How Much Will I Get?
If you have an active workers’ compensation claim, you are most likely very interested in learning more about how settlements work. There is a lot of misinformation about settlements and I hope that this section of my web site helps you learn more about this very important topic.
Workers’ Compensation Much Different than Negligence Cases
First, you should understand that settlements in workers’ compensation cases are very different from settlements in negligence cases like car accidents, slip & falls, or even medical malpractice. In a negligence case, if you cannot reach a settlement, you can take your case to a jury or to a judge for a verdict and hopefully an award of money.
In a workers’ compensation case, there is no jury or judge to award a verdict. there are also no damages payable for pain and suffering. Judges at the State Board of Workers’ Compensation cannot issue a money award concluding a case. If the insurance company refuses to offer a lump sum, there is nothing you can do to force their hand – they can simply pay out whatever weekly wage benefits they owe, continue paying for your medical care, and keep your case open indefinitely.
Insurance companies settle workers’ compensation cases because they do not like open ended liability. I find that I can maximize settlements for my clients when there are still a lot of unknowns:
- we don’t know how much longer you will be out on temporary total disability and receiving wage benefits
- we don’t know how extensive or expensive your future medical care will be
- we don’t know if your case will be deemed “catastrophic”
Remember that you are facing these unknowns as well and if you settle too early or for too little money, you may face a difficult future yourself.
When I am working up a demand letter, I try to put dollar figures to these and more unknowns in an effort to get an offer that you can accept. I can also advise you about how Social Security disability may offer some reassurance that you will be able to pay your bills and live a life with dignity.
I also know from past experience what other cases like yours have produced in settlement.
Liability vs. No Liability Settlements
Another factor that we have to take into consideration has to do with the type of claim you have. If the insurance company has “picked up” your claim and has paid lost wage or medical benefits, your settlement will likely be higher than a “no liability” case where the insurance company denies that you were injured on the job at all.
In a case where benefits are denied completely, our options are to ask for a hearing to have a judge rule that yes, you are entitled to wage and medical benefits, or we can enter into settlement negotiations to wrap up the entire case with one lump sum. I will advise you as to the pros and cons of each approach.
Catastrophic vs. Non-Catastrophic
Another important factor in settlement negotiations has to do with the type of injury you have and whether it is likely that you will recover full function. If your injury is extremely severe, we may argue that your case should be designated as “catastrophic” which has a specific definition under the workers’ compensation law.
Because there is no cap on the number of weeks you can collect lost wage benefits, a catastrophic case will usually result in a larger settlement.
Factors that Hurt Settlement Value
There are some factors that can hurt settlement value as well.
- If the insurance company has surveillance video of you performing some activity inconsistent with your claimed injury, they will use that factor to reduce their offer. If you have been released to full duty work, or if you have advised your doctor that you do not intend to have any more surgery, there is less uncertainty in your case and your settlement value will fall.
- Finally your age will impact your settlement value. A 35 year old man has a longer life expectancy and thru the potential for more medical and lost wage exposure than a 65 year old with the same injury.
I encourage my clients to recognize that every case is different and that the factors impacting settlement may be very different than those of your neighbor who may be a similar age and with similar injuries. As your attorney, my responsibility is to help you make the best decisions for you, your family and your future.
Sometimes it does not make sense to settle a case and sometimes, I will tell you that waiting will only reduce the uncertainty factor and reduce the settlement value.