If you have been injured at work, you are entitled to compensation for your injury and financial losses. Workers’ compensation insurance exists for this specific purpose. The worker’s compensation usually covers medical bills, ambulance rides, surgery, future medical treatment, if any, and disability payments. Given that some personal injury cases are in trial, you might wonder whether you must go to court to settle your claims.
The latest statistics from the Indiana Worker’s Compensation Board show that 54,311 workers sustained injuries. However, in many states, including Indiana, you cannot sue your employer for workplace injury, so you don’t have to go to court to settle your claims. Some exceptions exist, and you may find yourself in court fighting for your deserved settlement. Since these regulations are locally bound, consult an Indianapolis workers’ comp lawyer to help you seek restitution and guide your settlement claim to a high payout.
Is Going to Court Necessary?
There is no straight answer to this question. In Indiana, an employee cannot directly sue an employer for negligence when they suffer injuries. When you fall victim to a workplace accident or harm, you can collect your worker’s compensation settlement without providing proof of negligence or fault.
However, there are some exceptions to that rule. You may go to court if the law establishes that your employer’s negligence is severe enough to warrant further action. You can also file a lawsuit for your injuries if you have a third-party claim. In such cases, speaking to your Indianapolis workers’ comp lawyer will help you understand your options.
The Process of Settling Your Worker’s Comp Claim
While it may seem straightforward, settling a workers’ comp claim may involve negotiations with the insurer. Therefore, you may need an experienced lawyer to represent you.
The process of settling a workers’ comp claim typically follows these steps:
- The first step after incurring a workplace injury is to notify your employer immediately. Waiting more than 30 days after the incident may cause your claim to be denied.
- After reporting, you should seek medical attention. You may also have to undergo an assessment by an approved healthcare professional to establish the severity of your injury and appropriate treatment.
- File a workers’ compensation claim providing details about your workplace injury, including the cause.
- After filing the claim, your employer will meet with the insurer responsible for your compensation.
- The insurer will review the claim and determine the benefits you are eligible for, such as medical expenses and lost wages.
- You’ll then get a settlement offer from the insurer, and if you accept it, the case is closed. If you think the settlement is unfair, you can negotiate with the insurer with the help of a lawyer.
You may have to take the case further if you fail to reach an agreement after negotiating with the insurer.
Settlement Options for Worker’s Compensation Claims
A lump-sum settlement means you resolve your claim with a one-time settlement payment. It immediately gives you access to all your compensation and is a quick way to close your case. However, speak to an attorney before agreeing to a lump-sum settlement to understand its long-term effects on your finances.
Structured settlements involve payments in installments over some time. This option provides you with a regular flow of financial support. Usually, the parties involved will negotiate the settlement terms, and an administrative judge or workers’ compensation board must approve it.
What Happens When a Claim is Denied?
Sometimes, insurers can deny workers’ comp claims for workplace injuries resulting from horseplay, fighting, or when the victim is commuting to or from work. Other grounds for denial include if the injury occurred when going against company rules, under the influence of drugs or alcohol, or committing a crime.
In case of claim denial, you have a right to appeal. This means going to trial, known as a workers’ comp lawsuit or hearing. You can also go to trial if your claim was approved, but the relevant parties do not want to settle or negotiate.
The appeal hearing happens before an administrative law judge (ALJ). Both parties present their case during the hearing, and the judge will determine the settlement after evaluating both sides. Once the judge orders the appropriate settlement amount, both parties must comply with it. Note that the amount can be higher or lower than the initial offering.
With the above information, it is clear that you don’t have to go to court to settle your workers’ comp claim unless in special circumstances. Work with an attorney if you feel like you are getting a lowball offer or an unfair denial. Doing so will ensure you go through the process successfully to fight for your best interests.