Does the total settlement exceed $25,000?
The total settlement amount includes the following:
1) future medical or prescription expenses;
2) indemnity benefits;
3) attorney fees;
4) any settlement advances;
5) lien payments (including repayment of Medicare conditional payments);
6) amounts forgiven by the carrier or employer;
7) prior settlement amounts for the same claim; and
8) liability settlement amounts on the same workers’ compensation (WC) injury (unless apportioned by a court on the merits).
*Note: If an annuity will be used in the settlement, the expected payout must be included instead of the cost to purchase the annuity.