Top 10 Questions About Worker’s Compensation Cases
Missing work due to an illness or injury is never part of anyone’s plan.
You might be worried that you’ll run out of sick days. Worse, if your employer doesn’t provide paid sick days, you may stress over how you’ll pay all the bills that month or whether you’ll still have a job once you’re ready to go back to work.
But what if your injury happens on the job? Or what if your sickness is the result of repeated exposure to toxins in your workplace?
If you think that someone else should be held accountable for your suffering, then you’re right. That’s why worker’s compensation exists.
Common Questions about Worker’s Compensation
Since people aren’t expecting a workplace accident to happen, most aren’t familiar with worker’s compensation law. However, if you do experience a work-related illness or injury, you’ll want to learn as much as possible about workers’ comp.
Keep reading for answers to the most frequently asked questions about worker’s compensation.
1. How do worker’s comp cases work?
Worker’s compensation was created to protect employees and employers in the event of work-related injuries, illness or death.
If you or a loved one suffers an accident on the job, follow these steps to ensure your right to worker’s compensation:
- Notify your employer of the injury as soon as you can.
- Get medical attention right away and follow your doctor’s orders.
- Consider finding a workers’ compensation attorney.
Employers must have worker’s compensation insurance. This insurance pays medical expenses and cash benefits for employees who are hurt or become ill as a direct result of their jobs or workplace environment. If an employee dies due to a workplace injury or illness, his or her family may be eligible for worker’s comp benefits.
Employees don’t have to “pay into” worker’s comp, and there is not a time requirement to become eligible for benefits. The moment a person becomes an employee, he or she is entitled to worker’s compensation in the event of an on-the-job accident or work-related illness.
There are two big “ifs” that could exclude a person from worker’s compensation. An employee is not eligible for worker’s comp if:
- 1. The injury occurs due to the worker’s being intoxicated from drugs or alcohol
- 2. The employee intentionally injured himself or herself
2. How long do worker’s compensation cases last?
How long a worker’s compensation case lasts depends on the extent of the employee’s injuries or illness and the amount of time required for a full recovery—anywhere from a few months to over a year. After the worker reaches maximum healing, all parties will negotiate the final settlement.
If the parties can’t agree on a fair settlement, then the case may go into legal proceedings. When that happens, the case is usually resolved about a year from the date the legal proceedings started.
3. What is my worker’s compensation case worth?
How much your case is worth depends on the specific details of your case, including:
- Medical records
- Job duties
- The circumstances of your injury or illness
No one—not your lawyer, doctor, employer, family or friends— can guarantee you a specific sum of money. The amount of your settlement will depend on many variables which we can work to help you maximize your case.
4. Do all worker’s comp cases go to trial?
No, most worker’s comp cases don’t go to trial. In fact, most cases end in a settlement before a hearing is even needed. However, if you don’t reach a settlement and your case goes to court, an administrative law judge will decide the details of your compensation.
5. Do all worker’s comp cases end in a settlement?
Most worker’s compensation cases end in a settlement, meaning the insurance company offers either a lump sum of money or weekly payments for a specified period. The money may cover:
- Past and future medical care
- Partial or total disability
- Temporary or permanent disability
However, if the employee thinks the insurance company isn’t offering a fair settlement, then he or she may opt for a workers’ comp hearing. At the hearing, the judge will determine the terms of the employee’s compensation.
6. How long do worker’s comp cases take to settle?
Worker’s comp cases may take weeks, months or possibly more than a year to reach a settlement. The insurance company won’t make an offer until the employee making a claim is as healed as best as possible from the illness or injury that started the application.
After that point, the negotiations may go back and forth until the parties reach a settlement or decide to go to court.
7. How much do worker’s comp cases settle for?
The amount of a settlement all depends on your injuries and the facts of your case. Many insurance companies will try to undercut you and pay as little as possible in workers’ compensation. For that reason, it’s important that you hire an experienced workers’ comp attorney as soon as you are injured or as soon thereafter as possible.
8. Should I settle my worker’s compensation case?
The decision of whether or not to settle your worker’s compensation case is up to you. We can help you with many aspects of your case so that you can make the most informed and best decision possible for you.
If you want to settle, then the proposed settlement must be approved by the state’s workers’ compensation agency. The agency’s job is to make sure you understand the terms of your settlement and get a fair deal.
Some people decide not to settle and instead choose to go through legal proceedings. They often hope a judge will reward them a better deal than what the insurance company offered in the settlement. While that does sometimes happen, going to court could also backfire and result in less compensation. Our goal is to help you with that process so that you can make an informed decision.
9. Can a worker’s comp case be reopened?
Some worker’s comp cases may be reopened. However, figuring out which claims can be and which claims can’t is often quite complicated. How your case is settled determines whether or not it can be reopened.
For example, a case settled by a “compromise and release” agreement closes all past, present and future claims by the employee. The only way such a case could be reopened is if there’s evidence of fraud.
On the other hand, a case settled by “stipulation and award” can be reopened under particular circumstances, such as:
- A recurring or increased disability
- New evidence that shows the original settlement was unfair
- A mistake in the law that led to an inequitable award
- A clerical error that negatively affected the award
Furthermore, most claims fall under a five-year statute of limitations. If your case was closed over five years ago, then it’s probably not eligible to be reopened.
10. Do I need an attorney to win a worker’s compensation case?
You have the right to an attorney to advocate for your best interest in a workers’ compensation case. However, you aren’t technically required to have one.
Still, in many cases hiring an experienced worker’s comp lawyer is a very smart move to make sure you are being treated fairly and that your rights are protected. Worker’s comp cases can get complicated, and having an attorney is especially recommended.
For example, you may have a complicated scenario if:
- You already have significant pre-existing medical conditions or disabilities
- You need surgery as a result of your workplace injuries
- Your doctor believes you’ll never regain your full health
- Your work-related injuries are severe or complicated
- You won’t be able to work at any job regularly in the future
Get the worker’s compensation you deserve.
Dealing with a workplace illness or injury is a stressful and sometimes scary process. Don’t add to that the stress of dealing with your employer’s insurance company. Let us take on that burden for you.
Our experienced legal team is here to fight for your rights in your workers’ compensation case. Simply schedule a free consultation to discuss the facts of your case and to learn how our lawyers can help you and yours.
You can reach us at (843) 488-5000 or contact us through our online form.
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Contact Coastal Law to discuss your situation.
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Myrtle Beach, SC 29577
1314 2nd Avenue
Conway, SC 29526
231 King Street
Charleston, SC 29401
1201 Main Street, Suite 1913
Columbia, SC 29201
** Please be aware that any result achieved on behalf of one client in one matter does not necessarily indicate similar results can be obtained for other clients.
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** This website is meant to provide meaningful information, but does not create an attorney-client relationship. As each legal issue is unique, please consult with our firm prior to relying on any information found on this site.