How to get the right settlement after a workplace accident
Workers’ comp settlements. It’s an overwhelming topic. Faced with medical bills, lost income, and an insurance company pushing for a quick settlement… it’s easy to make costly mistakes.
The good news?
There are key legal considerations you should know before signing your settlement. Most workers leave thousands on the table by not knowing what to look for.
What you’ll discover:
- Understanding Workers’ Comp Settlement Basics
- Critical Legal Factors That Affect Your Settlement
- When You Need Legal Representation
- Common Settlement Mistakes To Avoid
Understanding Workers’ Comp Settlement Basics
Workers’ comp settlements are financial agreements between injured workers and insurance companies. These settlements are meant to compensate you for workplace injuries and their impact on your life.
Before you can negotiate a fair settlement, it’s important to understand some basic facts:
Nationwide, the average settlement is $44,179 according to the latest data from the National Safety Council. But this number can vary significantly depending on your situation. Some workers receive as little as $2,000, while others can receive over $100,000.
Several key legal factors determine how much insurance companies offer. If you’re dealing with a serious workplace injury, consulting with a workers comp lawyer in Fresno or your local area helps ensure you understand the true value of your claim. We’ll cover these factors in detail below.
Insurance companies have one goal – settling your claim for as little money as possible. They do not have your best interests in mind.
Understanding the legal considerations helps level the playing field. With this knowledge, you can negotiate from a position of strength rather than desperation.
Critical Legal Factors That Affect Your Settlement
Several key legal factors influence the value of your workers’ comp settlement.Â
Severity of Your Injury
The severity of your injury is the most obvious factor that should affect your settlement.
But here’s the problem – insurance companies often try to downplay the severity of your injury to reduce your payout. They’ll dispute your impairment rating or claim you can return to work sooner than your doctor says.
Permanent disabilities and injuries requiring long-term medical care typically result in higher settlements. Motor vehicle accidents at work, for example, result in average settlements of over $90,000.
Don’t fall for the insurance company’s wordplay. Your medical records are your best evidence. Trust what your doctors say.
Future Medical Expenses
Many injured workers focus only on immediate medical bills when thinking about their workers’ comp settlement. This is a big mistake.
What about future medical expenses? Ongoing physical therapy? Medication costs for the next ten years? Travel to see your doctors?
Your settlement needs to account for all future medical expenses related to your workplace injury. This includes surgeries, rehabilitation, assistive devices, medications, and any other treatments.
Insurance companies want you to settle before you have a full understanding of the long-term impacts of your injury. Don’t let them bully you into settling too soon. Wait until your condition has stabilized and doctors can accurately predict your future medical needs.
Lost Wages and Earning Capacity
Workers’ comp settlements must account for lost wages – past and future.
Past lost wages are easy to calculate – the income you’ve lost since your injury. Future earning capacity is where it gets tricky.
Here are some questions to think about:
- Can you return to your old job?
- If so, will you be able to earn the same income?
- Has your injury reduced your ability to work over the long term?
If you are unable to return to work or your injury reduces your long-term earning potential – this lost earning capacity must be considered in your settlement.
Permanent Disability Ratings
Permanent disability ratings are another legal consideration when it comes to workers’ comp settlements.
A permanent disability rating (usually a percentage) assesses the long-term impact of your injury on your ability to work. Higher ratings result in higher settlements.
Permanent disability ratings are often disputed by insurance companies. They’ll have doctors assess your impairment who typically give lower disability ratings than your treating physician. These battles over disability ratings often have a significant impact on your settlement value.
Don’t accept the insurance company’s disability rating at face value. Get a second opinion if necessary.
When You Need Legal Representation
For smaller, simple claims where the injury heals quickly and lost wages are minimal, you may be able to handle your claim on your own.
But when it comes to more serious injuries, complex cases, or disputed claims – legal representation is critical.
Look for these red flags to know when to get a lawyer:
- Your injury is severe or results in a permanent disability
- The insurance company denies your claim
- You are offered a settlement amount you know is too low
- Your employer retaliates against you for filing a claim
Insurance companies have experienced adjusters and lawyers who know how to minimize your payout. Having your own advocate ensures you are not taken advantage of during the claims process.
Legal fees are an investment in protecting your rights. Most workers’ compensation lawyers work on a contingency basis (only getting paid if you win your case) and you can usually recover their fees from the insurance company as part of your settlement.
Common Settlement Mistakes To Avoid
The number one question workers’ comp lawyers get from injured workers is “Am I being taken advantage of?”
In most cases, the answer is “Yes.” Injured workers make a series of predictable mistakes that cost them money. Let’s cover the most common ones.
Accepting The First Offer
Insurance companies are experts at making lowball initial offers.
They know most injured workers – desperate for money and confused by the process – will take the first offer without question. First offers rarely have any real bearing on the true value of a claim.
It’s the insurance company’s opening move in a negotiation process. Counter offers, justifications, and higher offers will follow.
The key is not to automatically accept that first offer. Get a legal opinion on its fairness before you commit.
Settling Too Quickly
Time is on the insurance company’s side, not yours.
Settling before you fully understand the extent and future impacts of your injury is a recipe for disaster. Once you sign a settlement, you usually cannot go back and ask for more money if future problems develop.
Most doctors cannot accurately predict the long-term outcomes of your condition until you reach maximum medical improvement (MMI). Waiting for this point before settling ensures you know the full extent of your injury.
Don’t rush. Document everything. And don’t settle until it’s in your best interest.
Not Documenting Everything
Documentation is the most valuable thing you can do when filing a workers’ comp claim.
Keep records of every aspect of your injury: medical appointments, treatments, medications, out-of-pocket expenses, and how the injury impacts your daily life. This evidence supports your claim and justifies higher settlement amounts.
If the insurance company challenges your claim or the injury’s impacts, this documentation will be your best defense. Missing records give them the ammunition to dispute your claim or lowball you.
Ignoring Future Impacts
Final workers’ comp settlements are final. You are generally barred from making future claims or demands for additional money related to this injury.
For that reason, you must account for all future medical expenses, lost earning capacity, and life impacts when calculating your settlement. Surgery needed in ten years? Ongoing pain management? Career retraining?
All of these future issues must be included in the settlement calculation.
Don’t shortchange yourself for a quick payout. Your future financial security is at stake.
Final Thoughts On Your Settlement
Workers’ comp settlements are one-time financial agreements that require careful consideration of legal factors most injured workers don’t fully understand.
From the severity of your injury to future medical expenses and lost earning capacity – all these elements combine to determine the total amount you receive.
Don’t rush the process. Document everything. Know the true value of your claim before you accept any offer. And don’t be afraid to get legal representation for complex cases or serious injuries.
Insurance companies only profit when injured workers settle for less than they deserve. You shouldn’t be one of them. Knowing these legal considerations and negotiating from a position of strength helps you get every dollar you’re entitled to by law.
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