How Much is My Workers’ Compensation Case Worth?
Ryan Zavodnick | April 29, 2020 | Workers' Compensation
If an employee is injured at work or develops a work-related illness, the employee may receive workers’ compensation benefits. The Pennsylvania’s Workers’ Compensation Act ensures that an employee injured at work receives the medical care the employee needs without cost to the employee. Depending on the circumstances of the case, the employee may also receive additional workers’ compensation benefits.
Most employers must carry workers’ compensation insurance. Employers who do not have the required workers’ compensation coverage could be subject to lawsuits by injured employees and penalties from the state.
Workers’ Compensation Laws Protect Employers and Employees
Workers’ compensation is a no-fault system. You do not need to prove that your employer was negligent in causing your injury or illness to receive benefits. You receive workers’ comp benefits, even if you caused your injury yourself.
However, the system protects employers from personal injury lawsuits by employees. Therefore, you are not entitled to compensation for all damages caused by an injury on the job. You are only entitled to the benefits provided through the workers’ compensation system.
There are instances in which an employee may file a personal injury lawsuit related to a workplace injury. If a third party was negligent in causing your injury, you could have a claim against that party in addition to your workers’ comp claim. This is what can make it difficult to determine how much your case is worth.
For instance, if the work-related injury resulted from a car crash while you were on company time, you may have a claim against the other driver who caused the accident. Likewise, if a defective product caused your injury, you may have a personal injury claim against the product’s manufacturer. Otherwise, you are limited to the benefits provided under the state’s workers’ compensation laws.
Calculating the Value of a Workers’ Compensation Claim
The value of a workers’ compensation claims depends on numerous factors. The type and severity of the injury can influence the value of your claim. How much you earn before the injury or illness can also impact the value of your workers’ compensation claim.
An employee injured on the job may receive:
The cost of your medical care should be paid in full by the employer if you receive treatment from an approved medical provider. Medical care must be reasonable and necessary.
Loss of Income
Workers’ compensation does not cover all losses of income for injured workers. Injured employees receive up to two-thirds of their average weekly wage while they are unable to work because of an injury. An employee who earns less than $600.55 in 2020 can receive up to 90 percent of the employee’s average weekly wage.
However, the maximum compensation allowed for 2020 is $1,081 for injuries occurring on or after January 1, 2020. The figures are reviewed and adjusted each year.
Permanent Impairment or Disability
Workers who sustain a permanent impairment, disability, disfigurement, scarring, or loss of body part receive additional compensation. The amount of compensation depends on the body part affected and the degree of disability or impairment. Many of the disputes regarding the value of a workers’ compensation claim in Pennsylvania originate from a claim of permanent impairment or disability.
A medical provider preforms an Impairment Rating Evaluation (IRE). Based on the medical examination, the doctor issues an impairment rating. If the impairment rating is below 35%, the compensation the worker may receive is capped at a maximum of 500 weeks.
If the impairment rating is above 35%, there is no cap on the number of weeks an employee may receive compensation. Therefore, the value of a workers’ comp claim depends heavily on whether the employee sustains a permanent impairment.
Medical costs and compensation for loss of income are relatively straightforward unless there is a dispute about whether the injury or illness was work-related. If the employer or the insurance company disputes the claim, the employee must fight for those benefits. However, the amounts are based on statutory calculations, so they do not change.
The change in the value of a workers’ compensation claim occurs when the employee has a permanent impairment. If an employee disagrees with the results of an IRE, the employee should seek legal counsel immediately.
Appealing the results of an IRE can be complicated. However, it may be necessary to file a workers’ comp appeal to ensure that the employee receives the benefits he or she deserves after being injured on the job. Quick action preserves the employee’s rights and options.