Throughout your workers’ compensation case, you will probably have several opportunities to settle your case. In addition to informal negotiations, through letters or phone conversations, many workers’ comp cases have at least one in-person conference (usually called a “mediation”) to facilitate settlement negotiations.
A mediation is an informal meeting between you and the insurance company, where you try to reach a settlement of your workers’ comp claim. Most states require the parties to attend mediation, or engage in some other form of dispute resolution, before the case can proceed to a workers’ comp hearing.
The mediation is facilitated by a neutral third party called a “mediator,” who is usually an attorney with workers’ comp experience, a workers’ comp judge, or another official of the state workers’ compensation agency. The mediator does not work for either side; he or she is there to help the parties reach a mutually acceptable settlement. If the parties aren’t able to reach a voluntary agreement, the case continues on to a hearing.
If there is a mediation scheduled in your case, there are a couple of things you can do to make the process go more smoothly. First, you should strongly consider consulting with a workers’ comp attorney if you have not already done so. A skilled attorney can make a mediation much more successful and easier to navigate. Although mediation is informal, you may be expected to answer questions, present a general summary of your position, and make and respond to settlement offers. An attorney will take on this role at the mediation and put you on equal footing with the insurance company, which is likely to have its own lawyer present.
Second, you should make sure that you’ve gathered all of the evidence that can lend support to your case. This is typically done through a process called “discovery,” which you can use to collect documents, question witnesses, and ask the insurance company about the evidence it plans to use against you. This is another place where an attorney can be very helpful to your case. (To find a workers' comp lawyer in your area, fill out our free case evaluation.)
If you have strong evidence in support of your case, you may even be able to settle your case prior to the mediation. If not, organizing the evidence in a simple, easy-to-follow presentation can be crucial to success at mediation. This will show your employer and the insurance company that they are taking a risk by not settling at mediation.
Make sure to arrive at your mediation on time and dressed neatly (casual attire is usually fine, but your clothes should be clean and you should appear well groomed). At the start of your mediation, the mediator will introduce himself or herself and briefly explain the process. The mediator typically asks each side to make a short presentation, highlighting the facts in support of their cases. Your lawyer, if you have one, will present the facts and arguments in support of your case. However, he or she may ask you to make a short statement as well.
After both sides have made their presentations, the mediator will separate the parties into two different rooms. The mediator will then meet with both sides individually. During this meeting, the mediator may ask questions or point out what he or she sees as the strengths and weaknesses of each side. After one or more rounds of this, one party—usually the employee—will make an initial settlement offer. The mediator will present your offer to the insurance company, which will usually respond with a counteroffer. This process continues, with the mediator going back and forth between the two rooms, until you either agree on an amount or decide that a settlement can’t be reached. This process usually takes at least an hour or so, but can be several hours, depending on the time allotted by the workers’ comp agency.
If you and the insurance company reach an agreement at mediation, the lawyers will draft an agreement outlining the terms of the settlement (including the amount, how payments will be made, and more). Workers’ comp settlements must typically also be approved by the workers’ comp agency before the agreement can be finalized.
Cases often settle at mediation, or shortly afterwards. However, if you’re not able to settle, your case will continue on to the next step in the appeals process, which is typically a hearing before a workers’ comp judge. For more about the workers’ compensation appeal process, including what happens at a formal hearing, see How to Appeal a Workers’ Compensation Denial.