Your Employer And Workers Comp Claims
You must report a workplace accident or injury to your employer. Once you have made that report, it becomes the responsibility of the employer to report the information to the insurer who they are working with for their workers comp coverage. Keep in mind, most employers must maintain this coverage.
According to the Pennsylvania Department of Labor and Industry , the insurer has 21 days following the report to issue their findingsthis may be one of three notices:
- Notice of Compensation Payable
- Notice of Temporary Compensation Payable
- Notice of Compensation Denial
Should your claim be accepted, you may collect up to two-thirds of your wages once you are out of work for seven days, and workers comp will cover your medical costs associated with the workplace injury for as long as you require treatment. Workers comp may deny your claim may if it questions whether the injury occurred at work. Should this happen, you need to hire a workers compensation attorney immediately upon receiving the denial so you can protect your rights.
Benefits To The Insurer During Workers Compensation Claim Process
For each claim reported, insurers have a legal duty to set up a claim file, investigate the circumstances, and establish a claims reserve. The reserve is the claim representatives best guess as to the ultimate future claim payout. It also establishes the amount of money an insurer must legally set aside to pay a claim when its time.
Claim representatives, supervisors, managers, and higher-ups periodically review open claims. They reevaluate the claim and increase the reserves as necessary. Even if the handling office doesnt increase the reserve, it will automatically increase for each year your claim remains open. These supplemental reserves acknowledge the fact that the longer a claim stays open, the higher the value increases.
When a claim is open, an insurer must comply with state workers compensation guidelines. The guidelines require insurers to provide the state with information concerning their pending claims. When an insurer settles a claim, their primary benefit comes from eliminating their claim-handling responsibilities.
What Is The Average Workers Compensation Settlement Amount For Back Injury And Lumbar Spine Degenerative Disc Disease
The potential settlement value for a work-related back injury claim depends on how the trauma impacts the lumbar spine, the medical treatment required , and whether you have permanent restrictions that prevent you from returning to your pre-injury job.
In my experience, the average workers comp settlement amount for low back injuries ranges from $45,000 to $500,000 or more, depending on the need for surgery or a career change.
This is higher than the average settlement amount for work-related upper back injuries is lower, ranging from $35,000 to $175,000 or more.
The average workers comp settlement amount for failed back syndrome is from $125,000.00 to $650,000.00 or more. Your claim has more value if you require pain management for the rest of your life and will have permanent light-duty restrictions that prevent you from returning to your pre-injury position.
The potential for surgery explains the difference in typical settlement amounts for upper and low back injuries, and even with similar injuries and lumbar spine conditions. Many low back injuries require spine surgery, while few upper back and thoracic spine injuries do.
My estimates are consistent with data from the National Council on Compensation Insurance . According to the NCCI, the average workers compensation costs for a low back injury were about $37,000, while insurers paid about $33,000 for a claim involving an upper back injury.
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How Is A Workers Compensation Back Injury Settlement Calculated
Back injuries vary from minor muscle strains that heal with chiropractic care to herniated disks that require extensive surgery and rehabilitation. Because of this, the amount of cash compensation workers receive varies quite a bit, too. Another factor that determines the ultimate cost of a back injury settlement is the location of the trauma. Lower back injuries tend to grant workers more cash compensation than upper back injuries. The cause of the injury, whether it was a vehicle accident or repetitive stress injury, and the characteristics of the spinal injury , also affect the amount a worker receives for his or her injuries.
Hiring A Workers’ Comp Lawyer
Although most workers with back injuries eventually receive compensation, many initially have their claims denied and need to file an appeal. The appeal process can be time-consuming and complex. Hiring a workers’ comp lawyer to help you through the process can result in you receiving much more in compensation than employees who don’t hire a lawyer.
Workers’ comp lawyers typically charge what’s known as a “contingency fee,” which is a certain percentageusually about 15%of your overall settlement or award. This means that you don’t have to pay anything up front, and if you lose you only have to pay expenses such as copying costs and filing fees, not hourly attorney fees. Even after accounting for the contingency fee, workers who have a lawyer to guide them through the workers’ comp process still generally take home more in compensation than those who don’t hire a lawyer.
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How Will My Injury Compensation Be Calculated
When calculating the amount of compensation owed to a plaintiff, a solicitor and his or her legal team will itemise various heads of damage and add them together.
These may include:
1. General damages: this is the term applied to non-pecuniary damages or non-economic loss experienced as a result of pain and suffering, disability or impairment, loss of amenities of life, disfigurement or reduced life expectancy.
2. Pecuniary loss: this term covers out-of-pocket expenses involved in past and future medical treatment, rehabilitation, care and support. It also covers costs involved in making adaptations to your home or mode of transport.
3. Income loss: covering actual income loss of income accumulated pre-settlement and future loss of expected earning capacity post-settlement. Please note: in some instances, a plaintiffs claim may be restricted to only past loss in others, to only future loss.
4. Aggravated damages: comprise an additional sum of money to be awarded to a plaintiff due to the humiliation brought on by the defendants conduct during the commission of a wrong.
5. Exemplary damages: in instances when a matter goes to court, a Judge may award what is known as punitive or exemplary damages. Such damages are awarded in order to punish a defendant rather than compensate the plaintiff.
Workers Comp Settlement Examples
While the average workers comp settlement is $42,000, settlement values for work injuries can differ substantially. For example, while the average settlement in a head injury case is $92,493, the average settlement involving an injured hand is $24,627.
Settlement amounts will vary depending on an injured workers pre-injury wages and the severity of the injury. An employee making a high hourly wage would receive a higher settlement than a worker at a lower pay level. Some states cap the amount of wage benefits available to injured workers, affecting the amount of settlements in that state.
Workers comp also pays for your injury-related medical treatment bills. Since serious injuries result in higher medical expenses, theyll lead to higher average claim settlements than mild injury cases.
Case Example: Workers Compensation Settlement for a Minor Work Injury
Lisa works at a nursery where she makes $20 per hour / $800 per week.
She is watering plants one morning and trips over the hose, rolling her right ankle. While she can get up on her own, Lisa cant place weight on her right foot.
A co-worker takes her to an urgent care center where the doctor diagnoses her with a Grade I ankle sprain. He advises her to stay off of her feet for two days and then spend a few days gradually bearing weight. Lisa misses one week of work.
She settles her workers comp claim for $2,500. The amount includes $800 for lost wages and $1,700 for medical expenses.
Did You Suffer A Spinal Injury On The Job Its Time To Contact An Attorney
Back injuries can be difficult to diagnose and treat, which means theyre often denied by workers compensation. If you suffered an upper back injury or a lower back injury on the job, you deserve fair compensation for your losses including payment for medical expenses, missed wages, and any permanent impairment.
At the Law Office of Gerald Brody & Associates, we have more than four decades of collective experience negotiating with insurance companies, filing appeals, and fighting for maximum compensation for our clients and we can do the same for you. We have several cases that have settled for over a million dollars and 100 perfect disability ordered by the court. *Call us today to schedule your free consultation at 528-9800.
*Each case is different and we cannot guarantee results or compensation/benefits for your case.
How Is My Compensation Payout Calculated
It depends on your personal circumstances and how bad the injury was, but broken down, most compensation payouts are calculated by:
- Lost wages. The wages youve missed out on because youve been unable to work because of the accident.
- Medical expenses. This includes all the hospital and out of hospital treatment and care youve had to pay because of the accident.
- Estimated future lost wages. This compensates you if youre still unable to work, cant work as much or need to change your job role because of the accident.
- Non-economic loss. This is a legal term used to refer to compensation for the physical and emotional impact the accident has had on you, which can include pain and suffering and loss of quality of life damages.
To give you a better idea of how much compensation you may be owed, you can use our online claims calculator. We can also put you in touch with a personal injury lawyer who specialises in the type of compensation youre seeking.
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How Much Money Will Workers Compensation Pay Out For A Lower Back Injury
The question how much money will workers compensation payout for a lower back injury? maybe difficult to answer. There is no definite amount that workers compensation will pay out for a back injury. The best way to accurately predict the amount you are likely to receive in a settlement is to have a lawyer assess the facts of your case and the nature of your lower back injury. You may also look at several data-driven studies that have determined the average workers compensation settlement amounts for back injuries.
Contact Krasno Krasno & Onwudinjo To Discuss The Settlement Amount For Your Back Injury
Knowing what the average workers comp back injury settlement is wont tell you for sure how much you as an individual are going to receive.
Since these figures are averages only, the amount you receive will depend on the facts of your case, as well as the skill and dedication of your lawyer.
The occupational injury lawyers at Krasno, Krasno & Onwudinjo handle claims like this daily, and we know all the tricks the insurance company uses to deny your claim or goad you into accepting far less than what your injury claim is worth.
Foyle Legal Provides Legal Services To All Of Wa
What suburbs in Perth does Foyle Legal provide legal representation to?
Looking for best personal injury & workers compensation lawyers near me in Perth? Foyle Legal provides legal presentation to Workcover claims, workplace injury claims, work accident claims, accident injury claims, and all personal injuries clients all over Perth. It includes but not limited to north of river, south of the river, Perth city areas, eastern suburbs, western suburbs and Fremantle areas.
North of the river Northern Suburbs
Ballajura Bassendean Bayswater Beechboro Carine Carramar Clarkson Connolly Currambine Dianella Doubleview Duncraig Eden Hill Edgewater Embleton Glendalough- Greenwood Gwelup Heathridge Hillarys Inglewood Innaloo Joondalup Kallaroo Karrinyup Kingsley Landsdale Maida Vale Malaga Marangaroo Mindarie Mindarie Keys- Morley Mullaloo Munster North Beach Osborne Park Padbury Scarborough Shenton Park Sorrento Trigg Tuart Hill Wanneroo Warwick Waterman Wembley Downs Woodlands Woodvale Yanchep
South of the River Southern Suburbs
Perth Inner City
Burswood CBD/Northbridge East Perth Highgate Leederville Maylands Mount Hawthorn- Mount Lawley North Perth South Perth Subiaco Victoria Park West Leederville West Perth CBD Kings Park Northbridge Perth
Average Settlement For Work
According to an analysis of workers who received settlements for workplace accidents, the average compensation for back injuries was $23,600. This amount was slightly higher than the mean settlement for all types of injuries, which was $21,800.
That said, the amount that individual workers receive can vary significantly. This is because the final compensation is often influenced by certain factors, such as the severity of the injury.
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Employees I Regularly Represent In Work
In 2018, ten occupations made up 40 percent of all workers comp cases arising from musculoskeletal injuries. You have a greater risk of hurting your back at work if you are a:
- Nurse. As a nurse, you probably spend most of your shift on your feet, moving heavy medical equipment and transferring patients. These activities put you at risk of suffering a back or neck injury. The nursing category includes certified nursing assistants and home health care aides.
- Heavy and tractor-trailer truck driver. If your job involves driving, you have an increased risk of suffering whiplash or a back injury in a work-related motor vehicle accident. This category includes light truck and delivery drivers for UPS, FedEx, or Amazon contractors.
- Construction worker. Laborers, electricians, plumbers, painters, forklift operators, welders, linemen, ironworkers, pipefitters, brick masons, crane operators, and roofers spend a lot of time lifting, twisting, climbing, and bending to get the job done. Youre also around heavy machinery and other contractors doing hard work. These acts and situations put you at risk of suffering a musculoskeletal injury to your back.
- Teacher or Childcare worker: Taking care of the educational and basic needs of children is a physical job requiring lots of lifting and exposure to tripping hazards. This can result in back injuries.
Possible Challenges When Getting Workers Compensation For Back Injuries
Even after reporting your injuries and filing the workers compensation paperwork on time, you still risk forfeiting your compensation if you cant prove that your injury was work-related.
Insurance companies are reluctant to pay workers compensation claims in most cases and often dispute whether work injuries occurred. Therefore, you will have to prove that your injury is work-related. Your injury doesnt necessarily have to happen at your workplace as long as it occurred while you were performing an activity assigned by or benefiting your employer.
Despite this, the insurer may claim that your condition is preexisting due to a previous accident, sports injury, or old age. A workers compensation lawyer can help you prove which activities caused your back injuries in these situations.
Even if you have preexisting conditions, a workers compensation lawyer can help you prove that your workplace injury aggravated your conditions. In these cases, you can still get compensation.
When you visit the doctor, make sure you tell them about any preexisting conditions and that you believe that your work duties aggravated your condition.
An experienced workers compensation lawyer will include several types of evidence to help establish your claim with the insurance provider.
For example, they might submit:
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Average Workers Compensation Payouts In 2022
Workplace injuries are an unfortunately common part of life in some cases.
While most injuries that occur on the job could have been avoided in some way or another.
According to the Operational Health and Safety Administration , there were 2,654,700 workplace injuries in 2020.
Of those injuries, OSHA states that 4,764 were fatal.
The good news is, both of those numbers are down from 2019. Unfortunately, limited work caused by COVID played a significant role in the decrease.
Accidents and negligence are everyday occurrences, and when we suffer from injuries sustained while working, it is vital we receive the compensation we deserve.
After all, that is why we have workers compensation insurance, isnt it?
What Are The Physical Requirements Of Your Pre
All other factors equal, your back injury claim has more value if your pre-injury job was physical. By that, I mean that your job involved lifting, carrying, standing, walking, running, or driving more than sedentary desk work.
For example, a nurse or construction worker who suffers a back injury on the job and undergoes a lumbar fusion will likely have permanent restrictions that prevent them from returning to the pre-injury position.
On the other hand, a person with a sedentary job that requires no lifting who injures his or her back in a work-related car crash and undergoes a diskectomy may be able to return to work with no problems within a few months of the accident.
Suppose you are unable to return to your pre-injury job because of a work-related back injury. In that case, you will be eligible for more temporary total disability and temporary partial disability payments. Studies show that more than 25% of you will experience a total disability of 6 months or more because of your back injury.
You will also be eligible for vocational rehabilitation services at the employers expense. These services, designed to find alternate employment, are expensive.
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