How Long Does it Take to Settle a Workers’ Compensation Claim?

It can often take between 4-6 months to settle a workers' compensation claim. The speed your claim is settle can vary on a variety of things, like if you need to appeal, go to court, negotiate, etc.

Workers’ compensation is a form of benefits available if you were injured or became ill because of a workplace accident or your working conditions.

Workers’ compensation is meant to cover the expenses of your medical treatment and any lost income due to missed work. Employers offer you workers’ compensation as a trade off for agreeing not to sue them for your injuries in civil court.

The timeline for settling your workers’ compensation claim depends on many different factors, such as the circumstances of your injuries and disability as well as the state in which you live and work.

Immediate Benefits After Injury

When you first become injured at your place of work, your employer, their insurance company, or the state should begin immediately paying for your medical expenses. It doesn’t matter whether or not you have filed your workers’ compensation claim yet.

Other benefits, such as your missed wages, begin when the court has accepted your claim. But how long does this process generally take?

Workers’ Compensation Claims

Most courts can’t determine the outcome of your workers’ compensation claim until you are fully finished with medical treatment and have reached your maximum medical improvement (MMI). This is when your injuries have been stabilized, but you are not expected to make any further medical improvement.

Your MMI helps the court determine if you totally or partially and temporarily or permanently disabled, which affects your case’s outcome and your amount of compensation. These options include:

  • Temporary total disability
  • Temporary partial disability
  • Permanent total disability
  • Permanent partial disability

Reaching your MMI and determining your level of disability can take a year, and usually longer. After you have reached your MMI, it usually takes about a year from your initial proceedings in court to fully settle your case.

What Happens After FCE In a Workers’ Comp Claim?

A Functional Capacity Exam (FCE) is a set of tests, practices and observations that are combined to determine the ability of the evaluated person to function in various circumstances, most often their job, in an objective manner. Diagnosis can be changed by a physician based on the FCE. If you have filed a workers’ compensation claim, an FCE may be ordered to determine your capabilities and the extent of your injuries.

After your FCE is completed, it will be typed and sent to your workers’ compensation doctor for a signature and approval. Your worker’s comp doctor will then approve the permanent restrictions established in the FCE. If your FCE report has restrictions, you should make sure you have a clear understanding of any restrictions. Do not hesitate to ask your doctor for any clarification regarding restrictions. The FCE plays an important role in your workers’ comp claim.

Your workers’ compensation attorney can help you understand the FCE process. Your lawyer will be able to review your FCE and help you determine the significance of the report on your claim. Your FCE will be scheduled, so you should be sure to be on time for the appointment. Be attentive, respond to any questions, and be factual. The FCE provides detailed information, so it is important for your work-related injury claim.

Your FCE can increase or decrease the value of your settlement as it paints a clear picture and shows the entire picture of your injuries and how you will be limited from performing your work-related duties.

Settling Your Case

You may decide to settle your workers’ compensation case outside of court. You can negotiate a lump settlement or structured settlement to receive all of the damages you are owed.

Keep in mind that if you decide to settle your case, your weekly compensation payments will stop, and you will not be able to receive any weekly payments in the future, as this part of the case will be permanently closed.

In terms of medical damages, some states allow you to still receive payments for further medical treatment after settling your case, although other states do not.

To settle your case, the settlement amount is first determined based on both:

  • The amount of benefits you may be entitled to in the future, which is based on your medical expenses and the outlook of your disability, and
  • How likely it is that you will receive those benefits, meaning the strength of your case’s details

You will take this amount to the Workers’ Compensation Agency in your state. This organization will hold a hearing to review the proposed settlement and either approve or deny it.

How Long Can a Workers’ Comp Claim Stay Open?

How long can a workers’ comp claim stay open? The answer depends on several factors that include the cause of your injury, the seriousness of your injury, and most importantly, the statute in your state that directly addresses the length of time a worker must file a claim for compensation.

Most states allow injured workers to file a claim for compensation one year after an incident that caused an injury in the workplace. If you suffered an injury in the workplace, you have between 30 and 45 days to notify your employer about the incident that caused your injury. If you fail to meet the notification deadline, you might lose the right to file a workers’ compensation claim. After you file a claim, the next question involves understanding how long the state where you live allows a claim to stay open.

How Long Does It Take Workers' Comp To Make An Offer After MMI?

When you’ve been injured at work you likely won’t be able to close out your workers’ compensation case until you reach MMI or Maximum Medical Improvement.

MMI is the point where the doctors agree that you’re either fully recovered and ready to return to work, or you are so injured that you won’t improve past the point that you’re currently at.

Once you reach MMI it’s possible to determine whether the settlement needs to contain money for future lost wages, retraining, or other things that you might need if you can’t work again or can’t work in your current industry again.

If you recover fully then the settlement will just include the money needed to cover any lost wages, medical expenses, and pain and suffering that occurred from the time of the accident up until the time you reached MMI.

After you have reached the MMI point it may take up to six weeks before you receive a workers’ compensation settlement offer. At that point you can decide to accept or reject the offer.

If you reject it then the process will start again and you may end up waiting another six weeks for another offer. It’s a good idea to speak with a Florida workers’ compensation attorney and have then negotiate on your behalf at the time you reach MMI so that you get a settlement offer that is fair. Having an attorney can make a big difference in the amount of money that is offered as a settlement.

Determining How Long Your Claim Will Stay Open

You have two options to take that determine how long can a workers’ comp claim stay open. You can choose to keep your claim open for an indefinite period to ensure you receive compensation for future medical bills. This option works best for workers that suffer serious injuries that require long-term medical care. However, most cases make sense for a worker to close a claim as soon as possible to receive a lump sum of money.

Receiving a lump sum of money allows you to set aside some of the money in an interest-generating bank account. You might not need to use the entire lump sum to take care of healthcare issues. Even if you need the entire lump sum for medical attention, you can increase the value of the lump sum by placing it in a bank account that produces interest.

How Long Will It Take To Settle?

While you may have a legitimate workers’ compensation claim, it might not be settled right away. Some cases that involve occupational disease and workplace injuries take time to reach an agreement.

You may think that as soon as you file your claim, it will be approved, and you will have access to the benefits that you need. However, that may be far from the truth and you could find your claim and your benefits hanging in limbo.

Here are a few of the factors that might affect how quickly your workers’ compensation claim gets settled:

  • The amount you receive – If you are injured on the job and cannot work, you should receive a check for lost wages either weekly or biweekly. The amount of your average wage and how much you should receive from workers’ comp are two of the most significant factors in determining the amount you are compensated – which is what the workers’ comp insurer is required to pay you regularly.
  • The injuries you suffered – The more serious you were injured, the greater the value of your claim. So, to sum it up, if your injury is so serious you cannot work in any capacity and perform any job, the more your claim is worth. Any injuries that keep you from returning to the same position at any time are typically worth more.
  • Your ongoing medical care – If your injury will require ongoing medical treatment, your claim is typically worth more. This is also true if your injury will require ongoing medications and physical therapy.
  • How work is affected – If you suffer injuries that will allow you to return to work and earn a salary that is in range of your past pay, your claim will not be worth as much as if you had to take a job that paid less.
  • The possibility of future issues – If your injuries could cause you to suffer additional injuries in the future, your claim might be worth more. If you suffered a back injury and you could suffer knee or hip injuries as a result later, and those injuries will require treatment as well, then your claim is most likely worth more.
  • The current status of your workers’ comp. claim – If you aren’t in litigation but currently receive workers’ comp benefits, your claim may have greater value. The workers’ comp insurer may try to lower your benefits to reduce your claim’s value, but with the help of a workers’ comp lawyer, you can ensure you are treated fairly.

Tips For a Faster Settlement

To help speed up your workers’ compensation settlement, you need to gather up al the supporting documentation to prove the severity of your injury, the long-term effects, the financial impact, and that it was caused by the workplace accident.

This will include the accident report, witness statements, medical bills, and proof of missed work and lost wages.

You should also enlist the help of a workers’ compensation attorney. With the help of a workplace injury lawyer, you are much more likely to recover a fair settlement for your damages.

Workers’ compensation attorneys are familiar with the state laws and can gather up the supporting documentation and evidence that your claim needs to be successful.

Also, the judge who is assigned to your case can have an affect on how quickly your case gets settled. Some courts and judges have a backlog of cases, so your claim might be delayed because it could take a while to have your hearing scheduled.

How Long Does It Take To Receive A Settlement?

After a settlement has been reached or awarded, you want to get access to your lump sum funds. There are different things that might come into play regarding this process as well. It could be affected by the amount of the settlement, the insurance company, and your employer. Usually, you will get the funds within 8 weeks of reaching the agreement.

If your lawyer negotiates a settlement with the workers’ compensation insurer, it can take a couple of weeks to get the agreement written up and signed by all parties. It then must be approved by the judge, which can take up to 30 days. After that, the settlement is legal and binding the insurance has 30 days in most states to cut the check and mail it to your workers’ compensation lawyer.

When the check is received, any medical bills are paid first. Workers’ compensation lawyers work on the contingency basis, which means they get a percentage of the money you receive in the settlement.

Most states have a limit set on how much a workers’ comp lawyer can receive as fees in such cases, and usually, the judge must approve those fees before the case commences. Also, you will reimburse the attorney for any expenses he or she had to advance, such as medical records, expert witnesses, and court reporters.

Settlement Example

As an example, if you suffered a leg injury and you settled your claim for $60,000. Your attorney has paid $3,000 in advance costs and there is a 20 percent contingency fee. After the $3,000 is reimbursed, that leaves $57,000.

Your lawyer will receive 20 percent, which is $11,400 if they base their contingency fee on the amount after costs. There are some lawyers who would base their fee on the $60,000 before expenses are deducted. After the expenses and fees are paid, you will receive the remaining amount of the settlement.

Depending on the judge and the laws in your state, if you had a workers’ compensation claim denied and you win your claim on appeal, the judge may order the insurance company to cover the costs of any unpaid medical bills.

If you have already paid those medical bills out of pocket, you can keep those funds but otherwise, they are earmarked in your settlement to take care of those costs. No two workers’ comp settlements are the same, so there is no guaranteed outcome for your case. Speak with a workers’ compensation attorney about the value of your claim.

Help from a Workers' Compensation Attorney

By hiring an attorney who specializes in workers’ compensation claims, you can help negotiate your claim quicker. An attorney will also be able to help you explore your options if you are considering settling your claim out of court.

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