California’s no-fault workers’ compensation law makes the claims procedure simple. The system is based on the legal idea that workers who sustain injuries at work are entitled to compensation without having to first demonstrate employer responsibility. Yet, there are several circumstances where a worker’s compensation claim is partially or completely rejected by the insurance provider for the employer.
When an employee and employer disagree over workers’ compensation benefits, the case is either brought before a workers’ compensation judge or both sides reach a settlement. Only a small portion of contested claims are heard by a workers’ compensation judge. If your employer has contested your workers’ compensation claim, there is a significant likelihood that you will resolve the issue amicably and avoid going to court.
When Should a Workers’ Compensation Dispute Be Resolved?
The amount of money provided and the extent of your accident or injuries are two factors that will determine whether you accept a workers’ compensation settlement. Your physical restrictions, the strength of the evidence, your financial situation, and your ability to wait for a decision made by a workers’ compensation judge are other issues to take into account.
If the offer appears substantial enough and you urgently need the cash to cover medical expenses, you might wish to accept. You can take care of the medical difficulties that have arisen as a result of your work-related accident, and you escape the stress that comes with a workers’ compensation hearing. On the other hand, if the insurance provider for your employer has made a blatantly inadequate offer, you should think about having a workers’ compensation court hear your case.
Settlements for Workers’ Compensation
According to California law, there are two ways to resolve a workers’ compensation claim: release and compromise, and specified conclusions and award.
Release and Compromise
You end your workers’ compensation claim when you accept a compromise and release settlement and receive a lump sum payment in exchange. This indicates that you are no longer eligible to receive money for future medical costs to treat and rehab one or more injuries.
Also, if your medical condition gets worse, you cannot reopen your claim. A judge will not let you withdraw from a compromise and release settlement once you have signed it. For a claimant who has been given a clear medical report, this kind of workers’ compensation settlement makes sense.
Specified Conclusions and Award
Your permanent disability diagnosis and the amount of your financial benefits must be agreed upon by you and the insurance provider for your employer in order for a stipulated findings and award settlement to take effect. Instead of a single lump sum payout, you receive biweekly disability payments. This agreement makes sense for a claimant who requires ongoing medical care and if your doctor anticipates a five-year decline in your condition. You can ask for the initial claim to be reopened after a stipulated and agreed settlement.
Obtaining the Approval of a Workers’ Compensation Settlement
The details of the settlement are spelled out in papers that your workers’ compensation lawyer submits to the California Workers’ Compensation Appeals Board. Then a judge conducts an informal hearing to make sure you understand the settlement and that its conditions. You can anticipate receiving your first payment, or only payment if it is a lump sum, within 30 days after the judge’s ruling assuming the workers’ compensation judge approves the settlement.
By handling your own workers’ compensation claim, you run the risk of reaching an unjust settlement with the insurance provider for your employer. You can anticipate receiving the most advantageous workers’ compensation settlement by working with a group of skilled workers’ compensation attorneys.
To get a free case examination, call PLBH at (800) 435-7542.