Should You Accept the First Compensation Offer in a Workers’ Comp Case?

If you have been injured on the job in Pennsylvania, you are likely entitled to workers’ compensation benefits to cover your medical expenses and offset part of your lost wages. How much you receive can impact your ability to heal from your injuries and provide for yourself and your family. The first settlement offer you receive from the insurance company might be tempting, as it represents a guaranteed payout after a difficult, painful experience. But depending on the severity of your injuries and whether they are permanent, it might not be enough to cover all of your losses.

The workers’ compensation attorneys at Calhoon & Kaminsky P.C. are here to protect your rights and advocate for your needs. We have more than 20 years of experience helping injured workers in Pennsylvania maximize their workers’ comp settlements. To learn more about when you should accept the first compensation offer, contact our office today for a free consultation.

What Is a Compensation Offer?

The two types of workers’ compensation benefits you can receive if you are injured or suffer an illness on the job in Pennsylvania are:

• Medical benefits — Typically, you will submit a workers’ comp claim to your employer’s insurer to start the process. Once your claim is approved, the insurer must cover all necessary and reasonable medical expenses related to your injuries. You are entitled to receive benefits until you fully recover or reach the point where further treatment will not make a meaningful difference. This is known as maximum medical improvement (MMI).
• Wage-loss benefits — If your injuries cause you to miss more than seven calendar days of work, you are eligible to receive wage-loss benefits. These benefits are set at two-thirds of your weekly wages, up to a limit set by state law.

Your employer’s insurance provider might make you a settlement offer. In a workers’ comp settlement, the insurer agrees to pay you a certain amount to cover your past and future medical expenses and lost wages. If you accept a settlement offer, you generally cannot receive any additional benefits. This may allow them to pay you less than you are owed in workers’ compensation benefits, especially if you have severe injuries that may be permanent.

How Does a Workers’ Compensation Settlement Work?

A workers’ compensation settlement can be structured in a few different ways. The insurance company could offer to pay you a lump sum for your medical expenses and the total number of weeks you are expected to be unable to work. Or they might break the payments up into smaller chunks paid at specific intervals. The details of any settlement offer are determined by the severity of your injuries, how long your recovery is expected to take, and certain other factors.

Remember that the maximum amount of any workers’ compensation settlement is 500 times the weekly disability benefit amount. State law says that injured workers can only receive disability benefits for up to 500 weeks after a work-related injury. That means any workers’ compensation settlement cannot exceed 500 weeks’ worth of benefits.

Factors to Consider When Evaluating a Settlement Offer

Here are a few questions to consider once you have received your first workers’ comp settlement offer:

• Are your injuries temporary or permanent?— If your injuries are permanent, you may not be able to return to work at all. Even if you can still work, you may have to find a new job that accommodates your impairment, which might pay less. You should factor this missing future income into your decision-making.
• Will you need future medical treatment?— Once you accept a workers’ compensation settlement, you are ineligible to receive any additional benefits. If there is a chance you may need further care, this treatment will need to be factored into the settlement amount.
• Will your settlement affect your other benefits or insurance claims?— Depending on how you were injured at work and who is responsible, you could be eligible for compensation through multiple sources. You should understand how a workers’ comp settlement could impact a personal injury lawsuit or any further insurance claims before you agree to a figure. A lawyer can review your options for compensation and explain how your settlement might impact them.

Should You Accept the First Settlement Offer from the Insurance Company?

It is often in your best interest to reject the first workers’ comp settlement offer you get from the insurer. Insurance companies are for-profit businesses and sometimes make lowball settlement offers, hoping people will accept them and move on. However, that doesn’t mean you have to accept the offer or that the insurance company is not prepared to pay more. It is best to speak with an experienced workers’ comp attorney before accepting a settlement offer from the insurance company because there’s no going back for more after you settle.

What Happens If You Reject the Settlement Offer?

Before accepting or rejecting a settlement offer, you should discuss your case with an experienced workers’ comp attorney. They can evaluate your financial needs and the strength of your case to determine a fair settlement figure. If the initial offer does not meet that number, you are free to reject it and make a counteroffer.

At that point, your attorney and your employer’s workers’ comp insurer will swap offers until they reach a mutually acceptable figure. If the two sides can’t agree, the case will go before a judge, who will make a decision. Either party then has 20 days to appeal.

Ask a Pennsylvania Workers’ Compensation Lawyer

The legal team at Calhoon & Kaminsky P.C. want to help you demand the settlement you deserve after a workplace injury. Contact us today to speak with an experienced, compassionate Pennsylvania workers’ compensation lawyer.