Workplace injuries are an unfortunate everyday possibility for all workers that are unpleasant but costly. If you get injured while working, you are sure to get workers’ comp benefits because of workers’ comp insurance.
However, there is a possibility that you might not feel adequately compensated. In that case, a workers’ comp settlement might be the next option. Workers’ comp settlement covers workers’ injuries, medical expenses, lost wages, rehabilitation, and death benefits for family members.
All businesses with at least two employees must get workers’ comp insurance in the US. As it will protect both the employer and employees in case a workplace accident occurs. However, not all businesses are willing to pay benefits to injured workers. This is why you need to speak with a workers’ comp attorney as soon as you suffer an injury or illness.
Below, we examine workers’ comp benefits and when you get a settlement offer.
How Does Workers’ Comp Settlement Work?
After an employee sustains an injury, a claim is made to the workers’ comp insurance provider by their employer. The insurance provider and the employee then negotiate on the amount to pay as compensation.
It’s essential to note that when you reject an offer and pursue a lawsuit, there is no guarantee that you will win. The chances are that you may lose and get awarded an amount lower than what the insurer offered initially.
Workers’ comp settlement is affected by the following factors:
- The state’s rules on workers’ comp where the injury occurred
- Payments for disability
- Lost wages
- Loss of potential future earnings
- Cost of retraining to perform the same job or a new job due to injuries sustained.
- The validity and strength of the employee’s claim
- Legal fees
- Permanent partial disability
- Temporary total disability
- Unpaid medical bills and cost of future medical bills
Types of Workers’ Comp Settlement
When going for a workers’ comp settlement, you will be getting certain benefits while relinquishing the right to some. Consequently, you will get one out of these two settlements:
Dispute Claims Settlement (DCS)
A DCS is a way to resolve the disagreement between the insurance provider and the injured employee over claims denial or condition. Here, a lump sum is paid to the employee, and the employee relinquishes their right to any future claims or benefits. It is final.
Claim Disposition Agreement (CDA)
In CDA, an employee releases the right to other benefits except for the preferred work benefit and medical treatment in exchange for a lump sum. You can choose to receive your settlements after you’ve reached a decision with the insurer as a one-time payment of a lump sum or structured over a period.
When Do You Get a Workers’ Comp Settlement Offer?
Thankfully, workers’ comp settlement is a no-fault settlement. Therefore, you are entitled to a workers’ compensation irrespective of whose fault it is that the injury occurred in the first place.
When you get a workers’ comp settlement offer depends on several factors. Immediately an employee suffers an injury while working; they have to report to the employer. The employer then does the following:
- Get the employee to the hospital or medical treatment on-site
- Investigates the cause of the accident that led to the injury
- File a claim with their insurance company
After the employer has filed a claim, the insurer investigates the accident and decides whether to accept or reject the claims request. An insurer decides on whether to approve or reject claims based on what they find out after investigations.
The insurance company can decide to reject a claims request for any of the following reasons:
- If the injuries were self-inflicted
- The injuries sustained were from horseplay or fighting
- Injuries occurred on an employee’s commute to work
- If the injuries resulted from being under the influence of alcohol or drugs
- Sustenance of injuries while committing a crime or violating company rules
On the other hand, if the insurance provider approves the claim, they will pay for medical expenses. They will also pay a portion of the employee’s weekly wages while they’re out of work.
However, if an employee feels that a claim requested by their employer is unfair and they deserve more, they can sue for a settlement. Thus, you can get a settlement offer immediately after the injury or within weeks or months if the process is contentious.
Miami Lawyers 360 Can Get You a Settlement Quickly!
Working with a workers’ comp lawyer is important as it would quicken the claims process. At Miami Lawyers 360, we have a team of dedicated attorneys ready to side with you. We will get you the compensation you deserve within the shortest possible time. Schedule a free consultation with us today to get started.