Learn when workers’ comp is most likely to offer a settlement and the pros and cons of accepting it
Navigating the world of workers’ compensation in Georgia can be a daunting task, especially when you’re focused on recovering from a workplace injury. One common question we often hear from injured workers in Atlanta is, When will workers’ comp offer a settlement?
The answer isn’t always straightforward, as it depends on various factors specific to your case, but it’s important to understand why a settlement might be offered and the pros and cons of accepting one at different stages throughout the claims process.
In this article, we’ll break down the general process for filing and receiving workers’ comp benefits in Georgia, shed light on the scenarios where settlement offers are most likely, and delve into the pros and cons of accepting such an offer.
Whether you’re just starting your claim or considering a settlement, understanding these key aspects will empower you to make informed decisions about your financial future.
General process for filing and receiving workers’ comp benefits in Georgia
Let’s start by giving you a basic overview of the steps involved in getting workers’ comp benefits in Georgia.
- Report the injury. Injured workers in Georgia must report their injury to their employer within 30 days of the incident to be eligible for benefits.
- Seek medical attention. Next, they should obtain medical treatment from an employer-authorized provider who will document their injuries and provide necessary treatments.
- File a claim. Injured workers must then file a workers’ compensation claim with the Georgia State Board of Workers’ Compensation (SBWC) by submitting Form WC-14. This form should include details about the injury, their employer, and any medical treatment received.
- Employer’s response. After being notified of the injury by the employee, the employer is required to report the injury to their workers’ compensation insurance carrier, which will then investigate the claim.
- Claim review. The insurance company reviews the claim and medical reports from the worker’s doctor to determine the validity of the claim and the benefits to be awarded. They have up to 21 days to either accept or deny the claim.
- Receive benefits. If the claim is accepted, the worker will begin receiving benefits. These may include:
- Medical benefits. Covers all necessary and reasonable medical expenses related to the injury.
- Wage loss (indemnity) benefits. Provides two-thirds of a worker’s lost wages if they’re unable to work.
- Rehabilitation benefits. May include physical therapy and vocational rehabilitation services.
- Dispute resolution. If there is a dispute about a worker’s claim, such as a denial of benefits or disagreement over the extent of the injury, the worker can request a hearing before the SBWC. An Administrative Law Judge (ALJ) will hear the case and make a determination.
- Return to work. When the worker is able to return to work or reaches maximum medical improvement (MMI), their benefits may be adjusted based on their ability to perform their previous job or any modified duties.
Pros & Cons of Accepting a Workers’ Compensation Settlement
Learn what you should know before accepting a workers’ comp settlement in Georgia.
When will workers’ comp offer a settlement?
Typically, workers’ compensation will offer a settlement at one of three key points during the claims process: at the onset, during a dispute, or after medical treatment is completed, each of which we’ll discuss below.
At the onset
Workers’ compensation insurance carriers might offer a settlement at the onset of a claim for several reasons. Primarily, it allows them to resolve the case quickly and avoid the costs associated with prolonged medical treatments and potential disputes.
By settling early, they can potentially settle the case on a no-liability basis, meaning they do not admit that the worker suffered an on-the-job injury. This strategy can be financially advantageous for the insurer, as it minimizes their expenses and risks.
So, what are the pros and cons of settling at the onset of their workers’ comp case?
Pros:
- Quick resolution. Settling early can provide immediate financial relief, helping the injured worker cover initial expenses without a lengthy legal process.
- Avoid legal hassles. An early settlement avoids the need for extended negotiations or court involvement, which can be time-consuming and stressful.
- Immediate medical treatment. The settlement funds can be used to seek prompt medical care without having to go through an approved medical provider of the employer.
Cons:
- Incomplete medical assessment. An early settlement offer usually occurs before the injured worker has received comprehensive medical care, meaning the full extent of their injuries and future medical expenses might not be known, potentially leaving them undercompensated for ongoing medical expenses and lost wages.
- No liability admission. Settling on a no-liability basis means the insurance company does not accept responsibility for the injury, which could affect the worker’s ability to receive full benefits and support in the long run.
How Can I Get the Best Possible Settlement in My Workers’ Compensation Claim?
Get our top tips, tricks and advice for maximizing your workers’ compensation settlement in Georgia.
During a dispute
Another time workers’ compensation insurance carriers commonly offer a settlement is during a dispute in a claim. Disputes can arise over several issues, such as the extent of the injury, the calculation of proper indemnity benefits, or the worker’s ability to resume their job duties.
Rather than engaging in potentially lengthy and costly legal battles, the insurance company might prefer to settle the claim. The threat of litigation often encourages them to offer a settlement as a way to resolve the dispute more quickly and efficiently.
So, what are the pros and cons of settling when there’s a dispute over benefits?
Pros:
- Resolution of dispute. Settling can provide a clear and immediate resolution to the disputed issues, allowing the worker to move forward without the stress and delay of litigation.
- Guaranteed payment. A settlement can provide a lump sum payment, offering financial certainty and immediate funds for the worker.
- Avoiding litigation. By settling, the worker can avoid the time, expense, and uncertainty of a court case.
Cons:
- Initial low offers. Insurance companies typically start with a low settlement offer. The worker or their attorney will need to engage in negotiations to reach a fair amount, which can be a lengthy and challenging process.
- Future treatment costs. Most workers’ compensation settlements completely conclude the claim. Without further benefits, the worker must ensure that the settlement amount will cover all future medical treatments and any additional time out of work. Miscalculating these needs can lead to financial difficulties.
After medical treatment is completed
Perhaps the most common time for workers’ compensation to offer a settlement is after medical treatment is completed, or when the injured worker has reached maximum medical improvement (MMI).
MMI means the worker’s condition has stabilized and is unlikely to improve further with additional medical treatment. At this point, the extent of the worker’s permanent impairment and future medical needs can be more accurately assessed, making it a practical time for the insurance company to propose a settlement.
By settling, the insurance company can finalize the claim, avoiding ongoing medical expenses and potential future disputes.
So, what are the pros and cons of settling after reaching MMI?
Pros:
- Accurate assessment. By reaching MMI, the worker has a clearer understanding of their medical condition and any permanent impairments. This helps ensure the settlement amount is appropriate for their long-term needs.
- Finality and closure. Settling at this stage provides a definitive conclusion to the claim, allowing the worker to move forward without the uncertainty of future medical or legal battles.
- Lump sum payment. The worker can receive a lump sum payment, providing immediate financial resources to cover any outstanding medical bills, lost wages, and other expenses.
Cons:
- End of benefits. Accepting a settlement typically means the worker will no longer receive ongoing medical or income benefits. If future medical issues arise related to the injury, they will need to cover those costs themselves.
- Potential underestimation. There’s a risk of underestimating future medical needs or the impact of permanent impairments, which can result in financial strain if the settlement amount proves insufficient.
Ultimately, the decision of when and whether or not to accept a settlement offer from workers’ compensation depends on a careful assessment of your medical condition, future needs, and financial situation. Consulting with a knowledgeable Atlanta workers’ compensation attorney can provide valuable insights and help ensure you receive a fair and adequate settlement.
What You Should Know About Georgia Workers’ Compensation Settlements
Learn about the different types of settlement agreements in Georgia workers’ comp claims and how each affects your future compensation.
How should I respond to a workers’ comp settlement offer?
When you receive a workers’ compensation settlement offer, it’s important to respond thoughtfully and strategically, so it’s best to avoid making any immediate decisions or signing any documents before understanding the implications of the offer.
You should start by carefully reviewing the settlement details, including the amount offered and the conditions attached. Make sure you fully consider whether the offer adequately covers your current and future medical expenses, lost wages, and any potential long-term care needs.
Consulting with an experienced workers’ compensation attorney is highly advisable before responding to a settlement offer, as they can provide valuable insights into whether the offer is fair and in your best interest.
They can also help you understand your rights, negotiate a higher settlement if necessary, and ensure that you’re not waiving any essential benefits unknowingly. By seeking professional legal advice, you can make a more informed decision that safeguards your financial and health needs in the long term.
Do I have to settle my workers’ comp case?
No, in Georgia, you are not required to settle your workers’ comp case. Neither your employer, an insurance adjuster, nor a workers’ compensation judge can force you or the insurance company to settle a claim. All settlements must be reviewed and approved by the State Board of Workers’ Compensation and must be entered into voluntarily by both parties.
If an agreement cannot be reached, the case will remain open, and you will either continue to receive or fight for the benefits you’re entitled to. While settling can sometimes be advantageous, it is always a voluntary decision.
Let our experienced Atlanta work injury attorneys help maximize your benefits
If you’ve suffered a serious or catastrophic work injury in Georgia and are considering a workers’ comp settlement offer, it’s crucial to seek expert legal advice before making any decisions to ensure your rights and financial security are protected.
With over 75 years of combined experience helping injured workers across Georgia, the knowledgeable Atlanta work injury attorneys at Gerber & Holder Workers’ Compensation Attorneys are dedicated to recovering maximum compensation for your claim.
Learn how we can help negotiate the settlement you deserve by scheduling your free consultation today.
