If you’re injured at work, you may wonder what to expect in the worker’s comp process. The insurance company may deny coverage. If they do, you may wonder where the case goes from there.
Ultimately, most workers comp cases end with a settlement. Our workers compensation lawyers explain why that’s the case and what you can do to reach a good outcome.
Do all workers compensation cases end with a settlement?
Most workers compensation cases end with a settlement. About 5% go to trial. If a case goes to trial, a judge decides the payment. Usually, the parties can negotiate a settlement.
What happens if your workers comp case doesn’t settle?
If your workers comp case doesn’t settle, it goes to a trial before the Workers Compensation Appeals Board. A judge conducts a hearing where the parties may call witnesses and make arguments. Between 30 days and six months after the hearing, the judge issues a ruling.
What are the two types of workers comp settlements in California?
The two types of workers comp settlements in California are Stipulation and Request for Award and Compromise and Release
Stipulation and Request for Award
- The victim receives periodic payments of temporary and/or permanent disability
- Medical care is awarded and ongoing, if applicable
- Employment may be continued
- Coverage for medical care may be revisited if circumstances change
Compromise and Release
- Typically awarded in a lump sum amount
- Medical care is typically not included – the victim must pay their own doctor going forward
- Is uncommon in cases where the person continues to work for the employer
- Final – the case does not reopen if circumstances change
What are the possible outcomes in a workers compensation case?
Settlement isn’t the only possible way that a workers compensation case can end. The possible outcomes in a workers compensation case include:
- The insurance company agrees to pay right away – the insurance company may agree that your claim is covered and pay the benefits that you are asking for
- You contest the insurance company’s decision. The parties engage in discovery, narrow the issues, negotiate and reach a settlement.
- The case goes to trial. The judge finds in favor of the victim and awards benefits.
- The case goes to trial. The judge finds in favor of the insurance company and does not award benefits.
If you go to trial, you might get all, some or none of what you ask for. That’s one reason why most workers compensation claims settle – the parties may have a lot to lose by going to trial.
Why hasn’t my workers comp case reached a settlement?
A workers comp case may not reach a settlement for any of the following reasons:
- Paperwork is missing, and the insurance company doesn’t know what to pay you
- The insurance company wants to see more medical information to verify your inability to work or the continuing need for medical coverage
- There is confusion about your rate of pay. More information may be needed to clear it up
- The parties have a large dispute about coverage, and a party wants to risk going to trial
If your case hasn’t reached a settlement, an experienced attorney can help you understand what to do next. They can work with you to gather missing information if it might be helpful. They may help you negotiate with the other side.
In addition, your attorney can help you decide if you should go to trial. If the other side simply won’t pay, you can demand the compensation that you deserve by having a hearing. Your attorney can help you prepare for the hearing process so that you’re ready and confident.
How can I get my workers comp case to settle?
If you have a workers comp case, don’t let worry about trial stand in the way of getting the compensation that you deserve. There are things that you can do to get your workers compensation case to settle. With the help of an experienced workers comp attorney, you can:
- Understand what types of compensation are allowed in your situation.
- Carefully evaluate your claim and be sure that you are asking for things that are covered. Ask for the full amount that you deserve under the law including medical benefits, temporary disability, permanent disability, supplemental job displacement training and death benefits.
- Know the rules. Be sure to follow instructions and avoid things that may make you ineligible for continued benefits like missing medical appointments.
- Work with your attorney to secure the medical documentation that you need to support the requests that you are making for coverage.
- Gather witnesses, proof of income and anything that you may need to make your case.
- Negotiate with the insurer. An attorney can help you target negotiations and skillfully work towards your goals.
- Prepare for trial. The very act of being ready for trial shows the insurance company that you’re not backing down. When you’re carefully prepared, it can make your case more likely to settle.
Who pays for medical care in a workers comp settlement in California?
Whether a workers comp settlement covers future medical care in California depends on the type of settlement. A stipulation and request for award generally includes continued medical care. A compromise and release does not. Before you accept a settlement, be sure you understand the terms.
How do the parties work towards a workers comp settlement in California?
Every workers comp case in California has a mandatory settlement conference and exchange of witnesses before trial. In addition, discovery and stipulation of uncontested facts can help the parties work towards a settlement.
Attorneys for Workers Comp Settlement
Have you been hurt at work? Are you wondering how to get a workers comp settlement? Are you worried about trial? When you work with our dedicated team of workers comp attorneys, there’s no need to worry.
Let us put our experience to work helping you reach the best possible outcome for your workers compensation case. Call or send us a message today to talk about your case.