Lump Sum Compensation

Questions and Answers

 

How long does the insurer have to determine a claim for lump sum compensation?

The insurer has one month to determine a claim for lump sum compensation if the degree of permanent impairment is fully ascertainable. If the insurer requires additional information the insurer has two months to determine the claim after all relevant information has been provided, this can include obtaining a report from an independent medical examiner.
“Fully ascertainable” means that the degree of permanent impairment has been agreed to by the parties or determined by an Approved Medical Specialist.

When is a complying agreement required?

A complying agreement is only required when the insurer accepts the workers claim for permanent impairment or the worker accepts an offer of settlement from the insurer.

A complying agreement is not required when a certificate of determination is issued by the Workers Compensation Commission.