Disclaimer: This article is for informational purposes only and does not constitute legal advice. Consult a licensed attorney to address your specific situation.
Detailed Answer
When an injured worker in Connecticut pursues a personal injury claim against a third party, the employer or its insurer may assert a workers’ compensation lien to recoup benefits paid. Resolving that lien involves these key steps under Connecticut law:
- Identify the Lien and Statutory Basis
Under Conn. Gen. Stat. § 31-293, an employer or insurer gains a right of subrogation to recover benefits paid from any third-party recovery. Conn. Gen. Stat. § 31-293a authorizes the Workers’ Compensation Commission to apportion proceeds.
• § 31-293: https://www.cga.ct.gov/current/pub/chap_568.htm#sec_31-293
• § 31-293a: https://www.cga.ct.gov/current/pub/chap_568.htm#sec_31-293a - Provide Statutory Notice to the Insurer
Before settling a personal injury claim, send written notice to the workers’ compensation insurer. The notice should include:
- Names of all parties.
- Description of the personal injury claim.
- Demand to preserve the subrogation lien.
Failure to notify can jeopardize your ability to challenge or reduce the lien.
- Negotiate Lien Reduction
Most insurers will negotiate the lien amount in light of attorney’s fees and costs incurred in the third-party action. Typical reductions range from 25% to 50% of the total lien.
Keep records of all communications and offers.
- File a Petition with the Workers’ Compensation Commission
If the parties cannot agree, file a “Petition for Apportionment of Subrogation Lien” with the Connecticut Workers’ Compensation Commission. Include:
- A copy of the personal injury settlement agreement or judgment.
- Detailed accounting of the workers’ compensation benefits paid.
- Proof of attorney’s fees and case expenses.
The Commission will schedule a hearing and determine a fair allocation between medical expenses, wage-loss benefits, attorney’s fees, and the insurer’s recovery.
- Obtain Commission Approval and Release
After the Commission issues its decision, obtain an official Order approving the settlement and lien apportionment. Request a signed release or reimbursement check from the workers’ compensation insurer.
- Disburse Settlement Funds
Follow the approved allocation. First, satisfy medical expense liens and statutory priorities. Then pay wage-loss portions and attorney’s fees. Finally, remit the net subrogation recovery to the insurer as ordered by the Commission.
- File a Final Report with the Court
Submit proof of lien resolution to the court overseeing the personal injury case. Include the Commission’s Order and a copy of the release or reimbursement receipt. This step ensures a clean closing of the case and prevents future claims by the insurer.
Helpful Hints
- Start the lien resolution process early to avoid settlement delays.
- Keep all correspondence in writing and track delivery dates.
- Retain detailed invoices for medical and wage-loss benefits.
- Consult a workers’ compensation attorney if negotiations stall.
- Review any proposed settlement language for broad releases that may affect the lien.
By following these steps and leveraging Conn. Gen. Stat. §§ 31-293 and 31-293a, you can effectively resolve workers’ compensation liens and close your personal injury claim without unexpected subrogation issues.