When and Why Does a Georgia Workers' Compensation Case Settle?

In the aftermath of a workplace injury, it's crucial to address both immediate and lasting concerns. In the short term, securing medical care, reimbursement for transportation to medical appointments, and weekly wage benefits are paramount. As a representative for recently injured clients, I dedicate a significant amount of time to these pressing matters.

However, it's equally important to consider the long-term implications of the workplace injury. Questions about the ability to return to work and the potential work restrictions become central to discussions about settlement.

It may not be common knowledge, but employers and their insurance companies are not obligated to present a settlement offer. Unlike a negligence case where a jury might award a lump sum, the Georgia State Board of Workers’ Compensation lacks the authority to mandate such settlements. The resolution of your case through a lump sum settlement is contingent upon mutual agreement between you and the insurance company to close out the claim.

Why would an insurance company want to settle?

Recognize that time can become a critical factor in your workers' compensation case. According to Georgia law, your eligibility for temporary total disability benefits is limited to 400 weeks (approximately 7.5 years). Additionally, once a treating doctor assigns a "PPD" (permanent partial disability) rating, the insurance company can determine your PPD payment by multiplying your weekly benefit amount by the PPD percentage.

For instance, if you've been receiving TTD benefits for an extended period, say 390 weeks (though unlikely), and you have a 10% PPD rating, your case becomes relatively predictable with limited settlement value.

When an insurance adjuster assesses your case, their central queries revolve around minimizing costs and pondering the worst-case scenario in terms of financial implications.

Regardless of your long-standing dedication to your company, having been a loyal employee for two decades and a repeat recipient of "employee of the month" awards, these accolades lose significance once you file a workers' compensation case. In the eyes of the employer and their insurance company, you transform from a valued contributor to an expense that needs elimination.

This explains why, as part of a settlement package, your employer and their insurer might insist on your resignation – viewing you as damaged goods they wish to move beyond.

From our standpoint, it's essential to present compelling evidence and arguments to convince the insurance company that allowing your case to remain active could potentially incur significant costs for them in the ensuing months and years.

When is the best time to settle a Georgia workers' compensation case?

Over the past 30 years of representing injured workers, we've learned that approaching the insurance company either too early or too late can result in unreasonably low settlement offers.

In our experience, the optimal time to pursue a settlement is when numerous uncertainties still surround your case. These uncertainties may include:

• Being on "no work" status, making you eligible for TTD payments for an indeterminate number of future months.
• The potential necessity of costly surgery.
• The likelihood of surgical complications.
• The possibility that your initial surgery may not yield favorable results, necessitating a second surgery.
• The need for extensive post-surgical rehabilitation.
• The requirement for fitting braces or other assistive devices.

While these represent just a handful of potential unknowns, the insurance company perceives them all as potential costs. Simultaneously, they understand that delaying the settlement process can lead to a decrease in the overall value of your case.

Is there a downside to settling my case?

You have the opportunity to exchange the uncertainties listed above for a more substantial lump sum settlement, provided you are open to embracing the inherent risks associated with the unknown factors. By consenting to a specific settlement amount, you are relinquishing certain entitlements, such as the right to receive future weekly wage benefits and company-paid medical care.

While we can assist you in understanding these risks, and provide insights into the optimal timing for settlement, the ultimate decision to settle rests with you.

If you are a loved one has been injured at work give our lawyers a call today at 770-214-2500 for a free consultation