The workers’ compensation process in Missouri is sometimes complex. You will have many steps along the way that could take some time before you receive the compensation you deserve. At any time during the process, you may decide to accept a settlement offer from your employer or the insurance company. Knowing when to settle a workers’ compensation settlement claim and how much to settle for is not always straightforward. If you settle too quickly, you may be giving up your rights.
If you have been hurt at work, do not let the process confuse you. Our experienced Missouri workers’ compensation lawyers can help ensure you receive the full settlement you are entitled to and advocate for your rights.
What is a Workers’ Compensation Settlement in Missouri?
Workers’ compensation settlements are agreements reached between employees and employers or employees and their employer’s insurer. The insurance company agrees to pay a certain amount and the worker in exchange agrees to allow the insurer to close the case. Once a settlement amount is reached, it is usually paid in a lump sum.
Once you have agreed to a settlement amount, you cannot return to the insurance company for more in the future. This holds true even if you later discover that the settlement is not enough to fully cover the cost of your injuries or future medical expenses if your condition worsens. It is for this reason that it is so critical to make sure any settlement offer is fair before you accept it.
What is the Workers’ Compensation Settlement Process?
Once your treatment is completed, you are entitled to a settlement on your case. The employer and insurer will not advise you of this benefit and will seek to simply close out your case. As a result, once your treatment is completed, it is crucial that you contact that insurer and make a demand for a settlement on your case.
Most workers’ compensation cases settle before they enter the hearing stage. If you and the insurer are unable to come to an agreement, there is a legal dispute resolution process to help. You can request of conference with a judge to obtain some input regarding the value of your case. However, the judges are specifically limited in the input that they can provide as they are not allowed to give you specific legal advice. Under the law, the judge can only inquire on the following issues:
- The agreement was reached as a result of undue influence or fraud
- The injured worker is not agreeing to the settlement voluntarily
- The injured worker is not fully aware of their rights, or
- The settlement infringes on the rights of one of the parties
If you fail to reach an agreement, you are entitled to a formal trial where you will provide testimony about your accident the judge will a formal decision. It is recommended that you seek legal assistance at this stage due to the complexity of the trial proceedings.
If you reach an agreement with the insurer, a judge at the Missouri Workers’ Compensation Commission must approve it. If you are working with a Missouri workers’ compensation lawyer, they will submit a Stipulation of Compromised Settlement to a judge. This document outlines the full details of the settlement. Settlement agreements prepared by attorneys are usually approved by judges due to the fact that both sides are represented by attorneys.
Following the judge approving the contracts, the insurance company is required to issue a settlement check within approximately one month after approval. If you are working with a Missouri workers’ compensation lawyer at JSK, the check is sent to our office. Your attorney will deduct costs and issue you a check for the remaining amount. This process will be completely transparent as we will provide you with a breakout of each element to ensure that you understand and are happy with the amount you receive.
When to Settle a Workers’ Compensation Case
Technically, you can settle your workers’ compensation case at any point during the process. The insurance company may even offer you a settlement at the very start of your case. However, they do not offer these settlements because they prioritize your safety and well-being. Insurance companies prioritize their profits and want to settle your case for as little as possible.
You should not even consider settling your workers’ compensation case until you have reached maximum medical improvement (MMI). This means that you have healed as much as possible and that while your condition will not become any worse, it also will not become any better. Only once you have reached MMI will you know the impact your injuries will have on you in the future and how much future medical treatment will cost. Knowing the cost of future treatment is critical when determining whether to accept a settlement offer.
Unfortunately, too many injured workers make the mistake of assuming that their health insurance will cover the cost of medical treatment if their settlement is not enough. This is not always the case. Many health insurance policies exclude the cost of treatment for workplace injuries. Before you accept any settlement offer, it is important to let our Missouri workers’ compensation lawyers review it to determine if it is fair.
How Much Can You Receive in a Workers’ Compensation Settlement in Missouri?
We cannot determine how much you may receive in a workers’ compensation settlement without first fully evaluating the facts of your case. The value of any given settlement depends on the type of injury you suffered and the severity of it. The insurance company and the workers’ compensation judge will also consider your ongoing symptoms; permanent work restrictions; if you can return to work; impact that the injury has on your work life and personal life.
Regardless, all settlements where the injured worker returned to work in some capacity begin with a Chart of Permanent Partial Disability. This Chart legislatively limits each body part to a number of weeks or units of compensation. A percentage of disability is multiplied to this body part which is then multiplied by 60% of your average weekly wage.
For example, if you sustained a low back strain, the Chart of Permanent Partial Disability notes that you begin at 400 weeks/units. If you settle this for 5%, it would be 20 weeks of compensation multiplied by your average weekly wage. (400 x 5% = 20 weeks). As you can see, your settlement would vary depending on the part of the body that you injured; the extent of your disability; and even the average amount of your wages prior to the accident.
Sometimes, people try to increase their workers’ compensation settlement amount by obtaining additional medical treatment. This is a strategy that does not work. Workers’ compensation benefits are meant to cover the cost of reasonable and necessary treatment. Receiving treatment that is not necessary will not increase your settlement amount, and could leave you responsible for paying those costs. Always reach out to us at JSK if you are unsure about which medical treatments will be covered.
Why Work with a Missouri Workers’ Compensation Lawyer?
In the ideal situation, you would reach a fair settlement agreement with the insurance company with little fuss. Your employer would accept liability and you would receive the medical treatment you need fairly easily. Unfortunately, the workers’ compensation settlement process is rarely this easy. Employers and the insurance companies that cover them do not prioritize the safety and well-being of employees the way they should and instead, are more concerned with keeping their costs low and their profit margins high. To ensure your rights are always protected, it is important to work with one of our Missouri workers’ compensation lawyers at JSK.
For the most part, injured employees generally receive more in workers’ compensation benefits when they are represented by an attorney than when they are not. This is true in all legal cases pursuing financial compensation and is imperative in workers’ compensation cases specifically. If the insurance company feels as though they can get away with excluding compensation for a certain expense, they will try to.
The insurance company may even investigate your case looking for evidence they can use against you. They will seek to obtain a recorded statement to attempt to trick you or twist your words. Please note that there is NO requirement under the law to provide a recorded statement. We strongly urge you to never agree to a recorded statement.
Further, the insurance company may try to argue that your injuries were pre-existing or were not caused by the workplace accident. To prove this, they may ask you for certain items, such as a signed medical release that allows them to go through your medical records. Before signing any authorization, we recommend that you have it reviewed by an attorney. Many authorizations seek not only a release of your records but also add language allowing them to talk with your doctors about your private medical conditions without you even being present!
When working with a workers’ compensation lawyer, they will start by collecting evidence that strengthens your case. This is an important step because it proves the compensation the insurance company is responsible for paying. There are many types of evidence a lawyer will collect, but they generally include:
- Medical documents, including diagnosis reports and invoices for treatment
- Test resets and medical examination reports
- Testimony given by medical experts during depositions
- Vocational expert testimony pertaining to the requirements of your job and your ability to perform them
- Statements of witnesses to your accident
- Statements from family and friends regarding your injuries or condition
After a lawyer has collected the important evidence, they will then begin to determine a fair settlement amount. They will begin negotiations with your employer’s insurer. During negotiations, your attorney will communicate with the insurer on your behalf. They will provide them with certain information the insurer asks for as is deemed fit, but they will also put pressure on the adjuster to make sure that you receive the full settlement that is justly yours.
Throughout the process, your lawyer will inform you of any settlement offers made by the insurance company and advise on whether they are fair. Your attorney will also always keep you updated on the status of your case. We believe that after suffering a work injury, now is not the time for you to negotiate with the insurance company in pursuit of a fair agreement. Now is the time for you to heal. Our lawyers will handle everything else.
Our Workers’ Compensation Lawyers in Missouri Can Help You Obtain the Full Settlement You Deserve
No one wants to go to work just to suffer an injury. While this is bad enough, you then have the challenge of negotiating a fair settlement with the insurer. At the Law Office of Jerome Salmi Kopis, LLC, our Missouri workers’ compensation lawyers will negotiate aggressively with the insurance company so you obtain the full and fair settlement you are entitled to. Call us now at (618) 726-2222 or reach out to us online to schedule a free consultation.