How long does it take to settle a work injury claim? It depends.
A question that our workers’ compensation attorneys frequently get asked is: How long will it take for my claim to get settled?
The best answer we can give is likely the one answer that you don’t want to hear: It depends.
In this article, we will explore why a precise answer is impossible to give without knowing more about your specific case, but we’ll also provide some information about a basic timeline of a workers’ compensation case.
Here are the questions that need to be answered before a timeline of your claim can be properly calculated.
Which benefits are you entitled to?
The reason why it’s difficult to tell an individual exactly when their case is going to settle is because there are so many variables. For starters, an injured worker is entitled to 3 benefits in a Georgia workers’ compensation claim:
- Medical treatment
All 3 of these benefits are interdependent on each other and sometimes are even out of the control of the injured worker.
How much should your final settlement amount be?
The amount of the settlement is very critical to the injured worker. Settlements are final. The injured worker cannot go back and ask for additional money once the settlement has been approved by the State Board of Workers’ Compensation.
When an individual settles their workers’ compensation claim, they are usually receiving a lump sum of money. In exchange for receiving this money, they are forgoing their rights to additional indemnity benefits and a permanent partial disability rating if they have not already received it.
Most times, the injured worker is also relinquishing their right to obtain additional medical treatment as part of the settlement. Closing the case can mean the complete and total end of the workers’ compensation claim. Therefore, a lot goes into determining what the ultimate settlement figure will be.
How are you feeling?
When an individual is initially hurt, it is very difficult to determine the exact nature of their injury. It takes time, treatment, testing and even physical therapy to make an accurate assessment of what is actually wrong.
Each person’s body reacts differently to different medical treatment. Furthermore, people heal differently and at different speeds. So when we get asked at the outset of a claim how long until settlement, we typically respond with another question: How are you feeling?
What can you do for work?
Remember: once the settlement is approved, indemnity benefits cease.
If an individual is hurt and cannot work, they have to consider what they will do for income once the case is settled. They may have different skills they can rely on to obtain work in a different field, or they may have other sources of income they can turn to. This is information that the injured worker has to share with their attorney so they can assist them in determining the most advantageous time to settle.
What does your doctor say?
The medical component of a workers’ compensation claim is usually the driving force behind when a case is ripe for settlement. The authorized treating physician in an accepted compensable case (or the treating doctor in a contested case), determines the work capabilities of the injured worker.
Have you reached maximum medical improvement?
If a permanent partial impairment rating has not been provided by the authorized treating physician, a case can still be settled. Once a rating has been issued by the authorized treating physician, the insurance carrier has a certain amount of time to make the payment. However, receiving a permanent partial impairment rating may not always be in the best interest of the injured worker.
To receive a permanent partial impairment rating, the injured worker must be at maximum medical improvement. This means that the injured worker is not going to be getting any better — in essence, they are as good as they are going to get. There may not be any more medical treatment that can make them better.
The closure of medical treatment means limiting the exposure of the insurance carrier because they will not have to spend more money on treatment. Furthermore, being given a rating means that it is much more difficult to argue for a higher rating. Ambiguity often helps.
Sometimes, the injured worker has another avenue to receive medical treatment. This information has to be relayed to their attorney so proper judgements can be made. Once a case is settled, the injured worker has the choice to treat with whatever doctor they want to, but they will have to find another source of payment to those providers.
Is the insurance company willing to settle?
Additionally, there is the issue of the insurance company. Just because an injured worker is ready to settle their case, doesn’t mean the insurance company is wanting, willing or able to do the same. Unlike in other personal injury cases, going to trial in a workers’ compensation claim doesn’t guarantee a settlement.
The administrative law judge presiding over your case cannot order the insurance company to pay a settlement. All the judge can do in a workers’ compensation case is award the injured worker benefits or medical treatment, not a lump sum settlement.
Is now the best time to settle your workers’ compensation claim?
There are many different times throughout a workers’ compensation claim where a case can be settled. However, there are pluses and minuses during each of these times. Knowing all factors of the claim, including medical treatment already performed, currently taking place and what will be required are vital to know when thinking about settling a case.