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23-941.01 Settlement Of Accepted Claims; Exception; Definitions

23-941.01. Settlement of accepted claims; exception; definitions

A. The interested parties to a claim may:

1. Settle and release all or any part of an accepted claim for compensation, benefits, penalties or interest.

2. If the period of disability is terminated by the carrier, special fund or self-insured employer, negotiate a full and final settlement.

B. Any full and final settlement shall:

1. Be in writing.

2. Be signed by the carrier, special fund or self-insured employer and the employee or the employee's authorized representative.

3. Acknowledge that the employee had the opportunity to seek legal advice and be represented by counsel.

4. Include a description of the employee's medical conditions that have been identified and contemplated at the time of the settlement agreement.

C. If the employee is represented by counsel, the full and final settlement shall include the following attestations:

1. The employee understands the rights settled and released by the agreement and was represented by counsel.

2. The employee has been provided information from the carrier, special fund or self-insured employer that outlines any reasonable anticipated future medical, surgical and hospital benefits relating to the claim and the projected cost of those benefits and that provides an explanation of how those projected costs were determined.

3. The employee understands that monies received for future medical treatment associated with the industrial injury should be set aside to ensure that the costs of such treatment will be paid.

4. The parties have considered and taken reasonable steps to protect any interests of medicare, medicaid, the Indian health service and the United States department of veterans affairs, including establishing a medicare savings account if necessary.

5. The parties have conducted a search for and taken reasonable steps to satisfy any identified medical liens.

D. If the employee is not represented by counsel, the employee shall appear before an administrative law judge and the administrative law judge shall make specific factual findings regarding whether the requirements of subsection B and subsection C, paragraphs 2, 3, 4 and 5 of this section are satisfied. The administrative law judge may not approve the settlement if the requirements of subsection B of this section are not met or if the settlement is not deemed fair and reasonable to the employee.

E. A full and final settlement is not valid and enforceable unless the full and final settlement is approved by the commission. When determining whether to approve a settlement, the commission shall consider whether the settlement is in the best interests of the employee based on the following criteria:

1. Whether the employee's injuries are stabilized.

2. The permanency of the employee's injuries.

F. A lump sum settlement payment shall be made to the employee within fifteen days after the award approving the settlement becomes final.

G. The carrier, special fund or self-insured employer shall notify the attending physician of the approval of a full and final settlement if the full and final settlement terminates the employee's entitlement to medical benefits. Unless medical benefits rendered before the approval date of the full and final settlement are subject to a dispute or payment for the treatment was included in the full and final settlement agreement, the carrier, special fund or self-insured employer remains responsible for payment for the treatment not covered by the full and final settlement agreement as provided by this chapter.

H. Notwithstanding subsection A of this section, a full and final settlement may not be negotiated to settle issues resulting in total and permanent disability pursuant to section 23-1045, subsections C and D.

I. A full and final settlement agreement may not include the settlement of claims unrelated to the claim for compensation, benefits, penalties and interest.

J. This section does not apply to the settlement of claims that have been denied.

K. For the purposes of this section:

1. "Full and final settlement" means a settlement in which the injured employee or, if the injured employee is deceased, the employee's estate, surviving spouse or dependent waives any future entitlement to benefits on the claim and any future right to change the claim pursuant to section 23-1044, subsection F or reopen the claim pursuant to section 23-1061, subsection H.

2. "Special fund" means the special fund established by section 23-1065.

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Local Government
Arizona
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Doug Ducey
Doug Ducey
January 5, 2015 -
Republican
602-926-3620
1700 West Washington Street, Phoenix, AZ, 85007

Keywords
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