A Santa Rosa workers’ compensation lawyer can help injured workers negotiate a favorable workers’ comp settlement
Most workers’ compensation cases settle. When they do not settle, a Santa Rosa workers’ compensation lawyer can present the injured worker’s case to a workers’ compensation judge, who will decide what benefits she should receive. Since a claim is more likely to settle than to proceed to a contested hearing, however, injured workers often wonder how much they might receive in a settlement.
The answer depends on the facts of the case. Most settlements resolve a dispute about the extent of one’s permanent disability. The amount of a settlement will depend on the evidence regarding that disability. It will also depend on what the injured worker is likely to need in the way of medical treatment in the future.
Permanent Disability Benefits
Settlements usually resolve claims for permanent disability benefits. A permanent disability occurs when a work injury leaves the worker with an impairment that will never completely heal.
The value of permanent disability benefits depend on the date of the injury and the injured worker’s wages at the time of the injury. Those factors are generally easy to determine.
Permanent disability benefits also depend on the disability rating assigned to the injured worker’s condition. That factor is often disputed. Negotiating a favorable disability rating is the most important task performed by a Santa Rosa workers’ compensation attorney when negotiating a workers’ comp settlement.
Disability Ratings
Disability ratings are based on a number of factors, including the injured worker’s age at the time of the injury and the nature of his job. Again, those factors can be easy to determine.
The most important factor in determining a permanent disability rating is often the most likely to be disputed. The rating is based in part on the degree of the injured worker’s permanent functional limitations and on how much of it was caused by his job. That determination hinges in large part on the assessment made by a Qualified Medical Examiner (QME).
The QME must write a report, known as a permanent-and-stationary (P&S) report. This is a report which is generated once it is determined that the injured worker’s medical condition will not improve any more, and will likely never completely heal. The report describes the injury and any permanent functional limitations the injured worker will have (such as lifting, bending, or climbing).
A disability rating is based on the information contained in the QME report. The rating can range from 0% (no disability) to 100% (total disability). The rating is the single biggest factor that leads to disagreement between workers’ compensation lawyers and insurance claims administrators when they negotiate a workers’ comp settlement.
Workers’ Comp Settlements
A California workers’ comp settlement can be paid as a lump sum of money that ends the case entirely, or it can be paid out in installments with the insurance company obligated to provide future medical care to the injured worker for life. The choice is up to the injured worker, and generally depends on the level of his/her permanent disability and what medical care may be needed in the future.
One type of workers’ comp settlement is called a Stipulation with Request for Award. Here, the permanent disability benefits are paid out over time. The parties agree on the permanent disability rating and other key facts. They then submit the agreement to a workers’ compensation judge for review and approval.
When Stipulation with Request for Award is used to resolve a claim, the insurance company must also pay the ongoing medical expenses that are related to the work injury. This settlement method can therefore be a good choice when one will require ongoing medical treatment.
In many cases, an injured workers prefer to be responsible for their own future medical care. In those cases, the injured worker might choose to settle for a lump sum of money. This form of a workers’ comp settlement is known as a Compromise and Release.
Workers’ compensation claims administrators are usually willing to make a more favorable settlement if an injured worker will accept a Compromise and Release instead of a settlement by stipulations. The insurance company is typically willing to pay more to get off the hook for paying future medical expenses.
Accepting a Compromise and Release can be a bit of a gamble, since the injured worker is giving up the right to receive payment of future medical bills without knowing when or what type of future medical treatment might be necessary. If the injured worker feels that future medical expenses are unlikely or has other means of paying those expenses if they arise, receiving extra compensation in exchange for that risk may be a good choice.
Settling Workers’ Comp Claims
In the end, how much money an injured worker will receive in a workers’ comp settlement depends on the nature of the permanent disability and the kind of settlement the injured worker chooses. An experienced workers’ compensation lawyer in Santa Rosa can help injured workers make the decision that is right for them. To get advice about your workers’ comp settlement, call Kneisler & Schondel at (707) 542-5132 or ask a question by submitting our online contact form.