Release of Liability Procedures — Leaving Future Medical Liability Open

Neb. Rev. Stat. § 48-139(1)(a) lists the factors that determine whether a Lump Sum Settlement Application must be submitted to the Worker’s Compensation Court for review, or whether the parties may submit a Release of Liability (release).* 

A release cannot be filed if:

This form may only be used if: 

Medicare has not paid medical, surgical, or hospital expenses; or if Medicare has paid medical, surgical, or hospital expenses for which it claims it is entitled to reimbursement and medicare has been reimbursed for such expenses at the time the settlement is executed.

Filing Fee:

Other Filing Instructions:

*Please Note: 

In all cases, the parties have the option to file a Lump Sum Settlement Application instead of a Release of Liability. A Lump Sum Settlement Application is filed with the court clerk, is reviewed by the court for compliance with the Workers’ Compensation Act (laws) and the Workers’ Compensation Court Rules of Procedure, and is either approved or disapproved/dismissed by a judge of the compensation court. In contrast, a Release of Liability is filed with the clerk of the court; however, neither a court staff attorney nor a judge reviews the Release of Liability.

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liability_release_future_medical.pdf