Workers' Compensation Settlement Amounts for Common Injuries
A workers’ compensation settlement gives funds to a worker who sustains injuries in a work-related environment. The process of calculating the amount for damages will depend on the type, location and severity of the injury. Most states allow you to negotiate a lump sum settlement over receiving weekly disability payments. Workers’ compensation laws vary from state to state, but the process of calculating a settlement is similar in most cases.
Calculating a Settlement
You will need to have copies of all your medical records, billing statements, accident reports and witness statements related to the injury. It’s recommended to wait until all treatments are completed and your condition is completely improved before filing a claim because the final totals from treatment facilities make up a portion of your settlement amount.
Calculating the percentage of bodily impairment makes up another portion of your settlement total. A doctor will evaluate your injury and determine at the conclusion of treatment what level of impairment your injury has caused you. 100 percent is equal to being fully impaired, down to 0 percent, which means your injury is completely healed. The percentage amount is then compared with your state’s laws on estimated time it takes for the particular injury to heal and the amount of workers’ compensation wages you are entitled to. The impairment percentage is then multiplied by the wage amount to calculate the second portion of your workers’ compensation settlement amount.
An estimate of future medical expenses and treatments related to the injury will also be calculated at the conclusion of your medical treatment. This amount will then be added to the comp settlement total. Legal fees and attorney costs might also be added to your settlement amount.
Disability payments are paid on a permanent or semi-permanent basis, depending on the extent of your injury.
Temporary Total Disability is the most common workers’ compensation case, which means the worker is temporarily unable to perform the pre-injury job or another job with the employer that the worker could have performed before the injury. Most workers who receive these benefits fully recover and return to work, at which time benefits end. Most states pay weekly benefits for temporary total disability that replace two-thirds of the worker's pre-injury wage (tax free), subject to a dollar maximum that varies from state to state.
Temporary Partial Disability means that workers return to work before they reach maximum medical improvement and have reduced responsibilities and a lower salary. In those cases, they receive temporary partial disability benefits.
Permanent Total Disability means the doctor does not think you are able to return to any employment (not just the type of work you were doing before the injury). If you are determined to be Permanently and Totally Disabled (“PTD”) you may be entitled to receive weekly benefits for life, or for so long as you remain permanently and totally disabled. If the parties agree, a PTD case may be settled for a lump sum.
Permanent Partial Disability means while you may be unable to do certain jobs or certain job tasks, and will have physical complaints that will remain on a permanent basis, you are still able to work at some full-time job. If you are determined to be Permanently and Partially Disabled (“PPD”), your PPD benefits will generally be paid in a lump sum depending on your state’s laws.
Accepting the Settlement
When deciding whether or not to accept a settlement offer, keep in mind that a settlement closes your case completely, which means that the workers’ compensation insurance company will not be responsible for paying you any additional compensation and, more importantly, will not provide any more medical treatment for your injury. Health insurance may or may not provide treatment after you settle the case, as the health insurance company may refuse to pay for treatment that should have been the responsibility of the workers’ compensation insurance company. One of the advantages of a settlement is that it guarantees you benefits without the risk of a trial. And in some states, you can’t receive a lump sum payment after you win at trial; you’ll be limited to receiving weekly payments for a number of weeks or years.
If you believe you are ready to close your case, and you believe that the settlement offer is acceptable, then you may want to accept the offer. The settlement must be approved by a judge before it is final. This usually requires you to appear before a judge along with the insurance company’s lawyer, discuss the proposed settlement, and answer any questions that the judge may have. If both parties agree, the judge (at a conference) may give his or her thoughts regarding an appropriate settlement amount. You always have the right to consult with a lawyer or hire a lawyer before settling your case. It should not cost you anything to consult a lawyer. Lawyers who regularly practice workers’ compensation law offer free initial consultations. Being offered a settlement does not mean you have to settle your case immediately.
Reasons Not To Accept Settlement
On the other hand, if you feel that you need more medical treatment, or you feel you are not ready to settle the case (for any reason), tell the insurance company that you are not ready to settle and what your concerns are. Other reasons for not accepting a settlement offer might include; if you are unsure about whether you will need any more medical treatment and would like a second opinion, ask the insurance company to send you to another doctor for a second opinion. If you have ongoing or future medical needs (which have been documented by a physician) as a result of your injury, you have the right to ask the insurance company to include, as part of the written settlement agreement, a promise to provide certain medical benefits to you in the future, or to pay an additional amount in the settlement for future medical needs.
If the amount of the settlement offer is not acceptable, you have the right to negotiate a different amount with the insurance company or the insurance company’s lawyer. You should be specific (in dollars) when discussing settlement. If you feel you are not ready to settle, it is best that you don’t until you’re in total agreement with all the terms of the settlement to ensure you receive a fair amount from your workers compensation settlement.
Workers’ compensation cases can be extremely complicated. Before you make any decisions and agree to settle your workers’ compensation case, you should read all the information available to you on the AVVO website, and find or consult with a lawyer experienced in workers’ compensation cases and laws for your state.