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What to Know About Settling a Workers’ Comp Claim in California

  • Published: January 5, 2022
Settling a Workers' Comp Claim in California

California workers are entitled to receiving fair compensation for injuries sustained while working under California workers’ compensation laws. Workers’ comp can cover medical care, lost wages, and sometimes disability payments. An injured worker must file a claim with their employer’s insurance to approve their benefits. However, insurance companies are not often willing to cover all expenses and might offer lowball settlements.

Most of the time, insurance companies and the injured employee resolve the claim by reaching a settlement. Unfortunately, an injured employee may decide to accept a one-time settlement rather than continuous weekly benefits because they don’t have enough knowledge of their rights or the process of accepting settlements. Although a lump sum settlement might seem tempting, especially if it’s a struggle to make ends meet while recovering, it’s crucial to consider all options and seek legal advice to help make an informed decision before accepting a settlement.

When to Settle a Workers’ Comp Claim

Before considering a settlement offer, it’s critical to reach the stage called maximum medical improvement, which may also be referred to as “permanent and stationary.” Maximum medical improvement is when a doctor determines the injury will not improve any further, regardless of treatment. Once the doctor determines your injury has reached maximum improvement, they can determine whether the injury caused permanent limitations that result in permanent disability and to what extent. Until your injury has reached the point of maximum medical improvement, it’s challenging to determine the complete worth of your claim.

Whether or not it’s wise to accept a settlement offer depends on several factors. These factors include the severity of your injury (best determined after reaching the state of maximum medical improvement), the strength of your medical evidence, your financial situation, and how long you are willing to wait for the claim to unfold. If the settlement offer is good enough and you need money urgently, then it may be worth accepting a lower amount to avoid the hassle and time it takes to undergo a workers’ comp hearing. However, if the insurance company is not offering a fair amount, it may be worth going through a hearing and fighting to receive fair compensation.

The best way to ensure fair compensation is to work with an experienced California workers’ compensation lawyer. Determining whether to accept a one-time settlement versus weekly claim benefits can be complex, especially without knowing how to accurately calculate a fair settlement. A workers’ compensation lawyer understands California workers’ comp law intricacies and knows how to negotiate with insurance companies.

California’s Two Types of Workers’ Compensation Settlements

There are two types of workers’ compensation settlements in California: compromise and release, and stipulated findings and award.

Compromise and Release

When agreeing to a compromise and release settlement, you agree to close out your workers’ comp case permanently in exchange for a lump-sum payment. You will receive payment upfront and avoid going to a workers’ comp hearing. However, if your condition worsens, you will be unable to reopen your case to receive further compensation to cover any future expenses.

Compromise and release settlements are final. Before accepting this type of settlement, it’s vital to have reached the stage in your injury of maximum medical improvement to ensure you won’t need any further treatment and that the lump sum will cover the cost of medical bills.

Stipulated Findings and Award

During a stipulated findings and award settlement, you and the insurance company agree on the extent of your permanent disability and the amount of the benefits you will receive. You will receive biweekly payments rather than a lump sum unless there is a financial need for a part or all your benefits to be paid upfront. In this type of settlement, the insurance company does pay for future medical treatments as long as you follow California’s workers’ comp rules for getting medical treatment. If your medical condition worsens within five years after the initial injury, you may be able to reopen your case.

A California Workers’ Compensation Lawyer Can Help You Negotiate a Fair Workers’ Comp Settlement

KCNS Law Group is a dedicated law firm specializing in California workers’ compensation law. Our attorneys have over forty years of experience in handling workers’ compensation claims and advocating for the rights of injured workers. We understand that filing a workers’ comp claim can be complicated and sometimes overwhelming while recovering from an injury.

At KCNS Law Group, we focus on individualized strategies that prioritize our clients’ needs to best represent their interest when negotiating with insurance companies. Our attorneys are determined to help ensure you receive the maximum amount of workers’ compensation benefits you are entitled to under the law.

Contact KCNS Law Group to help ensure you receive fair compensation for your work-related injury. You can schedule a consultation here or by calling (818) 937-9255.

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