There are many who misunderstand the workers’ compensation system as something where you and the insurance company negotiate a settlement, but this actually might not be true. If you file for workers’ compensation, there is a possibility that you won’t receive any settlement, but that doesn’t mean you won’t be receiving anything.
Settlements Mean Disputes
A settlement in your workers’ compensation case is not always something that is guaranteed, but simply because there may not be a need for it. What a settlement means is that you and the insurance company are coming together to mutually agree to end a dispute in order for a set monetary amount. If there is no dispute, there need not be a settlement.
For example, if you break your leg at work and need a minor surgery on your knee because of it, workers’ compensation could come back and cover the medical bills for that injury and the surgery. They will also pay you a set amount for your lost wages. Finally, if you are able to return to work, but have a certain percentage of permanent disability, you may get payments for that as well.
It is possible that if there is enough medical evidence that shows that work caused this condition and the treatments were necessary to fix it as much as one possibly can fix that injury, then yes, workers’ compensation won’t dispute covering it. You won’t be heading to court to get coverage, and as such, no settlement is necessary.
When Will You Get a Settlement From Workers’ Comp?
Unfortunately, the above scenario is the best possible one for workers’ compensation. Ideally, you don’t want disputes to happen as it slows the whole process down. Yet, workers’ compensation is an insurance company. They want to keep costs as low as possible and prevent fraud, which means they may fight you on some things, or deny your case all together.
A common scenario in which workers’ compensation fights back on coverage is if they believe that a procedure you want covered is not needed for a workplace injury or if your condition was caused by preexisting conditions and not an injury at work.
If you ask workers’ compensation to cover a surgery on your shoulder after a shoulder injury at work. However, if the surgery is deemed not necessary for the injury or is an experimental surgery, workers’ compensation may not want to cover it. You would then challenge that with your lawyer and a court hearing will be arranged.
Most settlements happen shortly before that scheduled court hearing. The insurance company will gauge the strength of your medical evidence and either proceed to court where they feel they will win and have to pay nothing, or end up settling with you to avoid having to pay more if they do lose the court hearing.
It is crucial to not think of workers’ compensation as an extra pay day. It will never be that. Instead, think of the best case scenario of workers’ compensation is getting coverage for bills caused by a work injury. You won’t come out richer, but you won’t be left in poverty by medical bills either. Before accepting a settlement, meet with a lawyer who can advise you on whether the amount you are receiving and the terms of the settlement are appropriate. In most cases, a work comp attorney can get you a much better deal than the insurer has offered you.
Need Help?
Settlements don’t happen in every workers’ compensation case. However, if your case is having some disputes, now is the time to bring in an experienced workers’ compensation attorney if you have not already. If you need representation in the Southern Minnesota/Mankato area, contact us today. You need fair compensation for your work injury, let the professionals at Harvey & Carpenter help you get it.
