So there's a workers' comp settlement on the table! Finally! It has likely been a long road of treating appointments with workers' compensation doctors and in-depth phone calls with your attorney -- maybe even a few court appearances and deposition. Now that you're getting close to the light at the end of the tunnel, there are likely a number of questions you are asking yourself. How do you know if you should accept the offer? What are the right questions to ask your lawyer or Workers' Compensation case manager? These questions should help you figure out if the settlement on the table is right for you.
1. Is This Everything, or Do I Get More Later?
California workers' comp settlement claims goes in two main ways: a Compromise and Release or by Stipulation. There is a big difference. A Compromise and Release aka a C&R is for the settlement of your Permanent Disability, Future Medical Treatment, and for anything else that might be owed to you. This is paid in one lump sum directly from the insurance company, minus any attorneys' fees (generally 15%).
A Stipulation (Stips) is very different. You get paid for your Permanent Disability, but your medical treatment stays open for life for the particular injury. That money is paid directly to the medical providers for your additional treatment. Because Open Medical Awards still go through the Workers' Compensation system -- which, as you well know, comes with a host of issues -- most of our clients opt to try for a full Compromise and Release. Some insurance companies never want to do C&Rs, and some only want to do C&6Rs. Just make sure to ask and clarify with your attorney which one is being offered.
2. How Much Will I Get After It's All Said and Done? Do I Owe Anyone Else?
Always ask what the net amount will be after attorneys' fees are deducted. A good California workers' comp settlement should make sure that all medical expenses incurred for your Workers' Compensation treatment are taken care of by the insurance company either prior to settlement or included in the settlement. You shouldn't owe anyone. If you aren't sure if this is the case, just ask.
3. How Long Will it Take to Process the Workers' Comp Settlement?
Workers' Compensation defense attorneys and insurance companies move at very slow speeds, even when settling a case. Ask for an approximate timeline of how long it will take to get everything processed once you say yes to the settlement. Generally, it should take a week or two to get the settlement agreement to your attorney from the other side. When everyone has signed, your settlement must be approved by a Workers' Compensation judge, which can take up to two weeks. Once it is approved, an insurance company has up to 30 days to mail your check.
4. Can I Get More if We Keep Fighting?
This is always an important question to ask your attorney! Attorneys are paid to fight and give the best advice they know how. There are many factors that go into whether to accept a case. Some clients will take less money because a workers' comp settlement offer comes early, and they want the case to be over. Some want to take the case all the way through trial.
An experienced and respected attorney can often maximize a case through careful preparation and good negotiation. The offer your lawyer gets you can frequently be higher than what you get from a trial -- especially if you draw a bad judge. If your attorney says that they believe a lot more is available, keep asking the questions, but trust their expertise. What's the likelihood that you will get more? Although an attorney can never guarantee an outcome, their experience can give them insight into what may happen later.
5. Will This Be Approved by the WCAB Judge?
California Workers' Compensation claims require a judge to approve the settlement. There are so many unscrupulous attorneys out there that judges want to make sure that a case settlement meets certain criteria before it is approved. There are times when even experienced Workers' Compensation attorneys will have a settlement rejected by the court, but this is a rare occurrence. Most experienced and upstanding attorneys won't even try to get a bad settlement approved.
An expert in negotiations once said that you can always tell a good settlement when both parties walk away a bit happy and a bit unhappy. The key is to make sure that your attorney is maximizing your case. Remember, your workers' comp settlement claim belongs to you, not your attorney. Attorneys can negotiate on your behalf, but they cannot accept a settlement without your approval. Make sure you get your questions answered and you are comfortable before you accept.
Negotiation Process for a Workers' Comp Settlement
Step 1: Evaluation of the Claim
Before negotiations, both parties (the injured worker, their attorney if applicable, and the insurance company) assess:
- The extent of the worker’s injuries.
- The need for future medical treatment.
- The level of permanent disability (PD) as determined by medical evaluations.
- The estimated costs of future care and lost wages.
Key Players
- The claims adjuster or attorney representing the insurance company.
- The injured worker (with or without an attorney).
- A workers' compensation judge (if required for approval).
Step 2: Initiating Settlement Discussions
Once an injured worker reaches Maximum Medical Improvement (MMI) (i.e., their condition is stable and unlikely to improve), settlement discussions begin.
- The insurance company often makes an initial lowball offer.
- The injured worker (or their lawyer) counteroffers with a higher amount.
- Medical reports, disability ratings, and estimated future costs are used as bargaining tools.
Key Tip
Having strong medical evidence and a well-documented injury report helps secure a better settlement.
Step 3: Formal Negotiations & Counteroffers
- If both sides disagree, negotiations continue.
- If they remain far apart, they may request a Mandatory Settlement Conference (MSC) before a workers’ compensation judge.
What to Expect in an MSC:
- A judge will review the case and try to facilitate an agreement.
- If no agreement is reached, the case moves toward trial before the Workers' Compensation Appeals Board (WCAB).
Step 4: Settlement Approval
Once both parties agree on a settlement:
- The agreement is filed with the Workers' Compensation Appeals Board (WCAB).
- A judge reviews the terms to ensure fairness.
- If approved, the settlement is finalized, and payments are issued.
Final Warning
After signing a Compromise & Release, you cannot reopen your case later, even if your condition worsens.
If you have a case, don't hesitate to get help! Contact Pacific Workers’ Compensation Law Center to schedule a free consultation today!
About the author
Bilal Kassem President and Co-founder
Introducing Bilal Kassem, the visionary leader of Pacific Workers. His unwavering commitment to excellence, empowering others at the core of our organization. With a flair for creativity, Bilal infuses fresh ideas into every initiative we take.
Drawing inspiration from captivating stories like “Goosebumps”, he guides our team with determination. Beyond his professional endeavors, Bilal embraces the great outdoors. As a result, relishing adventures such as backpacking and exploring uncharted territories. Sushi is his preferred treat, nourishing both his body and spirit.
In his free time, he enjoys hitting the gym and indulging in blockbuster films. Also, he finds motivation in the legacies of historical figures like George Patton. By leading with empathy, Bilal fosters a supportive atmosphere. This is why every team member feels empowered to excel.