How Much is My Workers’ Comp Case Worth?

Workers’ compensation insurance generally covers accidents that happen at work. The purpose of workers’ comp is to provide medical treatment for injured employees. It also provides wage replacement benefits if the person cannot work because of their injury.

Workers’ compensation does not pay for your pain and suffering or other non-economic damages. If you recover fully from your injuries and return to work, the only benefits you receive are temporary disability benefits (wage replacement) and paid medical expenses. There is not a settlement when you recover fully from your work-related injuries.

However, if you sustain a permanent impairment, you may be entitled to a workers’ compensation settlement. How much your workers’ compensation case is worth depends on the severity of your impairment and the type of injury you sustained. 

What is Maximum Medical Improvement?

Before you can settle your workers’ compensation claim, you must reach maximum medical improvement or MMI. The Florida Workers’ Compensation Code defines the date of maximum medical improvement

MMI is the date after which further recovery or lasting improvement from an injury or disease is not reasonably expected. The assessment is based on medical evidence.

In other words, MMI occurs when your doctors tell you that no further treatment will improve your condition. In many cases, workers fully recover from their work injuries when they reach MMI. They do not have any lasting impairments because of the injury.

However, other workers may have permanent disabilities or impairments when they reach MMI. In the most severe cases, a person is totally and permanently disabled. In other cases, a person may sustain partial disability or impairment. 

Compensation for Total Permanent Disability

The statutes define permanent total disability as being unable to engage in at least sedentary employment within a 50-mile radius of the employee’s residence. 

Some conditions automatically result in the worker being presumed to be permanently and disabled. As a result, the worker would receive total disability benefits unless the employer or insurance carrier can prove that the worker can perform at least sedentary work within a 50-mile radius of the employee’s residence. 

  • Spinal cord injuries involving severe paralysis of the trunk, arm, or leg
  • Amputation of a hand, arm, foot, or leg involving the effective use of the appendage
  • Severe brain or closed head injury
  • Second or third-degree burns covering 25 percent or more of the total body surface or third-degree burns covering five percent or more of the hands and face
  • Industrial or total blindness

Weekly benefits are based on 75% of your average weekly wage before the accident. Benefits for permanent total disability end when the employee reaches the age of 75 years, unless the employee is not entitled to Social Security benefits. 

Compensation for Partial Permanent Disability

In most cases, a worker sustains partial disability because of a workplace accident. Instead of being fully disabled, they receive a permanent impairment rating. Based on the degree of the impairment, your physician assigns you a permanent impairment rating. 

The rating is a percentage. That percentage is used to determine the number of weeks of disability benefits you should receive as compensation for the permanent impairment.

The amount you receive is based on 75% of your average weekly wage times the number of benefit weeks. Benefits have a cap of $1,011 per week for 2021.

Settlements for Workers’ Compensation Claims in Florida

Many workers’ compensation insurance providers offer to settle permanent disability claims by paying a lump sum payment. However, they are not required to settle claims by law. Some of the factors that the insurance company could consider when negotiating a settlement of a workers’ compensation claim include, but are not limited to:

  • The type of injury and the severity of your impairment 
  • The anticipated cost of future medical care for impairment
  • Your wages before your injury
  • The likelihood that you would be able to pursue gainful employment in the future

If you do not settle your claim, you continue receiving your weekly benefits. You also receive medical care related to work-related injury and vocational benefits. If you choose a settlement, your workers’ compensation claim is closed, and you do not receive any further benefits.

Because accepting a settlement ends your workers’ compensation claim, you may want to consult with a workers’ compensation lawyer before settling your claim. As with all other injury claims, the insurance company seeks to pay the lowest amount to end your claim. Having legal counsel can help ensure that you receive a fair workers’ compensation claim.

Furthermore, some workers may have a third-party claim related to their workplace accident. If that is the case, you could be entitled to receive additional compensation for damages that are not covered by workers’ compensation. An attorney can assess your case and advise you about all legal claims that could result in compensation after a workplace injury.