Should I Settle My Workers’ Comp Case?

Workers' Compensation in Illinois

Workers’ compensation insurance in Illinois offers benefits to workers who get injured or contract an occupational illness while performing their work duties. How does workers' comp work? The insurance covers the injured worker's medical costs and replaces a fixed percentage of the victim's lost wages. Injuries or illnesses with causes that are unknown are ineligible for workers’ comp benefits.

As an injured worker in Illinois, you have 45 days from the incident or accident to notify your employer of the injury. You also have 3 years from the incident or accident to start a claim with the Workers’ Compensation Commission.

Types of Benefits Available to Injured Workers

Illinois workers’ compensation insurance offers four main categories of benefits, including:

Medical Benefits

You are entitled to receive compensation for your medical expenses if you suffer a job-related injury or illness. These medical expenses include but are not limited to:

• Doctor visits and diagnostic tests
• Hospital stays
• Physical therapy
• Prescription medications
• Transportation costs for travel to and from the hospital

Workers’ compensation should cover any medical costs arising from your job-related injury or illness. You should continue receiving reimbursement for your medical costs until you attain full recovery and return to work. If your injuries are permanent, your medical care may be covered for your lifetime.

Wage Replacement Benefits (Disability Benefits)

These benefits offer income to workers who miss work because of a job-related injury or illness. They cover lost wages while a worker is at the hospital or recovering at home and cannot work.

Wage replacement benefits do not pay a worker the weekly wage he or she was earning before the job-related injury or illness. Instead, insurance provides an injured employee with a percentage of his or her wages. This income allows the worker to address his or her financial obligations while he or she is away from work to seek treatment and concentrate on recovering.

Wage replacement benefits further fall into four categories that determine how much income an injured worker receives. These categories include:

Temporary Total Disability (TTD) Benefits

You may be entitled to TTD benefits if your work-related injury or illness keeps you from working temporarily. These benefits offer you 66% of your pre-injury average weekly wage. If you miss work for more than three days because of your injury or illness, you will be entitled to receive TTD benefits from the fourth working day. If you continue missing work for 14 working days or more, the first three working days will also be included in your compensation.

Temporary Partial Disability (TPD) Benefits

You are entitled to TPD benefits if you can perform light tasks as a part-time or full-time worker but earn less than your pre-injury wages or salary. These benefits are usually 66% of the difference between your pre-injury wages and post-injury wages.

Permanent Partial Disability (PPD) Benefits

You are entitled to PPD benefits if you suffer loss of use of a body part partially or completely, lose a body part partially or completely, or lose use of the entire body partially. You must have attained maximum medical improvement (MMI) to be eligible for PPD benefits. These benefits exist in four categories:

• Wage Differential Benefits: You may be eligible to collect a wage differential payout if your injury prevents you from returning to the same job and you secure a new job that pays less than your pre-injury job. This payout is usually 66% (or two-thirds) of the difference between your pre-injury occupation earnings and your new job earnings.
•  “Schedule of Injuries” Benefits: You may be eligible to receive these benefits if your job-related injury or illness affects the functioning of your body part (or parts). Illinois Workers’ Compensation has a list that allocates compensation value to each body part. A lawyer can assess your situation, determine your eligibility for “schedule of injuries” benefits, and do the calculations on your behalf.
• “Non-Schedule Injuries” Benefits: This award covers disabling and life-changing injuries that do not appear on the “schedule of injuries” list. Core injuries and spinal cord injuries are some examples of injuries that qualify as “non-schedule” injuries.
• Disfigurement: You may be eligible to receive this award if your job-related injury or illness leaves disfiguring marks or scars on your body. The scars or disfiguring marks must be severe and permanent. They must affect the face, neck, upper chest, hand, arm, or lower limb.

Permanent Total Disability (PTD) Benefits

You can request PTD benefits if your injury prevents you from returning to work or doing any income-generating activity for the rest of your life. The workers’ comp insurance will give you 2/3 of your average weekly wage for the rest of your life if it's determined that you have a permanent and total disability.

Vocational Rehabilitation Benefits

Vocational rehabilitation benefits can help you acquire new skills or secure a job that accommodates any impairments or disabilities arising from your job-related injury or illness. They include on-the-job training, job retraining, vocational rehabilitation services, career counseling, and job search and placement help.

Death Benefits

Death benefits may be available to dependents of a worker who dies because of a job-related injury or illness. These benefits pay for any medical bills incurred by the worker before death, funeral and burial costs, and offer financial support to the surviving spouse, children, or other eligible dependents.

What Are the Pros of Settling a Workers' Comp Case?

Financial Considerations of a Settlement Offer

Settling a workers’ comp case provides immediate financial relief. It eases financial constraints arising from unanticipated medical expenses and lost wages. What’s more, out-of-court settlements often result in lump-sum payments. The one-time large payout can help you clear major expenses accumulated during the settlement process.

A settlement gives you full control over how you spend the money. For instance, you may use part of the money to pay for ongoing medical care and vocational rehabilitation services. You may also invest the rest of the money or start a business.

Closure and Peace of Mind

The workers’ compensation process is usually lengthy and stressful. Setting your claim marks the end of your case, removing a lot of pressure from your shoulder. It also minimizes anxiety, allowing you to focus on other productive aspects of your life. As such, accepting a settlement creates a sense of closure and peace of mind.

A Lawyer Can Handle the Settlement Negotiations on Your Behalf

A workers’ compensation attorney can push for your best interests during settlement negotiations. Your lawyer will help level the playing field when facing the insurance company’s seasoned legal team. The company will also be more likely to uphold your rights and offer a reasonable settlement when working with a lawyer than when representing yourself.

Shortening the Wait

A workers’ comp case can take months or even years in court before resolution due to backlogs and delays arising from rules of procedure. Opting for an out-of-court settlement can significantly reduce the time it takes to receive compensation for your workplace injury or medical condition.

Are There Any Cons to Settling Your Workers' Comp Case?

Settling your workers’ comp case may result in the following drawbacks:

Loss of Future Benefits

Settling waves your right to future medical or disability benefits. In other words, you cannot pursue further compensation under workers’ comp insurance if your injury or illness exacerbates over time.

Undervaluation

Offering lowball settlements is one of the tactics insurance companies use to save money and grow their profits. You could accept an offer that does not cover your present and future expenses, especially if you are working alone.

When Should I Settle My Workers’ Comp Case?

Accurately specifying the best time or situation to settle your workers’ comp case is hard. This is because each case has different facts and circumstances. Fortunately, a skilled lawyer can review your case, identify all your options, and determine if settling is in your best interest. Some common situations when settling may be the best decision include:

You Have Received a Reasonable Settlement Offer

It makes sense to settle your case if the workers’ comp insurance sends you a reasonable settlement offer. Be sure to review the offer with your lawyer to determine if it reasonably compensates you for medical costs, wage loss, and other types of losses.

You Have Reached Maximum Medical Improvement (MMI)

Consider settling your workers’ comp case once your doctor declares you have reached MMI. This point means that your injury or health status has stabilized, and you are less likely to record any significant improvement with further improvement.

At MMI, you have a true picture of physical, psychological, and financial effects of your job-related injury or illness. You can determine medical care costs and wages lost during the recovery journey. You can also estimate the costs of future treatment and rehabilitation.

You Have a Poor Prognosis

Accepting a reasonable settlement makes sense if your condition worsens, and you have a few years to live. Lifting the case off your shoulder allows you to enjoy quality time with your family for the few remaining years.

You Can Return to the Same Job

Accepting a fair settlement may be a wise decision if you can return to your pre-injury job. That way, you will receive monthly compensation if you perform light duties and earn less than your pre-injury job.

You Need to Undergo Rehabilitation

You can accept a reasonable settlement if you want to concentrate on your rehabilitation. Your lawyer can evaluate your situation against the settlement offer and advise if settling is a good idea.

Types of Workers’ Comp Settlements in Illinois

You will receive either a lump-sum payout or structured settlement if you accept to settle your workers’ compensation case.

Lump-Sum Settlements

A lump-sum settlement is a single, huge payout. It happens after successful negotiations and covers the whole amount in the settlement agreement. Your employer or workers’ comp insurance sends the check for the full amount to you or your lawyer.

A lump-sum payout could be ideal if your condition keeps you from returning to your pre-injury occupation. The large payout can help you purchase equipment or devices to match your unique needs caused by disability. You could also pay for vocational rehabilitation services.

You should choose a lump-sum settlement if your condition does not involve ongoing doctor appointments. This type of settlement is also a perfect choice if you are less likely to incur future medical expenses.

Structured Settlements

This type of workers’ comp settlement offers regular cash payments over a long period agreed on by you and the insurance provider. This settlement option may be favorable if you need constant cash flow. You can also choose it if you are worried about misusing a lump-sum payment or failing to spread it adequately to pay future expenses.

Each settlement option has its pros and cons. A knowledgeable workers’ comp lawyer can explain the two settlement options in detail and help you choose one that is a perfect fit for your unique situation. The lawyer can also help you accurately predict when workers’ comp will offer a settlement.

Call Strong Law Offices at 309-688-5297 for a free initial consultation.