Settling Your Workers' Compensation Case in Florida

Whether you're receiving workers' comp benefits or appealing the insurance company's denial of your claim for a work-related injury or illness, you might eventually consider signing a settlement agreement with the insurer. While settling a workers' comp claim has its benefits—such as getting money right away to pay your mounting bills—there are also risks involved. Before you sign on the dotted line, make sure you understand the settlement agreement and the rights you're giving up under Florida law.

Kinds of Workers' Comp Settlements in Florida

There are different kinds of settlement agreements in Florida, depending on the rights you're giving up and how you receive the money:

• Full and final release of liability or partial release. Typically, the insurance company will want you to agree to a full and final settlement, which means you're giving up your right to any more workers' comp benefits available under Florida law for your injury—including any injuries and illnesses that happened while you were working for your employer before the settlement but that haven't yet been identified as work related (such as a repetitive stress injury or an occupational disease). You may be able to negotiate a limited settlement in which you receive money in exchange for your right to some benefits (like permanent impairment benefits), but the insurance company will continue to pay your medical bills. This type of settlement is relatively rare, however.
• Lump-sum or structured settlements. Most settlements pay you a lump-sum of money. But in some cases, the insurance company might agree to pay the money in installments over time. Structured settlements are frequently used in cases involving catastrophic injuries, because they can help seriously injured employees manage their settlement money and pay for long-term care.

With these two factors combined, the most common type of settlement in Florida is a full-and-final release with a lump sun.

When Can I Settle my Florida Workers' Comp Claim?

If you have a workers' comp lawyer, you can settle your claim at any time. If you don't have a lawyer, Florida law sets special requirements for when you can agree to a full-and-final lump-sum settlement. You can agree to this type of settlement without a lawyer only if:

• the insurance company has denied your workers' comp claim, and a judge finds that there's a legitimate disagreement as to whether you're entitled to benefits; or
• your doctor believes that your medical condition is stable and that you probably won't get any better (a stage known as maximum medical improvement, or MMI).

However, it's almost always wise to wait until reaching MMI before you consider settling your case. Because the insurance company typically stops paying your medical bills after a settlement, you'll be financially responsible for any unexpected medical treatment you need. Also, while you're still healing, it won't be clear whether your work injury will leave you with any permanent medical problems or lost function (known as "permanent impairment" in Florida workers' comp law). That makes it hard to figure out how much money you should look for in a settlement.

How Much Will I Get in a Settlement?

Like most states, Florida doesn't use a set formula to calculate settlement values. Instead, insurance companies and lawyers base their settlement offers and demands on a series of factors, including:

• the severity of your injuries
• the extent of any permanent impairment you have as a result of your injury
• the amount of any unpaid medical bills
• any unpaid temporary disability benefits, as well as any penalties for late payments
• whether you're likely to need future medical treatment for the work injury and if so, an estimate of how much that will cost
• whether you're able to return to work and, if not, how much you earned before the injury; and
• whether there is conflicting evidence in your case.

You should keep in mind that certain costs might be deducted before you receive the money—including attorneys' fees, other legal expenses, any child support that you owe, and a sum of money to cover medical treatment that may be required for your injury when you're eligible for Medicare. (Learn more about how much of your workers' comp settlement you get to keep.)

How Are Settlements Finalized in Florida?

The process of finalizing a settlement varies, depending on whether you have a lawyer and the type of settlement agreement.

Settling a Claim With a Lawyer's Help

In Florida, you typically don't need to attend a settlement hearing if you have a lawyer. Instead, the lawyer will guide you through a series of documents, including the written settlement agreement and an explanation of the expenses that will be subtracted from the settlement amount.

A workers' comp judge must approve the amount of fees that will go to your lawyer. Otherwise, Florida doesn't require the judge to review the settlement itself when you have an attorney. The state assumes that your lawyer has already protected your interests. Once you sign the paperwork, the settlement is final.

Settling a Claim Without a Lawyer

If you've agreed to a full-and-final lump-sum settlement without a lawyer, a workers' comp judge will hold a hearing to review the settlement agreement, along with supporting evidence and other documents, to see if it's fair. The judge will also ask you questions to make sure you understand the settlement and your rights under Florida law.

If you've settled your case after the insurance company denied your claim, the settlement won't be valid unless the judge approves it. If you've settled after reaching MMI, the judge will decide whether the settlement amount is greater than the value of workers' comp benefits you would otherwise be entitled to receive. If so, the judge doesn't have to approve it.

Can I Change My Mind After Settling?

Once a full-and-final settlement is final, you may not ask the Florida Division of Workers' Comp to reopen your claim in order to seek additional benefits, even if your medical condition gets worse and you need additional treatment.

This means that you shouldn't agree to a settlement unless you fully understand its terms and are completely comfortable with the long-term consequences. That can be difficult to do without a lawyer's help. An experienced workers' comp attorney can help you evaluate settlement offers, negotiate with the insurance company, explain the meaning and consequences of all of the language in the settlement agreement, and ensure that all the paperwork is completed correctly.