Frequently Asked Questions - Do You Get a Settlement from Workers Compensation?
It depends. There is never a requirement for an injured worker to ever settle their case. However, this works both ways. The employer and the insurance carrier (“Employer/Carrier”) don’t ever have to settle the case either. Therefore, the only way a workers’ compensation case ever settles is if you and the Employer/Carrier are able to reach a settlement agreement that makes sense to both sides. No one can force the other side to settle a workers’’ compensation case, not even the Judge of Compensation Claims (“JCC”).
This is a difficult concept for most people going through a workers’ compensation case for the first time to understand. If a settlement agreement cannot be reached voluntarily between the parties, the case may never settle. And, the JCC does not have the power or authority to award a settlement of your case. In any workers’ compensation case, you are ultimately faced with two options. The first option is to keep your case open and receive ongoing treatment for your injuries with a doctor authorized by the insurance company. If there are issues with your workers’ compensation benefits, you have the right to file claims with the court and have those specific issues addressed by the court. Again, the JCC would only have the power to rule on the specific claims at issue and cannot award a lump sum settlement.
The only other option other than keeping your case open is the possibility of settling your workers’ compensation case for a lump sum amount of money in exchange for closing out the case. As indicated above, settlement is always voluntary. Your right to authorized medical care and any right to future lost wages would end in exchange for a lump sum amount of money. And, if your claim is denied or disputed in some way by the Employer/Carrier, you would be agreeing to settle instead of having those issues resolved by the JCC. Again, the JCC has no power to settle your case, but can resolve medical or lost wage disputes that may arise in your case.
It is extremely important to note that most employers and their workers’ compensation insurance carriers will require you to leave your job as part of any settlement agreement. You are also often precluded from working for the employer in the future. These potential requirements could be a deal breaker for you if you do not want to leave your job or agree not to seek rehire. If you are no longer employed by the same employer where you were injured, this is obviously a non-issue.
However, you are also usually required to execute a General Release which would preclude you from suing the Employer/Carrier for any possible disputes outside of workers’ compensation such as overtime disputes or wrongful termination. While these potential issues would not be part of your workers’ compensation claim, this is usually required as part of your workers’ compensation claim.. These potential requirements can often be a deal breaker for an injured worker if they are not ready to leave their job or wish to pursue other claims outside of worker’s compensation. However, there are rare situations where you may not be required to leave your job as part of a settlement agreement. And, sometimes you would not be required to sign a General Release although both are typically required. When negotiating a potential settlement agreement, it is important that you understand all of the terms and conditions of any offer to see if settlement makes sense or not. Therefore, if you are possibly interested in settlement but not willing to leave your employment, you will want your attorney to find out if this is a requirement to any settlement agreement.
If the Employer/Carrier requires a separation of employment to settle and the injured worker is not interested in leaving their job, the claim will not settle unless circumstances change. In those situations, the injured worker should simply continue treating with the authorized doctor on a regular basis so the statute of limitations does not run. As long as the injured worker does not let the statute of limitations run, the claim will almost always have some settlement value once circumstances change. Obviously, there are many reasons why employment with a particular company may come to an end. Some people quit their jobs to work elsewhere. Some people plan to retire at some point. People get fired for reasons unrelated to their work accident. Some people are physically unable to return to their job position at the time they were hurt. Others relocate to a new city or state. If/when circumstances change regarding your work status, you may want your attorney to contact the Employer/Carrier to begin negotiating a potential settlement on your behalf.
If you are interested in the possibility of overall settlement, you will want to have discussions with your attorney to begin the process. The Employer/Carrier rarely makes an offer without the injured worker starting the negotiations by providing an initial demand for settlement. Typically, your attorney will provide an initial demand for settlement on your behalf often starting significantly higher than the case is probably worth. Obviously, the goal is to encourage the Employer/Carrier to offer as much money as possible understanding that they have no obligation to settle either.
Settlement negotiations can happen a number of ways. Some cases settle through informal negotiations between the parties by way of phone calls, emails or letters. However, in order for an agreement to be legally binding, it must be made in writing outlining the terms so there is no confusion later. Therefore, you want to be absolutely sure about your decision before instructing your attorney to accept an offer on your behalf since you will not be able to change your mind later.
In most situations, the Employer/Carrier may be interested in overall settlement, but this does not mean they will make a reasonable offer. While there are some cases that an Employer/Carrier may offer nothing to settle, as is their right, this is fairly unusual. In most situations, they are interested in discussing settlement, but the key is your willingness to separate from the company, sign a General Release and reaching a settlement figure that makes sense to both sides. Remember, there is no requirement that the Employer/Carrier has to settle any more than you do.
The value of every case varies depends on various factors but the same general rules apply. You and your attorney should discuss whether settlement makes sense at that particular point in time. For example, if you are required to leave your job as part of the agreement and you do not wish to do so, settlement will not occur until circumstances change. Or, if the Employer/Carrier makes you an offer but you feel it is too low, you have every right to reject it and continue to keep your case open. Settlement negotiations can occur at any time if both sides are interested.
Settlement negotiations can also be conducted at a mediation. . Mediation is an opportunity for both sides to meet and attempt to reach an agreement with help of a neutral and independent mediator. Some mediations are court ordered while others are completely voluntary. If both sides are interested in settlement, the Employer/Carrier may want to set up a voluntary mediation to discuss overall settlement only. If there are medical or lost wage claims filed on your behalf, a court ordered state mediation would need to occur before having your day in court on those particular issues. While the real purpose of a court ordered mediation is to resolve any lost wage or medical issues, this is also an opportunity to discuss the possibility of overall settlement. In most situations, the Employer/Carrier would prefer to discuss overall settlement of the entire claim rather than resolve a lost wage or medical issue since it would result in a complete resolution of your case.
In sum, settlement is always a possibility, but never a requirement, for you or the Employer/Carrier. If settlement does not make sense to one side or the other or the parties simply cannot reach an agreement to the satisfaction of both sides, the case may never settle. If you are interested in the possibility of overall settlement, you should immediately consult with a lawyer specializing in workers’ compensation to discuss further.