Jul 24, 2024
When Will Workers’ Comp Offer a Settlement?
Nate Hansford
In workers’ compensation cases, settlements can be proposed at any stage—but they often occur after the injured workers have reached maximum medical improvement (MMI). MMI is the point when a physician determines further recovery is unlikely. This diagnosis helps in estimating the long-term consequences of the injury, which is essential for calculating a fair settlement. The process is generally completed within six months after reaching MMI.
However, each case is different, and the precise timeline depends on the severity of the injuries, the number of parties involved, and any disputes that may come up. It is important to know when workers’ comp insurance offers a settlement.
How Does the Workers’ Compensation Settlement Work in Georgia?
A workers’ comp settlement is a legal agreement between an injured worker and their employer’s insurance company to resolve a workers’ compensation claim, which is meant to pay the worker for their injuries or illnesses, future medical expenses, and lost wages due to their inability to work, either temporarily or permanently. The settlement closes the claim in exchange for a sum of money agreed upon by both parties.
The value of workers’ compensation settlements is based on the following:
- The extent of medical care needed and the potential for long-term disability
- All past and estimated future medical bills associated with the injury
- The impact of the injury on the employee’s ability to work and earn wages, both currently and in the future
- Whether the injury imposes permanent restrictions that affect the ability to perform work at the same capacity as before the injury
- The Permanent Partial Disability (PPD) Rating assigned by a physician
If you have pressing financial needs or prefer to manage the money yourself, you may receive the entire amount at once in the form of a one-time lump sum payment. Alternatively, your workers’ compensation lawyer can arrange for you to be paid in installments over time. This arrangement provides a steady income stream for easy management of ongoing care and living expenses if you are unable to return to work.
The Average Workers’ Compensation Settlement Timeline in Georgia
Step 1: Notify Your Employer
You must report the injury to your employer within 30 days from the date the injury happens. However, Georgia’s workers’ compensation laws recognize that some injuries and illnesses may not be immediately apparent. In that case, the 30-day reporting window starts from the date you become aware, or should have reasonably become aware, of the injury and its connection to your employment.
Step 2: Seek Medical Care Immediately
As soon as the injury occurs or is discovered, your employer should give you a list of authorized healthcare providers. You must choose from this panel for your treatment to ensure the costs are covered by workers’ compensation insurance. However, in an emergency, you can go to the nearest ER and then later go to an approved physician for follow-up treatments.
Step 3: Employer Notification to Insurer
Your boss has a legal obligation to notify their workers’ compensation insurance company about the injury within 21 days of your report. The insurer then files the WC-1 (Employer’s First Report of Injury or Occupational Disease) claim form with the Georgia State Board of Workers’ Compensation to officially document the injury and start the process for determining benefits.
Step 4: Waiting Period for Temporary Total Disability (TTD) Benefits
If you are injured and unable to work, you do not receive TTD benefits for the first seven days of your absence unless your absence extends beyond 21 consecutive days. If your absence lasts beyond seven days, you start receiving these benefits from the eighth day onward. If you are off work for three weeks or more, you will eventually be paid for the entire period starting from the first day of your absence.
Step 5: Ongoing Treatment Until You Reach Maximum Medical Improvement
MMI refers to the point where the injured worker’s condition has stabilized and no significant improvement is expected, even with further treatment. It means the condition has plateaued. The authorized physician responsible for coordinating your care and monitoring your progress will eventually determine when MMI is reached.
Sometimes, the insurance company may ask you to undergo an IME (Independent Medical Examination) by a third-party physician of their choosing to confirm the progress toward MMI.
Step 6: The Permanent Impairment Rating is Determined
When you have reached the MMI, a qualified physician needs to determine if the injury has caused a permanent disability, and if so, calculate the extent of this impairment through a rating (a percentage that quantifies the impairment level) as per the American Medical Association’s Guidelines. This step takes between a few weeks to a couple of months, depending on how quickly it can be scheduled, conducted, and reviewed.
Step 7: Workers Comp Settlement Negotiations Begin
Georgia follows a “no-fault” system for workers’ compensation, so you can receive benefits without proving your employer did anything wrong. However, the amount you should be paid out is not always straightforward.
This is why you need an experienced Georgia workers’ compensation attorney to represent your interests and make sure your claim is not undervalued. Both sides would exchange medical records, expert opinions, and other evidence showing the extent of your injuries and their impact on your work capability. If the injury is minor, you can expect a settlement within one to two months. If there are complex injuries, disputes about the extent of impairments, or if you require ongoing medical treatment, it may take several months or even years.
The final workers’ comp settlement has to be a compromise between you, your employer, and their insurance company. If the parties cannot agree, either one may request a formal hearing before an administrative law judge at the State Board of Workers’ Compensation. If you or the opposing side is dissatisfied with the judge’s decision, an appeal may then be filed with the Appellate Division of the State Board of Workers’ Compensation.
Step 8: Settlement Agreement is Submitted
Your workers’ comp lawyer and the insurance company’s representative will draft a settlement offer outlining the amount of the settlement, the nature of the payments (lump sum or installments), and any provisions regarding your future medical costs or employment status. Your workers’ compensation attorney will submit the settlement agreement to the Board. All workers’ compensation settlements in Georgia must be approved by the State Board of Workers’ Compensation. This may take anywhere from 30 to 45 days.
Step 9: Settlement is Approved by the State Board of Workers’ Compensation
Generally, within 15 to 30 days after submission, a claims examiner or an administrative law judge from the Board will make sure the settlement is fair and adequately covers your injuries and any related disabilities. If there are any concerns, a hearing may be scheduled where both parties can present their case. However, this is more the exception than the rule if both parties are in agreement.
Step 10: Settlement Funds are Disbursed
Finally, the insurer completes the claim processing and sends out the payment. They are required to issue the payment within the timeframe stipulated in the workers’ compensation settlement agreement. This last step is typically set within 14-20 days of the approval by the State Board.
Why Choose the Law Offices of Hansford McDaniel – Workers’ Compensation Attorneys in Georgia
We are committed to our clients
Our workers’ comp attorney team is determined to make sure:
- Your employer files a report of injury as soon as possible and guides you to an authorized physician for treatment.
- Your workers’ comp claim is not denied based on lack of notice, a pre-existing condition, missed deadline, or your employer’s allegations that your injury is not work-related.
- The severity of your injury is not underestimated by the physician. We may challenge their assessment and request a second opinion.
- All injury treatments you received are covered under your claim, even if some of them were not initially authorized.
- Any disputes raised about the validity of the claim or the benefits owed are litigated vigorously.
- Any attempt to modify or terminate your benefits prematurely is unsuccessful.
We have 60+ years of combined experience in workers’ compensation cases
We have been representing injured employees and their loved ones across Georgia for decades. Our law firm has handled a variety of claims for workers’ comp: medical-only claims, lost time claims, Permanent Partial Disability (PPD) claims, Permanent Total Disability (PTD), catastrophic injury claims, worker’s death claims, and more. There is no workplace injury scenario we have not seen before.
We can help expedite the workers’ comp settlement process
We anticipate objections on workers’ compensation claims from the insurance company and address them preemptively in the claim submission or early negotiation phase, avoiding delays associated with back-and-forth disputes. We have a network of expert medical providers who understand what legal information is needed and how to provide it efficiently to resolve your claim quickly.
Reach us online or call at 770-922-3660 to discuss how long will it take for workers’ comp to settle in your case.
