Workers’ Compensation cases can often be settled, which has a few benefits. First, you get to control your own money instead of getting it paid in installments, plus your case often resolves faster. However, settlements can be risky in some cases.
You should never settle until after you’ve spoken with a lawyer about what your claim should be worth. If you settle for a low value, you cannot go back and adjust it later, so check with a professional. Settlements are best in cases where your lost earnings and medical expenses are predictable. If it is hard to judge or you may run into complications that need more medical care, you cannot go back and get more money, so settling those claims might be risky.
Work with our Certified Pennsylvania Workers’ Compensation Lawyers at Cardamone Law by calling (267) 651-7945 today.
When in the Process Can You Settle a Workers’ Comp Claim?
Workers’ Compensation claims can be settled at any point, but there is an initial window when settlement first becomes possible. You should typically report your injury to your employer within 21 days of it happening, then they get 21 days to respond to your claim. At that point, they have four options:
- Deny your claim
- Start paying benefits temporarily and investigate further
- Start paying benefits fully
- Settle the claim.
Many cases are denied here, so our Philadelphia Workers’ Comp lawyers need to file a Claim Petition to take your case before a Workers’ Comp Judge (WCJ). Once we start negotiations with your employer and their insurance carrier, we may receive a fair settlement offer any time after that initial filing.
If the case needs to go before a judge to decide eligibility or benefit value, cases can still be settled after the ongoing benefits start, converting the remaining benefits to a lump sum payment.
Do I Need a Lawyer for a Settlement?
Workers’ Compensation is a very strict process where judges like to make sure that workers have the representation they need to make fair decisions, especially since the system is so complex and hard for outsiders to understand. While you may be able to accept a settlement without a lawyer in the early stages of a claim, you may need a lawyer to settle at a later date.
You technically can accept an initial settlement without a lawyer, but you really should have your attorney review the offer with you. There may be medical expenses and future lost earnings that are unaccounted for, and settling now would mean you end up with too little money. Do not trust that your employer or their insurance company got the math right or that they had your best interests in mind when coming up with a settlement value.
For settlements after the case goes before a judge, the judge usually has to hold a hearing to make sure you understand your settlement. There, the judge wants to make sure that you understand the finality of a settlement. They will make sure you know you cannot go back and add more money later, and that you’ve reviewed the settlement with a lawyer. Some WCJs will not sign off on the settlement until you do have a lawyer review it with you.
When Settling is Good
Often, the point of settling is to get the money in a lump sum. This allows you to control it or set up your own annuity instead of receiving the money in a weekly trickle.
Settling can also get you money faster. The insurance company saves themselves money by not putting on a hearing, getting you the benefits you need without having to go through the full steps of a hearing.
If control and speed are important, then a settlement is often the way to go.
Lastly, ongoing wage-loss benefits stay at the same amount over time. If you get to a point where the medical expenses are finished or stable, but your disability is permanent, settling can save you from having to attend impairment rating evaluations every 6 months for the rest of your life to prove you are still disabled.
When Should I Avoid Settling
Settlements have many benefits, but they are not always good for your case. If you have any of these issues arise in your case, it might be best to take your case to a hearing and let the judge decide issues or to accept ongoing benefits instead of a lump-sum settlement.
Insurance Company Won’t Offer a Fair Value
If the defendant employer and insurance company refuse to acknowledge the full value of your case, then their settlement offers will be too low. You may have to get your case before a judge to have a fair benefit value set before you can discuss converting it to a lump sum settlement.
This commonly comes up in cases where insurance companies disagree on what the law requires them to cover.
Insurance Company Denies Injuries
If you have multiple injuries, the insurance company might accept that some injuries were caused by your work-related accident but deny coverage for others. If they refuse to cover those injuries, then we cannot recommend settling. We might need to take the case to court to get the insurance company to pay for all of your injuries.
Similarly, insurance companies tend to deny coverage for some hard-to-prove conditions. It may require additional medical evidence to convince them or a court to accept that the injury is real.
Unpredictable Injuries or Conditions
In many cases, settlements have straightforward calculations. If we know how much longer you will be out of work and what additional medical care you need – if any – then we can estimate those values and total up your claim.
If your condition is unpredictable, settling could be risky. If there is a high chance that your injury or condition could get worse, keep you from work longer, and require additional medical care, it can be hard to predict these costs. If we undervalue the claim, you would be left without coverage for these expenses and additional lost wages.
In the end, it might make more sense to keep getting ongoing benefits instead of settling, so that any surprise expenses or worsened conditions would be covered.
Call Our Workers’ Comp Lawyers in Pennsylvania for Help with Your Case
Call (267) 651-7945 for a free case review at Cardamone Law today.
