In Illinois, there are different ways to settle a workers' comp case, and many injured workers don't realize that they're eligible for settlement. Determining when to settle a worker's compensation claim, and for how much, is not always a simple task.
Hiring a workers' comp lawyer can help you value your claim and navigate the settlement process, though many injured workers choose to handle their claims themselves.
Here are some guidelines for settling your workers' comp case in Illinois.
A settlement is an agreement between the injured worker and the insurance company to release some or all of the insurance company's responsibilities in exchange for a sum of money. In most cases, your settlement will be paid in a lump sum. However, you may get paid in installments over time, if:
Settlements in Illinois usually close out your right to all workers' comp benefits, including future medical care. In some cases, the insurance company will agree to keep your medical rights open. For example, the insurance company might consider this option if a Medicare set-aside would be too costly because you'll need extensive medical treatment in the future. (For more information about Medicare set-asides, read our article on deductions from workers' comp settlements.)
The best time to consider settlement is when you're at maximum medical improvement (MMI). This is the point in time when your doctor finds that you've either fully healed or you've improved as much as you're going to with treatment. Settling your case before you reach MMI is risky because you can't predict how severe your injury is or what medical treatment you might need in the future. There's a presumption in Illinois that any settlement contract made within seven days of the injury is fraudulent.
If you haven't reached MMI but have good reasons for wanting to settle your case right away, speak with an attorney. An attorney might be able to negotiate a settlement that leaves your right to future medical care open or that includes additional compensation to cover any future medical care that you might need.
The value of your claim depends on a variety of factors such as your pre-injury wages, medical treatment recommendations, ability to return to work, and whether you have a permanent disability. You can get an idea of how much you might be entitled to in our article on types and amounts of Illinois workers' comp benefits. However, other factors will also impact your claim's value, such as evidence that your injury wasn't work-related. A well-versed worker's comp attorney can evaluate your claim and advise you on a fair settlement amount.
Certain items will be deducted from your settlement check. For example, if you have a lawyer, attorneys' fees and legal costs will be deducted from your settlement. For more information about attorneys' fees, read our article on how much a worker's comp lawyer costs.
If you have an attorney, your attorney will make a settlement demand to the insurance company or its lawyer. If you don't have an attorney, the insurance company might approach you with a settlement offer, or it may not approach you at all. Many injured workers do not know that they are eligible to receive a settlement for their injuries. You are under no obligation to accept any settlement offer.
There is usually some back and forth before the parties come to an agreement on the dollar amount of settlement. Once you reach an agreement, a settlement contract will be drafted by one of the attorneys. The contract will specify all of the terms of the agreement, including what rights you are giving up.
All settlements need to be approved by the Illinois Worker's Compensation Commission. An arbitrator at the Commission will review the settlement contract to make sure it is fair and reasonable and that there are no mathematical or clerical errors.
If there is a problem with the settlement contract, the arbitrator will send it back to the parties for correction. Generally, arbitrators like specific language instead of broad and sweeping language that might be too restrictive of the injured worker's rights. For example, some arbitrators will not approve contracts that state that "any and all" accidents are included in settlement.
Settlement contracts should only list the accident date or dates in question. If you got hurt on the job multiple times, it is very important to understand which injury you are settling, and for how much.
If you settle your case, you are waiving your right to a worker's compensation hearing. Once an arbitrator approves your contract, the terms of your settlement are final. For example, if you are dissatisfied with the dollar amount of settlement, you cannot reopen your case to get more.
If you closed out your medical rights as part of settlement, you cannot reopen your case to get future medical treatment covered. You can only revisit the terms of your contract in very rare cases, such as when there is a clear clerical error in your settlement contract.
Under Illinois law, it is possible to reopen your case if your condition worsens due to the injury, within 30 months of settlement approval. Most often, however, settlement contracts include a waiver of your right to reopen your case for this purpose.
Because settlements are final, you should have an attorney review the settlement contract with a fine tooth comb and make sure you agree with the terms. There are many complexities to a settlement. For example, if you are receiving other governmental benefits, such as Social Security, they might be reduced or discontinued unless there is specific language in your worker's compensation contract to prevent this. You also need to understand whether you have any unpaid medical bills or government liens (such as child support or Medicaid) and how they will be handled.
Reviewing your own settlement contract without the help of a lawyer is risky, because the contracts often contain highly technical legal language. A well-versed attorney can help you understand what you're signing off on.
For more information on how an attorney can help you, read our article on what you should expect from a lawyer.