Workers’ compensation claims may take anywhere from weeks to years to settle, depending on the specific factors involved. There isn’t a universal average amount of time these cases take, as each involves different circumstances that influence the process and settlement amount.

Knowing more about what to expect with a workers’ compensation lawyer claim and the different elements factoring into these cases can help you gauge how long a case might take to settle.

Factors That Affect the Length of the Workers’ Comp Claim

The workers’ compensation settlement process will depend on numerous influencing factors. Not all cases are alike, meaning you must consider each element in your case to gauge how long it will last.

The following are some of the specific factors that can shorten or increase the amount of time the claims process will take:

The Injury Type and Severity

The type of injury you sustain, and its severity will largely dictate how long a case will take. Before you can recover a workers’ comp settlement, you must reach maximum medical improvement (MMI), a state of permanency in these cases.

The MMI is the point at which a doctor has determined that an injury victim has recovered as much as possible after an incident. More severe injuries will require longer recovery periods and more extensive treatments, potentially leading to higher settlements but longer claims processes.

In particular, injuries like traumatic brain injuries (TBIs) can lead to uncertainty in these cases and require more scrutiny before deciding on a settlement amount.

Lost Income and Earning Capacity

Another factor that can impact the length of a workers’ comp case is the income lost because of the injuries and the lost future earning potential. Insurers and attorneys must determine how much money the victim has lost and is likely to lose because of the recovery process or temporary or permanent disabilities.

Disputes Regarding Work-Related Injuries

Employers may work to show that an employee’s injuries developed outside their scope of employment, disputing workers’ comp claims. In some cases, employers may concede that an injury is work-related but argue that the employee is capable of returning to work or is exaggerating the severity of their injuries. If the employer opts to dispute the claim, this could make the workers’ compensation process take longer.

The Involvement of a Lawyer

When you hire a lawyer to help handle your case, you may speed up the workers’ compensation process. Many people make the mistake of only hiring legal counsel for a workers’ comp case after a dispute arises between them and their employers. Still, at that point, it’s often too late to recover sufficient evidence that can assist in proving the employee’s side of the dispute.

Waiting too long to seek representation in a case can lead to lost evidence and other issues that may make it harder to recover the amount of compensation injury victims deserve. Conversely, working with a lawyer early on can help you get a good start on the claims process and increase its efficiency.

The Need to Settle the Case in Court

Sometimes, workers’ compensation cases won’t settle during negotiations in the claims process. If this occurs, you and your lawyer may need to take the case to a hearing to settle it. This will require a longer process to recover compensation as you navigate the legal process after attempting to settle a claim.

The Appeals Process

If you receive a denial of your claim and cannot seek compensation through initial negotiations, you may appeal the decision. The appeal will require more time to settle your case and recover compensation.

Potential Delays in Workers’ Comp Cases

Multiple situations can lead to delays in workers’ compensation cases. Insurance companies must investigate each claim, which can lead to certain specific delays in the claims process.

Some of the potential delays in these cases may include:

  • Slow response times on the part of adjusters and insurers
  • Slow response times from medical facilities and physicians to extract medical records
  • Difficulties in seeking and receiving treatment from doctors and other medical professionals
  • Ignored requests to receive medical care
  • Delays on the part of claimants, including waiting too long to seek treatment

In some cases, insurers may also intentionally delay claims in the hope that the claimant will either settle for a lowball offer or abandon the claim altogether.

Reasons for Denying a Workers’ Comp Claim

Even if a claimant is entitled to compensation for their work injuries, insurers and employers may want to avoid paying and find a reason to deny a workers’ comp claim. There are different situations when this may occur.

For example, employers or insurers may claim that the employee is working as an independent contractor, not a part-time or full-time employee, rendering the worker unable to seek workers’ compensation.

In other situations, entities may argue that you sustained injuries that were not work-related, either because they occurred outside of your scope of employment or outside of the workplace. Some cases may also involve insurers arguing that injuries aren’t as severe as the worker claims or that the injury was preexisting and didn’t result from a work accident.

If insurers deny your workers’ comp claim, you should receive a formal letter explaining the denial. Depending on the situation, you may appeal the decision and reopen the case to continue seeking compensation. An attorney may assist you with the appeals process to help you argue why you’re qualified to recover workers’ compensation.

For instance, if an employer claims that you aren’t an actual employee of the company, an attorney may show that the company withheld taxes from your pay, which could qualify you as an employee and make you entitled to workers’ compensation.

How to Make the Workers’ Compensation Process Smoother

If you want to speed up the workers’ compensation process, there are some steps you can take to increase its efficiency and minimize delays. These steps include the following:

Find Out Why a Delay Is Occurring

If you see a delay at any point during your claim, find out the specific reason for this delay. Your case may take a long time to settle because of slow response times from various parties, lengthy investigations, or even uncooperative employers or bad faith by insurers.

Once you discover why your case is taking longer to settle, you can determine how to accelerate the process and mitigate the situation.

Collect as Much Evidence as Possible

When negotiating a workers’ comp claim, you must collect and present as much evidence as you can to prove the extent of your injury. While you don’t need to prove that your employer was negligent, you must prove that your injury is as severe as you claim and work-related.

Some of the crucial evidence you should collect in these cases include:

  • Medical records, bills, and receipts for treatment
  • Pay stubs that show your income both before and following your injuries
  • Photographs or video evidence of injuries and the scene of the accident

If you cannot obtain any of this evidence at any point, a workers’ comp attorney may help you collect it from employers, medical professionals, and other parties.

Connect With a Workers’ Compensation Lawyer

Even if your workers’ compensation claim appears simple, you may benefit from contacting an experienced workers’ comp attorney. A lawyer may guide you to successfully file a claim, and you may also more efficiently find out why your case is taking longer to settle if you experience a delay.

If an attorney chooses to represent your case, they may also find out exactly how much your case is worth and handle negotiations with insurers to reach a fair settlement. If insurers deny your claim, your attorney may help with the appeals process and enable you to continue seeking compensation even after the denial.

Keep Up With Your Case

As your case progresses, it’s best to monitor it continually. Find out your claim’s status and request updates from insurers or employers. Requesting these updates may help ensure that insurance companies and employers continue addressing the claim and don’t let it stagnate.

Facilitate Effective Communication

When beginning and negotiating a workers’ comp claim, do what you can to regularly communicate with all parties involved and make any necessary requests as needed.

For example, you’ll want to request medical records from your physicians and other medical professionals, workers’ comp forms and other documentation from employers, and other information from insurers about your case. While your attorney can help send all important documentation to these parties, you can accelerate the claims process by making all pertinent requests on time.

Attend Doctors’ Appointments and Stick To Your Treatment Plan

To keep the claims process moving along smoothly, also be sure to attend all scheduled appointments with your medical provider. Also, follow your doctor’s orders to allow for a smooth recovery and provide you with consistent medical records.

If you have any issues with your treatment plan, consult your doctor before making any changes. Your doctor may work with you to develop a new plan.

Steps for Filing a Workers’ Comp Claim

Keeping the workers’ comp claims process efficient involves taking the right steps to properly file this claim.

The following are some of the specific steps to take when filing a workers’ comp insurance claim after a work-related accident:

Seek Professional Care

You shouldn’t wait to seek medical care if you sustain a work-related injury. Treatment can help you begin the recovery process and provide medical documentation proving the extent of your injury and that it was work-related.

Notify Your Employer

You must notify your employer of any work-related injury you sustain, which will help you initiate the claims process. You have a limited time to notify your employer after a work-related incident, often within days after sustaining the injury. If you wait too long to do so, you may no longer file a workers’ comp claim.

Once you notify your employer of your injury, you must wait for the employer to respond. The response should indicate which medical professionals you’re approved to see under the workers’ comp insurance policy, and the employer should initiate the claims process with the insurer. The employer also has limited time to issue a response after notification.

Find Out Which Office to File Your Claim With

Each state in the U.S. has a specific office where you can file a workers’ compensation claim. If you plan on filing a claim, you can visit the U.S. Department of Labor’s website to locate your state’s office.

When filing your claim, you must submit various documentation forms to the corresponding office. This documentation would include details about the accident and injury, medical records, and witness information if anyone else saw the accident.

Depending on the state, you may either seek treatment with a medical professional that your employer’s workers’ comp insurance policy designates or seek independent medical examinations from other third-party medical professionals.

Check Your Claim’s Status

After filing, keep up with your case by checking its status regularly. By checking the status, you can see how far along your case is and determine if any delays are slowing the process.

Take the Right Course of Action to Speed Up Your Workers’ Comp Claim

Jacque D. Hawk - Workers’ Compensation attorney in Augusta, GA area
Jacque D. Hawk, Workers’ Compensation Lawyer in Augusta 

If you’re wondering why your workers’ compensation claim is taking so long, you can identify any delays and accelerate the process. With the help of a personal injury attorney in Augusta, you may take the appropriate steps to shorten the claims process and recover compensation for any work injuries you sustained.