In California, workers’ compensation is designed to help employees recover from workplace injuries by providing necessary medical care and wage replacement. While many workers’ compensation cases are resolved through settlement, others may proceed to trial if disputes arise between the injured worker and the insurance company or employer.
Deciding whether to settle your case or take it to trial is a significant decision that can impact the compensation you receive and how long it takes to resolve your claim. Settling offers a quicker resolution and certainty, while going to trial provides the opportunity to fight for maximum benefits but with more risk and time investment. In this guide, we’ll explore the key factors to consider when deciding whether to settle your workers’ compensation case or proceed to trial in California.
1. Understanding Workers’ Compensation Settlements in California
What is a Workers’ Compensation Settlement?
A settlement in a workers’ compensation case is an agreement between the injured worker, the employer, and the insurance company to resolve the claim. Typically, the injured worker agrees to accept a lump sum or structured payments in exchange for releasing the employer and insurer from further liability related to the injury.
Types of Workers’ Compensation Settlements
There are two main types of settlements in California workers’ compensation cases:
- Stipulated Award: This type of settlement includes ongoing payments for permanent disability and future medical care. You and the insurance company agree on the extent of your disability and the amount of benefits you will receive. You do not waive your right to future medical care under this type of settlement.
- Compromise and Release (C&R): A C&R involves a lump-sum payment in exchange for closing your case entirely. Once you accept this settlement, you waive your right to future medical benefits, meaning you cannot seek additional workers’ compensation benefits related to your injury in the future.
Both types of settlements allow you to avoid a trial and provide a quicker resolution to your case. However, it’s crucial to carefully consider the long-term implications, especially when accepting a C&R, as you give up your right to future medical treatment.
2. What Happens When You Take a Workers’ Compensation Case to Trial?
Why Cases Go to Trial
While most workers’ compensation cases are resolved through settlement, some disputes cannot be resolved through negotiation and end up going to trial. Common reasons for going to trial include:
- Disagreements over the extent of your injury: The insurance company may argue that your injury is less severe than claimed, affecting your disability rating and the amount of benefits you receive.
- Disputes over medical treatment: If the insurance company denies necessary medical treatments or therapies, you may need to take the case to trial to secure proper care.
- Pre-existing conditions: The insurance company may claim that your injury is due to a pre-existing condition rather than a workplace accident, which can lead to a dispute over your eligibility for benefits.
- Permanent disability rating disagreements: A dispute may arise over the percentage of your disability rating, which directly impacts the amount of permanent disability benefits you receive.
The Trial Process in California Workers’ Compensation Cases
If your case goes to trial, it will be heard before a judge from the Workers’ Compensation Appeals Board (WCAB). Here’s what you can expect during the trial process:
- Pre-Trial Discovery: Both parties gather evidence, including medical records, depositions, and witness statements.
- Testimony and Cross-Examination: You and any witnesses may be required to testify. The insurance company may also present its evidence and cross-examine you.
- Medical Expert Opinions: Medical experts may be called to provide opinions on your injury and treatment.
- Judge’s Decision: After hearing all the evidence, the judge will issue a decision. This decision is binding, but either party can appeal it if they disagree with the outcome.
Going to trial can take months or even years to resolve, and the outcome is not guaranteed. However, in some cases, pursuing a trial may result in a higher settlement or more comprehensive benefits than you would receive through a settlement.
3. Factors to Consider Before Settling Your Workers’ Compensation Case
The Extent of Your Injuries
The severity of your injury and the likelihood of requiring future medical care are critical factors to consider when deciding whether to settle or go to trial. If you have a severe injury that may require long-term treatment, a Stipulated Award may be a better option, as it preserves your right to future medical care. On the other hand, if your injury has stabilized and you don’t anticipate needing further treatment, a Compromise and Release (C&R) may provide a quicker resolution and a lump-sum payment.
Certainty vs. Risk
Settling your case offers a guaranteed outcome, while going to trial carries risks. At trial, a judge may rule in your favor, but there’s also a chance that the judge could award you less than what you were offered in a settlement or even deny certain benefits altogether. If you value certainty and are satisfied with the settlement offer, it may be best to settle your case and avoid the uncertainty of a trial.
Financial Needs
For many workers, financial pressure plays a significant role in deciding whether to settle. If you need immediate financial assistance to cover medical bills, rent, or other living expenses, settling may be the quickest way to receive compensation. Trials can take months or even years to reach a resolution, which may not be feasible for workers in need of urgent financial relief.
Future Medical Care
When accepting a Compromise and Release (C&R) settlement, you waive your right to future medical care through workers’ compensation. This means that if you need additional treatment or surgery down the line, you’ll have to cover the costs out of pocket or through private insurance. Carefully consider the long-term medical needs related to your injury before agreeing to a C&R.
4. Benefits of Settling Your Workers’ Compensation Case
Settling your workers’ compensation case offers several advantages, particularly for workers who are looking for a quicker resolution and a guaranteed payout.
Faster Resolution
One of the main benefits of settling is the faster resolution compared to going to trial. Settlement negotiations can be completed in a matter of weeks or months, while trials can drag on for years. If you want to avoid the lengthy litigation process and move forward with your life, settling may be the best option.
Guaranteed Outcome
When you settle your case, you agree to a specific amount of compensation. This provides you with certainty about the outcome of your case and allows you to plan accordingly. Going to trial, on the other hand, carries the risk of receiving a lower payout or losing certain benefits altogether.
No Need for Court Appearances
Settling your case means you won’t need to appear in court or testify before a judge. This can be a significant advantage for workers who feel uncomfortable in a courtroom setting or who want to avoid the stress and uncertainty of a trial.
Flexible Settlement Terms
In some cases, you may be able to negotiate favorable settlement terms that meet your specific needs. For example, you could negotiate a higher payout in exchange for waiving future medical care, or you might opt for a Stipulated Awardthat provides ongoing payments for disability and future medical treatments.
5. Benefits of Taking Your Workers’ Compensation Case to Trial
While settling offers a quicker and more certain resolution, there are situations where going to trial may be in your best interest. In cases involving significant disputes or the potential for a larger award, pursuing a trial may result in a better outcome.
Potential for a Larger Award
At trial, the judge has the authority to award you full benefits, including back pay, ongoing disability payments, and future medical care. If the settlement offer you received is significantly lower than what you believe you’re entitled to, going to trial gives you the opportunity to fight for the full value of your claim.
Ability to Challenge Low Disability Ratings
If the insurance company has assigned you a low disability rating that you believe does not accurately reflect the severity of your injury, going to trial allows you to challenge this rating. Medical experts can testify on your behalf, and the judge can issue a new rating based on the evidence presented at trial.
Appealing Unfavorable Decisions
If the judge rules in your favor, the insurance company must comply with the decision. However, if the judge rules against you, you still have the option to appeal the decision to a higher court. This gives you another chance to present your case and potentially receive a more favorable outcome.
Holding the Insurance Company Accountable
Some workers choose to go to trial to hold the insurance company accountable for wrongful denials or delays in processing their claim. A trial gives you the opportunity to present your case in front of a judge and challenge any bad-faith actions taken by the insurance company.
6. How Laguna Law Firm Helps You Decide
Choosing whether to settle your workers’ compensation case or take it to trial is a complex decision that should be made with the help of an experienced workers’ compensation attorney. At Laguna Law Firm, we have decades of experience representing injured workers across Southern California, including Mission Viejo, Los Angeles, West Covina, Corona, San Diego, Orange County, and Newport Beach.
Case Evaluation
We start by conducting a thorough evaluation of your case, including reviewing your medical records, disability rating, and the settlement offers made by the insurance company. Our attorneys will provide you with a clear understanding of the strengths and weaknesses of your case and offer advice on whether settling or going to trial is in your best interest.
Negotiation Expertise
If you decide to pursue a settlement, our attorneys will negotiate aggressively on your behalf to ensure that you receive the maximum compensation possible. We will work to secure a fair settlement that covers your medical expenses, lost wages, and any future care you may need.
Trial Preparation
If a settlement cannot be reached and you choose to go to trial, we will build a strong case on your behalf. This includes gathering evidence, working with medical experts, and representing you at all hearings. Our goal is to secure a favorable outcome for you, whether through settlement or trial.
Conclusion
Deciding whether to settle your workers’ compensation case or take it to trial is a personal decision that depends on the specifics of your injury, financial needs, and long-term health considerations. Settling offers a quicker and more certain resolution, while going to trial gives you the opportunity to fight for the full value of your claim.
At Laguna Law Firm, we’re here to help you make the best decision for your case. Our experienced attorneys have successfully handled workers’ compensation cases across Southern California and are ready to provide you with the guidance and representation you need. Whether you choose to settle or go to trial, we’ll fight to ensure that you receive the benefits you deserve.
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