When Will Workers’ Comp Offer a Settlement?

What Is Workers' Compensation?

Workers' compensation is an insurance program that allows employees who are injured or disabled due to a workplace injury to recover financial reimbursement for the costs they incur. Workers’ compensation insurance is a state-run program built with the intention of protecting Illinois workers. In exchange for their right to sue for an injury, workers instead can recover benefits from the employer’s insurance policy.

Workers’ compensation benefits are paid out through a settlement provided either in a lump sum or in payments over time. A settlement is calculated based on the costs a victim incurs from sustaining the injury. The value of a settlement is determined during negotiations between the injured party and the insurance company.

How Long Do You Have to File a Workers’ Compensation Claim in Bloomington?

Typically, victims have around three years to file a claim for workers' compensation benefits, though most employers require you to report the injury within 30 days from the date of the workplace injury. The time limit for filing a claim and initiating the workers' comp process can vary, as exceptions do apply to some cases. A Bloomington workers' compensation lawyer can help keep your claim on track and preserve your right to compensation.

What Are Settlement Negotiations? 

An insurance company will settle with you on your workers' comp claim if you both come to an agreement during negotiations. In a settlement negotiation, the parties will present evidence on the dispute at hand and try to find an agreement regarding the value of damages and compensation amounts. 

Some insurance companies may choose to pay you the full amount you requested, if your request reflects the expenses you incurred because of the injuries or disabilities you acquired. Many insurance companies, however, will attempt to dispute your claim and delay the settlement process.

The insurance company may choose a variety of methods to delay processing your claim. This could include looking for minor technical errors in your claim, trying to pin your injury or disability on your preexisting conditions, disputing your medical expenses as unnecessary medical treatment, and claiming you are seeing doctors or clinical physicians that are not included in the insurance company's internal network. 

By dragging out your claim or disputing its value, the insurance company aims to get you to agree to less than your case is worth. If settlement negotiations fail, the case will usually go to trial. 

How Long Do Workers’ Comp Settlements Take?

The average duration of a workers’ compensation claim in Bloomington can vary, depending on the circumstances of the case. The settlement process may take around 12 months, or may last years. The length of the settlement process can depend on the severity of your injury or disability, the expenses you incurred, and how cooperative the insurance company is in paying your claim.

The type of injury you have or the type of disability you developed, the recovery period of your injuries, the amount of lost wages or medical expenses, the projected expenses needed for ongoing rehabilitation programs, and whether your injury or disability is covered by the Illinois workers' comp insurance program will also impact how resistant the insurance company is to paying your claim. Any purposeful actions and decisions by the insurance company when processing your case will prolong your claim. 

If your injury is not covered by the Illinois workers' insurance program, then your claim will be denied by the insurance company. Insurance companies may delay your claim purposely for any reason, including those manufactured out of bad faith. If your medical expenses for your injury or disability treatment are due to any unnecessary treatment, as interpreted by the insurance company, a claims processor may refuse to pay for those expenses.

An insurance company can find any reason to not cooperate with your claim, which can further complicate and delay settlement negotiations. Having a lawyer by your side will be beneficial for your case because a workers' comp attorney will be able to advocate for your right to collect benefits. 

What Does a Workers’ Compensation Settlement Cover?

The workers' compensation insurance program allows employees who developed an injury or disability while performing their work-related duties to recover financial benefits. These financial benefits are intended to help reimburse the expenses the employee has incurred from the workplace injuries. Employees are automatically eligible for this coverage. However, independent contractors or those working under other classifications are not eligible for workers’ compensation benefits. 

Injuries sustained in traumatic accidents, as well as those that accumulate over time, are covered as long as they occur during the course of the victim’s job duties. A workers' comp claim settlement doesn’t just reimburse you for expenses incurred, but can also provide you with access to rehabilitation services which may assist you in being able to work again.  

Injured workers can recover a variety of expenses through a workers’ compensation settlement. There are four types of compensation available in a settlement. These include medical expenses, wage replacement benefits, rehabilitation expenses for career support, and death benefits in fatal accidents. 

• Medical Expenses - The cost of treating your workplace injury is covered through workers’ compensation. This includes initial treatment expenses, as well as ongoing care costs, prescription costs, and the cost of medical equipment.
• Wage Replacement Benefits - Wage replacement benefits are intended to prevent financial hardship to the victims during his or her recovery. These benefits may be permanent or temporary, and apply both when a worker has to reduce his or her earning capacity or eliminate working altogether.
• Career Rehabilitation - If an injured worker is no longer able to perform in his or her previous field because of a workplace injury, the cost of pursuing further education, certification, or training may be covered. Vocational rehabilitation will provide the victim with career support and job skills so that he or she is able to return to the workforce in the future.
• Death Benefits - In a fatal workplace accident, a decedent’s family members can recover benefits on his or her behalf. Typically, these make up for medical expenses leading up to death, funeral and burial costs, lost financial support, and any other associated costs.

How Often Do Insurers Offer a Settlement in a Bloomington Workers’ Compensation Case?

Many workers’ compensation cases end in a settlement, rather than proceeding to trial. Insurance companies may not want to risk going to trial, and would rather pay you a settlement to avoid additional legal expenses. 

Sometimes, insurance companies may delay or deny your claim, even if you are covered by workers' comp insurance. Typically, a workers' comp claim is denied because a claims agent does not see your injury or disability as covered under your state's workers' compensation program. You may be able to appeal against this decision if you have clear evidence that demonstrates that your injuries stemmed from work. 

How Insurers Respond to Workers’ Compensation Claims

The response of insurers to workers' compensation claims can vary, as some insurance companies will try to settle with the injured employee as quickly and efficiently as they can, and other insurance companies will attempt to dispute the claim and delay the settlement process.

The objective for an injured or disabled employee is to recover benefits to be reimbursed for the expenses he or she incurred because of his or her workplace injuries. The objective for insurance companies is to reduce payouts or avoid paying victims altogether in an effort to cut costs. This can include processing your claim at a slow rate in the hopes of pushing you to give up or accept a reduced amount, or disputing any part of your claim for any given reason. Disputing claims will inevitably delay the settlement negotiation process.

How long it takes insurers to offer you a workers’ compensation settlement can depend on a variety of factors, but having an attorney to help guide the legal process can speed things up. A workers’ compensation lawyer can anticipate the insurance company’s tactics and refute their disputes to help you achieve a fair settlement.