You’ve been injured at work, and now you’re left to navigate a complex web of questions.
Who will pay my medical bills? Will I receive compensation for time away from work? If I got hurt at work, will I get a settlement? How does the process work?
While the process can be confusing and intimidating at times, the St. Louis workers’ comp lawyers at Niemeyer, Grebel and Kruse are here to help you every step of the way.
Understanding workers’ compensation and settlements
In Missouri, the workers’ compensation process is designed to provide benefits to employees who suffer job-related injuries or illnesses.
If you are injured while at work in Missouri, it’s important to report it to your employer as soon as possible. The deadline to report is 30 days following discovery of your injury or illness. Next, to initiate a claim, you’ll need to file paperwork with the Missouri Division of Workers’ Compensation.
What happens next depends on the nature and permanence of your injury. You might be eligible for temporary total disability benefits. These benefits are typically two-thirds of the employee’s average weekly wage.
If the injury results in permanent disability, you might be eligible for permanent partial or permanent total disability benefits, based on the extent of the impairment.
Once your injury is evaluated, you will likely receive a settlement offer. Many workers’ compensation claims in Missouri are settled through a lump-sum payment or structured settlement agreement.
Workers’ compensation settlements are agreements between injured employees, employers and a workers compensation insurance company, providing a payment in exchange for releasing future legal liability. In other words, accepting a settlement means you’ll receive compensation, and the insurance company will no longer be responsible for medical benefits and weekly payments related to your workers compensation claim.
In other words, your case will be closed after you accept a workers’ comp settlement and you won’t be able to seek further compensation. For this reason, it can be very helpful to first speak with a workers compensation attorney before making any decisions.
What’s the difference: Settlements vs. Regular benefits
A settlement in workers’ compensation is a one-time lump-sum or structured payment agreed upon between the employee and the employer or insurance provider. This negotiated amount is meant to resolve the claim entirely.
Once a settlement is reached and approved, it typically signifies the closure of the case, where the employee generally waives rights to any future claims related to that injury. Settlements are ideal for those seeking a conclusive resolution to their workers’ compensation claim.
On the other hand, regular benefits are ongoing payments made to an employee for as long as they are deemed eligible under the workers’ compensation law. These benefits cover aspects such as medical expenses for the work-related injury and compensation for lost wages if the employee is temporarily or permanently unable to work.
Unlike settlements, regular benefits continue over a period and adjust according to the employee’s recovery progress and ability to return to work. This option is better for those who require continuous support during their recovery period.
Eligibility criteria for workers’ comp settlements
To be eligible for a workers’ comp settlement, there are several factors to consider, such as reaching Maximum Medical Improvement (MMI) and the extent of your permanent disability.
The role of Maximum Medical Improvement (MMI)
Maximum Medical Improvement (MMI) is a key factor in determining settlement eligibility. MMI is the point at which your medical condition is unlikely to improve further, as determined by a medical professional. At this stage, a disability rating may be assigned, and the settlement process can move forward.
Reaching MMI doesn’t necessarily mean that you’re fully recovered or improved, but rather that there is no further reason to continue attempting to improve. It’s important to wait until reaching MMI before considering a settlement, as this will give you a better understanding of the severity of your injuries and potential future medical expenses.
Considering permanent disability and future medical expenses
Before accepting a settlement, consider the extent of your permanent disability. A permanent disability may result in an increased settlement amount due to the long-term or permanent nature of the injury.
Another important consideration is future medical expenses, including ongoing medical care, medication and physical therapy.
The settlement amount is typically calculated to cover these future medical expenses. An attorney can help you make an informed decision about your settlement and ensure that you receive fair compensation for your injuries.
Calculating your potential settlement amount
Your potential settlement amount hinges on factors like medical bills and lost wages.
How medical bills shape settlement offers
Medical bills significantly influence settlement offers. Workers’ compensation insurance typically covers the cost of medical treatment associated with your work injury, and the settlement offer considers the amount of medical bills incurred and any future medical expenses that may be needed. Recording all medical bills and providing documentation to support your reimbursement claim is necessary.
Workers’ compensation settlements generally cover all approved medical treatment, prescriptions, and medical devices. This can include:
- Hospital bills
- Physician visits
- Surgery
- Post-surgical rehabilitation
- Prescriptions
- Medical equipment
- Travel expenses for medical appointments
The impact of lost wages on your settlement
In a workers’ comp settlement, lost wages are typically calculated as a percentage of your average weekly wage, often around two-thirds.
A workers compensation attorney, like those at NGK Law, can help you recover your lost wages by:
- Assessing the specifics of your case
- Procuring relevant evidence
- Engaging in negotiations with the insurance company
- Representing you in court, if necessary
It’s important to consult with a workers compensation lawyer to ensure that your lost wages are accurately calculated and fairly represented in your settlement.
Making the decision: To settle or not to settle
The decision to settle or not hinges on factors such as the severity of your injury, recovery time and financial needs.
When deciding whether to settle, consider factors like the severity of your injury, the length of your recovery time and your financial needs. The severity of your injury can impact the settlement amount, as more serious injuries tend to result in higher settlements due to the associated medical expenses, long-term treatment needs, and pain and suffering.
Navigating the settlement process with NGK Law
The settlement process might seem complex, but the skilled attorneys at Niemeyer, Grebel and Kruse can help with expert legal representation and guidance. Contact us at (314) 350-1900 for a free consultation to discuss your case in depth.
FAQs
How long do most workers comp settlements take?
On average, workers comp settlements take 17-18 months when handled by a lawyer. Negotiated settlements may take slightly longer, but offer a higher chance of achieving a favorable outcome.
What work injury pays the most?
- Injuries to the head or central nervous system are the most expensive lost-time workers’ compensation claims, with an average of $94,285 per claim in 2020 and 2021. Injuries involving the neck and multiple body parts come next, with respective averages of $65,659 and $62,257.
Will going back to work affect my claim?
- Going back to work will likely affect your claim as total disability benefits are reserved for those who cannot work in any capacity. Returning to work too early may prevent you from showing that you are unable to work and thus reduce your eligibility for settlement benefits.