As a no-fault workers’ comp state, California makes the claims process relatively easy. The system is based on the legal principle that employees that suffer work-related injuries qualify to receive compensation without first having to prove negligence on the part of employers. However, there are instances in which an employer’s insurance company denies all or part of an employee’s workers’ compensation claim.
When a dispute arises between an employee and an employer concerning workers’ compensation benefits, either the claim goes before a workers’ comp judge or both parties agree to a settlement. Only a small percentage of disputed claims go before a workers’ comp judge. If your employer has disputed your workers’ compensation claim, chances are good that you will avoid litigation and settle the dispute.
When to Settle a Workers’ Compensation Dispute
Whether you accept a workers’ comp settlement depends on several issues that include the amount of money offered and the seriousness of your injury or injuries. Other factors to consider are your physical limitations, the strength of the evidence, your finances, and your ability to wait out a decision handed down by a workers’ comp judge.
If you need the money now to pay off medical bills and the offer seems to be generous enough, then you might want to settle. You avoid the stress generated by a workers’ compensation hearing and you can take care of the medical issues that have developed because of your work-related injury. On the other hand, if your employer’s insurance company has made an obvious lowball offer, then you should consider taking your claim in front of a workers’ comp judge
Types of Workers’ Compensation Settlements
California law stipulates two methods for settling a workers’ compensation claim:
- Compromise and release
- Stipulated findings and award
Compromise and Release
When you agree to a compromise and release settlement, you close out your workers’ compensation claim and in return, you receive a lump-sum payment. This means you cannot receive any more money for future medical expenses to treat and rehabilitate one or more injuries. Moreover, you cannot reopen your claim if your medical condition worsens. If you sign a compromise and release settlement, a judge cannot allow you to take it back. This type of workers’ comp settlement makes sense for a claimant who has received a clean bill of health.
Stipulated Findings and Award
A stipulated findings and award settlement requires you and your employer’s insurance company to agree on your permanent disability diagnosis, as well as the amount of your financial benefits. You receive biweekly disability payments instead of one lump sum payment. This arrangement makes sense for a claimant who needs future medical treatment and if your physician expects your condition to get worse over the next five years. A stipulated and findings settlement allows you to request a reopening of your original claim.
Getting a Workers’ Compensation Settlement Approved
Your workers’ comp attorney files paperwork with the California Workers’ Compensation Appeals Board that describes in detail the terms of the settlement. A judge then holds an informal hearing to ensure you understand the settlement and that the terms written into the settlement are fair to you. If the workers’ compensation judge approves the settlement, you can expect to receive your first payment or your only payment if it is a lump sum within 30 days of the judge’s decision.
Going through the workers’ compensation settlement process on your own can lead to an unfair agreement between you and your employer’s insurance company. By working with a team of experienced workers’ comp lawyers, you can expect to get the most favorable workers’ compensation settlement possible.
Contact the PLBH Law Firm today by (800) 435-7542 to schedule a free case evaluation.