Should I Settle My Workers’ Compensation Claim?

Jan 3, 2017

Should I Settle My Workers’ Compensation Claim?

Obtaining benefits through the workers’ compensation program can be time-consuming and frustrating. For this reason, many injured employees choose to enter into settlement proceedings with their employers and their employers’ insurers. Settlements can be initiated at any time in the claims process, so if you live in Atlanta and were recently injured while on the job, it is critical to contact an experienced workers’ compensation attorney who can explain your options and help defend your interests.

When Should I Settle?

If and when settlement proceedings should be initiated varies depending on the circumstances of the particular case. For example, many workers who have had their claims denied choose to settle prior to the hearing to ensure that they receive some type of compensation. In other cases, it is appropriate to settle when the injured employee has reached a point of maximum medical improvement. This means that a person’s condition has improved as much as can be reasonably expected. It may become clear at this point that the employee will most likely be unable to return to work and beginning settlement proceedings will bring the case to a close. Once a settlement has been reached and approved, it becomes permanent and the employee will waive all claims for medical benefits and lost wages in exchange for receiving a lump sum payment, so before coming to an agreement regarding a settlement, it is critical for injured employees to speak with an experienced attorney who can help decide what is in the injured worker’s best interest.

Types of Settlements

Generally, there are two basic types of settlements, including:

  • A liability stipulation; and
  • A no liability stipulation.

Liability stipulations are used to settle claims where all parties agree that an injury occurred and that there is a genuine dispute about benefits. A no liability stipulation, on the other hand, means that an employer is unwilling to concede that the employee was injured on the job, but is still willing to settle. No liability stipulations still require the parties to draft a written document describing the agreed-upon amount of benefits as well as the terms of the settlement. However, regardless of the type of settlement, the agreement must always be filed with and approved by the State Board of Workers’ Compensation.

Initiating Settlement Proceedings

To begin settlement proceedings, the injured party and his or her attorney must send the employer’s insurance company a settlement demand. The insurance company will then accept, deny, or respond with a new offer. This process will continue until the parties come to an agreement. Another method of settlement involves mediation. In these cases, the parties meet for an informal conference where a neutral third party attempts to guide the parties through negotiations. Once an agreement has been reached by the parties, it will need to be recorded in a document.

Agreement Requirements

To be considered valid, all settlement agreements must contain certain information and attachments, including:

  • The names, addresses, and telephone numbers of all parties to the agreement;
  • The date of the accident covered by the agreement;
  • The names and addresses of all attorneys;
  • The federal tax identification number of the employee’s attorney;
  • The employee’s claim number; and
  • A copy of the fee contract between the employee and his or her attorney.

Regardless of the type of stipulation, these documents cannot exceed 25 pages. Furthermore, liability stipulations have additional requirements, including that the agreement:

  • State the legal and factual matters about which the parties disagree;
  • State that all medical expenses have been or will be paid by the employer or insurer;
  • Specify whether the agreement concerning medical treatment is limited to certain providers;
  • State that the parties must petition the Board before changing physicians if the parties cannot agree;
  • Be attached to the most recent medical report or summary describing the employee’s condition;
  • Contain a provision explaining that the insurer sent a copy of the proposed settlement to the employer prior to the signing; and
  • State the amount of attorney’s fees owed and itemize all reimbursable expenses.

Approval Process

Once an agreement has been signed by all parties and filed with the State Board, the agreement will be reviewed by the Settlement Unit. If it is found to be acceptable, the Board will approve the agreement, although it also has discretion to choose to hear evidence and make informal and confidential inquiries before making a decision. This process could take anywhere from a few days to a few weeks. However, if approved, the settlement payment will be sent directly to the employee, usually within 20 days of approval.

Settlements can be canceled at any time before approval by the Board. However, once a settlement is approved, it becomes final and permanent and cannot be altered. Finally, attorneys cannot receive their fee as a percentage of any medical expenses or out of any funds designated for medical treatment.

Although most settlement agreements are approved, some are rejected. In these cases, the parties can file a motion for reconsideration by:

  • Immediately notifying the Division Director of the Settlement Division or the Board by telephone that they intend to appeal;
  • Using the approved form for the motion;
  • Limiting the request to 10 pages, including briefs and exhibits; and
  • Serving a copy on all attorneys, along with supporting documents.

Contact our Atlanta Workers’ Compensation Legal Team Today

At the offices of Ted A. Greve & Associates, P.A., we understand how frightening and painful it can be to suffer an injury while on the job. Deciding whether to pursue a workers’ compensation claim or to settle with an employer can make the situation even more difficult, so it is especially important for those who have been injured at work to obtain the advice of an attorney who is well-versed in this area of the law and is familiar with relevant procedures and deadlines. We are dedicated to helping our injured clients seek the compensation they deserve, so if you were recently injured at work, please contact a member of our determined Atlanta worker’s compensation legal team today by sending us a brief message or initiating a live chat and we’ll help you set up a free consultation.