Do All Workers’ Comp Cases End in a Settlement?

March 27, 2021

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Brent Eames

In 2019, there were 2.8 million nonfatal workers’ comp cases in the US. Construction accidents alone account for approximately 250 workers’ comp incidents per 10,000 full-time workers.

This number of workplace injuries and illnesses is why 90% of US workers are covered by workers’ compensation insurance, which is mandated by Illinois law.

If you’ve somehow injured yourself or fallen ill on the job, you may be confused by the workers’ compensation process. If you’re in the middle of a claim, what happens if you don’t believe the compensation offered is a fair amount?

If you’re unhappy with the amount offered to you, a settlement may be in order. Keep reading for a look at what workers’ compensation settlements typically look like.

Workers’ Compensation Claims

To receive financial compensation or a settlement for a workplace injury, you must follow a particular path. If your claim is partially or fully approved, you’ll receive monetary compensation. If your workers’ comp case (claim) is denied, you won’t receive anything. 

The workers’ compensation settlement process begins when you’re injured or become ill at work. There are limits for every step of the claims process. In Illinois, you have 45 days to report your illness or injury to your employer. You may also need to report your injury to the state workers’ compensation commission.

Because you’ll need to prove your injury to the insurance company, it’s vital to gather evidence to confirm that the incident happened at work. 

You must prove that your injury occurred at work, even if you were responsible for causing it. You’ll also be required to prove the amount that your medical expenses cost, and the scope of your injuries. 

You can use medical evidence such as doctors’ notes, x-rays, medical reports, and invoices to prove these elements.

Employers and insurance companies will always investigate the circumstances of your accident and injuries. This investigation includes processing and approving or denying your claim.

You’ll have the ability to fight back if you receive a denial. However, you must do so within the deadlines imposed by the state.

Workers’ Compensation Benefits

Workers’ compensation requires employers to cover all related medical expenses. Typically, there are restrictions concerning the physicians you see. There may also be paperwork involved when switching providers.

Workers’ comp wage benefits fall into four categories: TTD, TPD, PPD, PTD. You must fall into a specific set of criteria to be eligible for each type. If you qualify for benefits, your employer must make the first payment to you within days of receiving notice of your incident.

Temporary Total Disability Benefits (TTD)

TTD benefits are paid out to employees who cannot work while recuperating from an injury or illness at work. In most cases, the injury must keep you out of work for a specific number of days before you can file a claim. 

These benefits continue until you reach maximum medical improvement, receive benefits for the full amount of weeks granted by the state, or return to work.

Temporary Partial Disability Benefits (TPD)

Employees who can return to work in a modified capacity can receive TPD benefits. 

The amount you receive is usually equal to the difference in the amount you would get under TTD and the amount you’re making in the modified position. These benefits typically cease when you return to work or reach maximum medical improvement.

Permanent Partial Disability Benefits (PPD)

If you experience a permanent impairment, like losing a limb, as a result of a workplace incident, you can receive PPD benefits. 

The amount received depends on the severity of your disability. Typically, a specific number of weeks is assigned to your injury and multiplied by the amount you’re eligible for based upon your average weekly wage.

PPD generally takes effect when you reach maximum medical improvement. You may be eligible for these benefits even if you’re receiving other workers’ comp wages.

Permanent Total Disability Benefits (PTD)

If you become severely disabled due to a workplace incident and cannot return to work, you’re eligible for PTD benefits. 

This is a lifetime benefit, and if you are proven to be eligible, you will receive your TTD benefits for the rest of your life.

Workers’ Compensation Settlements and Trials

If your workplace injury leaves you with a partial disability or permanent total disability, it will likely end in a settlement. 

You may not receive a settlement offer if you have not retained an attorney, or if you return to work quickly after your incident and do not have a disability caused by the injury. Otherwise, injured workers are often times entitled to a settlement equal to the current and future loss of earning capacity caused by the injury. 

Settlements are encouraged by the Illinois Workers’ Compensation Commission. They’re advantageous to you if they provide enough compensation to cover your immediate and ongoing medical costs. You must make sure your settlement accounts for losses if the injury impacts your ability to work into the indefinite future. 

Settling means you are forfeiting your ability to seek further compensation. It’s best to wait until you improve completely before considering a settlement. 

Accepting or Refusing a Settlement

Be sure to assess all settlement offers carefully to ensure that they meet your needs. Don’t accept a settlement without the advice of a qualified workers’ compensation attorney.

How long the settlement process takes typically starts with your decision to accept or refuse a settlement. It is tempting to accept the first offer. However, it’s almost impossible to assess your actual expenses when you’re still in active treatment. 

While accepting the first settlement offer means you’ll get your money more quickly, talk to your lawyer before deciding. Any offer you take must be fair to you and cover all of your expenses. 

If your claim turns into a legal proceeding, you’ll need to turn to your attorney for advice early and often.

The value of your settlement depends on many factors, including:

  • Injury severity
  • Whether you’re able to return to the work
  • Possible conflicting evidence

This is where having an experienced attorney can prove invaluable. They can take every factor into account and compare your settlement offer to your specific workers’ comp case’s details.

Hearings for Workers’ Comp Cases

Refusing a settlement often leads to a hearing where you and your employer will present information and evidence before an arbitrator. 

You will provide testimony under oath regarding your accident and subsequent injuries. The defense will have the opportunity to cross-examine you, if necessary. A court reporter will be present to record all of the details of your case. 

Attorneys will present documents, and may call witnesses such as fellow employees, or supervisors to testify. Once both sides have presented their information and evidence, the arbitrator will determine how much workers’ comp you’re owed.

Finalizing a Workers’ Compensation Settlement

Accepting a settlement doesn’t mean it’s final—the state will have to approve your settlement before it’s totally finalized. Once everyone, including your employer, has agreed to the settlement terms, you will submit documents to the state agency.

The documents you send to settle your workers’ comp case may include:

  • Past and future medical expenses
  • Medical records regarding your injuries
  • A stipulated settlement agreement
  • Attorney-fee-related documents

As long as you stay organized, Commission will likely approve your settlement once reviewed. 

When the Commission approves your settlement, it’s final. You shouldn’t get to this point in the process without being completely comfortable with your decision, because there is no going back once it’s finalized. This is another reason you don’t want to go through this process without legal representation.

How Settlements Are Paid

Workers’ compensation settlements are paid out in either of two ways: a lump sum or through structured payments. 

If the settlement is paid in a lump sum, you’ll sign an agreement concluding the case, and your employer or their insurance company will send a one-time payment.

Choosing structured payments means you’ll receive workers’ comp payments over an agreed period. 

Get In Touch with Your Illinois Workers’ Comp Lawyer

While most workers’ compensation cases end in a settlement, not all of them do. Proving a workers’ compensation claim can be difficult, so it’s vital to have an attorney to guide you through the process. 

A lawyer experienced with workers’ comp cases will help you prove that your injury or illness occurred at work. A workers’ compensation attorney can then advise you on how to proceed after your incident, as well as which steps to take when filing a workers’ compensation claim.

If you’re searching for answers, or want to increase your chances of receiving a settlement for your injuries, you need an aggressive attorney that will fight for you. Brent Eames fights to secure maximum recoveries for his clients across the state of Illinois. 

To learn more or request a free consultation unique to your situation, contact us today.

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