Table Of Contents
Workers Comp Settlement Process
According to Brown & Crouppen, in settling a workers’ compensation claim, several steps are involved, ideally following this sequence [1]:
- Step 1: Injury and Notice – When an employee is injured at work, they must notify their supervisor of the injury, providing details of where and how it occurred. This notification is crucial, and in Missouri, the statute of limitations for workers’ compensation is 2 years, meaning a claim must be filed within this period after the work injury or death. Additionally, employees must report their injuries to their employer within 30 days of the injury or upon discovering the work injuries.
- Step 2: Report of Injury – After receiving notice of the workplace injury, the employer is legally required to submit a Report of Injury to the Division of Workers’ Compensation. This report is not a workers’ compensation claim for the employee; rather, it is the employer notifying the state that an injury occurred. The employer should also report the injury to its workers’ compensation insurance company.
- Step 3: Medical Evaluation and Treatment – After receiving notice, the employer should refer the injured worker for a medical evaluation and treatment.
- Step 4: Filing the Workers’ Compensation Claim – The injured worker (or their attorney) files the Claim for Compensation with the appropriate state agency, such as the Division of Workers’ Compensation in Missouri or the Illinois Workers’ Compensation Commission.
- Step 5: Ongoing Medical Treatment – Work-comp injuries vary in severity, from muscle strains to serious injuries requiring extensive treatment. Injured workers typically have little say in choosing their medical provider, as employers and workers’ compensation companies often control this aspect. If an injury prevents an employee from working, the employer may pay some portion of lost wages.
- Step 6: Release from Treatment – Once the workers’ compensation doctor releases the employee from medical care and instructs them to return to full, unrestricted duty, the claim moves towards the settlement phase if everything has progressed correctly. If not, it may enter a hardship phase.
- Step 7: Settlement – If the employer has accepted the claim, provided necessary medical treatment, paid work comp wages, and accommodated light-duty work without any issues regarding permanent disability, the settlement process can be relatively straightforward and may occur as soon as 6 months after the conclusion of medical treatment.
- Hardship Phase – If the employee is still injured, believes more treatment is necessary, or faces other difficulties making settlement premature, the claim may enter a hardship phase.
What to Expect if Your Workers Comp Case Goes to Trial
According to the Department of Labor and Industrial Relations notice, in workers’ compensation, a trial is known as a “hearing.” However, to be more precise, it should be referred to as an “evidentiary hearing.” This type of hearing before a workers’ compensation administrative law judge is a formal proceeding, similar to a non-jury civil trial in a circuit court [2]. The rules of evidence are applied, and the employee usually has the burden of proof on most contested issues.
Proper pre-trial preparation of the employee’s evidence is crucial because if the employee fails to present admissible evidence on a contested issue, they may lose on that issue.
The judge cannot help you prepare your evidence. The judge cannot help you present your evidence. The judge cannot explain the rules of evidence to you. Therefore, you will want to have a lawyer represent you in a case that is going to trial. While you have the right to represent yourself at trial, it is never a good idea – the agency stated.
Also Read: Can I Get Disability After a Workers Comp Settlement?
Workers Compensation Cost Statistics
According to the NSC 2022 research [3], the most expensive lost-time workers’ compensation claims varied by cause of injury, nature of injury, and part of the body affected:
Cause of Injury:
- Motor-vehicle crashes: $89,152 per claim
- Burns: $52,161 per claim
- Falls or slips: $49,971 per claim
- Caught: $47,076 per claim
Nature of Injury:
- Amputation: $126,033 per claim
- Other trauma: $63,044 per claim
- Fracture, crush, or dislocation: $62,240 per claim
- Burns: $52,222 per claim
Part of Body Affected:
- Head or central nervous system: $94,285 per claim
- Neck: $65,659 per claim
- Multiple body parts: $62,257 per claim
- Leg: $60,901 per claim
- Hip, thigh, and pelvis: $60,155 per claim
- Arm or shoulders: $49,838 per claim
These figures represent the average costs per workers’ compensation claim for each category during 2020 and 2021.
Related Articles:
- Can I Get a Settlement from Worker’s Comp if I Go Back to Work?
- Can You File a Workers Comp Claim After Termination?
- Helpful Tips to Improve the Chances of Winning a Workers’ Comp Case
FAQs
Can I settle my workers’ compensation case before it goes to trial?
Yes, you can settle your workers’ compensation case at any time before the trial begins. Settlement is often a preferred option because it provides a quicker resolution and avoids the uncertainty and stress of a trial. Settlements can be reached through negotiation between the parties or with the assistance of a mediator.
What are the chances of winning a workers’ compensation trial?
The chances of winning a workers’ compensation trial depend on the strength of your case, the evidence presented, and the specific circumstances surrounding your injury. Having strong medical documentation, credible witness testimony, and an experienced attorney can significantly increase your chances of success. However, as with any legal case, outcomes cannot be guaranteed.
How long does it take for a workers’ compensation case to go to trial?
The time it takes for a workers’ compensation case to go to trial can vary widely, but it typically ranges from several months to over a year from the time the dispute arises. The timeline depends on factors such as the complexity of the case, the court’s schedule, and the readiness of both parties. Delays can occur if additional evidence or expert testimony is needed.
What should I do if my workers’ compensation case is headed for trial?
If your workers’ compensation case is headed for trial, it is important to prepare thoroughly with your attorney. This includes gathering all necessary medical records, securing expert testimony, organizing evidence, and preparing to testify about your injury and its impact on your life. Your attorney will guide you through the process and help you build a strong case.
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References:
- https://www.brownandcrouppen.com/blog/how-long-do-workers-comp-settlements-take/
- https://labor.mo.gov/dwc/injured-workers/what-to-expect-at-trial
- https://injuryfacts.nsc.org/work/costs/workers-compensation-costs/