Workers’ comp settlements don’t happen automatically, and they’re not based on fairness or need. They happen when it makes financial sense for the insurance company. Let's break down why some people get early low offers, others hear nothing for years, and some cases suddenly move fast out of nowhere.
Workers’ comp insurance companies usually offer a settlement when continuing the case becomes riskier or more expensive than paying it off.
Most often, that happens after you reach Maximum Medical Improvement (MMI), when your doctor says you’re not expected to get much better. At that point, the carrier can estimate permanent disability and future costs.
Another key window is before a judge officially decides permanency. Once permanency is locked in, settlement value becomes predictable and leverage drops.
Offers may also come when medical evidence strengthens your case, litigation heats up, or—especially in New York—as the two-and-a-half-year mark approaches. Sometimes, internal insurance company deadlines also trigger offers.
In short, settlements happen when your case becomes clear, costly, or risky enough that settling makes financial sense for the insurance company.
A workers’ comp case is usually worth the most after it’s clear your injury is permanent, but before a judge officially locks in your disability rating.
At that point, the insurance company knows it’s facing long-term exposure, but the exact numbers aren’t set yet. That uncertainty gives you leverage. Once a permanency decision is made, the value becomes predictable math, and settlement flexibility drops.
The goal isn’t to settle too early, when the medical picture is still unclear, or too late, when time and prior payments have already reduced what’s left. The sweet spot is when the risk to the insurance company is high—but the outcome isn’t finalized.
A settlement offer usually gets triggered when something changes the insurance company’s risk or makes the case easier to measure.
The most common trigger is Maximum Medical Improvement (MMI), because it allows the carrier to estimate permanent disability and future costs. Strong medical reports or IME findings can also push things forward, especially when they support ongoing or permanent limitations.
Settlement talks often pick up when permanency reports are being requested, litigation costs increase, or hearings and depositions are approaching. In New York, the two-and-a-half-year mark can also trigger negotiations, since waiting longer may reduce the carrier’s future exposure.
If you have a New York workers’ compensation case and want to talk things through, you can call me, Rex Zachofsky. No pressure, no sales pitch—just a straightforward conversation about where your case stands and what your options look like.
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