Do All Workers’ Comp Cases End in a Settlement?

On This Page

1. Filing for Workers’ Compensation
2. You May Have to Fight for Your Benefits
3. A Lawyer Can Help You at Every Stage

REVIEWED BY

C. William Kenny

December 12, 2023

Board certified by National Board of Trial Advocacy

Each workers’ compensation case is different, so it is not possible to make a generalization about whether all workers’ comp cases end in a settlement, or what the outcome of your case may be. This article will give you more information about what your case may entail and how to get a settlement (if you want one).

Filing for Workers’ Compensation

According to the Pennsylvania Workers’ Compensation Act, if you were injured while doing your job for an employer who is required by law to carry workers’ compensation insurance, you are entitled to benefits. There are some exceptions to this rule, however. For example, purposely self-inflicted injuries are not covered.

Per the Pennsylvania Department of Labor & Industry, to get workers’ compensation benefits, you must do the following:

• Inform your employer about your injury immediately,
• Let them report your injury to the Bureau of Workers’ Compensation (BWC), and
• Wait seven days from the date of the injury.

At this point, if your claim is accepted, you can begin to receive workers’ compensation benefits. Such benefits include two-thirds of your weekly salary and medical treatment for your injuries. Unfortunately, there are many ways and reasons that your employer (or their insurance company) could withhold the money you need.

You May Have to Fight for Your Benefits

Some workers’ compensation cases are more difficult than others. Your employer may deny your claim or stop paying for your benefits before you are ready to go back to work. In cases like this, you can petition the Workers’ Compensation Office of Adjudication for a new decision. From there, as explained by the Pennsylvania Department of Labor & Industry, your case may proceed like this.

Mediation

The first step in resolving your workers’ compensation case may be mediation. The Office of Adjudication will order you and your employer (or your employer’s insurance company) to sit down with a workers’ compensation judge and try to work out your differences. If you reach an agreement, you do not have to go any further in the appeals process. You can just sign the agreement and move on.

Hearing

If you and your employer cannot agree during mediation, you will have to appear at a hearing before a judge with the Workers’ Compensation Office of Adjudication. Both sides will present evidence to support their claims. In your case, this means providing testimony and medical evidence to prove that you really were injured and that your injuries have not healed enough to allow you to go back to work.

Appeal

If the Office of Adjudication judge rules against you, you can appeal their decision to the Workers’ Compensation Appeal Board. They will review your case and all of the evidence before making a new decision.

A Lawyer Can Help You at Every Stage

If you are having trouble getting the compensation you need, you may want to seek professional legal advice. Your employer and their insurance company may have legal representation. You deserve the same.

A workers’ compensation lawyer can help you navigate the many intricacies of the application and appeals process. This includes negotiating for a settlement, if that is what you want. A lawyer can also help you by:

Explaining the Process

Fighting for workers’ compensation can be a lengthy and complex process. A lawyer can make sure you understand what is happening and that you do not inadvertently give up any of your rights.

Submitting Paperwork

Every step of the process requires you to submit paperwork to various people before strict deadlines. If you hire a lawyer, they will take care of all that for you.

Gathering Evidence

A lawyer can help you collect medical records and locate witnesses to testify at the hearing. They can also help you figure out how to present your own testimony.

Negotiating on Your Behalf

It can be difficult to know what to ask for and how to ask for it. This is especially true when the people on the other side of the negotiating table are professionals and you are not. A workers’ compensation lawyer will work with you to create a game plan for getting the money you deserve, and then do all of the negotiating for you.

While you can accept a settlement if you want to, it is not the case that all workers’ comp cases end in a settlement. You have the right to decide when to settle and when to keep fighting. If you need help with your workers’ compensation claim or appeal, call Berger and Green at (412) 661-1400.

We serve Pittsburgh, Pennsylvania and the surrounding areas. One of our leading attorneys, Laurence Green, has decades of experience in helping people just like you. Let us evaluate your case free of charge and fight for your rights.