I have written posts before about the timing of a workers compensation settlement. It’s a personal decision between you and your family. The topic of this post is — settlement expectations. There are a few realistic expectations that must be discussed to better help you understand the settlement process.
Workers Compensation Settlement Realities
First, just because an injured worker decides they are ready to settle their claim, does not necessarily mean the workers compensation insurance carrier is interested in settling the claim. It has to be a two-way street, “it takes two to tango”.
Second, it is important to understand that settlement often does not occur quickly. Many times, if a Claimant is interested in settling, an insurance carrier may commence litigation, such as filing a Suspension or Termination Petition, to gain leverage in settlement discussions. Other times it can take weeks or even a few months for an insurance carrier to evaluate your claim and respond to a demand. I can’t dictate their pace. The point is — just because an injured worker makes a decision that he/she is ready to settle their claim, that does not mean the process will be immediate.
Third, it is important to understand that just because this friend, or this co-worker, or this neighbor, etc… got this specific amount, that does not translate to what you may receive. Facts are always different in every case. Litigation posture is different. Insurance carriers may be different. Injuries, even if to the same body area, are different and vary in extent of disability. Employers themselves are different in amounts they will pay and jobs they will offer. A big factor — wages of the injured worker, play a critical role in settlement. There are just too many factors that go into case value, than simply, “I hurt my shoulder, so did my buddy, so I should get what he gets”.
Finally, and more importantly, an injured worker must understand that settlements in workers’ compensation are fairly limited, in terms of payout, despite what you might hear. Why? The Workers Compensation Act limited recovery and made workers compensation benefits the EXCLUSIVE remedy when you are injured on the job. What does that mean? It means there is no pain and suffering, despite popular belief and what you may believe to be fair. With workers compensation benefits, you are entitled to wage loss benefits, payment of medical bills, and specific loss benefits, which only apply to amputation and loss of use injuries. We hear a lot about pain and suffering damages in motor vehicle and slip and fall cases. Since these damages are unavailable in workers compensation, settlements in the six figure amounts are the exception, rather than the norm.
Generally speaking, you can expect a workers compensation settlement to be between two and five years of additional weekly wage loss benefits. Notice I said the word ‘generally’. Again, many factors go into this, such as work availability, extent of injury and disability, whether the injured worker had surgery, whether the injured worker is out of work or working light duty, whether restrictions are permanent or temporary, strength of case and evidence, insurance carrier and employer, etc… It’s a complicated process, which is why you should NEVER negotiate a settlement yourself. You will always be undercut and not provided the true value of your case.
Before you decide to settle your case, have a frank discussion with your attorney. In most cases, settling a claim means settling the entire claim, which includes settling the right to wage loss benefits and medical benefits. In most cases, when you settle, your claim is finished in its entirety, including future medical treatment. It is absolutely vital to discuss your claim, your situation, and your treatment with your attorney before settling. Once you settle, it’s over. Period. If your condition were to worsen after settlement, you need to understand that a Judge can not reopen your claim. If you have not reached MMI (Maximum Medical Improvement) and you settle your case, any future medical treatment and expenses will become your sole, exclusive responsibility.
Other factors that effect settlement include: offsets/credits involving any unemployment compensation you may have received, offsets for Social Security Retirement (SSR) benefits; social security disability benefits, pension/severance benefits; short-term and long-term disability (STD/LTD) benefits, salary continuation, etc . . . Receipt of these types of benefits can reduce settlement value of your claim.
Finally, the most important factor that impacts your settlement value of your case is your actual compensation rate, which is based on your wages. Generally the main rules is this — the lower your wages, the lower the settlement value, and the higher your wages, the potential for higher settlement values.
Count on Mooney
Settling your workers’ compensation case is a critical decision because of the impact on your workers compensation rights, entitlement to wage loss payments and medical benefits. You do not need to go it alone, nor should you.