The average amount of time it can to settle a workers’ compensation case is about 15.7 months. Employees injured during work are entitled to workers’ comp benefits. Workers’ compensation claims typically cover medical expense coverage, a part of missed wages, and temporary disability payments.
One of two resolutions can occur: either the case is voluntarily settled with the insurance company, or it is decided by a judge.
Settling a workers’ compensation case means that the case against your employer will be closed, and you’ll receive a lump sum, instead of ongoing disability benefits and medical expenses.
Of course this depends on the state you’re in, as some require insurers to continue paying medical benefits after settlement.
The amount of time a settlement can take depends on many factors, which we’ll cover in this article.
How do I reach a workers’ compensation settlement?
When you bring a workers’ compensation case against your employer, the insurance company may offer a payment plan for disability and also medical bills. As the employee you can choose to accept this offer or pursue a settlement.
If you want to go for a workers’ compensation settlement, you’d have to negotiate with your attorney and the insurance company. A lawyer who specializes in workers’ compensation cases will negotiate a settlement that has your best interests in mind. The steps are as follows:
- The attorney will draft a Settlement Demand to the insurance company. This settlement outlines for the insurance company all the different components of exposure.
- The initial demand needs to be approved by you before going forward. Once approved the negotiation begins.
- The insurance company makes a counter offer and then negotiations will go back and forth. Negotiations can be direct with the insurance company, or at a settlement conference at court or at mediation with both involved parties.
- If the two parties can’t agree on a settlement, there will be a workers’ comp hearing.
Before you reach a worker’s compensation settlement, a permanent disability rating will be sent to you by the insurance company. The amount of benefits you’re owed under state law is then converted according to that rating, and a starting settlement can be brought up. However, you may want to ask for more if there is a permanent disability, or future medical treatment required.
You and your attorney will need to calculate what you think the payout should be. Take into account:
- Hospital bills, ambulance rides, or other medical costs
- Any future treatments you may need, like surgery
- Lost wages or future wage loss
- Disability payments
- Attorney fees
- State workers’ comp laws
Once an agreement is reached between you, your lawyer, and the insurer, the settlement will need to be submitted to the state workers’ compensation agency. The agency will then decide on approval.
What is involved in the workers’ comp settlement process?
You’ll review the settlement at a hearing held by your state’s workers’ compensation agency. A judge or hearings officer will evaluate if you agree with the settlement voluntarily, you understand it, and it’s in your best interests.
If the judge or hearings officer thinks you aren’t being awarded enough money in the settlement, they might reject it.
Workers’ compensation benefits aren’t related to pain and suffering, as opposed to personal injury claims.
Settlements are calculated based on these two factors:
- The amount of workers’ comp benefits you might be entitled to in the future, and
- The chance that you will receive those benefits
Different states have different rules when calculating a workers’ comp settlement.
The answer to the following questions is essential concerning your settlement:
- Following the settlement, will your worker’s compensation claim be closed completely, or can it be reopened or stay open to pay for any future medical bills?
- Does the amount of compensation settlement include permanent disability advances that have already been received by you? Or does the workers’ comp settlement amount represent all new money?
How long does the whole settlement process take?
The whole settlement process can take about 18 months with an attorney and a little more than 12 months without. Although the time is longer with an attorney, the end result will be more effective. The settlement could be almost 33 percent higher if you use an attorney than if you don’t.
If you and your attorney negotiate your settlement, the process will be longer than if you don’t. Negotiations can cause the process to take more than 17 months, whereas if you take the first offer the insurance company gave, you could settle within 15 months.
Factors That Affect the Length of a Workers’ Comp Case
Of course there are many factors that can affect the length of a worker’s comp case. Here’s a list:
- If the insurance company or employer doesn’t move quickly. Sometimes insurance companies use these tactics to frustrate you so you will give up or settle for a lower amount.
- If your attorney may have a heavy caseload and is juggling too many cases.
- If you are still recovering from your injuries.
- Whether the insurance company disputes the fact that you are permanently disabled.
- Whether or not you hire an attorney.
- If you accept the first offer made or decide to negotiate.
- If appeals are filed and you need to attend a hearing.
Receiving workers’ comp for an injury at work can be settled, but retaining an attorney is the best way to go.