In theory, the workers compensation audit system is meant to streamline the method for workers to urge compensated for his or her injuries. However, in practice, a standard complaint among injured workers is that their workers’ comp cases seem to tug on forever. To find out current time estimates and what factors seem to play a task, we surveyed our readers about their experiences.
Average Duration of a Workers’ Compensation Case
According to the results of our survey, it took a mean of 15.7 months for our readers to resolve their workers’ compensation cases—either through a voluntary settlement with the workers' comp insurance firm 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'll get 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 his or her cases to conclude.
Given that the workers’ compensation system is understood for having a slow process, these time frames aren't too surprising. The good news, though, is that you simply might still receive some benefits before your case is officially resolved. For example, if you've got to miss work due to your injuries, you'll receive temporary disability payments to exchange a 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.
Factors That Affect the Length of a Workers’ Comp Case
Many factors influence how long or short a workers’ compensation case is going to be, including whether the worker hires a lawyer, whether the worker tries to barter a far better settlement, and whether the worker requests a workers’ compensation hearing or files an appeal. A longer workers’ compensation case wasn't always a nasty thing, though. Factors that attended lengthen cases also attended end in higher settlements or awards.
Whether the Insurance Company Disputes Permanent Disability
Because permanent disability benefits usually structure the majority of a settlement or award, both the worker and therefore the insurance firm has a robust interest in what permanent disability (PD) rating the worker ultimately receives.
Whether the insurance firm disputed a worker’s disability rating played an outsized role in how long the workers’ compensation case took. When the insurance firm didn't dispute the worker’s PD rating, the case was resolved in 14.4 months. However, when the insurance firm did dispute the worker’s PD rating, the case took 18.7 months.
The increased time-frame is sensible given the additional effort that goes into a disability rating dispute. In most cases, the insurance firm will send the worker to an independent checkup (IME) by a doctor of its choosing, so as to urge a second opinion as to the worker’s disability. The IME doctor will then write a report, which the worker will have a chance 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.
Whether the Injured Worker Hires a Lawyer
Workers who hired lawyers attended have longer workers’ compensation cases than those that didn’t. On average, cases resolved in 17.9 months for workers with lawyers, compared to 12.2 months for workers without lawyers.
It is sensible that a lawyer would add time to a workers’ compensation case. Lawyers have more tools at their disposal to challenge the insurance firm and obtain you more in benefits. Among other things, your lawyer may file motions, negotiate with the insurance firm, and obtain second opinions on your medical condition—all of which take time.
While the added time could seem sort of a point against hiring a lawyer, there’s a crucial upside to those numbers. Although cases typically took longer to resolve with a lawyer, the top result was usually much better: Workers with lawyers received almost one-third more in compensation than workers who did not have lawyers.
Whether the Worker Takes Steps to Get a Higher Settlement or Award
Workers who tried to barter a better settlement attended have longer workers’ compensation cases than those that didn't. On average, workers who engaged in negotiations with the insurance firm resolved their cases within 17.7 months. In contrast, workers who accepted the primary offer they received from the insurance firm 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 firm 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.
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 that didn’t request a hearing or file an appeal.
The longer time-frame is sensible because a workers’ compensation appeal takes over time and energy. 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 collect evidence and prepare their arguments for the judge.
Common Reasons for Workers' Comp Delays
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.
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, also as their strong business incentive to attenuate payouts on workers' comp claims.
Insurance companies may stall a workers’ compensation case during a number of ways—for example, by taking overtime to research a claim, denying or ignoring requests for medical treatment, or being slow to schedule important events (such as an independent medical examination). While a number of these actions could also be a part of legitimate defense of a claim, insurance companies can also use delay tactics to frustrate workers into abandoning 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 are due to a scarcity of communication on the lawyer’s part—for example, the case may need to be been progressing because it should, but the lawyer didn’t keep the worker informed about what was going on. The delay can also are because the lawyer was juggling too many cases; because attorneys’ fees are capped in most states, workers’ comp lawyers tend to hold heavier caseloads than other attorneys.
Another common explanation for the 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 the maximum amount as possible. Depending on the sort of injury sustained, it can take several months, or maybe years, for a worker to succeed in now. 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 an extended time to succeed in a good settlement agreement, 7% reported that it took an extended time to find a lawyer, and 19% reported that the delay was thanks to a spread of other factors.
Consult With a Lawyer
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 upon a variety of things 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.
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