You have questions about workers compensation…we have answers.
Wondering “When will workers comp offer a settlement?” or “Should I even accept this offer?” Here’s everything you should know.
Whether you work in a warehouse or an office on the 87th floor, we all run the risk of suffering a work injury or illness. If you suffer an injury at work, you’re entitled to certain benefits to cover your medical expenses and lost wages.
Sometimes, this means that your lost wages are reimbursed and your medical bills are covered by your employer’s insurance company. But what happens if you are offered a lump sum settlement instead? And when will workers comp offer a settlement?
But if you’re anticipating a settlement offer, there’s a lot more to consider than “When will workers comp offer a settlement?”
At first glance, workers compensation settlements sound enticing. You receive one lump sum payment (sometimes hundreds of thousands of dollars), which you will then use to cover your medical expenses and lost wages. If there’s anything left over, you get to keep it.
Sounds great, right? Here’s why that offer deserves a second look.
When Will Workers Comp Offer a Settlement?
The answer to this question depends on how quickly you and the insurance company are able to come to an agreement. (That’s right: we said the insurance company!)
One of the most pervasive myths about workers comp cases is that injured employees are in a dispute with their employer. In fact, workers compensation claims are between the employee and the insurance company.
Nine times out of ten, the insurance company would prefer to reach a settlement before you reach your Maximum Medical Improvement (MMI), because you won’t have as good an idea of your future medical expenses.
As a result, your settlement is typically based on what your case is likely to cost the insurance company (not you) if the case does not settle. If you wait until most or all of the anticipated benefits you could receive have been paid out, the value of your case from a settlement perspective will be lower than it could have been if settled earlier.
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WORKERS COMP SETTLEMENT AMOUNT
Unlike figuring your workers comp pay rates, there is no formula that is used to calculate your workers comp settlement amount. Rather, workers compensation insurers will base their offer on a number of different factors:
- the type and severity of your injuries;
- whether or not you have a total or permanent disability as a result of your work related injury;
- whether you can return to work;
- your expected future wages and earning capacity as a result of your injuries;
- any outstanding medical bills;
- your expected future medical expenses.
This is just a small list of the various different factors examined in workers compensation claims.
Some injured workers prefer to wait until they reach Maximum Medical Improvement (MMI) before accepting any settlement offer. Reaching your MMI and receiving a Permanent Impairment rating (if applicable) will help you understand the extent of medical treatment you will need going forward.
Of course, there is always a risk when settling your case. Your injuries could be worse than believed and your future treatment could cost more than anticipated.
For this reason, the question “When will workers comp offer a settlement?” is not as important as “Will that lump sum payment cover your future medical care?”
Once the case is settled, you are responsible for covering all future treatment relating to your accident and dealing with any lost wages that result from your injuries on your own.
WHAT TO CONSIDER
Because every workers comp claim is unique, no article can tell you for certain whether to accept a settlement offer. But there are some factors to consider that may have a bearing on your decision.
As a layperson, if you have not specifically addressed your anticipated future medical treatment with your doctor, it will be difficult for you to understand how expensive those medical treatments could be. You should also consider whether you have health insurance, plan on obtaining health insurance, and whether or not that insurance policy will allow you to utilize that coverage for your future treatment.
Each policy is different, so you will need to address this with the insurance company on a case-by-case basis. Some policies may permit use but have a set amount of time that you must wait before using the coverage for treatment of your industrial injuries.
The last thing you want is for that workers comp settlement amount to run out when you still have healing to do.
Another thing to consider is the lifetime effects of your injury. Accepting a settlement offer that releases the insurance company from all future liability will mean that you are 100% financially responsible for your future medical care.
Even if you have reached your MMI, this doesn’t mean you will never have to visit a doctor again. It just means further treatment is unlikely to provide you with lasting improvement from your injuries.
In other words, it means your condition is as good as it’s going to get.
Continued treatment certainly may be necessary to maintain your health as certain injuries, illnesses, and conditions will require lifetime care. This should be taken into consideration when deciding whether to accept a workers compensation settlement.
Lastly, if you haven’t already, you should meet with a qualified attorney to discuss the details of your case. Workers compensation attorneys will not only have the experience necessary to advise you on the settlement offer, they will be able to advocate for you during mediation or litigation.
Facing a lifetime of medical needs is too serious a prospect to deal with on your own. Having a work injury lawyer on your side can help you navigate the ins and outs of a delicate situation.
GUIDANCE FOR YOUR WORKERS COMP CLAIM
It can be extremely tempting to accept a guaranteed workers comp settlement amount. A lump sum or structured settlement takes away some of the uncertainty that comes with litigation. But once the process is complete, there’s no going back.
Your workers comp claim is not something to be taken lightly. You should not sign any workers compensation settlement agreement without the guidance of an experienced workers comp attorney.
Brian D. Tadros has been working exclusively in workers compensation cases for more than 14 years. If you have received a workers comp settlement offer and have questions about your next steps, contact our office today for a free consultation.
