When you are hurt on the job, you should be concerned about both short term problems and the long term effect of your injury.
In the short term, you need medical care, transportation reimbursement for when you go to the doctor and weekly wage benefits. Not surprisingly I spend a great deal of time focusing on these matters when I am representing a client who was recently injured.
But you should also pay attention to the long term impact of your work injury. Will you be able to go back to work and, if so, under what work restrictions?
These long term concerns are what I focus on when discussing settlement with you.
You may or may not know this but your employer and their insurance company do not have to make a settlement offer. The Georgia State Board of Workers’ Compensation cannot award a lump sum like a jury might in a state court negligence case.
Instead, we can settle your case only if both you and the insurance company agree to close out your claim for a lump sum.
Why the Insurance Company Will Agree to Make a Settlement Offer
Understand that time can work against you in your workers’ compensation case. Under Georgia law, you can only recover 400 weeks (about 7.5 years) of TTD (temporary total disability benefits). Further, once a treating doctor issues a “PPD” (permanent partial disability rating, the insurance company can calculate your PPD payment by multiplying your weekly benefit amount by your PPD percentage.
So, if you have been receiving TTD benefits for 390 weeks (unlikely but possible) and you have a PPD rating of 10%, there are very few unknowns left in your case and it would have very little settlement value.
Many years ago I represented insurance companies and I can tell you what motivates them – money.
When the insurance adjuster picks up your file the main question they are asking is “how do we make this case go away for as little money as possible” and “what is the worst case scenario in terms of our costs.”
You may have been a loyal employee for your company for 20 years and a multiple recipient of “employee of the month” but once you have filed a workers’ compensation case, none of that matters. You are an expense that needs to be eliminated.
This is why, by the way, that your employer and their insurance company will force you to resign as part of your settlement package. In their eyes you are damaged goods and they want to move on.
From our perspective, we need to present evidence and argument to convince the insurance company that keeping your case active could potentially cost them dearly over the months and years to come.
When to Enter Into Settlement Negotiations
In the above video I talk about the timing of entering into settlement negotiations. I know, after 25+ years of representing injured workers, that if you approach the insurance company too early, they will make a very low offer.
Similarly, if you approach them too late, when they can accurately calculate their risk as discussed above, you will get an equally low offer.
So, in my experience the best time to pursue a settlement happens when many unknowns remain in your case:
- you may be on “no work” status and thus eligible for TTD payments for an unknown number of months in the future
- you may need costly surgery
- you may have surgical complications
- your surgery may not go well and you may need a second surgery
- you may need extensive post-surgical rehabilitation
- you may need to be fitted for braces or other assistive devices
These are just a few possible unknowns but the insurance company sees them all as potential costs. At the same time, they realize that if you wait too late to settle, the value of your case will go down.
What You Give Up When You Settle – Should You?
We can “trade” these unknowns for a higher lump sum settlement if you are also willing to accept the risks of the unknown. When you agree to a settlement figure you are giving up certain rights – the right to receive weekly wage benefits in the future and the right to receive company paid medical care.
I can help you better understand these risks and offer perspective about the timing of settlement but ultimately you have to make the decision to settle.
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