does medical bills match settlement, or is it more?

A settlement in workers' compensation is based on your level or percentage of permanent disability, estimated costs of future (not necessarily past) medical treatment, the costs of handling the claim, and whether you still have the right to reopen your case to try to establish new and further disability. This reopening must be sought within 5 years of the date of the injury. Other factors which may be considered include possible unpaid temporary disability benefits. Also, if your treating physician or a QME has determined that you are unable to go back to work at your usual and customary job, you are entitled to a "supplemental job displacement benefit" (a voucher for schooling, that can be worth from $4,000 to 10,000, depending on your percentage of permanent disability.) Carriers want to close out the whole case, and may want to include the cost of the voucher in the settlement. In short, there is no formula in workers' compensation to settle based solely on the value of past medical treatment. What is the expected future cost of treatment? That is a more important factor for the carrier and you to consider. If your condition has been permanent and stationary for a year or two (or more), and if you have been using medical treatment, then look at the last couple of years to determine the average cost of that treatment. Then you can project that over your lifetime. You can argue with the insurance carrier that that is the true measure of any settlement (but don't forget permanent disability). However, it is often difficult to get the carrier to agree that that is a correct value for your settlement.