What injured workers in Georgia should know about work injury settlements
One question we are often asked is: Do I have to settle my workers’ compensation case?
This question typically arises at 3 points during a claim:
- At the outset when the individual is injured
- While the injured worker is getting treatment
- At the end of medical treatment
The answer is, quite frankly, no.
You never have to settle your workers’ compensation claim. There are consequences of both settling and not settling your claim, and also implications regarding when you settle your claim which we will discuss below.
Workers’ compensation settlements are completely voluntary in Georgia
Neither your employer, an insurance adjuster, nor a workers’ compensation judge can force an injured worker or an insurance company to settle a claim. Furthermore, all settlements in the workers’ compensation field must be reviewed and approved by the State Board of Workers’ Compensation.
Each party must voluntarily enter into the agreement and all settlements must contain language expressing as much. Nobody can ever force an injured worker to settle a claim. There may be times where it is more advantageous to settle your claim, but this must always be done willingly.
Types of workers’ compensation settlements
There are two main types of workers’ compensation settlements in Georgia: liability settlements and no liability settlements.
When an injured worker receives indemnity benefits, their case is considered to be compensable in the eyes of the law. Therefore, any settlement will have to be concluded with a liability stipulation and agreement. In this agreement, the employer (and/or their insurance carrier) admits that there was an on-the-job injury, but the parties agree to settle and close the claim.
If an insurance carrier hasn’t paid indemnity benefits, the case can be settled on a “no liability” basis. This means that the employer doesn’t admit that the injured worker was hurt on the job, but they are willing to pay them money to settle the case.
When workers’ compensation settlements are typically offered
Even though settlements are voluntary, a majority of workers’ compensation claims end with a settlement. The amount of the settlement must be agreed upon by the employee and the employer (and their insurance company).
If the employee and employer/insurance company cannot agree on a number, the case will stay “open.” While the case remains “open,” the employee will either continue to receive the benefits to which they are entitled, or will continue to fight for the benefits to which they argue they are entitled.
Typically, the first time an insurance carrier will offer to settle a case is right at the outset. This is usually before the injured worker has received proper medical care and almost definitely before any indemnity benefits have been paid. It can therefore be settled on a no liability basis.
Nobody has to settle their workers’ compensation case, but many times they feel pressured—by their employer or an insurance company—to resolve the claim right after they were hurt.
The second point at which settlement is typically offered is when there is a dispute in the claim. This can arise in a number of different areas such as authorization of medical treatment, calculation of proper indemnity benefits, or changing authorized treating physicians. Instead of litigating this matter, or maybe partly due to the threat of litigation, an insurance carrier may offer you a settlement at this point.
Most workers’ compensation settlements will completely conclude the claim. In other words, the employee will not receive any income or medical benefits after they receive their settlement check. For this reason, it is important for employees to properly evaluate how long they will remain out of work after settlement, and the cost of their future treatment needs.
Inevitably, the insurance company will start with a low settlement offer. The employee or their attorney will need to negotiate back and forth until the employee is offered a fair amount.
The final time a settlement may be offered is upon the conclusion of the medical treatment in the claim. This doesn’t mean that the injured worker is fully recovered; it just means that they have reached maximum medical improvement (MMI) and they will not continue to improve. The settlement cannot take into account pain and suffering, as that is not available in a workers’ compensation claim.
Importance of hiring a lawyer to negotiate your workers’ compensation settlement
Any settlement should be negotiated between the parties. It’s highly recommended that an injured worker seek help from an experienced attorney who can represent their best interests during the entire settlement process.
A workers’ compensation judge cannot determine the overall value of a workers’ compensation claim. A judge can only determine whether or not an employee is entitled to a specific benefit for an undetermined length of time.
If you are an injured worker considering settlement, we strongly recommend discussing the value of your claim with an experienced workers’ compensation attorney at Gerber & Holder Workers’ Compensation Attorneys. Our attorneys can guide you through the negotiation process. We frequently help our clients obtain a higher settlement than they would have been able to negotiate on their own.
We are very experienced in negotiating settlements for their clients, and will be happy to consult with you about your case.