If you have suffered an injury while working, you may be eligible to receive workers’ compensation benefits. These benefits cover medical expenses and lost wages related to your work injury. At some point, the insurance company may want to settle your workers’ comp claim with a lump sum payment instead of paying ongoing benefits.
Understanding how workers’ comp settlements work is important so you can decide if accepting a settlement is in your best interest. This article provides an overview of the workers’ comp settlement process in New York and what to consider when evaluating a settlement offer.
Understanding the Workers’ Compensation Settlement
A workers’ compensation settlement entails an accord between the injured worker and the insurance company to resolve a workers’ compensation case. The settlement usually entails the employee receiving a lump sum payment or structured settlement in exchange for giving up certain rights, such as future medical care or additional comp benefits related to the work injury.
Accepting a workers’ comp settlement can have significant implications. For instance, acceptance usually means relinquishing the right to any future claims related to the injury. Therefore, it’s crucial to carefully consider whether a settlement offer adequately compensates for the injury, including future medical needs and lost wages.
How Do Workers’ Comp Settlements Work in New York?
In New York, an injured worker will receive workers’ compensation benefits like medical treatment and a portion of lost wages until the case is settled. At that point, the workers’ compensation insurance company will offer a lump sum settlement to end the claim.
The settlement amount aims to compensate for any future medical costs and lost earning capacity related to the work injury. The employee gives up future workers’ compensation benefits in exchange for the lump sum payment.
Settlements allow both parties to avoid the uncertainty of a long claims process. It gives the injured worker a lump sum and closes the case for the insurer. But it’s critical to negotiate a fair settlement that fully compensates you for the impact of the work injury.
The Settlement Process in New York Workers’ Comp Cases
If the insurance company wants to settle a workers’ comp claim, the typical process involves:
- The insurer makes a settlement offer – This initial offer tends to be on the low end to test if the injured worker will accept a discounted amount.
- Negotiation happens – The injured worker can make a counteroffer, usually assisted by an experienced workers’ compensation lawyer. They’ll advocate for a higher settlement.
- An agreement is reached – With back-and-forth negotiation, both sides eventually compromise on a mutually acceptable settlement amount.
- Legal documents finalize the agreement – The injured worker signs a settlement agreement releasing the insurer from future liability in exchange for the lump sum payment.
While every workers’ comp case is unique, top lawyers aim to negotiate 2-5x the initial offer amount, ensuring injured workers maximize their settlement.
When Should You Expect a Settlement Offer?
When and if you receive a settlement offer can depend on various factors, including the complexity of the workers’ comp claim, the clarity of the facts surrounding the injury, and the insurer’s assessment of the case. Sometimes, an insurer may offer a lump sum settlement very quickly, particularly if they believe the claim is clear and straightforward.
However, it’s crucial to carefully consider any offer and not rush to accept a settlement that doesn’t adequately compensate for the injury and its impacts. An experienced workers’ compensation lawyer can provide invaluable assistance in evaluating settlement offers.
How Long Do Workers’ Comp Settlements Take in New York?
In New York, most workers’ comp cases will settle within 1-3 years. However, more complex cases involving permanent disability can take 5 years or longer to resolve.
Here are some factors that can impact the timeline:
- Insurers often make initial settlement offers quickly, within 6-12 months of the injury date. But the first offer is rarely adequate or fair.
- The more serious your injury, the longer it may take to reach maximum medical improvement before settlement.
- If you reject an offer, additional negotiations or a workers’ comp hearing may be needed to reach an agreement. This can add months to the process.
- If you hire an attorney, they will likely need time to investigate your case and obtain documentation to maximize the settlement.
While insurers may try to pressure fast settlements, it’s important to take the necessary time to ensure adequate compensation. An experienced workers’ compensation attorney can help speed the process while still prioritizing your best interests.
What Is the Average Workers’ Compensation Settlement Amount in NY?
It’s difficult to pinpoint an “average” workers’ comp settlement amount due to variations in injury severity, lost wages, etc. However, data provides some benchmarks:
- The “median” settlement amount for all NY workers’ comp cases is around $75,000.
- The average is higher – approximately $150,000 – due to some very large settlements raising the mean.
- For serious injuries involving surgery, the average climbs to around $250,000.
- Permanent partial disability claims tend to settle for $75k-$150k on average.
- Death claims average just over $500,000 in NY.
- Disputed claims often settle for above-average amounts if litigation secures a positive outcome for the injured worker.
While each case is different, having general benchmarks helps set reasonable expectations when evaluating a settlement offer. An experienced attorney can assess if an offer seems appropriate for the specifics of your situation.
How Can I Maximize My Workers’ Comp Settlement in NY?
Here are some key strategies injured workers can use to maximize workers’ compensation settlements in New York:
- Document everything – Keep thorough medical records, work logs, and any evidence related to your injury, treatment, and lost income. The more evidence you have, the better.
- Follow doctor’s orders – Don’t miss prescribed treatment and attend all appointments. Your recovery and ability to return to work will impact settlement amounts.
- Consult an attorney – An experienced NY workers’ comp lawyer can help compile evidence, negotiate with insurers, and advise you on a fair settlement amount for your situation. Their expertise pays off.
- Wait for full recovery before settling – Settling too early leaves money on the table for future medical costs and lost wages. Wait until you reach maximum medical recovery.
- Gather wage and benefit documentation – To recover lost earnings, you need pay stubs, tax returns, employment contracts detailing compensation and benefits.
- Calculate future costs – Project future medical expenses, living assistance, medication, modified transportation, and other costs directly related to your injury. Account for inflation.
Following these steps helps demonstrate the full economic impact of the injury so insurers can properly compensate you. Patience and persistence are key.
What Happens If There’s No Settlement?
If a workers’ comp claim doesn’t settle, that doesn’t necessarily mean the case is over. Typically, benefits continue while parties exhaust all options, such as:
- Proceeding to a workers’ comp hearing – Contested issues get argued before a judge who makes a legally binding decision.
- Waiting out appeals – After a hearing judgment, the dissatisfied party may appeal, which drags out the case.
- Seeing if time and treatment resolve disputes – With more evidence, cases that once seemed hotly contested can sometimes settle.
- Pursuing a civil lawsuit – In extreme cases of negligence, injured workers may file lawsuits to claim additional damages beyond workers’ comp.
- Accepting statutory benefits – If you reach “maximum medical improvement” with continued disability, long-term wage benefits kick in.
So while settlement brings closure, there are still paths forward if you and the insurer remain at odds over your claim’s value.
How Can a Compensation Lawyer Help?
A workers’ compensation lawyer can play a crucial role in the settlement process. They can help you understand workers’ comp law, assess the value of your claim, negotiate with the insurance company, and represent you at a hearing or trial if necessary.
Hiring a workers’ compensation lawyer like O’Connor Law PLLC can often lead to a higher settlement, as they have the knowledge and experience to push back against lowball offers and fight for the compensation you deserve.