Usually, a long time. The workers’ compensation settlement process varies so much in different states that it’s difficult to say how long your case will take. The Social Security Disability process, which is a similar process, offers some guidance. From start to finish, an SSD claim usually takes between eight and twenty months. Generally, the workers’ compensation process is somewhere in the middle.
Things weren’t always this way. Until the 1990s, the workers’ compensation was efficient and independent, at least in most states. Then, bureaucracies expanded and insurance companies started meddling. At about the same time, workers’ compensation insurance premiums began declining, so there was less money in the system to compensate injured victims. It was a perfect storm. Today, victims who don’t have lawyers almost always get frustrated and agree to unfavorable settlement terms. A lawyer makes the workers’ comp settlement process shorter and easier.
Workers’ Comp Issues
Frequently, disputes over medical bills delay the workers’ comp settlement process. Sometimes, victims and adjusters speak different languages in this area.
Generally, victims do whatever their doctors tell them to do. They take prescribed drugs, undergo recommended surgical procedures, and see preferred physical therapists. Victims usually don’t think about the cost until they get the bills.
Insurance adjusters take the opposite approach. They think about the cost first and the victim’s welfare second.
Assume Rick, who has a bad shoulder because of an old football injury, falls at work and breaks his shoulder. An adjuster enters Rick’s injury and location into a computer, and the computer produces a reasonable medical bill figure. If Rick’s bills are above this figure, the insurance company won’t pay them.
Rick is in a bad position. His bad shoulder complicates the injury recovery process. But the insurance company doesn’t care.
Similar issues sometimes affect lost wage replacement issues. Most victims are entitled to two-thirds of their average weekly wage (AWW) for the duration of their temporary disabilities. To make initial settlement offers, adjusters almost always add the victim’s last five or six paychecks, divide the net income by five or six, and presto, that’s the victim’s AWW.
Let’s go back to Rick. If his injury means he’ll miss a performance bonus, his AWW must reflect that future change.
Workers’ Compensation Mediation
Because of these issues, most workers’ compensation claims settle during mediation. The mediation process varies in different states. It’s mandatory in some states and discretionary in others.
A neutral third person, who is usually an unaffiliated workers’ compensation attorney, hears brief arguments from each side in an informal environment. Then, the mediator conveys settlement offers and counter-offers back and forth, until hopefully, the two sides reach an agreement.
This process almost always works. During mediation, both sides have a duty to negotiate in good faith. “Take it or leave it” is not a good faith negotiating position. Instead, both sides must be willing to make some compromises, if that’s what it takes to reach a settlement.
As a result, most victims end up settling for less than they requested. However, lawyers ensure that victims don’t accept low ball offers. Furthermore, a bird in the hand is usually worth two in the bush. Generally, accepting a good deal during mediation is better than hoping for a better result at an appeal hearing.
Written by
Bret Thurman
