Workers injured on the job often look forward to a workers’ comp settlement to cover medical bills and provide financial support while temporarily or permanently disabled. If you are an injured employee, you may wonder about the process for workers’ comp and ask yourself, “When will workers’ comp offer a settlement in California?” The timeline for being offered a workers’ comp settlement varies depending on different factors of a claim.
Understanding Workers’ Comp Settlements
When a workers’ comp case reaches a settlement, the injured worker and the insurance company have agreed to resolve the case. In California, there are two ways a case can be settled:
- Compromise and Release (C&R): Typically, with this type of settlement, the injured worker agrees to accept a one-time payment and close the case for good. If you accept this settlement, you forfeit potential future benefits, including medical care, if your condition gets worse than expected. Settling through C&R is common in cases where the worker has a permanent disability, and future medical costs can be predicted.
- Stipulations With Request for Award: In a stipulated settlement, the insurance company and injured worker agree on the amount of benefits that will be paid in installments. This agreement will usually include specific terms for ongoing, necessary medical care, and it allows you to reopen your case in the future to seek additional benefits.
When to Expect a Settlement Offer
In some cases, you can expect to receive a settlement offer from the insurance company soon after your claim is accepted. The insurance company often waits until you reach maximum medical improvement (MMI) to settle. MIM is determined when a doctor concludes that your condition has stabilized and is unlikely to change significantly, even with additional medical treatment.
When you reach MIM, you can be given a more accurate permanent disability rating, and the insurance company can offer a settlement amount they deem fair. It’s critical to have a worker’s comp lawyer review any agreement before you accept it and maybe even negotiate with the claims administrator to ensure you get a settlement that is truly fair.
Factors That Influence When a Settlement Is Offered
Several factors can influence the timeline for when a worker is offered a settlement, depending on how complex your case is, including:
- The severity of injury – The severity of your injury will typically determine how long it takes for you to reach MMI, which, in turn, can determine when you will receive a settlement offer. If your injury is minor, MMI can potentially be reached in a few months; however, if you have severe injuries, MMI may take much longer.
- Disability rating – You are assigned a disability rating once you reach MMI, which determines the degree of permanent disability and heavily influences the settlement amount. If your disability rating is high, the insurance company may want to contest it or begin negotiations, which can delay an offer.
- Current and future medical care – In cases where a worker requires ongoing, long-term medical care, the insurance company may wait to make an offer until there are clear costs for any future medical treatment. For example, if you need rehabilitation or multiple surgeries, the insurance company may want to estimate the financial impact before offering a settlement.
- Negotiations with insurance companies – It may take time to negotiate a settlement, particularly if there is a dispute over the extent of medical care needed or the disability rating. Taking the time to hire a lawyer to advocate for a fair settlement can also delay the process.
- Legal processes – If there are disputes about an aspect of the case, whether it’s the injury itself, medical treatment, or anything else, court intervention may be necessary. This can add significant time to the workers’ comp process and further delay a settlement.
FAQs
Can I Settle My Case Before Reaching MMI?
While settling your case before reaching MMI is possible, it is in your interest to wait. Settling before reaching MMI puts you at risk of settling for fewer benefits than you deserve and need. It’s difficult to determine an appropriate settlement amount when you don’t know the full extent of your injuries and if you’ll need future medical treatment. Although an insurance company may be willing to settle before you reach MMI, they may offer a lower amount than you are entitled to to minimize costs.
Do I Need a Workers’ Comp Lawyer to Negotiate a Settlement?
You need a workers’ comp lawyer to negotiate a settlement if you want to ensure you receive a fair and appropriate settlement amount. An experienced lawyer can evaluate your case and advocate for your interests, handling disputes regarding your disability rating, medical care, and other factors that could potentially reduce your settlement. With proper guidance from a lawyer, you have a greater chance of receiving the maximum compensation you deserve.
What if I Disagree With My Disability Rating?
If you disagree with the disability rating you were given by your treating doctor, you can be evaluated by a qualified medical evaluator (QME) you choose or an agreed medical evaluator (AME) who is chosen by your attorney and the claim administrator. Getting a second opinion can lead to a new disability rating, which can influence your settlement amount.
Does Workers’ Comp Pay for Pain and Suffering in California?
Workers’ compensation in California does not pay for pain and suffering, which is typically available in personal injury cases. Workers’ comp is intended to make sure injured employees are given the necessary financial support and medical care to recover from their injuries and continue working, not compensate for intangible damages, such as pain and suffering.
If workers would like to pursue compensation for pain and suffering, they would have to make sure they have cause to do so, as workers generally can’t sue for a workplace injury.
Consult an Attorney at English Lloyd & Armenta
Workers’ comp settlements in California are highly individualized, and multiple aspects of a case can influence when an injured worker is offered a settlement. A California workers’ compensation attorney can review your claim and determine if anything could possibly delay a settlement offer. Contact English Lloyd & Armenta to get started.