The Workers Comp Settlement Process

If you get injured at work, you can file a workers’ comp claim to help you get compensation. However, before you receive workers comp benefits, there is a process involved and issues to resolve before the case is over.

The workers’ comp settlement process can end in days or months, depending on several factors. However, most workers’ comp cases take months to conclude. In this article, we’ll examine the processes involved in a workers comp claim.

Medical Attention

As soon as the workplace accident occurs, you should receive medical attention as quickly as possible. This is to prevent a worsening of the injuries and get an official medical report detailing the injury’s type and extent. In some states, workers comp policies may require you to visit a specified doctor, while some states do not.

It is essential to get medical attention or a medical report even if you do not feel the need to. It is an integral part of the workers comp process. The medical information serves as an official document detailing your injuries.

Injury Report and Filing 

After receiving medical treatment, the next step is to notify your employer within the statutory deadline, preferably as soon as the incident occurs. There are deadlines within which the employee must inform the employer about a workplace injury in many states.

It is essential to report any injury during this deadline. If the damage is progressive, such as one resulting from gradual exposure to harmful substances, ensure you note the injury as soon as you notice the symptoms.

The notification must be in writing, even if you give a verbal notice first. After you report the injury, your employer will provide an official claim form, and you will be required to fill in the necessary information. The employer will then submit the claim to the insurance company or the state workers’ comp board.

Approval/Denial of the Claim

After you submit the claim, the insurance company will investigate the request and either approve or deny it. If you are not comfortable with the settlement, your workers comp lawyer can negotiate.

Steps Involved in the Negotiation Process

  • Maximum Medical Improvement

The first step involves certifying whether you have reached a Maximum Medical Improvement level. This is when the doctor certifies that the patient has reached the maximum recovery level, and further treatment cannot improve their condition.

  • Disability Rating

The next thing to consider before negotiating a workers’ comp settlement is the disability rating. If you sustained the injury during working hours, you would receive a disability rating after getting assessed by a doctor.

A physician will assess the injuries and give a rating based on the extent of the damage and how it affects the employee’s ability to work. The disability can either be temporary or permanent, and the rating is from 0% t0 100%.

This rating is essential in calculating how the incident affects the worker’s earnings, and the employer’s insurance company will use it to calculate the compensation. The higher the disability rating, the more benefits the worker will receive. The disability rating system varies depending on the state. Each state has its regulations and method for rating disabilities.

  • Impairment Rating

Impairment rating refers to the extent of the loss of normal body function or a body part. This rating is used for permanent injuries that may not prevent the employee from working.

A doctor will conduct an assessment and give an impairment rating. Insurance companies also consider this when calculating the worker’s compensation. If the worker has injuries on numerous parts, a doctor will provide a whole person impairment rating.

  • Independent Medical Examination

Sometimes, the insurance company may disagree with the doctor’s assessment and opt for an independent medical exam (IME). The insurer demands the IME when they deny your claim or dispute with the settlement rate.

  • Mediation

Medication involves bringing a third party to help resolve the case and push towards a settlement. The mediator will speak with both parties and help them agree on a resolution. If mediation fails, then the case will proceed to a workers’ comp hearing.

Injured at Work? Pinder Plotkin Can Help You Get Compensation!

If you have suffered an injury at work, you deserve to receive workers compensation. However, things may get complicated in some cases, and you may not receive the maximum payment amount you deserve. Therefore, it is best to consult a workers comp attorney. At Pinder Plotkin, we can help you get the compensation you deserve. Contact us today for a free consultation.

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