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IS THERE A MAXIMUM FOR WORK INJURY SETTLEMENT AMOUNTS?

 

Is there a maximum for a workers’ compensation settlement? The St Louis legal team of Buchanan, Williams & O’Brien answers this question and more. Call us!

We are personal injury experts who have achieved results for our clients in Joplin for over 40 years.

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Workers’ Compensation Settlements

While a worker may do all they can to prevent mishaps, accidents, and work-related injuries from happening, when an accident occurs at work, injured employees are entitled to workers’ compensation benefits. There is no average workers’ comp settlement. A workers’ comp settlement amount will depend on many factors, including the injury’s severity and the future medical costs the injured worker will likely incur.

However, the insurance company will typically be motivated to settle for the lowest amount possible. Working with a personal injury attorney experienced in evaluating and filing a workers’ compensation claim is essential. They can negotiate on your behalf and ensure you receive the maximum compensation for your injuries that your case warrants.

 

What Is a Workers’ Compensation Settlement?

Workers’ Compensation settlements are payments made to employees for work-related injuries. The purpose of this settlement is to provide financial compensation to injured employees for their medical expenses, lost wages, and any other costs resulting from a work-related injury or illness. Employers must provide workers’ compensation benefits in Missouri through an insurance carrier. Compensation generally includes amounts for medical expenses, lost wages, disability, and death benefits.

 

Types of Workers Comp Settlements

There are two types of workers comp settlement.

  1. Lump-sum settlements: It is a one-time payment to cover all medical expenses of the workers’ injuries and any other losses. The injured worker will receive a large lump-sum amount in a single payment that would resolve and close the claim.
  2. Structured settlements: This type of settlement involves periodic payments to the workers from the employer over a specified period of time. The frequency of payment could be set to monthly, bi-weekly, or weekly.

Both types of settlement options come with their own good and not-so-good factors. The lump-sum settlement provides immediate relief from financial suffering but not be the best option in all cases. Sometimes, some underlying medical conditions arise after a few weeks of the injury or accident. In those cases, it will be hard for you to navigate your financial situation.

The structured payments plan can be a more stable option as a source of income. It works best in cases of long-term medical needs or injury caused by a permanent disability. But sometimes, the total amount may be less than the amount that would have been received in a lump-sum settlement.

Is There A Maximum Settlement Amount?

There is no set maximum for a workers’ compensation settlement as it varies by state and case. However, most states have guidelines and regulations determining the maximum compensation an injured worker can receive.

The average workers’ compensation settlement amount will depend on various factors, including the severity of the injury, the extent of the disability, and the worker’s average weekly wage. Sometimes, the worker may be entitled to ongoing benefits, such as medical treatment or wage replacement, which can affect the final settlement amount.

It’s important to note that settlements are typically negotiated between the injured worker and their employer or insurance company. The parties involved will consider the facts and circumstances of the case to determine a fair and reasonable settlement amount.

In some cases, the worker may also have the option to take their case to court, where a judge or jury will decide the compensation amount. In this case, the settlement amount may be higher or lower than what could be negotiated outside of court.

How Are Workers’ Compensation Settlements Calculated?

 

Insurance companies and lawyers calculate a workers’ comp settlement based on many factors, including the following:

  1. Current and future medical expenses;
  2. Lost wages;
  3. Employee’s impairment rating. The impairment rating is what happens after MMI in workers’ comp cases. Once you reach the Maximum Medical Improvement (MMI) the doctor thinks you are capable of, the doctor will issue a rating as to what your permanent impairment will be;
  4. Part of the body was injured;
  5. Employee’s years of experience and education level;
  6. Cost of retraining if the employee is unable to return to their current position.

Workers’ Comp Benefits for Disability

 

The Missouri Department of Labor offers the following disability benefits:

 

Temporary Total Disability (TTD)

Employees not working on doctor’s orders because they are recovering from a work injury are eligible for temporary disability benefits until the doctor clears them to return to work. TTD payments under workers’ comp rules are weekly payments of 66 2/3% of the difference between average earnings before the accident and projected earnings during the disability period.

 

Temporary Partial Disability (TPD)

If employees can return to work but have restrictions on their job duties under doctor’s orders due to workplace accidents and receive less than full pay are eligible for TPD benefits. TPD payments are weekly at 66 2/3% of the difference between the gross weekly wage before the accident and the projected weekly wage during the disability period.

The Missouri legislature approved a 3-part formula to determine benefits paid for Permanent Partial and Total Disability under a Workers’ Compensation claim.

  • Part 1 depends on the part of the body injured and the number of weeks workers’ compensation is payable. If a body part has been severed, the number of weeks compensation is payable is increased by 10%.

  • Part 2 depends on the percentage of your disability related to the injured body part.

  • Part 3 is based on a workers’ compensation rate equal to 2/3 of your average weekly wage at the time of injury to be, at most, the maximum rate of 55% of the state average weekly wage.

 

Permanent Partial Disability (PPD)

An employee who is permanently impaired by severe injuries but still able to do some work after an accident is eligible for PPD benefits.

 

Permanent Total Disability (PTD)

An employee who cannot return to work due to permanent disability after a work-related accident may receive weekly payments for life under a structured settlement or a lump-sum settlement.

Compensation settlement agreements for permanent disabilities usually come as a lump sum workers’ comp settlement or structured settlements. After the injured employee receives the compensation settlement, the insurance company will require the employee to release it from liability for future medical treatment and medical bills. They cannot file a claim to the insurance company for more money. For employees that have suffered permanent disabilities or impairments due to workplace injuries, a settlement may not be enough to cover future medical care.

Tips for Negotiating a Fair Worker’s Compensation Claim

 

Negotiating a fair worker’s compensation claim could be challenging. Here are some tips you can follow.

  • Gather necessary documents: You will need your medical records, wage information, and vocational assessments to support your claim. These documents will provide a solid ground for your workers’ compensation claims and will be used to determine a fair range of compensation settlement amounts.

  • Work with an experienced workers’ compensation attorney: An experienced work injury lawyer can help and assist you in navigating the complex process while ensuring that your rights are protected. Your attorney will help you negotiate a fair settlement on your behalf, represent you at meetings and hearing, and help you determine if the proposed settlement is fair or if you should pursue additional benefits.

  • Knowing your rights and state laws: A better understanding of state laws and your rights as an employee can help you make the right decision.

 

How Long Do Most Workers’ Comp Settlements Take? 

 

The settlement usually takes 12 to 18 months from filing the compensation claim to receiving the sum in your account. The time may vary based on the facts of the case and whether the employee has legal representation. Without a lawyer and without negotiating a settlement, the settlement process should take up to 14 months.

What Happens When a Workers’ Comp Claim Goes to Trial in Missouri? 

 

Workers’ comp claim cases that cannot be resolved through a settlement agreement go to a WC trial. A Missouri workers’ compensation trial is a formal evidentiary hearing before an administrative law judge. The judge presides over the case and ensures the trial is fair.

Either party may appeal the decision, and a higher court will hear the case. Still, the administrative law judge’s decision is generally the final word unless it is successfully appealed.

A workers comp lawyer well-versed in workers’ compensation laws can work with injured workers when any of the following has occurred:

  • Your claim was denied

  • Your claim was ignored

  • You were fired after making a claim

  • Your employer refuses to honor work restrictions

  • Medical bills or prescriptions are not reimbursed

  • Medical treatment authorization has been refused

  • Low settlement offers for disability injuries

 

Determining Who Is at Fault for Your Workplace Injury 

 

Understanding employer negligence and workers’ compensation is essential to initiate a valid workers’ compensation claim. In most cases, the parties held responsible could be the employer or a third party, such as an equipment manufacturer. The employer will be held accountable if it is due to a lack of proper maintenance because they are required to inspect and maintain the equipment.

However, the manufacturer will be held liable if the equipment is appropriately maintained but fails and causes injury due to a faulty part or bad design. Liability for the damage could also fall on the operator if he knew the equipment was defective but continued to use it. 

Let a Personal Injury Lawyer Help You with a Workers Comp Settlement 

 

The workers’ compensation process can be complex and lengthy, especially if the injury is severe. Therefore, hire an experienced personal injury lawyer to get the settlement you are entitled to for your injury. Buchanan, Williams & O’Brien, personal injury lawyers, have represented workers with many types of injuries in different industries in Missouri.

As a result of our commitment to ensuring just outcomes for our clients, a $1,000,000 workers’ comp settlement was upheld by an appeals judge in Missouri

We will work in your best interests. Contact us for a free consultation today.

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