How Long Does a Workers' Compensation Case Take to Settle in California?
Workers' compensation cases in California can be lengthy and complex, especially if you're navigating the system on your own. Employers and insurance companies often complicate the process intentionally, adding unnecessary hurdles and delays.
Here's a clear breakdown of the timeline and key milestones you can expect in your workers' compensation case, including how Lee Partners Law helps move your case forward efficiently:
Timeline of a California Workers' Compensation Case
Detailed Breakdown of the Process
Step 1: Filing Your Claim (Form DWC-1)
Once you provide your employer or insurance company with the DWC-1 form, they have 90 days to admit or deny your claim. Unfortunately, denials are common, often citing insufficient medical evidence—even if they've neglected to send you for medical evaluations or obtain your medical records. Having an attorney ensures prompt responses to unjust denials and untimely denials.
Step 2: Treatment and Disability Payments
Your primary treating physician (PTP) issues reports every 45 days, indicating your temporary disability status. If you're temporarily disabled, you're entitled to two-thirds of your salary for up to 104 weeks. Attorneys can help ensure timely medical evaluations and secure disability benefits quickly.
Step 3: Panel Qualified Medical Examiner (PQME)
At any point after filing your claim, you can request a Panel Qualified Medical Examiner. Both sides then have 10 days to strike one doctor from the panel. Your QME appointment should be scheduled within 90 to 120 days under California Code Regulation section 31.3. Your attorney facilitates efficient selection and scheduling to minimize delays. After the examination, the doctor must issue their report within 30 days.
The PQME can also address if you are totally temporarily disabled as well in addition to the PQME.
Step 4: Maximum Medical Improvement (MMI)
Reaching Maximum Medical Improvement (MMI) is key to settling your case. MMI means your condition has stabilized, and no substantial further improvement is expected with or without medical care. The QME or PTP assigns you a Whole Person Impairment rating, determining your permanent disability benefits. You are still entitled to future medical care for all body parts injured as long as the PQME or PTP indicates you will need further care down the road.
Settlement Options
Stipulated Award: Provides lifelong future medical care and regular payments (typically around $290 per week) based on your disability rating.
Compromise and Release (C&R): Offers a lump-sum payment covering permanent disability and estimated future medical care. You can enter into a C&R as early as a week after filing your claim or as late as five years afterward—it can be negotiated at any time. Typically, the best approach is after reaching MMI, but there are exceptions. If you have an excellent attorney experienced with your condition, diagnostic reviews, and your likely need for future medical care, negotiating a C&R shortly after filing could make sense. Ultimately, this is your body and your life, and you decide what is best for you.
Why You Need a Workers' Compensation Attorney
Insurance companies frequently attempt early, lowball settlements to save money. An experienced workers' compensation attorney estimates your permanent disability rating, future medical costs, and negotiates for a fair settlement. Generally, settlement offers improve as the case progresses—making professional representation essential.
At Lee Partners Law, we understand the complexities of the California workers' compensation system and proactively advocate to expedite your case, ensuring you receive the maximum compensation without unnecessary delays.
If you're searching for a trusted Workers' Compensation Attorney near Los Angeles or anywhere in Southern California, contact Lee Partners Law today. Our dedicated team specializes in navigating the intricate workers' compensation system, fighting tirelessly to protect your rights and secure your benefits.
Contact Lee Partners Law to schedule your free consultation and expedite your case today at (310)295-0822.
Click here to see: How to File a Workers’ Comp Claim in California: Step-by-Step Guid