Case Study: How a Workers’ Comp Attorney Negotiates Settlements

Not all workers’ compensation claims will end with a court hearing. In fact, it is much more common for the two parties—the injured employee (with or without an attorney) and the employer (with the insurance company’s attorney)—to agree to a settlement. Insurance companies more often than not prefer to negotiate a settlement amount rather than take their chances in court, which is typically a lengthier and more costly process. However, the insurance company will likely offer less money than you deserve for your work injury or illness. That is where an experienced workers’ comp attorney comes in. For this second in a series of articles, let’s look at how one Rose Legal workers’ comp attorney managed to negotiate a settlement for Lucy Harper (name changed to protect identity).

The Workplace Injury

Despite being retirement age, Lucy Harper worked part-time at a fast food restaurant in order to supplement her social security income. But one day, she tripped over a chair and fell to the floor, breaking her arm near the shoulder. She suffered a painful recovery, and could not return to work due to difficulties in using her arm, including range of motion restrictions.

Note that Lucy’s workplace injury is not unusual. OSHA states “the second-most common cause of workplace injury is a trip or slip hazard that leads to a fall. And 20-30% of workplace falls result in a moderate or severe injury like deep bruising, broken bones, or concussions.”

A Hurdle to Overcome

There are many factors that impact the negotiation of a workers’ comp settlement and its final amount. And each side in a case will strive to support their claim with evidence. In this instance, the Rose Legal attorney argued that Lucy Harper was entitled to permanent total disability compensation: the earnings she would have received at work if she were capable of returning, paid for the remainder of her life. However, the insurance company argued that her arm’s restrictions were simply the result of her arthritis from old age. With the medical records to back this preexisting medical condition up, there was a chance the employer would be able to avoid providing Lucy any further assistance.

A Settlement in Lucy’s Favor

An effective workers’ compensation attorney has to be a skilled communicator, capable of remaining calm yet assertive throughout the back-and-forth of settlement negotiations. For this case, the Rose Legal attorney was able to focus on the goals of the claim and the right evidence in order to guide the discussions to a positive outcome for Lucy. In the end, she received a lump-sum settlement based on her lifetime expectancy, which enabled her to realize the benefits of her workers’ compensation more quickly and conveniently.

The Settlement Negotiation Process

What does the typical process look like for an attorney to negotiate a workers’ compensation settlement? Steps along the way may include:

• Determining settlement goals — It’s important for the injured employee and attorney to discern precisely what financial benefits need to be compensated for in the worker’s case. Then they’ll want to ensure they have all the evidence needed to back up their argument.
• Sending a demand letter — A demand letter to the insurance company’s attorney will describe the worker’s injury and the desired monetary amount to settle the claim.
• Receiving a counter-offer — If the insurance company does not accept the settlement amount, their attorney may make a counter-offer with a lower monetary amount or other terms.
• Continuing communication — The workers’ comp attorney will review the counter-offer with the injured worker, then advise to accept, decline, or negotiate further.
• Reaching an agreement — If both sides manage to agree upon a fair settlement amount, the insurance company’s attorney will write up a settlement agreement. This will be reviewed by your attorney to ensure that all of the necessary provisions and safeguards are included, and make sure you are fully informed before signing.
• Submitting settlement to judge — Once both parties have signed the agreement, it goes to the court judge assigned to the case. Upon approval, the judge will issue an order for the settlement’s payment.
• Receiving payment — The injured employee will receive payment based on the terms of the settlement agreement. The time from reaching an agreement to receiving payment is usually 30-45 days, but can vary based on many factors from the particular case being settled.

The First Step for Your Case

Experienced workers’ compensation lawyers have knowledge of the tactics various insurance companies employ, and are able to plan accordingly for negotiations. An attorney at Rose Legal will focus on your particular interests in the claim and take a proactive approach in ensuring you receive adequate compensation. For a free consultation, call 801-810-7673, or email legal@workcomputah.com for more information regarding the first step to take for your case.