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How Is A Workers Comp Claim Settled?


About 95% of all workers’ comp claims are resolved through a settlement. In other words, about one claim in twenty actually goes to “trial” at the State Board of Workers’ Compensation. This does not mean that you have to settle. If you ever hear anyone guarantee a favorable settlement, then whoever makes such a guarantee is likely to recommend too low a settlement, which is not in your best interest.

Agreements for settlement are usually for a lump sum dollar amount. The injured worker, or claimant, gets a lump-sum dollar amount all at one time, which is attractive if you, the claimant, will be able to recover and get back to some kind of suitable work. Also, workers’ comp cases sometimes settle for a lump sum payment plus a period of “open medical care” to assist the injured worker to ease back into the work force. Again, all settlements are voluntary. No one can force you or the employer or the insurance company to agree to a settlement.

I have no hesitation in stating that you should not engage in settlement negotiations without having your own lawyer. Your employer and the insurance company will have lawyers on their side. Your lawyer can help you in many ways to deal with the wide variety of issues that can arise during negotiations. Even if the negotiations do not proceed to a settlement, your lawyer can find out what laws and facts are not disputed, so that the hearing can be limited to only the important issues of your claim.

Even very difficult cases can often be settled at a “mediation.” Mediations are conferences scheduled by the State Board of Workers’ Compensation once the employer and the insurer agree that they will negotiate in “good faith” to try and reach a settlement with the injured worker. It is good news when an insurance company and the employer agree to mediate a claim with an injured worker.

Sometimes, several months can pass before the employer/insurer is willing to negotiate a money settlement with an employee. Once an agreement is reached, however, the State Board must approve the settlement. The extra time required for the approval process at the State Board serves the employee very well. It ensures that your rights are fully protected.

Again, no one can force or order a settlement. If all parties (the worker, the employer and the insurance company), do not agree to settle some issue, then that issue must be decided after a formal hearing on the issue.

Posted in: Workers Compensation