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HOW DO I MAXIMIZE MY WORKERS' COMP SETTLEMENT?

John Bruscato Aug. 14, 2020

If you or a loved one has been injured at work, you may be wondering how you're going to pay the medical bills and win your workers' compensation rights. In this article, I will explain how to increase the odds of winning your case and maximize the compensation you deserve for your losses.

Every day, injured workers in Louisiana apply for workers' compensation benefits and eagerly await their due payment. Some of these workers are met with good news. In contrast, others receive denied workers' comp claims — even if they have equally valid workplace injuries.

So how can you ensure that yours is one of the successful claims? How do you win a workers' compensation case?  

Read on to learn the three crucial steps to winning a workers' compensation case in Louisiana. Then, once you're confident in your case, you'll discover eight time-tested strategies to maximize your settlement value.

How To Win Your Workers Compensation Case

Before you worry about maximizing your settlement, first focus on winning your workers' comp case. Here are three ways to do it.

1. Make Sure Your Workers' Comp Claim Is Legitimate 

People tend to lose workers' compensation cases for one of two reasons.

Either they 1) fail to report their injury or 2) present their case so that the insurance company interprets the claim to be fraudulent. 

Avoid both of those mistakes right now by taking a moment to review what types of injuries are eligible for workers' compensation in Louisiana:

  • On-the-Job Injuries —Whether it's a back injury, slip and fall, car wreck, loss of limb, or other accident, a work injury should qualify for workers' compensation as long as it happened at your workplace (or because of a work-related task).

  • Repetitive Stress Injuries — Continually repeating a movement can lead to repetitive stress injuries like tendonitis, bursitis, and carpal tunnel syndrome. Link such a condition to your work, and you have a valid claim to workers' compensation benefits.

  • Occupational Illnesses — Many work environments expose workers (often, unintentionally) to all kinds of toxins and chemicals that later lead to severe illnesses and cancers. If this has happened to you or a loved one, filing for workers' comp can not only get you compensated, but it can protect other workers as well.

If you're afraid your claim might be denied (or if, like so many others, you've already been denied workers' comp benefits), get an experienced workers' compensation attorney on your side sooner rather than later.

My Monroe-based personal injury law firm offers free consultations for workers' compensation cases, so you have nothing to lose by reaching out. 

2. Document Your Case Correctly

To win a workers' compensation case, you must start by following Louisiana's workers' comp protocols. Your first action is to report the incident to your employer within 30 days of the accident (or within 30 days of discovering your condition). 

However, there are other steps you can take to strengthen your case from the start:

  • Report the injury to your employer within 30 days (this step is mandatory, so it bears repeating)

  • Provide details (as requested by your employer) about the events that led up to the injury or illness

  • Write down everything you remember about the incident (for your records)

  • Report the incident to your union, if you belong to one

  • Consult with an attorney if you have any questions or concerns (if you live in the Monroe area, I invite you to contact my firm, Bruscato Law)

While there is no guarantee these steps will lead to a victory, I can tell you that these steps do dramatically increase your chances of successfully collecting workers' compensation benefits. 

And fortunately, you don't have to figure it all out on your own. My law firm is here to guide you through the process and fight for your workers' comp case.

3. If Your Claim Is Denied, File an Appeal

In 2016 the National Academy of Social Insurance reported that nearly $62 billion of workers' compensation was awarded to injured workers. An encouraging statistic, to be sure, but it fails to illustrate an important truth: thousands of those workers' compensation settlements were only awarded after the original claim was denied.

A lot of legitimate workers' comp claims are denied the first time around, but that doesn't mean all hope is lost. If you and your attorney decide to file an appeal (that is, formally ask the court to reconsider your original claim), you may get another chance to win your case.

So far we've discussed how you can improve your chances of winning your workers' comp claim. 

Now let's talk about how to maximize your workers' comp settlement once your claim has been approved.

How Do I Maximize My Workers' Comp Settlement? (8 Key Strategies)

Most Louisiana workers' compensation claims result in a lump sum settlement. But how do you know how much to settle for? How do you know what an injury is worth? And most importantly, what can an injured worker do to increase the settlement value of his or her workers' comp case?

Here are eight proven strategies to help maximize your settlement amount.

1. Notify Your Employer and File Your Worker's Comp Claim

The first step to securing a fair settlement is to report the work injury to your employer. Do this as soon as possible. The longer you wait, the harder it will be to prove to your employer and the insurance company that you have a legitimate case. 

Also, you must report your injury in writing. When you report the accident to your employer, expect to be given a workers' compensation claim form. Once you fill out this form, your employer will be responsible for sharing it with the insurance company. 

This step marks the official notification to the insurance company of your injuries.

2. Seek Medical Treatment

You should seek medical attention immediately after your injury — do not wait. 

Any delay in seeking medical care can give the insurance company a reason to either lower your settlement amount or deny your claim. Think about it from the other side's point of view. If the injured worker didn't feel the need to seek medical treatment when the injury first happened, then perhaps it wasn't such a serious injury at all. 

It's this line of thinking that can lead to a denied claim or a lesser settlement amount, so be sure to act immediately.

3. Understand Your Workers' Comp Disability Rating

Work injuries often result in some form of lasting physical disability that can prevent you from working for a certain time.

There are four main categories of disability to be aware of:

  • Temporary total disabilities — Disability that completely prevents you from working for a certain time.

  • Temporary partial disabilities — Disability that prevents you from performing some, but not all of your work-related duties for a certain period of time.

  • Permanent partial disability — Disability that permanently prevents you from performing certain work-related duties.

  • Permanent total disability — Disability that prevents you from ever working again, regardless of employer.

If you are left with a permanent disability, your doctor will assign you a disability score based on severity. This severity score can range from 5% to 100%. 

Permanently injured workers may be eligible for lifetime wages to replace wage loss from the injury.

4. Take Advantage of Your Disability Benefits

Disabilities are eligible for weekly benefits at a set percentage of your average weekly wage. The insurance company may be more likely to settle if they are already sending you a disability check every week. 

To maximize the amount in your weekly checks, make sure to check your average weekly wage calculation to make sure you're being paid fairly. If you had any overtime work, side jobs, or any other deviations from your fixed wages, they may be factored in to increase the amount of money in your weekly check. 

If you haven't yet applied for disability benefits, you can apply here.

5. Keep a Record of Everything

To set yourself up for success, it will help if you have a complete record of the details of your injury and associated medical costs.

When you keep track of medical records, associated costs of your injuries, forms you've collected and filled out, and the various paperwork you've accumulated since the time of injury, you'll have documented proof of every aspect of the injury. This documentation can be used as proof. It may be used by your workers' comp attorney to help fight for maximum compensation.

Out-of-pocket expenses are also eligible for reimbursement from the insurance company, so don't forget to keep your receipts for medical expenses, parking lot fees, medications, and gas bills for your car. 

6. Prepare for an Independent Medical Exam

Even if you're sought medical attention with your primary doctor, your employer's worker's compensation insurance company may request that you get an independent Medical Exam (IME). 

An IME is performed by a doctor who is working for your employer's insurance carrier. Insurance companies often request these exams because it allows them to use a doctor within their network to make a trusted medical evaluation. 

There is no reason to refuse an IME, since this may lead to a termination of your benefits. If you decide to change doctors during the process, make sure to tell your worker's compensation insurance adjuster before receiving treatment from your new physician.

7. Be Careful What You Tell The Doctor

When meeting with your doctor, make a point to describe how your injury happened and how the injury is affecting you. Be honest, be specific, and, most of all, stick to the facts. What you tell your doctor will influence how the insurance company decides to proceed with your settlement. 

If your injury caused disabling symptoms that were not present before the accident, then you must make those details clear and known so they will be documented in your medical report. 

The insurance company will carefully review your medical record and look for a reason to limit your compensation or deny your claim altogether. That's why it is crucial that you be clear and specific about your injury when interacting with your medical provider.

8. Be Careful What You Tell The Insurance Company

The insurance company may request a recorded statement from you explaining in detail how your injury occurred. Insurance companies will use this information to try and find discrepancies and even use it to lower their settlement.

You are not legally obligated to give them a recorded statement. If the adjuster asks, tell them you're going to speak with your workers' comp attorney first. An experienced workers comp attorney will help you handle the insurance company, and maximize the value of your settlement offer and medical benefits as compensation for your injury.

Turn to an Experienced Workers' Compensation Lawyer in Monroe, Louisiana

Contact Bruscato Law today for legal advice on how to win your worker's compensation case and maximize your settlement. 

Whether your workers' compensation claim has been denied or you're concerned that it might get rejected, please don't hesitate to schedule a free consultation with Bruscato Law. As an experienced workers comp lawyer, I am happy to act as a legal resource to clients throughout Monroe and the surrounding areas.