How Is A Workers' Comp Settlement Calculated?
How do they calculate how much my workers’ comp settlement is worth?
One person doesn’t decide your settlement amount- it is an agreement between both sides.
Workers' Comp Is An Agreement
First, understand that no one person decides what the settlement amount will be. Not you, not the insurance company, not your employer, not opposing counsel, not the judge. A settlement can only happen when both sides agree on an amount that, if paid to you, ends your case for all time. Beyond that, the court must approve any settlement which, generally is not a problem.
When determining the settlement value of your case, you will want to consider the amount that you get per week in your present workers’ compensation check and how much longer you are likely to continue to receive that check on a weekly basis. You will also want to consider whether or not you’re likely to be suspended from benefits, and/or whether or not you are close to “the gate” (which is the amount of time that any person in your situation is allowed to collect weekly benefits).
With any workers’ compensation settlement, you have to be willing to compromise, because in many cases there is no guarantee that you’ll actually collect all that you could possibly collect. When each side determines their risk, there is often some lump sum amount that can be arrived at that fairly compensates the employee, and that the employer feels is in their best interest because it ends their exposure forever. In a traditional personal injury claim, a jury can officially determine what a case is worth. Therefore, in a personal injury case, both sides can fight all day long as to what the “true value” of the case is, but no one really knows for sure unless they have a trial and the jury decides for them.
Employer vs Employee
Unlike cases that get decided by a jury, there is no mechanism for getting a determination on what you’re entitled to as a lump sum to settle your workers’ compensation case. The only way to truly know, ironically, is to not settle and see what happens. Therefore, to arrive at a settlement, the employer/insurance comapny has to look at the maximum amount of exposure or money that they could potentially pay out over time, and the employee has to determine what the “worst case” scenario is for them under the facts of their particular case. Sometimes, both sides can agree on a number. Sometimes they can’t.