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How Long Does A Workers’ Comp Case Take To Settle?

Typical time frame: 

The length of time it takes to resolve a workers’ compensation case can vary depending on a variety of factors, such as the complexity of the case, the severity of the injury, the number of parties involved, and the jurisdiction where the case is being heard. However, in general, workers’ compensation cases typically take several months to a year or more to be resolved.

In some cases, if the injury is relatively minor and the employer and the workers’ compensation insurer agree on the claim, the case may be resolved quickly, within a few weeks or months. However, if the injury is more severe or if there is a dispute over the claim, the case can take much longer to resolve.

In some cases, the injured worker may need to undergo multiple medical evaluations or treatments before a determination can be made on the case. Additionally, if there is a dispute over the claim, the case may need to go through a hearing or mediation process, which can also add to the length of time it takes to resolve the case.

The average workers comp case will take about 16 months to be resolved. A resolution may result in a settlement agreement or a hearing with a judge.

  • Under 20% of cases will be resolved within the first six months.
  • 50% of all workers finished their claims in between 13 and 24 months.

Why does your case get prolonged?

There are several factors that can prolong the time it takes to settle a workers’ compensation case. Here are some of the most significant ones:

The nature and severity of the injury: 

The nature and severity of the injury can be a significant factor in delaying the settlement of a workers’ compensation case. Generally, the more severe the injury, the longer it may take to resolve the case. This is because the medical treatment required for severe injuries can be more extensive, and medical evidence may need to be reviewed more thoroughly to ensure that the injured worker receives the appropriate benefits. Additionally, more severe injuries can lead to longer periods of disability and a longer recovery time, which can prolong the time needed to resolve the case.

Injuries that are complex or require specialized medical treatment may also contribute to longer settlement times. For example, injuries that involve chronic pain or require surgery may require ongoing medical treatment and rehabilitation, which can extend the time needed to resolve the case.

The severity of the injury can also impact the negotiations between the injured worker and the insurance company. Insurance companies may be more hesitant to settle cases with more severe injuries because the cost of providing benefits could be higher.

Dispute over the claim: 

A dispute over the claim can significantly delay the settlement of a workers’ compensation case. A dispute can arise when the insurance company denies the claim, disputes the extent of the injury, or disputes whether the injury occurred while the worker was on the job. In some cases, the injured worker may also dispute the benefits offered by the insurance company.

When a dispute arises, it can extend the time needed to resolve the case because it may be necessary to provide additional evidence or undergo additional medical examinations to support the claim. Disputes can also lead to negotiations between the injured worker and the insurance company, and in some cases, may require the involvement of a lawyer.

The appeals process can also add further delays to the settlement process. If the injured worker disagrees with the decision made by the insurance company, they can file an appeal with the workers’ compensation appeals board. This process can take several months or even years to resolve.

Jurisdiction: 

Jurisdiction can be a factor that delays the settlement of a workers’ compensation case. Workers’ compensation is regulated at the state level, and each state has its own laws and regulations governing workers’ compensation claims. The jurisdiction refers to the state where the injury occurred and where the claim is being filed.

If a worker was injured in a state other than their home state or where their employer is located, it can lead to jurisdictional issues. In some cases, the insurance company may dispute which state’s laws apply to the claim. This can lead to delays in the settlement process as it may be necessary to determine which state’s laws should apply.

Additionally, if the injured worker is located in a different state than their employer or if their employer has multiple locations, it can also lead to jurisdictional issues. The laws and regulations governing workers’ compensation can vary from state to state, so it is important to determine which state’s laws apply to the claim.

The involvement of third parties:

Third parties can include individuals or entities that are not directly involved in the employment relationship, such as subcontractors, equipment manufacturers, or property owners.

If a third party is involved in the injury, it can complicate the settlement process. The injured worker may need to file a separate claim against the third party, and it may be necessary to coordinate the settlement of both claims. In some cases, the injured worker may need to file a personal injury lawsuit against the third party in addition to the workers’ compensation claim.

The involvement of a third party can also lead to disputes between the injured worker, the insurance company, and the third party. For example, the insurance company may dispute whether the third party is liable for the injury, or the third party may dispute the extent of the injury.

Timeliness of filing the claim:

The deadline for filing a workers’ compensation claim can vary from state to state. If the claim is not filed on time, it can delay the processing of the claim and prolong the time it takes to settle it.

The timeliness of filing a claim can be a factor in delaying the settlement of a workers’ compensation case. Each state has its own time limit for filing a workers’ compensation claim after an injury occurs. If an injured worker fails to file a claim within this time limit, they may be ineligible for workers’ compensation benefits.

If an injured worker does not file a claim within the time limit, it can lead to delays in the settlement process. The insurance company may dispute the claim or deny it altogether, which can lead to negotiations and the need for additional evidence. In some cases, the injured worker may need to appeal the decision, which can add further delays to the settlement process.

Additionally, if an injured worker waits too long to seek medical treatment or fails to report the injury to their employer in a timely manner, it can also lead to delays in the settlement process. The insurance company may dispute the extent of the injury or whether it occurred while the worker was on the job.

Attorney involvement: 

While it is important to have an experienced attorney to ensure that your rights are protected and your claim is fairly evaluated, the attorney’s involvement can also lead to delays in the settlement process.

One reason for this is that negotiations between the attorney and the insurance company can take time. The attorney may need to gather evidence and documentation to support the claim, which can take time. Additionally, negotiations can be lengthy, particularly if there are disputes over the extent of the injury or the amount of benefits to be awarded.

In some cases, the involvement of multiple attorneys can also add further delays to the settlement process. For example, if there are multiple injured workers involved in a case or if a third party is involved, it may be necessary to coordinate the efforts of multiple attorneys.

Overall, it’s difficult to predict exactly how long a workers’ compensation case will take, as it depends on the specific circumstances of the case. However, it’s important for injured workers to work with an experienced workers’ compensation attorney to help ensure their rights are protected and to help move the case along as quickly as possible.

If you’re looking to speed up this process and truly accelerate your claim with the best outcome possible reach out to us here at Solov and Teitell. Our attorneys have decades of experience and connections that will get it done for you!

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