In theory, the workers’ compensation system is designed to streamline the process for workers to get compensated for their injuries. However, in practice, a common complaint among injured workers is that their workers’ comp cases seem to drag on forever. To find out current time estimates and what factors seem to play a role, we surveyed our readers about their experiences.
According to the results of our survey, it took an average of 15.7 months for our readers to resolve their workers’ compensation cases—either through a voluntary settlement with the workers' comp insurance company or after a workers’ compensation hearing with a judge. That’s almost a year and a half. So if you were hoping for a swift resolution of your workers’ compensation case, you may need to adjust your expectations. Only 19% of workers resolved their cases in less than six months. For 50% of workers, it took between 13 and 24 months for their cases to conclude.
Given that the workers’ compensation system is known for having a slow process, these time frames are not too surprising. The good news, though, is that you might still receive some benefits before your case is officially resolved. 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. These payments are typically made while the claim is ongoing, rather than in a settlement or award at the end of a workers’ comp case.
Many factors influence how long or short a workers’ compensation case will be, including whether the worker hires a lawyer, whether the worker tries to negotiate a better settlement, and whether the worker requests a workers’ compensation hearing or files an appeal. A longer workers’ compensation case was not always a bad thing, though. Factors that tended to lengthen cases also tended to result in higher settlements or awards.
Because permanent disability benefits usually make up the bulk of a settlement or award, both the worker and the insurance company have a strong interest in what permanent disability (PD) rating the worker ultimately receives.
Whether the insurance company disputed a worker’s disability rating played a large role in how long the workers’ compensation case took. When the insurance company did not dispute the worker’s PD rating, the case was resolved in 14.4 months. However, when the insurance company did dispute the worker’s PD rating, the case took 18.7 months.
The increased time frame makes sense given the extra effort that goes into a disability rating dispute. In most cases, the insurance company will send the worker to an independent medical examination (IME) by a doctor of its choosing, in order to get a second opinion as to the worker’s disability. The IME doctor will then write a report, which the worker will have an opportunity to review and challenge. And, if the IME doctor disagrees with the worker’s treating doctor (which is often the case), the case can come to a standstill until the parties can reach an agreement or until a hearing occurs.
Workers who hired lawyers tended to have longer workers’ compensation cases than those who didn’t. On average, cases resolved in 17.9 months for workers with lawyers, compared to 12.2 months for workers without lawyers.
It makes sense that a lawyer would add time to a workers’ compensation case. Lawyers have more tools at their disposal to challenge the insurance company and get you more in benefits. Among other things, your lawyer may file motions, negotiate with the insurance company, and get second opinions on your medical condition—all of which take time.While the added time may seem like a point against hiring a lawyer, there’s an important upside to these numbers. Although cases typically took longer to resolve with a lawyer, the end result was usually much better: Workers with lawyers received almost one-third more in compensation than workers who did not have lawyers. (For more details, see Workers’ Compensation Settlements and Awards: How Much Will I Get for My Injury or Illness?)
Workers who tried to negotiate a higher settlement tended to have longer workers’ compensation cases than those who did not. On average, workers who engaged in negotiations with the insurance company resolved their cases within 17.7 months. In contrast, workers who accepted the first offer they received from the insurance company typically resolved their cases within 14.7 months. In other words, it took about 20% longer for workers who negotiated to resolve their claims.
However, as was the case with hiring a lawyer, negotiating with the insurance company usually resulted in much higher settlements or awards. Workers who attempted negotiations ended up with almost 150% more in compensation than workers who did not negotiate. (For more details, see our article on how much you may get for a workers' comp illness or injury.)
The same is true of workers who requested a workers’ compensation hearing or filed a workers’ compensation appeal. While it took 20% longer for workers who requested hearings (or filed appeals) to resolve their claims, they received 34% more in benefits than those who didn’t request a hearing or file an appeal.
The longer time frame makes sense because a workers’ compensation appeal takes additional time and effort. Once the worker files the appeal, the case is assigned to a workers’ compensation judge and set for a hearing. The hearing can often be scheduled months away, and both parties need time to gather evidence and prepare their arguments for the judge.
The overwhelming majority of readers, 90%, believed that there was a delay in their workers’ compensation cases. We asked our readers to report what they believed to be a source of delay in their cases.
According to 34% of our readers, the number one cause of delay was due to the employer or its insurance company not moving fast enough. This isn’t too surprising, given insurance companies’ general reputation for being slow and bureaucratic, as well as their strong business incentive to minimize payouts on workers' comp claims.
Insurance companies may stall a workers’ compensation case in a number of ways—for example, by taking additional time to investigate a claim, denying or ignoring requests for medical treatment, or being slow to schedule important events (such as an independent medical examination). While some of these actions may be part of a legitimate defense of a claim, insurance companies may also use delay tactics to frustrate workers into giving up or settling for a low amount to avoid the hassle.
Another reported cause of delay was the worker’s own lawyer: 13% of workers felt that their lawyers weren’t responsive or didn’t move fast enough. This may have been because of a lack of communication on the lawyer’s part—for example, the case might have been progressing as it should, but the lawyer didn’t keep the worker informed about what was going on. The delay may also have been because the lawyer was juggling too many cases; because attorneys’ fees are capped in most states, workers’ comp lawyers tend to carry heavier caseloads than other attorneys.
Another common cause of delay is one that can’t be blamed on either side: 12% of workers believed their cases were delayed because they were still recovering from their injuries and still receiving medical treatment. In most cases, settlement discussions don’t happen until a worker has reached “maximum medical improvement” (MMI)—the point at which a doctor declares that the worker has improved as much as possible. Depending on the type of injury sustained, it can take several months, or even years, for a worker to reach this point. Because it’s not clear until then what, if any, permanent impairment a worker will have, the case usually can’t be resolved before then.
As to other causes of delay, 12% of workers reported that it took a long time to reach a fair settlement agreement, 7% reported that it took a long time to find a lawyer, and 19% reported that the delay was due to a variety of other factors.
While surveys are helpful in determining current trends and practices, they can’t predict how long your workers’ compensation case will take. The duration of your case will depend on a number of factors particular to your situation, including how long you receive treatment for your injuries, the degree of any permanent impairment you’ve suffered, and what state you were working in at the time of your injury. Each state has its own workers’ compensation rules and procedures, which may also impact how long your workers’ compensation case will take. You can get a better idea of what you can expect in your case by talking to an experienced workers’ compensation lawyer.
