Voluntary Agreement

There are many workers’ compensation claims that are non-adversarial. The employer’s insurance carrier accepts the claim. The injuries are largely agreed-upon. There is nothing to fight over. Even in contested claims, there can be situations where you and your employer can agree. In these circumstances, it is in everyone’s best interest to memorialize the agreement and put it on the record for the Administrative Law Judge’s approval. A Voluntary Agreement is a mechanism to accomplish this.

Voluntary Agreements

Suppose your injury or illness disables you for more than three days, and the employer’s insurance carrier does not deny your claim for workers’ compensation benefits. In that case, the employer’s insurance carrier must issue a Voluntary Agreement – essentially a written contract between your employer and you – which is a statement of acceptance of responsibility for your claim. The usual time where a Voluntary Agreement is issued is when your physician files a Form 42 and indicates that you have sustained a permanent partial disability rating (“PPD”). Assuming your employer’s insurance carrier does not challenge your PPD rating, they must issue you a Voluntary Agreement to reflect their responsibility to compensate you for your permanent injury.

The Voluntary Agreement is an official state document. The Voluntary Agreement Form contains important information about a claim (including benefit calculations). It should be completed and issued by the injured employee’s employer or its workers’ compensation insurance carrier.

Voluntary Agreements are extremely important because they memorialize the details of a workers’ compensation injury and your compensation award.

A Voluntary Agreement includes:

• Your name and legal representative.
• Your employer’s name and the insurance company.
• The date of the injury/illness onset.
• The date incapacity began.
• The name of the treating physician.
• The wages and compensation rate.
• A brief description of how the injury or illness occurred.
• The Voluntary Agreement establishes that your case is accepted.

Types of Voluntary Agreements

In workers’ compensation cases, there are two types of Voluntary Agreements. The first is a “jurisdictional” Voluntary Agreement. It memorializes the acceptance of your claim. It is like a judgment that your employer is liable for your workplace injury. The Commissioner approves the agreement, which has been signed by both sides. If accepted by your employer, your case deserves a Voluntary Agreement.

The second form of Voluntary Agreement is for your permanent partial disability benefits (PPD benefits). This is used in the event that you suffer permanent loss of function to any body part covered by workers’ compensation law. This Voluntary Agreement will list the body part affected and the number of weeks awarded – for example, it might list a five percent loss of the back or a 100 percent loss of the hand.

The Voluntary Agreement is printed on green colored paper according to a format approved by the Workers’ Compensation Commission. All parties must sign the Voluntary Agreement to your case, and the Administrative Law Judge must formally approve it. Suppose your employer’s insurance carrier does not issue a Voluntary Agreement to you within thirty days from the date of disability (the date your doctor specifies that you reached maximum medical improvement). In that case, you should contact your workers’ compensation attorney immediately. It is your right and their responsibility under the law to prepare and issue the Voluntary Agreement.

Once the Voluntary Agreement has been signed by you and your employer or its attorney or insurance carrier representative, the District Office will schedule you for an approval hearing before the Administrative Law Judge. Assuming that the Voluntary Agreement is in order, it will be approved by the Administrative Law Judge.

Getting Help

Your Voluntary Agreement is a legal document in full force and effect. It can impact your workers’ compensation claim and your eligibility to receive workers’ compensation benefits going forward. It is important that you completely understand your rights under your Voluntary Agreement with your employer. We recommend that before you enter into a Voluntary Agreement, you seek and obtain workers’ compensation legal counsel. With our clients, we review the Voluntary Agreement, and the information contained within it, in detail before our client signs the document. We handle the exchange of documents with the other side. Most importantly, we appear at your hearing, and we advocate on behalf of your best interests. When you present a legal document to the Administrative Law Judge and ask them to grant its approval, you want to be represented by legal counsel.

Contact our office immediately to schedule an appointment. We are here to help!