Tips, tricks and advice for maximizing your workers’ compensation settlement
The purpose of the workers’ compensation system in Georgia is to ensure that people who are hurt at work receive proper medical care, indemnity benefits if their injury prevents them from working, and payment for their permanent partial disability rating once they have reached maximum medical improvement.
In other words, workers’ compensation is supposed to take care of workers both medically and financially until they are able to return to work.
While this is an admirable goal in theory, the reality is that it doesn’t always work out this way. In this article, we’ll explore what complications can arise and offer advice on how to overcome these challenges in order to secure the maximum possible workers’ compensation settlement.
Reasons why a workers’ compensation settlement is preferred
For starters, there are a number of reasons why the injured worker may not be able to (or desire to) go back to work.
Here are a few examples:
- The injury is too severe. If the on-the-job injury leaves the injured worker with permanent injuries, they may rise to the level where the injured worker cannot go back to their prior job. An example of this type of injury could occur to a baggage handler. If they seriously injure their shoulder, they may be left with permanent lifting restrictions which make their return to work as a baggage handler impossible.
- The employer doesn’t want the injured worker back. This may occur for a number of reasons, including fear that the injured worker will reinjure themselves, animosity towards the injured worker for filing a claim, and desire to prevent the injured worker from informing other workers’ about their rights under workers’ compensation laws.
- The injured worker doesn’t want to return to the job where they were injured. The injured worker may feel like they will be ostracized and ultimately fired because they brought a claim, or they have bad memories of working where they were hurt.
There are also times when an injured worker doesn’t want to be treated by the doctor provided to them by the workers compensation system or their employer. Fortunately, an injured worker can choose their physician in certain situations according to the workers’ compensation system.
However, many times these are just choices between different doctors offered by the insurance company. They aren’t personal doctors of the injured worker. The injured worker may want to treat with a doctor who they are familiar with, but that physician isn’t available under the workers’ compensation system.
What happens when a workers’ comp claim is settled?
For the above-mentioned reasons (and others reasons not mentioned which can be personal to the injured worker), an individual may decide they want to settle their workers’ compensation claim.
When an individual settles their claim, typically 3 things happen:
First, their entitlement to indemnity benefits cease. This means that they will no longer receive temporary total or temporary partial disability benefits. Additionally, they will not be eligible for these benefits in the future for the date of accident that is being settled.
Second, they will not receive permanent partial disability benefits if they haven’t received them yet.
Third, they may no longer be entitled to medical treatment. There are times in which a case settles in the indemnity benefits aspect of the claim but the medical treatment benefits remain open. This treatment can be left open indefinitely, for a specific amount of time, or until a certain event takes place (such as after a surgical procedure or after physical therapy has been completed).
It’s important to understand:
The specific terms and conditions of any workers compensation settlement must be approved by the State Board of Workers Compensation pursuant to O.C.G.A. 34-9-15. These terms explain what is and what is NOT included in any settlement.
Tips and trick for maximizing your workers’ comp settlement
Now that we have discussed why a case might be settled and what it includes, let’s look at some ways to maximize the value of your case.
Tip #1: Hire an attorney
Unless you are intricately familiar with the entire Georgia code on workers’ compensation, we recommend hiring an attorney. An experienced work injury lawyer can help you apply pressure to insurance companies to comply with the law. They can even help you discover and leverage rights that you may not be aware are available to you.
For example, your attorney may be able to help determine whether or not the employer had a valid panel at the time of the accident. If the panel was invalid, the injured worker can treat with any doctor they want. Getting to an unbiased doctor to properly diagnose an injury could add significant value to your claim because the insurance carrier’s exposure could increase significantly.
Tip #2: Comply with ALL medical treatment
There are 2 aspects to this directive.
First, you should attend all appointments with the authorized treating physician and any therapy appointments they may schedule. This holds true even if you don’t like the doctor. Forgoing treatment may lead to the authorized treating physician releasing you to regular duty work, even if you are still injured. It’s best to attend all appointments and work with your attorney on changing doctors, rather than just not going to see a doctor.
Secondly, if the doctor places you on restrictions, do NOT try and “tough it out.” Tell your doctor if working within their restrictions is still causing you pain. Be vocal with your doctor. Your medical records tell the history of your pain, and it’s important to ensure there is proper documentation.
Tip #3: Don’t accept the first offer from the insurance company
If you aren’t properly represented, you may be offered a settlement by an insurance company and pressure may be applied to you to settle your case. Ask the insurance company why they are only offering the amount that has been presented.
Tip #4: Hire an attorney
Yes, we know this was mentioned twice — that’s how important it is to hire an experienced workers’ compensation lawyer. Insurance companies have attorneys working for them, so shouldn’t you have an attorney looking after your best interests as well? Sometimes an individual gets hurt on the job and the insurance company denies the claim and offers a minimal but quick settlement.
Don’t take the bait! Talk to our attorneys before foreclosing any and all rights you may have.
You only have one bite at the apple when it comes to settling your workers’ compensation claim. If you settle a case and it has been approved by the State Board of Workers’ Compensation, there is no real recourse in getting the settlement overturned (except in cases of fraud).
The knowledgeable Atlanta work injury attorneys at Gerber & Holder have experience dealing with insurance companies and we can help you develop a game plan to maximize the value of your workers’ compensation case.