Getting injured can have a devastating impact on your life. Besides the physical and emotional pain, you may also experience financial hardship due to missing work or being unable to perform your job duties.
If you have permanent impairments, you may be entitled to payment in the form of a workers’ compensation settlement, but beware! The insurance company is not on your side. Even if they seem helpful and cooperative, most make more by paying you less.
Don’t leave money on the table. This is generally your last chance to seek full compensation.
Here’s how the settlement process works, what you can expect, and how an attorney can significantly increase your odds of success.
How the Workers’ Compensation Settlement Process Works
Workers’ compensation is no-fault insurance that most employers are required to carry for when a worker is hurt on the job or gets sick from a work-related cause. While there are many different and complicated stages in workers’ compensation cases, let’s focus on the latter part of the process – the possible settlement stage for South Carolinians who have been injured at work.
Will My Workers’ Compensation Case Settle?
This is a great question because not all South Carolina workers’ comp cases settle. Sure, closure is great. But if you feel that you may need future medical care, such as ongoing physical therapy, and the insurance company does not agree to pay for your projected medical expenses, it may not be in your best interest to settle.
If you have reached maximum medical improvement and the doctor has released you back to work, the insurance company will likely try to close your case so they can stop sending you compensation.
At this point, if you have a permanent disability resulting from the injury, you can explore negotiating a settlement. Keep in mind that most insurance companies are for-profit businesses, which means they make more if you settle for less.
How Much Will My S.C. Workers’ Comp Settlement Be?
While we can’t tell you how much your potential South Carolina workers’ comp settlement amount will be, we can tell you that the following factors may need to be considered when negotiating for one:
- The nature of your injuries
- Balances on medical bills
- Unpaid benefits
- The likelihood and cost of future medical treatments, such as surgery or physical therapy
- The likelihood that your injury will prevent you from returning to work in some capacity
- Lost wages or future wage loss
- The extent of any permanent impairments you suffered
- Your weekly compensation rate, including overtime and bonuses
- The possibility of needing job retraining and its cost, if necessary
When Is the Right Time to Settle a Workers’ Compensation Claim?
While every case is different, a general rule-of-thumb is to wait until your doctor has declared that you have reached maximum medical improvement (MMI) before trying to settle your workers’ comp claim.
Maximum Medical Improvement is the point at which your treatment is complete in the sense that you’ve healed as much as can reasonably be expected. Note that this doesn’t mean you’re necessarily fully recovered, only that the condition has stabilized, and no remaining injuries or permanent disabilities are expected to further improve.
It may be the right time to settle your workers’ comp case if:
- Your physical condition is not likely to improve further with treatment.
- You know exactly how severe your injury is and whether you have any permanent impairments.
- You know exactly how your injury will impact your ability to work.
- An experienced workers’ comp attorney recommends that you settle.
If I’m Ready to Settle My Workers’ Comp Case, What Are My Options?
If you and your attorney are ready to negotiate, there are three main types of South Carolina workers’ comp settlements that may be available:
- Full and final clincher agreement – This agreement is designed to close out all further compensation and medical benefits in a lump sum settlement and release the employer and insurance company from all future liability relating to the injury.
- Indemnity-only clincher agreement – This agreement is a modified version of the full clincher agreement and is intended to close out only the compensation part of a claim while still providing for ongoing medical treatment.
- Form 16A – This settlement agreement is for an award amount that also provides for further medical treatment recommended by the doctor. In addition to leaving open the medical portion of a claim, it allows the injured employee to file for additional potential disability compensation based on a worsening of their condition.
- Tip: You must file the claim no later than one year from the date of the last payment of disability compensation.
Your attorney helps you decide which type of settlement may be optimal for your situation and negotiates on your behalf with the insurance company. Any final settlement typically takes weeks or months of back-and-forth discussion between the insurer and your lawyer.
What Happens at a Workers’ Compensation Settlement Negotiation in South Carolina?
The workers’ compensation settlement process follows a series of steps that will hopefully result in a settlement offer that fully compensates you for your injuries.
Settlement negotiations in South Carolina typically follow this process:
- Maximum Medical Improvement – Once you’ve healed as much as can be reasonably expected, the next thing to determine is your level of possible permanent impairment, which will factor into how much compensation you ultimately may receive.
- Settlement evaluation – You and your attorney can determine how much compensation you may be entitled to based on the costs of your workplace injuries. This is a complex calculation that includes the level of any permanent disability you suffered, your lost wages, the possible impact of your injury on your future earning potential, and other factors.
- Demand letter – You and your attorney can now compile the costs of your injuries and send the workers’ compensation insurance carrier a demand letter with a proposed settlement amount and the reasoning behind it.
- Counteroffer – The insurance carrier will respond to your demand letter, most likely with a counteroffer that is lower than your initial settlement demand. Remember, the insurer is protecting their interests, not yours.
- Settlement conference – You and your attorney may engage with the insurance company at a mediation session hosted by a third party to try to resolve your case. After some back-and-forth, cases are often resolved at this stage.
- Hearing (Optional) – If the parties are unable to come to an agreement during mediation, the case could then go to a hearing before the South Carolina Workers’ Compensation Commission (SCWCC). If this happens, a Commissioner will hear all the evidence in the case and then decide how much they think your potential compensation amount should be.
- Settlement agreement – If a settlement amount has either been agreed upon by the parties or awarded by the SCWCC, the insurance company will draft a settlement agreement that you will then sign. The SCWCC must approve the agreement before it becomes official.
- Payment – If the settlement agreement becomes final, you’ll receive distributions according to the schedule in your agreement.
Caution! Once you sign a settlement agreement, the settlement process is over. It is extremely unlikely that you’ll be able to renegotiate the terms of your agreement after it’s signed. That’s why it’s very important to make sure any agreement gives you the full amount of compensation to which you may be entitled.
How Long Will It Take for Me to Receive a Settlement Check?
We wish we could provide an exact answer to this question, but the timing of your possible settlement check will vary based on the specifics of your case. If a settlement has been negotiated, you will generally receive a check within one to two months.
Rest assured that at James Scott Farrin, our goal is to get you as much as possible, as quickly as possible. Our lawyers understand the workers’ compensation system and know how to try to move the process along with the insurance company.
How an Attorney Can Help With Your Workers’ Comp Settlement Negotiation
Here are some of the ways a workers’ comp lawyer can significantly increase your odds of success at every stage of the workers’ comp process:
- Handle the insurance company – The workers’ compensation insurance company handles claims like yours all day, every day, while you’re (hopefully) experiencing the workers’ compensation claims process for the first time. That’s why the insurance adjuster may feel they have the advantage over you in negotiations.
An experienced workers’ compensation attorney takes on the insurance company for you, evens the playing field, and fights for maximum compensation.
- Gather facts and evidence – To try to maximize compensation, you’ll need to provide evidence of the injuries you suffered, show that they were the result of your workplace accident, and demonstrate how the injuries may limit you going forward. Your attorney can interview witnesses, collect and organize comprehensive medical records, and present evidence for you effectively.
- Attend mediation and hearings – Your attorney will attend any settlement negotiations and any hearings before the South Carolina Workers’ Compensation Commission with you and advocate on your behalf, using their experience and knowledge of South Carolina workers’ compensation law to push for maximum compensation.
What Happens if I Can’t Reach a Settlement With the Insurance Company?
If you and your employer’s insurance company cannot agree on a settlement amount, you can request a hearing in front of the South Carolina Workers’ Compensation Commission (SCWCC), where a judge can resolve the case. At a court hearing, the judge will evaluate you, your evidence, and your situation to decide what you are potentially entitled to due to permanent disability.
To try to increase your chances of obtaining a favorable result at the SCWCC hearing, we recommend that you enlist the aid of an attorney who knows how the SCWCC works and how to present your case effectively.
Free Professional Opinion on Your Case – No Obligation
Contact us if you’re pursuing a workers’ compensation claim or are thinking about filing one. We’ll fight for you to receive the full compensation you may deserve.
Several attorneys on our workers’ compensation team have other side knowledge and experience from working for insurance defense firms. This means we can anticipate what the insurance company may do and plan strategies to help you pursue maximum compensation.
We were named to the 2023 edition of U.S. News – Best Lawyers “Best Law Firms” list, with the highest ranking possible for Workers’ Compensation Law – Claimants.3
You have nothing to lose by reaching out to us because of our risk-free guarantee.
That’s right. We work on a contingency fee basis, so if we don’t recover for you, you pay no attorney’s fee at all. Guaranteed.2
3For standards of inclusion, visit bestlawyers.com.Text Us