If you have a workers’ comp claim, you will probably consider settling your case. Many workers settle their claims because they prefer to have a lump sum payment and to be done with the workers’ comp system. In other cases, workers settle because they want to avoid the risk of losing at a workers’ comp hearing. While a settlement has its benefits, you also give up significant rights when you settle your case.
Learn more about Ohio’s workers’ comp settlement process below.
When you settle an Ohio workers’ comp claim, you give up your right to further workers’ comp benefits in exchange for an agreed-upon sum of money. Typically, you will be expected to give up all of your rights and benefits relating to your injury. However, a general release where you give up “any and all” workers’ comp claims is not allowed. Instead, your settlement must clearly state which injuries and dates of employment are covered. For those covered injuries, you are agreeing to close out your workers’ comp claim for good.
Occasionally, you might enter into a partial settlement of your claim. For example, you might close out your right to all disability and wage loss benefits, but keep your right to receive future medical treatment through workers’ comp. However, partial settlements are relatively rare.
Settlements are often paid out in a lump sum, but in some cases, a settlement will be paid in installments over time (this is sometimes called a “structured settlement”).
Ohio is one of the few states with a monopolistic workers’ comp system: The state insures most employers through the Ohio Bureau of Workers’ Compensation (BWC). A small number of employers are self-insured and pay out their own workers’ claims. (You can check the BWC’s online database to see if your employer is self-insured.)
If your employer is insured by the state, you (or your lawyer) will initiate negotiations with your BWC claims services specialist. If your employer is self-insured, you (or your lawyer) will negotiate directly with the company.
Because every workers’ comp claim involves different facts and legal issues, settlement values vary. Your claim’s value will depend on the total amount of workers’ comp benefits you could receive during the lifetime of your claim. (Read our article on Ohio workers’ comp benefits to learn how much you might be entitled to.) Any problems in your claim, such as conflicting medical evidence about the extent of your permanent disability, would reduce your claim’s value.
Several other factors can affect the value of your claim, and most workers won’t be able to accurately assess a fair settlement value without the help of an experienced Ohio workers’ compensation lawyer. Without a lawyer, you might significantly undervalue your claim.
Certain items will be deducted from your settlement check. Depending on the nature of your claim, these costs may include:
To learn more about these deductions, read our article discussing how much of your settlement you will get to keep.
In Ohio, you can settle your workers’ comp claim at any time. However, many workers wait to settle their claims until they reach maximum medical improvement (MMI). You are at MMI when your doctor believes your condition is stable and will no longer improve with treatment.
Settling before MMI is very risky. After a settlement, you typically are responsible for the cost of all your future medical treatment. If your recovery takes longer than expected—or you need additional treatment—your settlement funds probably won’t cover it.
In Ohio, the state must approve all workers’ comp settlements. However, the process of finalizing a settlement varies, depending on whether your employer is insured through the BWC or is self-insured.
If your employer is insured through the state, you will submit a series of settlement documents to the BWC, including a Settlement Agreement and an Application for Approval (Form C-240). If you have a lawyer, the BWC will contact him or her and negotiate. If you’re unrepresented, the BWC will contact you directly.
To settle a claim with a self-insured employer, you must file a different set of forms with the Industrial Commission (IC). Typically, you must complete and sign a Self-Insured Joint Settlement Agreement and Release (Form SI-42) and an acknowledgment form (Form S1-43).
Once the BWC or IC receives your settlement paperwork, it will review your claim and signed documents. If the settlement appears “fair and equitable,” the agency will approve your settlement and send you a settlement approval letter.
A workers’ comp settlement is always voluntary—neither party can force the other to settle. However, once the BWC or IC approves your settlement, you only have 30 days to back out of the settlement. (To revoke a settlement, you must file a written withdrawal.) Once the 30-day waiting period expires, your settlement is full and final and you cannot reopen the claim and request additional compensation.
Before you sign off on a settlement, make sure you understand the terms and what you are giving up. If you don’t already have a lawyer, you should consider consulting with an Ohio workers’ comp lawyer. A lawyer can review your claim and make sure that a settlement is in your best interests. While the BWC or your employer’s lawyer might answer some basic questions about your settlement documents, they cannot give you legal advice.