Almost all employees should be covered by workers’ compensation insurance through their employer. Workers comp ensures that if you are injured at work, you can make a claim for benefits to cover medical bills, missed wages, and weekly payments if your injuries keep you from working.
When you file a claim, the insurance company may send an offer of a payment plan and compensation for medical costs. After receiving this offer, you will need to decide whether to accept it or take further action.
What Does a Workers’ Compensation Offer Look Like?
The workers’ compensation offer will be sent to you by mail, and it will include the details of the benefits being offered to you. If your condition allows you to continue working but at a different or part-time job, the offer letter will include the details of any position being offered to you, as well.
The workers’ compensation offer will request contact by a certain date with your acceptance or denial of the offer, including when your first day of work will be if a new position has been offered.
If you accept the workers’ compensation offer, you’ll begin to receive weekly payments for an agreed-upon time, based on the severity of your injuries. On the other hand, you might disagree that the amount being offered is fair and sufficient to cover your costs as you’re away from work. If this happens, you have two main options:
- Negotiating for a settlement amount, which is either a lump sum or a payment plan
- Going to a hearing or trial, which will be ruled over by a judge
No matter which option you choose, it’s best to contact a workers’ compensation lawyer. They can examine the offer letter, learn about your case, and help you decide which course of action is best. A lawyer can also determine whether or not the initial offer will be enough money to cover the costs of your treatment and your other expenses as you heal.
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What Workers’ Compensation Benefits Will the Offer Include?
The benefits offered in the letter will depend on your injuries and your degree of disability:
Total Disability Benefits
If you have a
total disability, which means you are unable to work at all for a certain period of time, you will be eligible to receive weekly payments of two-thirds of your average weekly wage. However, you will not be able to receive more than $575 per week (Georgia Code section 34-9-261).
Temporary Partial Disability Benefits
If you have a temporary partial disability, meaning you are able to perform some work but temporarily not at the caliber you could before your injury, you are entitled to weekly payments equal to two-thirds of the difference between your average weekly wage before the injury and the average weekly wage you can now earn. This amount cannot exceed $383 per week and for no more than 350 weeks from the date you were injured (Georgia Code section 34-9-262).
Permanent Partial Disability
When you have a permanent partial disability, it means your condition partially but permanently disables you due to partial loss of use of a body part of the loss of limb. For permanent partial disability, you would still receive up to the maximums in dollar amounts and two-thirds of your average weekly wage, but the number of weeks you will receive benefits depends on your condition. The Bodily Loss Maximums per week and other details are found under Georgia Code section 34-9-263.
What Happens if I Deny the Offer to Pursue a Workers’ Compensation Settlement?
If you and your lawyer determine the workers’ compensation offer is not enough and it’s best for you to seek a settlement, negotiations will commence.
Most communication will happen between the insurance company and you and your attorney. However, your employer may still play a less active role in the back-and-forth negotiation. You and your lawyer will have already calculated what you think your workers’ compensation settlement should be. You’ll base it on factors like:
- Your total (to-date) medical bills
- Future treatments you may be facing
- Disability payments
- Current and future lost wages
- Your state’s workers compensation laws and any monetary restrictions you may face
Insurance companies are very strict when it comes to paying out money on a claim. Even if they won’t agree to the exact settlement amount you are seeking, you might be able to get them to settle on an amount that both sides accept. (Your chances of doing this are much higher if you work with an experienced workers compensation lawyer.)
If both sides agree to a settlement, it may be in the form of a lump sum or a payment plan structured similar to the original workers’ compensation offer.
Will I Need to Go to Trial?
Most of the time, workers’ comp claims are settled during the negotiation phase. However, there are situations where the insurance company refuses to negotiate or offer anything close to what you deserve. When that happens, you and your lawyer can weigh the pros and cons of pursuing a workers’ compensation hearing (also sometimes known as a workers’ compensation lawsuit).
If you ask for a workers comp hearing, a judge will evaluate your case and decide what is a fair settlement amount for you. A workers’ comp hearing is sometimes a risk because there is a chance the judge might award you even less than what the workers’ compensation offer covered. However, most of the time this doesn’t happen, and once the judge determines a fair amount, the insurance company will be ordered to pay your settlement.
Talk to a Workers’ Compensation Lawyer for Free Today
If you receive a workers’ compensation offer, you will need to decide whether it provides what you need after your work injury. At John Foy & Associates, we can help you evaluate your offer and determine if you need to take action. If you decide to seek a settlement, we’ll be there to help negotiate fair compensation.
To schedule a FREE consultation and discuss your options today, call us at (404) 400-4000 or contact us online.