Is Settling My Workers' Comp Case The Best Way to Go?

To have a job injury goes beyond the lesion itself. The whole situation fills you with fears and, most of all, many questions. One of the most popular is: Should I go for a settlement, or should I keep my case open?

At this point, it is a lot at stake for you as an injured worker. You may wonder if it is a good idea to settle your Workers’ Compensation claim or if it’s better to go for the benefits, as you might have first expected. What to do in this case? Well, this is not such an easy question to answer.

Accepting a lump-sum settlement might be a bad idea if you aren’t aware of the extent of your injuries, let alone your possible benefits. Before you sign any agreement, you need to learn a few things about settlements in Workers’ Comp:

Compromise and Release Settlement

A Compromise and Release (C&R) settlement is a lump sum payment that can rectify all the issues of your Workers’ Compensation case. This settlement is ideal for the employer and insurance company, as they can bring the issues and legalities to a closure.

One notable clause of a Compromise and Release settlement that differs from other agreements is regarding the liability for future medical bills or medication. When you say yes to the C&R settlement and get the payment, you take full responsibility for your own medical care.

With a lump sum settlement, the employee agrees to:

The inability to reopen the Workers’ Comp claim again
No future medical care for the injury
No additional PD or TD benefits (vocational rehabilitation benefits may be settled individually)

Consider closing your medical case if you think —and your PTP agrees—that you won’t need any medical treatment in the future for your Workers’ Comp case. If you know beforehand that you’ll need any treatment in the future, avoid taking a C&R and go for a Stipulated Award Settlement instead.

Stipulated Award Settlement

Choosing a Stipulated Award settlement means you won’t obtain a lump sum as a final settlement; alternately, you’ll reach an agreement for periodic Permanent Disability benefits, which you’ll receive every two weeks. This deal between the insurance and the employee will specify the maximum amount to pay.

This type of settlement allows injured workers to:

Reopen their Workers’ Comp case in California; or
Continue with another Stipulated Award; or
Request a Compromise and Release (C&R) later.

What is best for my situation?

When you face the decision of whether to choose one or the other settlement type, you must consider the following:

1. The amount of money the insurance company is willing to pay you

For example, if they offer you just $100 for your treatment, it isn't worth it. On the other hand, if the insurance company is willing to pay $200,000 to cover all your future medical expenses, it's worth taking the settlement.

2. The state of your condition

For instance, people with a static condition like paraplegia or quadriplegia require in-home nursing care for life. The future is uncertain, but the high costs are very certain.

Even if they receive a lot of money now through a C&R settlement, it may not be enough to cover this type of care in the future. Therefore, they should keep their medical care open.

In other words, it depends on how valuable the medical treatment is versus closing the case. And, most important, how much the insurance company is willing to pay.

Pros and Cons

If you get a C&R settlement, remember that you and only you must take care of the given money. You can’t spend it on anything else or change your mind because if your medical case is closed, it cannot be reopened.

The downside of closing your medical is that you can’t look for additional help in Workers’ Comp for your case. On the other hand, after you receive your settlement, you don’t have to deal with Workers’ Comp again. No more meetings and paperwork.

With a Stipulated Award, you keep your medical care open, but unfortunately, it means you must handle the insurance company for a very long time. In plain English, you will have to deal with Utilization Reviews, IMRs, and more authorization processes for Workers’ Comp.

Although you may need frequent medical treatment, it isn't always provided. This issue regularly influences individuals' decisions about whether to keep their medical care open or not.

Conclusion

When you think about getting a settlement you have to keep your future in mind: Would you need medical treatment for the rest of your life? As long as you have medical care needs, you would have to keep up with Workers Comp appointments.

If you don't have those needs, maybe settling is the way to go. After all, it is important to speak with a Workers' Comp attorney about all your options before making any choice.

Let us help you make the best decision for you and your health. With the company of experienced attorneys, you will make the right decision.

Do you want someone to guide you through this path? Talk to us for free at 800-606-6999 or make an appointment here.

Pacific Workers', The Lawyers for Injured Workers in Northern California's Premier Workers' Compensation Law Firm. Representing First Responders, Health Care Workers, Construction Workers, Delivery Workers, Warehouse Workers, and all the hard-working people that keep our community moving in their Fight for Justice against Insurance Companies.

With over 250+ Five Star Reviews; an incredible staff of caring, well-trained, advanced technology for superior client communication: a track record of an over 98%-win rate, and giving back to our community through the Pacific Workers' Foundation, it is easy to see why Pacific Workers' is the go-to law firm for all injured workers in Northern California. Offices in Oakland, Concord, Stockton, Tracy, San Jose, and Sacramento.

If you or a loved one need help or just have a question, give us a call at 800-606-6999 or email us at Intakes@pacificworkers.com.