At some point, many people who end up with an NJ Workers Compensation claim will end up having to make a decision about whether or not to settle that claim.
When you settle, a number of things can happen. Sometimes the insurance company will send money directly to your medical providers while sending your lost wages directly to you in a lump sum. Sometimes all the money will come to you in a lump sum and you will be responsible for reimbursing your medical provider. Sometimes you’ll end up with a structured payment plan.
Either way, you’re agreeing to a specific amount, and once that amount is paid, that’s it. The workers compensation insurance company no longer owes you any money. Yet receiving a settlement can often be a better option than constantly fighting to keep the workers compensation benefits flowing, or fighting to get the company to agree to treatments you should have.
Here’s what you need to know.
Both your attorney and your insurance company will be assessing “exposure.”
The main thing the insurance company wants to know, prior to offering a settle, is how much they will end up having to pay if they refuse to settle. If it makes sense for them to do so then they will then try to settle the claim for something under that number.
That means they’re going to try to estimate all of your projected medical expenses, along with the number of weeks they’re going to have to pay lost wages.
Your attorney is going to be attempting to do the same thing, because that tells the attorney whether you’re receiving a fair offer or not, which offers a basis for the advice they’re going to offer you in regards to whether or not they’re going to pay the settlement or not.
Giving up your job is often a condition of a workers compensation settlement.
Settlements come with compromises on both sides. One of the routine compromises that employers ask for is for you to sign a “General Release and Resignation.”
This document does several things.
First, it acknowledges that the claim will be closed after you settle.
Second, it acknowledges that you’re going to be resigning from your job. They do this so you can’t come back and claim that you were wrongfully terminated. It happens in about 80% of all cases.
Usually the insurance carrier is the reason why the employer is forced to make this decision. They don’t want to pay you twice if you end up injured on the job again. Re-injury claims cost more than initial injury claims do because if the new injury aggravates the old condition they must pay additional cash and benefits.
They also do this to try to send a message to other employees that it’s not a good idea to file workers compensation claims. It’s nasty but it’s true. Many companies simply do not care about the people who work for them. Many major employers require this document as a matter of course.
In many cases, you will never be able to work for that particular employer ever again.
There are risks and benefits both to settling and to keeping your claim open.
Giving up your job entirely is a risk of accepting the settlement, as there’s always a chance your benefits will run out before you find a new job. On the other hand if your employer was giving you fake light duty or was refusing to give you light duty at all this might be an opportunity to find a workplace that can accommodate your new medical reality.
If you keep your claim open you’ll keep receiving benefits as long as you’re eligible. You risk a situation where you get injured elsewhere and benefits end because they claim your condition is no longer work related and no longer the workers compensation company’s responsibility.
If you try to keep your claim open there’s always the chance that you’ll lose your chance to sue the insurance company. There’s a two year statute of limitations in New Jersey. The longer you wait, the less incentive the insurance company has to settle with you.
This is not a decision to make without an attorney’s help.
The final decision is always yours, but you should have guidance from an attorney who can look at the totality of your specific case. There are all sorts of factors to weigh that will be unique to your specific situation.
Grappling with a workers compensation claim? Get the good advice you deserve. Contact us for a consultation today.