How Are Workers’ Compensation Settlements Calculated?

If you have been injured at work, you may decide to settle your claim instead of receiving ongoing workers’ compensation benefits. Settling can impact how much compensation you’d receive, and there are various factors that go into calculating the amount.

Expenses Covered By Workers’ Comp

One of the factors involved in calculating a workers’ compensation settlement is the total amount of benefits you’d be eligible to receive. In Illinois, workers’ comp is designed to cover the following:

Medical expenses

The cost of medical treatment, both current and future, is covered by workers’ compensation. Illinois allows you to cover up to two doctors of your choice plus any chains of referrals from those two.

Disability

Disability benefits, including temporary and permanent disability, are designed to cover your lost wages. They may take the form of a wage differential if you’re relegated to a lower-paying job, or compensation of up to 2/3 your average weekly wages if you’re completely unable to work.

Vocational rehabilitation

If your injury causes you to need training to perform a new type of work, workers’ compensation should cover the expenses of vocational rehabilitation, including schooling and training.

Death benefits

Death benefits are made available to a worker’s dependents if the worker suffers a fatal injury on the job. Those benefits cover funeral and burial expenses and up to 2/3 of the worker’s wages for up to 25 years or $500,000.

Factors in Calculating Workers’ Comp Settlements

The total benefits received are only one component of a workers’ compensation settlement. The factors involved in calculating a settlement include the following:

Medical needs

First, your medical needs should be evaluated. Typically, you’ll want to settle after you reach maximum medical improvement (MMI) in order to know for sure how much your medical expenses will be. Before that point, it may be unclear. Fortunately, most settlements in Illinois allow you to maintain your right to medical care while accepting a settlement for other costs with the insurance company.

Wages

Your wages may come into play, especially if you’d be eligible for disability benefits. Temporary and permanent disability is paid based on 2/3 of your weekly wages.

Disability

If you have a temporary disability, the number of weeks you’d receive a wage differential or disability benefits would be affected. Permanent disability benefits may be more substantial, but could also be a point of contention between you and the insurance company.

Strength of your claim

The stronger your claim, the larger the settlement you’re likely to get. If, however, there are circumstances that put your case in jeopardy, such as evidence that your injury didn’t happen at work, you’ll likely get less for it.

Fees and other expenses

Additional fees such as legal expenses may cut into your settlement amount, so that’s worth considering if you’re thinking about settling.

Opting to Settle

The following situations may warrant accepting a settlement:

  • You have reached MMI.
  • There is some uncertainty to the strength of your claim.
  • You get a generous offer.
  • You need the cash to cover bills right away.

Settling can mitigate the uncertainty and stress involved in workers’ compensation, but it can also reduce the overall amount you’re likely to receive. Before deciding to settle a workers’ comp claim, contact an attorney at Hart David Carson LLP for a consultation.

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