Workers Compensation Settlements

Workers Compensation Settlements

At some point during the life of a workers comp case, injured workers will inevitably ask the question: Can I get a settlement? The answer is Yes. It is certainly possible to settle a workers comp claim. Many cases often go down this road. And it is often something that is discussed during the first interview of a client/injured worker. However, while it is certainly possible to settle a workers comp claim, it is not guaranteed. Furthermore, it is not something that an attorney or Judge can force a workers comp insurer to do.

Essentially, many factors come into play when determining when and if a comp case will settle.

What is a Settlement?

A settlement of a workers comp claim is an option to resolve the claim. It is provided for at M.G.L. Chapter 152, Section 48. Essentially, a workers comp settlement is a method to close out a part of the claim. Other parts of the claim will remain open, indefinitely, despite the settlement.

What closes out and what remains open?

An injured worker is entitle to various benefits under the workers compensation act. The two main benefits are 1) weekly disability payments, and 2) work related medical benefits. Click here for more information on the types of benefits available under the MA Comp Act.

When you settle your workers comp claim, you are closing out your right to receive any more weekly disability checks. That is the part that closes out. You would essentially take a lump sum of money and that will be the final monetary payment you will receive based on that particular injury.

Medical benefits, along with vocational rehabilitation benefits remain open. Medical benefits remain open indefinitely. In other words, so long as we can demonstrate that the need for the proposed treatment is reasonable, necessary and related to the work injury, those benefits remain open as long as the injured worker is alive. Vocational rehabilitation benefits, however, only remain open for 2 years post settlement.

How much is a settlement worth?

This is a very complicated question to answer. Settlements vary with every case. Factors which can determine what a case settles for are plentiful. These include the employee’s age, past work history, the nature of the injury, the extent of the injury, the employee’s educational background, the employee’s weekly compensation rate, the insurer involved, whether or not the employee can ever work again, etc.

When someone wants to know how much their case is worth, the only thing an attorney can really accurately due is explain the exposure to the insurer on their particular case. The exposure to the Insurer is how much the Insurer might have to pay out on the case. This is really just a function of 2 things: the injured worker’s weekly compensation rate, and the amount of time that worker may collect said benefit.

In other words, if an injured employee is receiving $1,000 per week under Section 34, he or she may collect said benefit for up to 3 years. $1,000 x 52 weeks x 3 years = $156,000. This is a very simple explanation. Often times, more than one section/benefit is involved. For example, a case may have exposure under Sections 34, 35, and 34A.

It is important to note, in our example above, if the exposure to the Insurer is $156,000, that almost certainly does not mean that the case will settle for that figure. An insurer will almost never offer the full exposure. So, in that example, while the amount of the settlement could be just about anything up to $156,000, it will most likely be for significantly less. It all depends on the factors mentioned above.

See our blog for more information on how a workers comp case is valued.

What about pain and suffering? Doesn’t that factor in?

The short answer is “No.” Unfortunately, pain and suffering provides no value in a workers comp case. Workers comp is a system designed to provide to an injured workers a portion of their pay while out of work, in the form of weekly disability checks, and medical benefits related to the work injury. Beyond that, there is no provision or recovery for things like pain an suffering. Again, this is an unfortunate shortcoming of the workers comp system.

This is unlike a typical personal injury case, such as a car accident, where pain and suffering gets factored into the value of the case.

Summing up

In summation, how much a workers comp case will settle for is not something an attorney can accurately predict. This is true both at the outset of the claim and during the actual settlement negotiations. The only thing the attorney can really do is do his or her best to give the client an accurate ballpark range.

Settling a workers compensation claim is a very important part of the injured workers case. Whether or not a settlement is in the Employee’s best interest requires a careful evaluation of all the factors outlined above. Sometimes, an attorney has to recommend that an employee not settle his or her case. This could be because the insurer is not offering enough money, or some other factor deemed to not be in the employee’s best interest. Many inexperienced attorneys will try to force a settlement on a comp claim. This is why having an experienced workers compensation attorney is vital to ensure that your rights are adequately protected and that your comp claim is handled properly.

At Troupe Law Office, we have been actively representing injured workers and their families for nearly 50 years. We are experience workers compensation lawyers located on the north shore of Boston in Peabody.

Call us any time for a free consultation of your case.