Cases of people getting injured while attending to their duties in the workplace are very common. The average workers’ comp settlement covers the damages you experienced after the accident, including lost wages and medical expenses. However, not all cases of work-related accidents result in a settlement.
A workers comp settlement concept seems simple on paper, especially if you’ve never used it before. You sustain work-related injuries while in your line of duty. You report the issue and get help in covering medical expenses, lost wages, and other damages. Nevertheless, the process of filing a claim in such cases is not as simple as it may look on paper.
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WHAT’S AN AVERAGE WORKERS COMPENSATION SETTLEMENT?
An average workers’ compensation settlement is the average amount that you are likely to get from your employer after sustaining injuries while working in your job. The settlement is usually in the form of compensation for damages like expenses, pain and suffering, and loss of the ability to do your work.
For instance, if you suffer a permanent impairment that prevents you from working, workers comp will enable you to get permanent disability benefits. These benefits include receiving weekly checks for a given period of time, usually depending on the location, severity of your injury, and other factors.
In some states like Florida, you can even opt to seek a settlement rather than getting weekly benefits. The settlement can be in the inform of structured settlement (specified duration) or a one-time payment. However, structured settlements are rare and are usually adopted when employees suffer a serious injury and need to manage their settlement over the years.
Settlements are voluntary, which means that the insurance company or your employer cannot force you to accept their offer. Unfortunately, when you agree to take a settlement, you give the right to demand additional workers comp benefits.
Types of Workers Comp Settlement
Usually, different things may happen when you file a claim after sustaining injuries in a work-related accident. First, the insurance company will cover medical expenses, including medications, doctor visits, physical therapy, disability coverage (in case of devastating injuries), and lost wages.
In this case, the insurance company offers a settlement amount that they consider fair to your claim. If you feel that the payment offered is not fair enough, you have the right to negotiate for a higher settlement. After you agree on the settlement, you will now choose whether the payout will be structured or lump-sum.
Unfortunately, the employer may try to avoid taking responsibility for the damages after filing your claim and try to argue that you had a pre-existing injury or your injury is not work-related. If this happens, you can argue your case with the help of an experienced personal injury attorney. In this case, the employee will have to go through an appeal process, but each insurer has a different path.
The appeal process can be tricky as it doesn’t always favor employees. Some employees may decide to proceed with a legal battle in court, but the fees and time required to push a case can be an impediment.
The Pros and Cons of a Workers Comp Settlement
Agreeing on a settlement is beneficial to all the parties involved. Here are some of the benefits to the injured employee:
- Enables you to avoid trial. Trials do not always work in your favor, as the jury could sometimes opt to lower your benefits.
- You may get more money for dropping future benefits that are irrelevant. If there are low chances that you will need surgery for the injury, you can request to have part of the cost as part of your settlement.
- Saves you time and stress. Court hearings involve stressful processes and can also be time-consuming. Therefore, reaching a settlement will save you time and unnecessary suffering and anxiety.
However, there are some cons that you need to consider before taking a settlement:
- Managing a lump-sum payment given as a settlement can be a daunting task for most people. It is possible to spend your money too quickly and be left without the weekly payments.
- Reaching a settlement means giving up your right to pursue future benefits in exchange for money. This can be risky since your injury might worsen or aggravate and require ongoing treatment or have surgery later. Your settlement might not be enough to cover the unexpected medical expenses and your normal bills in such cases.
How to Build a Strong Workers Comp Case?
According to the law, every employer should provide compensation insurance to every employee that doesn’t depend on any given factor. Consequently, every employee should be under coverage regardless of the time they have been with the company, dependents, or hours worked.
The process might sound straightforward, but it doesn’t mean that you will receive compensation just because you are insured if you are injured. In some cases, the insurer or the employer might quickly cover damages after an injury. However, in most cases, you will need to argue a case to get a fair settlement.
If you want to prove your case and get a fair settlement, you need to present a valid and strong case that shows that you sustained injuries during work. Besides, you should prove that the injury has led to damages that restrict your ability to work. To build a valid and strong case, you need to make sure that every detail after your injury is well-documented.
Therefore, it is important to make sure that all the paperwork is properly done and within the specified timeline, as the insurer or the employee can use it against you. The failure to follow a timeline is among the most common reasons for denial in many claims.
Once you get an injury, you need to visit your doctor for diagnosis and treatment plans. During these visits, make sure you share a full and factual medical history, including any existing injury or previous injuries.
Trying to hide or cover up something like an existing injury or old injuries might affect your case later. Therefore, you should let facts support your case since the settlements are meant for employees with people with real issues resulting from work-related injuries.
HOW A WORKER’S COMP SETTLEMENT IS CALCULATED
Usually, workers comp settlement is calculated based on a number of factors, including medical expenses, lost wages, scarring, specific loss, and future medical expenses. With this in mind, it is quite easy to understand why it is almost impossible to offer an average amount as the workers’ comp settlement.
Most benefits in workers’ comp settlement are calculated and paid out based on the average weekly wage. This involves multiplying the number of days worked in a year with the employee’s daily wage. Once you get the product, you divide the figure by 52 weeks.
For instance, if an employee received $60,000 last year, working 240 days, considering sick leave, vacation and weekends. It means that the employee made $250 per day as gross income. In a full year, the employee made $250 x (52 weeks x 5days), which is $65,000.
This means that the employee is entitled to receive $65,000 in terms of benefits per year, or $1,250 as average weekly wages. Moreover, if the employee suffers permanent disability, they will get 60% of the average wage, or $750 per week.
SHOULD YOU ACCEPT A WORKERS’ COMP SETTLEMENT?
A $50,000 lump sum can be tempting or hard to resist, but it is good to understand that a settlement is a one-time payment for damages that might affect the whole of your life. Therefore, it is important to reason well and consult your lawyer before accepting a workers’ comp settlement. It is also advisable to avoid settling for the first amount that the insurance company offers because they will always start with the lowest figure.
Moreover, you should also wait until a doctor confirms that your condition has greatly improved before accepting the settlement. Taking time to assess your medical improvement enables you to estimate the costs involved and future medical needs. On the other hand, settling too early makes it hard for you to understand the extent of the medical expenses in the future. It is also important to make sure that you involve an experienced attorney in the process as early as possible.
What is the average settlement for workers comp?
When it comes to the average amount that an injured employee gets after filing a claim, there are various factors that come into play. The usual workers’ comp settlement range is between $20,000 and $40,000, which means the average amount is around $20,000.
Injuries that meet the requirements for workers comp settlement differ significantly in severity, recovery time, and treatment cost. Therefore, these injuries cannot attract the same amount when it comes to covering lost wages and medical fees. This explains why there is a huge range between the possible payouts amounts.
Most of the claims that employees file receive some form of reimbursement. However, there are various tactics that employees can employ to make sure that they win huge settlements for work-related injury claims.
Fortunately, an employee has the right to negotiate for a higher amount, and better terms after the first settlement are offered as the payout amount for workers comp. If the injured employees take the first amount offered to them, they risk receiving a much less amount than if they decline and ask for better terms. In some cases, insurance companies are ready to offer better terms once you counter the offer and request for negotiation.
Does workers comp always offer a settlement?
The easy and quick answer to this common question is no. A workers comp insurance seems simple on paper if you’ve never used it before. You suffer injuries at work, report the injury and receive coverage for medical expenses and lost wages.
However, the process is not as straightforward as it seems on the surface. The employer or the insurer may try to avoid making any compensation for the damages resulting from a work-related injury.
Most people realize that they are several factors that you need to consider when they start the journey of filing their claim. There are several reasons why you might not get a workers comp settlement in some cases. But the most common is failure to meet the specified timeline after the accident.
The other reason is when you and the insurer or employer fail to reach a settlement, which causes the issue to proceed to trial. However, most of the workers’ comp cases end up in settlement since none of the parties is interested in proceeding to courts. The insurance company aims to save money in the long run while meeting their obligations while the injured employee wants to time and avoid the stressful nature of the court process.
Consequently, if your compensation claim involves a small amount of money, the insurer may decide to cover the medical expenses and any lost wages. If you suffered serious injuries like broken bones that require multiple surgeries, months or years of recovery time, physical therapy, the insurer will have to part with a lot of money. In such cases, the insurance company will opt to offer a settlement to reduce costs.
How are workers’ comp settlements paid out?
Workers comp settlement can be paid out in two different ways: structured or lump-sum settlement. In a structured settlement, the employee requests the insurer to pay out the settlement over time. The employee signs an agreement allowing the settlement to be spread over a long duration, either one year, five years, or ten years. In this case, the settlement is paid out weekly.
For lump-sum settlement, employees sign an agreement that concludes the case and awards them a one-time payment as settlement. Once they sign the agreement to receive the one-time settlement, they lose the right to pursue more benefits in the future.
Will Workers comp offer me a settlement?
The insurance company will often offer a settlement in workers’ compensation cases. If you accept the offer, the settlement will be reached, and you will lose the right to ask for any more benefits, appeal your case, or file any lawsuits. In some cases, the compensation case may end with a judicial decision or trial.
How long do workers comp settlement negotiations take?
The duration that workers comp settlement negotiations take differ with each case since each case is different. However, the entire process from filing the claim to receiving a settlement in your hands may take between 12 and 18 months. This will greatly depend on whether you will involve a personal injury attorney and the details of your case.
If you do not have a permanent disability or do not have any legal representation and accept the offer without negotiation, the timeline would be around 12 to 14 months. The settlement process usually takes a bit longer with an attorney, about 17 to 18 months and even 20 percent much longer if your lawyers negotiate.
After reaching a settlement with your employer or insurance carrier through mediation or direct negotiation, it takes 4 to 8 weeks for you to receive your workers’ comp settlement. However, this duration is a rough estimate that can be influenced by a number of factors.
What is a fair workers comp settlement?
A fair settlement refers to the amount that is enough to cover all the damages and also worth making you give up your rights to pursue future benefits. The workers’ comp settlement enables you to get a one-time or structured payment representing a percentage of the ongoing benefits. It represents a percentage of the insurer’s cost if you didn’t reach an agreement on the settlement.
How do I maximize my workers’ comp settlement?
Most workers comp claims do not proceed to the trial but end up with a lump sum settlement. Once you accept a settlement, you automatically lose your right to ask for ongoing benefits. Therefore, it is important to understand the worth of the injury and practical strategies that help maximize your workers’ comp settlement.
Here are some of the proven ways to maximize your settlement value.
- Report the injury to your employer and file your claim
First, you need to notify your employer about the injury to make sure that you secure a fair settlement in your claim. Waiting longer before you report the injuries to make it harder for you to prove to the insurance company and the employer that you have a strong case.
However, you must notify your employer in writing. In most cases, the employer will provide a form for you to fill and then return it so that they can share it with the insurance company.
- Seek medical attention
Once you report the injury to your employer, the next step should be seeking medical attention from your doctor. Failure to seek medical attention in time gives the insurance company a reason to deny your claim or lower your settlement.
- Know your workers’ comp disability rating
In most, work-related injuries lead to lasting physical disability that restricts your ability to work for a given period of time. Disability can be categorized into four main groups. These include:
1. Temporary partial disability – This refers to a form of disability that restricts your ability to perform some work-related duties for a certain time
2. Temporary total disability – As the name suggests, this category includes disabilities that completely restrict your ability to work for a given period of time.
3. Permanent total disability- This permanently prevents you from working.
4. Permanent partial disability– This permanently restricts you from performing some work-related duties
In case you suffer permanent disability, your doctor will assign you a score of between 5% and 100% based on the severity of your injury. This is a disability score. If you are permanently injured, you may be eligible to receive lifetime wages.
- Record every detail in the entire process
The other important strategy in maximizing your workers’ comp settlement is making sure that you keep a record of your injury, including the related medical costs. A record of all the injury details serves as a documented proof of the medical expenses and the severity of your injury. Consequently, you should store your receipts for medications, parking lot fees, gas bills, and other medical expenses.
- Understand the weekly wage calculations and take advantage of the disability benefits
If you suffer any form of disability, you may be eligible for weekly benefits. The disability benefits are usually at a set percentage of the weekly wage. However, you should check your weekly wage calculations to confirm that you are receiving fair payouts.
- Prepare for another medical exam and be careful when talking to the doctor.
Regardless of whether you sought medical attention from your doctor, the insurance company may request you to meet an independent doctor for a medical examination. When meeting the doctor, make sure that you only stick to the facts since what you share will greatly impact how the insurer decides on your settlement.
Conclusion
Most work-related injuries lead to the loss of working days for a certain time or permanently. Therefore, average workers comp settlement helps cover the damages resulting from lost wages and medical expenses. The settlement enables injured employees to recover without falling into a financial crisis.
However, it is important to involve your injury lawyer, especially when accepting the settlement. A workers comp settlement is a one-time payout that takes your right to pursue further benefits.
Resources
- Workers’ Comp Settlements: https://www.dli.mn.gov/sites/default/files/pdf/infosheet_settlements.pdf
- Workers Compensation: https://www.dol.gov/general/topic/workcomp
- Settling a Case: https://labor.mo.gov/DWC/Injured_Workers/settling_case
