Learn when and how to settle your Florida workers’ compensation claim, as well as what rights you are giving up in return for the money.
Whether you’re getting workers’ compensation benefits or disputing the insurance company’s rejection of your claim for a work-related injury or sickness, you may want to consider signing a settlement agreement with the insurer. While there are advantages to resolving a workers’ compensation claim, such as receiving money right immediately to meet your rising costs, there are also hazards involved. Make sure you understand the settlement agreement and the rights you’re giving up under Florida law before signing on the dotted line.
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Workers’ Compensation Settlements in Florida
There are many types of settlement agreements in Florida, based on the rights you are giving up and how you will be compensated:
Liability may be released completely or partially. Typically, the insurance company will want you to agree to a full and final settlement, which means you’re waiving your right to any additional workers’ compensation benefits available under Florida law for your injury—including any injuries or illnesses that occurred while you were working for your employer prior to the settlement but were not yet identified as work-related (such as a repetitive stress injury or an occupational disease). You may be able to reach a limited settlement in which you get money in return for the right to certain benefits (such as permanent impairment benefits), but the insurance company continues to pay your medical expenditures. This form of habitation, however, is rather uncommon.
Structured or lump-sum settlements. The majority of settlements give you a lump amount of money. However, the insurance company may agree to pay the money in installments over time in specific situations. Structured settlements are widely employed in catastrophic injury cases because they may assist badly wounded workers in managing their settlement funds and paying for long-term care.
When these two elements are considered together, the most typical kind of settlement in Florida is a full-and-final release with a lump sum.
When Can I Resolve My Florida Workers’ Compensation Claim?
You may settle your workers’ compensation claim at any moment if you have a workers’ compensation lawyer. If you don’t have a lawyer, Florida law specifies when you may agree to a full-and-final lump-sum settlement. You may agree to this form of settlement without the assistance of a lawyer only if:
Your workers’ compensation claim has been refused by the insurance company, and a court determines that there is a real dispute as to whether you are entitled to benefits; or your doctor feels that your medical condition is stable and that you are unlikely to improve (a stage known as maximum medical improvement, or MMI).
However, it’s nearly always a good idea to wait until you reach MMI before considering settling your case. Because insurance companies often cease paying medical expenses following a settlement, you will be financially liable for any unexpected medical care you need. Also, while you’re recuperating, it’s unclear if your job injury will result in persistent medical issues or loss of function (referred to as “permanent impairment” under Florida workers’ comp law). This makes determining how much money to seek in a settlement difficult.
How Much Will I Be Awarded in a Settlement?
Florida, like other states, does not utilize a defined formula to compute settlement amounts. Insurance companies and attorneys, on the other hand, base their settlement offers and demands on a variety of criteria, including:
the extent of your injuries
the degree of any lasting disability caused by your accident
the total sum of any outstanding medical bills
any underpaid temporary disability benefits, as well as any late payment penalties
if you are likely to need future medical care for the job injury and, if so, an estimate of how much that will cost; whether you are able to return to work and, if not, how much you earned before to the accident; and whether there is contradictory evidence in your case.
Keep in mind that certain charges, including as lawyers’ fees and other legal expenses, any child support owed, and an amount of money to pay medical treatment that may be necessary for your injuries if you are qualified for Medicare, may be withheld before you get the money. (Learn more about how much of your workers’ compensation payout you may retain here.)
In Florida, how are settlements finalized?
Depending on whether you have a lawyer and the kind of settlement agreement, the process of completing a settlement differs.
Using a Lawyer to Resolve a Claim
If you have a lawyer, you usually do not need to attend a settlement hearing. Instead, the lawyer will walk you through a sequence of paperwork, which will include the written settlement agreement and an explanation of the fees that will be deducted from the settlement sum.
The amount of costs that will be paid to your lawyer must be approved by a workers’ compensation court. Otherwise, if you have a counsel, Florida does not require the court to consider the settlement itself. The state presumes that your counsel has previously defended your rights. The settlement is final once you sign the papers.
Getting a Claim Settled Without a Lawyer
If you agreed to a full-and-final lump-sum payment without the assistance of a lawyer, a workers’ compensation court will convene a hearing to assess the settlement agreement, as well as supporting evidence and other papers, to determine whether it is fair. The court will also interrogate you to ensure that you understand the settlement and your legal rights in Florida.
If you resolved your lawsuit after the insurance company refused your claim, the settlement will not be legitimate until approved by the court. If you settle after achieving MMI, the court will determine whether the settlement amount is larger than the worth of workers’ compensation benefits you would otherwise be entitled to. If this is the case, the court is not required to approve it.
Can I Change My Mind After I’ve Made a Decision?
Once a full-and-final settlement is reached, you may not reopen your claim with the Florida Division of Workers’ Compensation to seek extra compensation, even if your medical condition worsens and you need further treatment.
This implies you shouldn’t agree to a settlement until you fully comprehend its terms and are absolutely satisfied with the long-term implications. Without the assistance of a lawyer, this might be challenging. An experienced workers’ compensation attorney can assist you in evaluating settlement offers, negotiating with the insurance company, explaining the meaning and implications of all the terminology in the settlement agreement, and ensuring that all paperwork is done appropriately.