Claim Resolution Under California Workers Compensation Law
California workers compensation law claim resolution is different than personal injury lawsuits in many ways. Although both workers compensation law and personal injury law both deal with bodily harm, the two are drastically different. Workers comp is an insurance policy that all employers in the State must provide for their employees. The policy needs to provide a certain set of benefits and be administered in a certain way as provided by State law. Benefits under the policy are available to employees on a no fault basis, which means that in most circumstances an injured worker can recover from the insurance so long as the injury arises out of and in the course of employment. This is true even if the employer is not negligent. And, unlike under the common law action of negligence, the way compensation is provided is much different.
Valuation For A Lump Sum Settlement
At the end of a case, the parties usually have a final medical report. That report has an impairment rating for permanent disability which once calculated out will equate to a dollar value to be paid out to the employee, with usually 15% withheld for the attorney fee by the judge. The final medical report will also state the nature and extent of treatment that the insurance company must provide into the future. If the case goes to trial, the judge will award the permanent disability and the future medical treatment. However, the judge will not award money for the future treatment at trial. This means that negotiations over a large lump sum settlement to settle all issues in the case is not based upon the cash value of the case at trial. This makes California workers compensation law claim resolution very unique. When a case closes as a lump sum, the value negotiated between the parties will not be valued by the potential sum awarded by the court should the case go to trial. Instead, it is based upon what the insurance company is willing to pay and what the applicant is willing to accept to not have the future treatment anymore. In many instances, the defendant is not willing to pay very much because they believe the likelihood of the applicant actually using the medical care policy is low. They also continue to exercise a lot of control over the treatment by their ability to deny on utilization review any care requested to be paid for by the primary doctor under the plan.
Obtain Proper Representation To Negotiate A Settlement