Settlement offer made by the insurance company

What happens if I don’t accept a settlement offer made by the insurance company in my workers’ compensation case?

Four Benefits Workers’ Compensation Provides

In every workers’ compensation case, once it has been determined that you have sustained a work related injury, you as the injured worker are entitled to pursue four main benefits:

  • Temporary disability – 2/3 of your earnings at no more than the maximum rate for up to 104 weeks while you are recovering from your work injury and unable to work in full-time capacity.
  • Medical treatment – lifetime treatment that is reasonably medically necessary consistent with the Medical Treatment Utilization Schedule to help cure or relieve you from the effects of your industrial injury.
  • Permanent disability – a level of compensation measured for the impairment of your injured condition and the loss of your ability to do some types of work.
  • Supplemental Job Displacement Voucher – In the event that you cannot return to your prior work due to your injury, you may be entitled to a voucher to assist you in retraining for other types of work.

These are the primary benefits that a workers’ compensation court can award or enforce. However, while not obligated to do so, it is not uncommon for an insurance company to offer you a lump sum of money in lieu of you maintaining the right to these other benefits. This is known as a Compromise and Release (“C&R”). It is important to know that no C&R will proceed unless two factors occur; (1) the insurance carrier makes a C&R offer, and (2) you accept the C&R offer. This comes down to whether both parties can reach a meeting of the minds on the value of a specific claim.

An insurance carrier is not obligated to make you a C&R offer nor even a reasonable one. However, it often does so if it thinks it will save it money in the long run. You are not obligated to accept any C&R offer and may continue to receive the benefits outline above. In evaluating any C&R offer, our team will assist and advise you as to the strengths and weaknesses of any C&R offer made. Yet, at the end of the day, you make the decision whether or not to accept a C&R. No one can force you to accept a C&R offer, not even the judge.

In the event that the parties cannot reach a C&R, then you maintain your right to the benefits described above, and in the event a dispute arises as to the scope of those benefits, then either party may seek relief at Workers’ Compensation Appeals Board.