300+ Google Reviews
You just received your workers’ comp settlement offer. It’s your first offer. Should you accept it?
Did you know that you may receive more? The first workers’ comp settlement offer is often too low. With the help of a Schiller & Hamilton workers’ comp attorney, you may receive a better offer.
You can discuss your workers’ comp first settlement offer with an attorney. Contact us today.
Workers’ Comp First Settlement Offers
The workers’ comp first settlement offer is an initial offer by the workers’ comp insurance company to resolve a claim. The insurance company may seek to resolve disputed issues by agreement between the parties. You may accept the first settlement offer or reject it and continue to pursue your claim.
The first settlement offer might be the fastest, but often, it’s not the best. The injured person may reach a better result by continuing to negotiate or with a hearing. You may have a workers’ compensation attorney represent you.
Evaluating the Workers’ Comp First Settlement Offer
If you are evaluating a workers’ compensation first settlement offer, here’s what you should know:
There are different types of settlements.
When the insurance company offers a settlement, make sure you understand what that means. There are three different types of settlements, each with their terms and conditions. A final clincher agreement means a lump sum for all benefits. The insurance companies like a final clincher settlement because they have no further responsibility to compensate you. If you accept, it’s the last and final payment of benefits.
By contrast, an indemnity agreement leaves open the possibility of future medical benefits. It resolves the claim for lost wages.
Similarly, a 16A settlement, named for the form used to finalize it, leaves open the possibility of future medical benefits. Additional medical benefits must be formally claimed within one year of the final disability payment.
Your medical needs are a big factor.
To evaluate whether to accept the workers’ comp first settlement offer, you need to understand your medical care. Medical benefits may include diagnosis, evaluation, care, surgery, medical devices, medication, treatments and therapy. Benefits should continue until you have reached maximum medical improvement.
If you anticipate long-term or expensive medical care, a settlement may not be in your best interests. However, if you have other health insurance or you want to pursue your treatment, a settlement may benefit you. If the offer comes too early, your medical needs may not be fully known.
You may deserve wage replacement if you can’t work.
Lost wage replacement depends on whether your injuries are temporary or permanent, and whether you can work in a reduced capacity.
- Permanent Total Disability (PTD): A person is completely and permanently unable to work. They may receive 2/3 of their average weekly wages, up to 500 weeks.
- Permanent Partial Disability (PPD): The injury is permanent, but the person can work some. They may receive 2/3 of their wage loss for a duration that depends on the severity of the injury.
- Temporary Total Disability (TTD): After a seven-day waiting period, you can claim 2/3 of your average weekly wages while you can’t work.
- Temporary Partial Disability (TPD): Pays 2/3 of your average weekly wage loss during a temporary period of partial disability.
When evaluating your first settlement offer, review the calculation of average weekly wages and the lost wage compensation that you should receive.
See S.C. Code § 42-9-5 et. seq., Workers’ Comp – Compensation and Payment
Your impairment rating matters, but it isn’t the final say.
Your disability payment depends on the specific body part injured and the impairment rating.
The impairment rating quantifies the extent of loss of body function. It’s determined by the doctor. However, your doctor cannot assign any percent they like. They must follow professional guidelines that are specific to impairment ratings.
When evaluating your workers’ comp first settlement offer, you should know that the impairment rating may not conclusively determine your disability award. At a hearing, the South Carolina Workers’ Compensation Commission is not bound by the doctor’s rating. They may accept other evidence including your age, work history and personal testimony. Often, when accounting for these factors, the commission makes an award that is higher than the doctor’s impairment rating.
See Cropf v. The Pantry, 289 S.C. 106 (S.C. App. 1986), where the full Commission awarded a 30% disability rating, even though two orthopedic surgeons testified that there was no permanent disability, and a chiropractor testified to only a 15% impairment. The victim testified to their own limitations in standing, walking, lifting and bending). See also Bundrick v. Powell’s Garage and Wrecker Service, 248 S.C. 496 (1966), where a hearing resulted in a 50% disability award for loss of use of an arm, even though medical experts testified to a 10-20% loss.
When evaluating your first workers’ comp settlement offer, know that it may be possible to get a higher award than your impairment rating. However, it may be necessary to have a hearing. Our attorneys can give you a personalized evaluation of your case and first settlement offer.
Legal Options After the Workers’ Comp First Settlement Offer
Your legal options after the first worker’s comp settlement offer are:
- Accept the offer: You agree to the terms and conditions of the offer and resolve your case.
- Have a hearing: Use Form 50 to request a hearing before a commissioner. The testimony that you present at this hearing is extremely important. Medical evidence is typically presented through deposition. You can have legal representation.
- Request mediation: Mediation is formal alternative dispute resolution, where you can continue to discuss a settlement.
- Continue to negotiate: You may make a counteroffer and negotiate directly.
If you are unsatisfied with the decision of a single commissioner after a hearing, you may appeal to the full commission. Then, you may appeal to the courts. Our attorneys can represent you throughout your case.
Should I Accept the Workers’ Comp First Settlement Offer? Ask an Attorney.
At Schiller & Hamilton, our attorneys help people get their workers’ compensation benefits. Let us evaluate your workers’ comp first settlement offer and whether you should accept it. Contact us now for your consultation.