If you're injured at work, the workers' compensation system is supposed to streamline the process for obtaining benefits so that neither you nor your employer have to deal with a complicated court case. Unfortunately, the reality is that workers' comp cases are sometimes just as lengthy and complex as filing a lawsuit and litigating your claim in court.
A longer workers' comp case isn't always a bad thing, though. Some of the same things that tend to make a case longer—such as rejecting an insurance company's first settlement offer and trying to negotiate a higher payment—also tend to result in higher settlements or awards in the long run. In addition, workers frequently receive some benefits while their case is still ongoing. For example, if you have to miss work because of your injuries, you can receive temporary disability payments to replace part of your lost wages.
How long it takes to resolve your workers' comp claim depends on a variety of factors, including the type and severity of your injury, whether the insurance company disputes permanent disability, whether you hire a lawyer, and whether you try to negotiate a higher settlement or award.
If your claim is straightforward and uncontested, you can receive benefits in as little as a week or two after reporting your injury. But most cases take significantly longer. According to a survey conducted by Martindale-Nolo, the average time for workers' comp cases to be resolved is 15.7 months, with only 19% of respondents reporting that their claims took less than six months.
Many factors influence the length of a workers' comp case, some of which are within your control (such as whether you meet deadlines and respond promptly to the insurance company's requests for information) and others which aren't (such as the insurance company denying or ignoring requests for medical treatment).
The more serious and complex your injury, the longer it can take to resolve your case. This is in part because the insurance company is likely to request an Independent Medical Examination (IME) by a doctor of its choosing, and the investigation of your claim might involve a larger quantity of evidence, such as medical records and doctors' testimony.
In addition, settlement discussions usually can't happen until you've reached "maximum medical improvement" (MMI)—the point at which a doctor determines that your injuries have healed or your condition has improved as much as possible. Depending on the type of injury you sustained, it can take several months, or even years, for you to reach this point. Because it's not clear until then what, if any, permanent impairment you'll have, the case usually can't be resolved before then.
Once you've reached MMI, a doctor will assign you a permanent disability rating, which is intended to reflect the degree of your disability.
Permanent disability benefits usually make up the majority of a workers' comp settlement or award, so whether an insurance company disputes your permanent disability rating can play a big role in how long your case will take. If the insurance company doesn't dispute the permanent disability rating, a workers' comp case takes an average of approximately 14 months to resolve. If the insurance company does dispute the permanent disability rating, a case might take around 18 months.
If you hire a lawyer, your workers' comp case is likely to take about six months longer than if you don't. Workers' comp cases resolve in about 18 months for workers with lawyers, compared to about a year for workers without lawyers. But workers' comp lawyers have the experience to know when and how to challenge the insurance company's decisions. And this can pay off. While hiring a lawyer can extend the length of your case, workers with lawyers typically receive almost one-third more in compensation than workers who don't have lawyers.
If you accept the first settlement offer you receive from the insurance company, your workers' comp case will probably be over 20 percent faster than if you negotiate with the insurance company for a higher settlement. On average, workers who accept the first offer they receive typically resolve their cases within 14.7 months, while workers who engage in negotiations with the insurance company resolve their cases within 17.7 months.
Of course, negotiating with the insurance company is also likely to result in higher settlements or awards. Workers who attempt negotiations end up with almost 150% more in compensation than workers who do not negotiate.
The same is true of workers who request a workers' comp hearing or file an appeal. While it takes 20% longer for these workers to resolve their claims, they receive 34% more in benefits than workers who don't request a hearing or file an appeal.
As discussed above, although hiring a workers' comp lawyer can add a few months to your case, it's also likely to result in a higher settlement or award. And workers' comp lawyers can make a difficult workers' comp case go much more smoothly by guiding you through the process, preparing a legal analysis of your claim, making sure you meet deadlines, negotiating for you at your settlement conference, and representing you at your hearings.
Hiring a workers' comp lawyer usually won't cost you anything out of pocket. In most states, workers' comp attorneys charge a percentage of your benefits if you win your case, and nothing if you lose.