Workers Comp Settlements

Some of the most important questions for your orange county workers compensation case regard workers comp settlements. How long does it take to settle a workers comp case? How do you know what a workers comp case is worth? Is the insurance company paying me enough for my workers comp case? How do I make a workers comp demand for settlement? 

Workers Comp Settlements Generally

There are two types of workers comp settlements. The first, is settling the workers comp case with future medical care left open. This is called “settling a case by stipulation,” or settling a case with “stipulations with request for award.” The second, is settling a workers comp case by compromise and release, or “C&R”. It is difficult to say how long it takes to settle a workers comp case because every workers comp case is different. However, as a general rule, it should take about 1-2 years to settle a workers comp case. Some cases can settle sooner, but these are usually workers comp cases with problems. It takes time to obtain evaluations to determine the extent of your injuries, to recover from surgeries, and then to settle. Sometimes you need additional workers comp evaluations after surgery. This can cause further delay.  Additionally, the injured can develop injuries due to multiple circumstances.

Settle Workers Comp Case With Future Medical Open

Do you need a workers comp surgery in the future? Do you have serious workers comp injuries that requiring ongoing medical attention? Are you taking expensive medications? Are you happy with your workers comp treatment thus far? Would you rather settle and be done with the workers comp case? Are you going to return to work with the same employer with your workers comp injury? These are important questions to answer when deciding how to settle your workers comp case.

Generally, when you leave your future medical care open, you will settle at your level of workers comp permanent disability for the workers comp injuries you suffered. For example, a worker hurts his left knee at work. He has a left knee surgery, and undergoes physical therapy for a period of months until he reaches a point of reasonable recovery. Then his primary treating physician declares him permanent & stationary, provides 7% whole person impairment, and states that he needs future medical care consisting of: medications, evaluations, diagnostic studies, and possible further surgery. In this scenario, if he were to settle the workers comp case with future medical care left open (stipulation), he would settle for 7% wpi (adjusted to final permanent disability), with future medical care on a workers comp (industrial) basis for his left knee. The future medical care will generally consist of the future medical care in the primary treating physician (or QME/AMEs) report.

Also, the injured worker may be eligible for an SJDB (supplemental job displacement benefit) voucher for vocational retraining. The doctor will comment on this, usually in a section of the report labeled qualified injured worker (QIW). SJDB workers comp benefits are either $4,000.00, $6,000.00, $8,000.00, or $10,000.00.

As a general rule, when you settle, you will settle any claims for other workers’ comp benefits accrued to that time. This includes retro Temporary Total Disability or Partial Disability, mileage, out of pocket expenses, medical bills, and so on. So you should make sure that you are paid whatever back benefits you are owed. One of the most important documents at this stage is a “benefits printout” of workers comp benefits. You need to know what the workers comp insurance is claiming they paid to you in temporary and permanent disability. Often times, the workers comp insurance will make an error and underpay you temporary disability. Also, the workers comp insurance might allege that there is an overpayment, or allege that they are entitled to credit for permanent disability.  Moreover, there could be an EDD duplication.  You need to make sure they are correct. Dont ever take the word of the workers comp insurance company or defense attorney without first checking to make sure they are correct.

Settle My Workers Comp Case & Close My Medical Care

 Do you just want to settle and close your workers comp case?  Many workers regret closing out their case later.  Many other workers would rather close for a lump sum payment and be done with the workers comp system.  You really need to spend some time thinking about if you want treatment in the future.  Additionally, if you have health insurance or treatment from another source, it might be better to close out your case.

If you do decide to settle by way of compromise and release, you will need to obtain a settlement of all due workers comp benefits.  This can include your mileage, temporary disability, permanent disability, all medical care, any penalties, and any other owed benefits and any disputed injuries or medical treatment. 

At this time, generally the workers comp insurance carrier will take credit for your permanent disability advances and any temporary disability overpayment.  The workers comp judges will have to approve the workers comp settlement as being adequate.