly, make friends with a mediator (or at least follow WCMediator News), so you can learn how to be creative about getting your claim files closed in a way that benefits all parties involved.

Special thanks to Jon Hyman at Ohio Employer Law Blog for including my story last week about LeBron James (sort of) in his “What I Read This Week” Friday edition.  You can check out the LeBron story there, along with a number of other great blog pieces about safety and other employment law issues.