In 2018, there were 2.8 million nonfatal workplace injuries and illnesses in the US. If you have been injured at work or fallen ill due to workplace conditions, you might be wondering how the workers’ comp process works.
Workers’ comp laws can be confusing and the process can be overwhelming. This article will hopefully take away some of that confusion with answers to frequently asked questions, such as “do all workers’ comp cases end in a settlement?”
For the answer to this question and other common questions, read on.
What Does Workers’ Comp Cover?
In general, workers’ compensation insurance covers medical expenses, lost wages due to the illness or injury, ongoing care costs (e.g., therapy, medications, etc.), long-term disability if a return to work is impossible, as well as funeral expenses if an employee dies as a result of an injury or illness that is work-related. Surviving family members may also receive death benefits if the employee dies.
What Does Workers’ Comp NOT Cover?
The types of things that are not covered by workers’ comp insurance vary by state. Common things that aren’t covered include:
- Injuries as a result of a fight that you started
- Intentional injuries
- Injuries due to being under the influence of drugs or alcohol in the workplace
- Emotional injuries not accompanied by a physical injury
If you are unsure if your injury is covered, check with your employer or state regulations.
What Should I Do If I Am Hurt on the Job?
If you are injured on the job, there are certain things you must do and they must be completed in a certain timeframe in most cases. In Colorado, for example, you must:
- Notify your supervisor immediately
- File a written workers’ comp claim within four days of injury (even if you have already notified them verbally)
- Seek medical attention from a designated medical provider (if your employer has a list of approved providers, you must select from this list)
- Report your injury to the Division of Workers’ Compensation
Even if you don’t report within four days, you should still report the injury in writing as soon as possible. You may still be entitled to compensation, but it may be reduced based on how many days after the injury you reported it.
If you are physically or mentally unable to file a written report within four days, someone is able to do it on your behalf.
Do All Workers’ Comp Cases End in a Settlement?
Not all workers’ comp cases end in a settlement, but the majority of them do. If the claim involved permanent disability or death, it is most likely to result in a payout. The best way to determine if you should take a settlement is to consult with an experienced workers’ comp attorney.
Settlements generally don’t come quickly, so be prepared to wait weeks, months, or even a year for your case to conclude and for you to get your settlement. Even then, you might not get the full amount. Settlements can be a lump sum or structured.
In a lump-sum settlement, you will get a one-time payment in exchange for giving up certain rights, such as compensation to any further medical treatment you might need. A structured settlement is paid out in smaller amounts over a designated period.
How Much Is the Average Worker’s Comp Settlement?
Settlement amounts vary widely, depending on the severity of the injury, negotiating the settlement amount rather than accepting the first offer, and hiring a lawyer to ensure you get the maximum settlement. In Colorado, the average settlement amount is around $27,000.
How Can I Increase My Chances of Getting a Settlement?
If you want to increase your chances of getting a settlement, there are certain things you should do and things you should avoid after a workplace injury. Dos include:
- Reporting your injury in the appropriate time frame
- Seeking prompt medical attention by approved providers
- Hiring an attorney to guide you through the process
Things that you shouldn’t do include:
- Abandoning the treatment plan provided by your doctor
- Refusing to submit to medical exams
- Refusing to speak with the insurance adjusters
- Lying about or embellishing your injuries
If you tell the truth, follow the process, and seek legal representation, you greatly increase your chance of success.
If I Accept a Settlement, Can I Sue My Employer?
If you accept a workers’ comp settlement, you typically give up your right to sue your employer. Every state offers no-fault workers’ comp coverage, which means that whether it was your fault or your employer’s fault you got hurt, you are still covered.
In exchange for this coverage and a settlement, you relinquish your right to sue your employer for negligence.
What Should I Expect If My Case Goes to a Hearing?
If your employer’s insurance company refuses to settle or you cannot agree on a settlement amount, there is the possibility that your case will go in front of an administrative law judge.
At the hearing, the judge reviews all of the evidence and information about your case and then issues a decision. Essentially, the judge is deciding whether you get benefits or not. While you can represent yourself, it’s not advised, as workers’ comp law is complex and involves specific rules and regulations.
Why You Should Consider a Workers’ Comp Lawyer
The answers to many of the questions presented here, like “do all workers’ comp cases end in a settlement” are multi-faceted and vary depending on your particular situation as well as the state where you are employed. Because of the complexities involved in workers’ comp cases, an experienced attorney is the way to go.
Here at Sweet Law, our attorneys have experience in handling workers’ comp cases and can work to get you the settlement you deserve. Contact us today for a free case consultation.