Learn what types of work injuries are most likely to result in workers’ comp settlements and when you can expect an offer
Dealing with a workplace injury can be overwhelming, and the uncertainty surrounding workers’ compensation settlements only adds to the stress. If you’ve been hurt on the job in Arizona, you might be anxiously wondering when, or even if, a settlement offer will come your way, which can make it difficult to plan for your recovery and financial future.
In this article, we’ll explore when and why workers’ compensation settlements are typically offered, so you can understand what to expect and how to navigate this complex process. By shedding light on the factors that influence settlement decisions, we aim to ease some of the stress and ensure you’re prepared to make informed choices that protect your rights and support your recovery.
Do all workers’ comp claims eventually end in settlements?
No, not all workers’ comp claims end in settlements. Some claims are resolved through the payment of monthly workers’ comp benefits for medical expenses and lost wages until the worker recovers, without ever reaching a formal settlement agreement.
A settlement typically occurs when both the injured worker and the insurance company agree to a lump sum payment or structured payments instead of ongoing benefits.
Settlements are more common in cases where the injury has resulted in permanent impairment or there is a dispute about the extent of the injury or the benefits owed. However, in many cases, workers continue to receive benefits until they have recovered sufficiently to return to work, and no settlement is needed.
What types of work injuries are most likely to end in settlements?
Workers’ comp claims that are most likely to end in settlements typically involve serious, permanent, or catastrophic injuries and occupational diseases that have long-term or lifelong impacts on a worker’s ability to perform their job.
Here are some of the common types of injuries and conditions that often lead to settlements:
- Permanent partial disabilities (PPDs), including loss of limb, partial loss of vision or hearing, or significant nerve damage. These injuries result in permanent limitations that reduce a worker’s ability to perform certain tasks or return to their previous job, so settlements reflect the long-term financial impact, including reduced earning capacity.
- Permanent total disabilities (PTDs), including severe spinal cord injuries, traumatic brain injuries, or complete loss of vision or hearing. PTD means the worker is unable to return to any form of gainful employment. Settlements in these cases can provide financial security and peace of mind because workers can receive compensation for future medical costs, long-term care, and the loss of future earnings upfront to help them better plan for their future.
- Catastrophic injuries, including paralysis, severe burns, multiple amputations, or injuries resulting in profound cognitive impairments. These types of injuries typically require lifelong medical care and adaptive services. Settlements are necessary to cover extensive future medical expenses, home modifications, and long-term loss of income.
- Occupational diseases like mesothelioma (from asbestos exposure), silicosis, occupational asthma, chronic obstructive pulmonary disease (COPD), black lung disease, hearing loss, or repetitive stress injuries like arthritis. Occupational diseases often develop over time and may cause permanent damage before they’re diagnosed and treated. Settlements may cover ongoing medical treatment and reduced earning capacity, especially in cases where the disease is progressive and debilitating.
- Fatal injuries, such as falls from height, electrocution, or being struck by heavy machinery. In the case of a worker’s death, the worker’s family may opt for a settlement to cover funeral expenses and the loss of future income, as the financial relief can allow them to pay immediate bills and focus on healing.
- Injuries leading to complex medical conditions like complex regional pain syndrome (CRPS) from crush injuries, severe infections, or multiple surgeries and prolonged recovery. These injuries often involve unpredictable recovery times and extensive medical treatment, so settlements provide a way to address the uncertainty and ensure that the worker has the resources needed for ongoing care.
Settling these types of cases can benefit both the injured worker and the insurance company. For workers, a settlement provides financial certainty, allowing them to plan for future medical care and living expenses without the stress of ongoing legal battles. For insurers, settlements help manage costs and avoid the unpredictability of long-term claims, bringing closure to complex cases more efficiently.
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When is workers’ comp most likely to offer a settlement?
Workers’ comp is most likely to offer a settlement at several key points in the claim process:
- After maximum medical improvement (MMI) and disability rating assignment. Once a worker reaches MMI, their condition has stabilized, and further recovery is not expected. At this stage, a permanent disability rating is often assigned, providing a clearer picture of the worker’s long-term prognosis and potential compensation. With this information, both the insurer and the injured worker are in a better position to negotiate a settlement based on the expected future medical costs and loss of earning capacity.
- Before a formal hearing or trial. Insurers often prefer to settle before the case goes to a formal workers’ compensation hearing or trial to avoid the costs, risks, and unpredictability of litigation. Settling at this stage can be mutually beneficial, as it allows the worker to receive compensation more quickly and avoids the possibility of a less favorable outcome in court.
- When the extent of injury or compensation is disputed. If the insurer acknowledges that the injury is work-related but there is disagreement over the amount of compensation, a settlement may be offered to resolve the dispute without further legal proceedings. Settlements in such cases can provide the injured worker with financial stability while allowing the insurer to avoid the uncertainty of a court’s decision on damages.
- When ongoing medical costs are anticipated. If the injury is severe and requires long-term or lifelong medical care, the insurer might offer a settlement to avoid the uncertainty and ongoing expense of continuous medical payments. This allows the injured worker to secure a lump sum that can be used to manage future medical needs and provides the insurer with a clear resolution to the claim.
Generally speaking, these points in the claim process represent moments when both the worker and the insurer may have a clearer picture of the case’s potential outcome, making settlement discussions more feasible and appealing to both sides.
Get help from an experienced Arizona workers’ compensation attorney
If you’ve been injured at work in Phoenix and have questions or need assistance with your claim, the experienced team at the Law Offices of Robert E. Wisniewski is here to help.
With over 45 years of experience advocating for injured Arizona workers, our knowledgeable work injury attorneys are dedicated to helping you recover the compensation you deserve. Whether you’re facing challenges with your claim, need help negotiating a fair settlement, or simply want to ensure your rights are protected, we’re here to guide you every step of the way.
