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When Will Workers’ Compensation Offer a Settlement?

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It's common for a workers' compensation claim to go through an evaluation before the settlement is finalized. 

As an experienced workers' compensation attorney who helps people with workers' compensation claims, I have seen a lot of variation in how long these workers’ comp settlements take.

In this article, I will tell you what you can expect when workers' comp offers a settlement and how long the process might take. 

Quick Summary

  • Injured workers may not get a settlement if their injury is self-inflicted, due to drug or alcohol abuse, or if they were committing a crime.
  • Workers' compensation benefits include lost wages, medical and hospital expenses, and vocational rehabilitation. 
  • A workers' comp settlement can take months or even years.

What Is Workers' Compensation Insurance?

A lawyer writing down on a clipboardWorkers' Compensation Insurance is an insurance policy that business owners are mandated to have in nearly every state within the U.S [1].

If employees sustain injuries while working, this coverage includes their medical bills, disability benefits, and lost wages.‍

​​The program is designed to be "no-fault," meaning that it does not matter how the injury occurred, whether it was due to the negligence of the employer or a co-worker.

What Are the Different Types of Settlements?

The different types of settlements for a workers' compensation claim are stipulation and award settlements or compromise and release settlements.

A stipulation and award is an insurance policy that agrees to pay for future medical care related to an injury. This policy creates an ongoing relationship with your employer's insurance company, where the insurance company agrees to pay any reasonable costs associated with the injury.

In a compromise and release, the insurance will pay you a lump sum of money, also known as a structured settlement. That settlement offer is the negotiated sum reflecting your work-related injury losses. 

It may be paid as a single payment or as part of a structured settlement agreement.

It's designed to compensate an injured employee for the following:

  • future payments for disability
  • future medical bills or expenses
  • Out-of-pocket expenses that the insurer still owes

A lump sum payment closes the workers' comp settlement, but a compromise and release end the case. 

If you accept a compromise and release but then find that future medical treatment costs more than expected, you will not be fully compensated by the lump sum settlement agreement.

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How Long Do Workers' Comp Settlements Take?

Two business people shaking handsWorkers' comp settlements may take several months or even several years. It takes both parties to come to an agreement on a settlement.

In my experience, it's not uncommon for a workers' compensation settlement offer to take months or even years.

They may also arrange your work compensation settlement based on their assumptions about how much your medical expenditures will be. 

This can happen if you haven't yet achieved maximum medical improvement (MMI). They might do this because they believe you'll be ready to accept a lower sum if they wait long enough for you to feel financial pressure to settle.

"Workers' compensation law also provides medical benefits that cover your medical bills from the injury." - Neil Shouse, Prosecutor

Depending on the state you live and work in, employees have a limited time frame to report any occupational injuries sustained during their job. 

The range for every state is different, with some giving as much time as two years and others only 72 hours. In most cases, however, employers will request that workers notify them of the injury within 30 days to start filing for workers' compensation.

How Often Do Insurers Offer a Workers' Comp Settlement?

Insurers don't offer a workers' comp settlement very often. Most insurance companies do not settle cases until after a lawsuit has been filed. 

Although several methods exist to resolve claims, settlements are the most frequent. Nobody wants to waste time and money associated with going to court, which is why no one in the equation—employee, employer, or insurer—wants to do it. 

Workers Comp Settlement Process
A lawyer pointing to insurance paperwork

A few things happen when an injury occurs:‍

  • No matter how severe their injuries may be, the injured worker will receive the necessary medical care.
  • After assessing the situation to ensure that whatever caused the accident won't happen again, the business owner begins filling out the necessary paperwork to file a claim. This might include taking pictures of the site and having employees fill out forms if possible.
  • The insurance company receives the claim and sends whatever the owner requests as documentation.‍

Factors That Influence the Timeline for a Comp Settlement

Two of the most important factors that can impact how long it takes to settle a workers' compensation case are:

  1. The parties' willingness to compromise
  2. Whether there are any factual disputes about what occurred or about your injuries

Willingness To Compromise

A business shaking hands with someoneIf the parties are willing to compromise, the settlement procedure will go faster. Some workers' compensation insurers are notorious for fighting for every penny to protect their bottom line.

The settlement timeline can speed up if the injured workers are willing to accept a lower amount than you're entitled to.

You may not get compensated for all your losses, but you'll get paid more quickly.

Factual Disputes About The Case

Factual disputes may add time to a workers' compensation claim.

The two most common types of factual disputes in a workers' comp case are:

  1. Whether the denial of the claim was appropriate
  2. How much money you deserve for your injuries

There is a chance that workers' compensation may not cover your injury if you are injured at work.

Your compensation claim can be denied if the injury falls into one of the following categories:

  • it was self-inflicted
  • you got the injury while you were committing a crime
  • the injury was due to drug or alcohol abuse
  • you got the injury while fighting, joking around, or roughhousing with someone else; that is considered an accident

Many factual disputes will center around your medical expenses and the type of care you received. This is especially likely if your injuries are severe, lead to long-term disabilities, or require medical attention.

How To Know If You're Receiving a Fair Settlement?

A lawyer discussing a bookIf you're receiving a fair settlement, the workers’ comp benefits should cover all costs related to your injury. The insurance provider should cover lost income and future medical expenses as well.

If you're an injured employee who has suffered from a work-related injury, you'll want to discuss your case with your doctor to know how the insurer will handle your problem in the future. 

Payment limited to past medical costs may not be enough to cover all of your health expenses.

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FAQs

Do You Always Get a Workman's Comp Settlement?

You don't always get a workman's comp settlement, but if you and the insurance company can agree on a fair settlement, then you will most likely receive one.

What Happens When a Workers Comp Claim Goes to Trial?

When a workers comp claim goes to trial, a judge will hear evidence from both sides and then decide who is entitled to what benefits.

Can The Insurance Company  Delay Their Response in an Attempt to Derail Your Claim?

The insurance company may try to delay their response in an attempt to derail your claim because the longer you wait for a response, the more likely you are to give up or accept a lower settlement offer. 

What Is the Highest Workers’ Compensation Settlement?

The highest workers' compensation settlement payment in a workers' comp case was a $10 million settlement agreement.

At Schmidt & Clark, LLP, we understand that workplace injuries are stressful and overwhelming. Maximize your workers' compensation settlements and get a free consultation with a workers' compensation attorney to better understand your legal rights and options. 

Our experienced workers' compensation lawyers will review your claim and help you determine if you are entitled to a workers’ comp offer and workers' compensation benefits. Contact us today to get started on your road to recovery.


Reference:

  1. https://www.irmi.com/term/insurance-definitions/workers-compensation

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