When Will Workers’ Comp Offer a Settlement?
Understand when workers’ comp settlements are typically offered
and how they impact your right to future benefits in Colorado
A workplace injury or occupational disease can turn your world upside down. Medical bills, lost wages, and the stress of recovering from your condition can be overwhelming. Workers’ compensation is designed to provide financial support during this difficult time, but the process can be confusing, especially when it comes to settlements.
If you’ve been injured on the job in Colorado, you’re likely wondering when and how settlement offers come into play. This guide will help demystify the settlement process, explaining when you might be presented with a settlement offer and what it means for your future. We’ll also address common concerns about potential risks, such as giving up your right to future benefits.
When is workers’ comp most likely to offer a settlement?
If and when workers’ comp will offer you a settlement depends on the specific circumstances of your claim, including the severity of your injury or occupational disease, but there are some key times when workers’ comp is more likely to try to settle. They include:
- After reaching maximum medical improvement (MMI). When you’ve reached maximum medical improvement (MMI), it means your medical condition has stabilized and further recovery is not expected. At that point, if you have a permanent impairment, the insurance company may offer a settlement to cover future medical expenses and compensation for your reduced earning capacity.
- When vocational retraining is necessary. If your injury prevents you from returning to your previous job, you may need vocational rehabilitation or job placement assistance. A settlement may be offered to cover the costs associated with retraining programs, education, and support to help you transition into a new career. This can provide financial stability while you acquire new skills and seek suitable employment.
- During mediation sessions. If there are disputes between you and the insurance company or your employer regarding the extent of your injury, your ability to return to work, or the need for ongoing medical treatment, either side may request mediation. Mediation is a process where a neutral third party helps facilitate discussions between you and the insurance company to reach a mutually acceptable settlement. Mediation can occur at various stages of the workers’ comp process and is often a key time when settlements are reached.
- Right before trial. Another time settlements are commonly offered is right before a trial. At this time, insurance companies often seek to avoid the uncertainty of a court case, so they may propose a settlement to resolve the claim and minimize their legal expenses. This approach allows both parties to have more control over the outcome and avoid the risk of an unfavorable verdict.
Should I Take a Full and Final Settlement
or Structured Payments?
Understand the key differences between structured and lump-sum workers’ comp settlements so you can make an informed decision about your financial future.
Do most Colorado workers’ comp claims end in settlements?
Whether or not a case ends in a settlement typically depends on the complexity of the case and the severity of injury. In most workers’ compensation claims, a doctor assesses the patient when they reach maximum medical improvement (MMI). Their impairment rating reflects the extent of the worker’s permanent disability resulting from the injury.
After the injured worker reaches maximum medical improvement (MMI), a doctor assesses their condition and assigns an impairment rating. This rating reflects the extent of the worker’s permanent disability resulting from the injury.
In most cases, the insurance company then agrees to pay the benefits corresponding to the impairment rating. Once these payments are made, the case is generally considered closed.
Settlements are more common in situations where there are disputes over the severity of the injury, the necessity of ongoing medical treatment, or when the injured worker’s condition results in a permanent disability that significantly impacts their ability to work.
What’s the difference between closing my case and settling?
When your workers’ compensation case is closed, it typically means that the claims process has reached its natural conclusion and the insurance company has agreed to pay the benefits associated with your impairment rating, which may include compensation for any permanent disability and necessary medical treatments.
Once these payments are made, the case is considered closed, but you may still be entitled to benefits for ongoing medical care related to your injury.
Settling your case involves reaching an agreement with the insurance company to receive a lump sum payment or structured payments to resolve your claim. When you settle your case, you give up the right to any future benefits related to your injury, except those explicitly outlined in the settlement agreement.
What Benefits Are Available in a Colorado Workers’ Compensation Claim?
Learn about the different types of workers’ comp benefits available to injured workers in CO.
What happens if my injury gets worse after my case is closed or settled?
Your ability to reopen your case if your injury or condition worsens later will depend on whether you agreed to a settlement or your case was simply closed.
Case closed without settlement
If your case was closed but not settled, you have the option to ask for your case to be reopened if your condition deteriorates or if there was a mistake in your initial claim.
Reopening your case could allow you to receive additional medical benefits, temporary disability benefits, and additional compensation for any increased permanent impairment. If your condition becomes so severe that you can no longer work in any capacity, you may be eligible for permanent total disability benefits, which can provide lifetime compensation.
Case settled
When you settle your case, you give up the right to reopen it based on a worsening condition. This means you will not receive any additional money, benefits, or medical treatment for your injury in the future unless you can prove that the other party committed fraud or there was a “mutual mistake of material fact.”
A mutual mistake of material fact means that both parties made the same significant mistake that was crucial to the agreement, and it’s a rare occurrence. If you simply underestimated your future medical needs or the extent of your disability, this is not considered a mutual mistake of fact, and you cannot reopen your claim.
If you have any doubts about the long-term impact of your injury or the potential for future complications, it is crucial to consider these factors before agreeing to a settlement.
Consulting with an experienced workers’ compensation attorney can help you understand your rights and the potential consequences of settling your claim, so you can make the best decision for your health and financial well-being.
What happens after I sign a settlement agreement with workers’ comp?
In Colorado, after you sign a settlement agreement with workers’ compensation, the agreement must be approved by the Division of Workers’ Compensation before it becomes final. To ensure you fully understand the settlement, the Division requires you to participate in a process known as “advisement.”
During advisement, you have the opportunity to ask questions about the settlement, but you will not receive legal advice.
You have the right to request an individual advisement, where you can speak directly with a judge or an attorney from the Division of Workers’ Compensation, or if you feel confident that you understand your settlement, you can opt to view a presentation provided by the Division that explains the settlement process and your rights.
After signing the settlement, you have a 3-day window to request an individual advisement if you initially chose not to have one.
It’s important to be aware that you have the right to consult with an attorney at any point during the settlement process. They can help you understand the full value of your claim and work to negotiate a fair settlement on your behalf.
Considering a workers’ comp settlement in Colorado? We can help!
Deciding whether to accept a workers’ compensation settlement can be one of the most critical decisions you make following a work injury. Given the complexities and potential long-term implications, it’s essential to have experienced legal guidance on your side.
The seasoned Denver work injury attorneys at The Babcock Law Firm are here to help. We can assess your unique situation, help you determine if a settlement is in your best interest, and negotiate on your behalf to ensure you receive fair compensation.
Don’t navigate this challenging process alone—contact The Babcock Law Firm today to schedule a free consultation to learn how we can help protect your rights and secure your future.
References
Settling Your Claim. (n.d.). Colorado Department of Labor and Employment. Retrieved July 11, 2024, from https://cdle.colorado.gov/sites/cdle/files/Pro_Se_Settlement_Advisement_English.pdf
