How a Workers' Comp Settlement is Calculated

How much are your injuries worth?

Your workers’ comp settlement isn’t “free money.” Here’s what to consider when deciding whether that settlement offer is worth it.

If you’ve been injured in a workplace accident, it’s very likely that your life has been turned upside down.

With your reduced work hours and all those medical bills, that workers’ comp settlement offer is starting to look pretty good. But how did the insurance company arrive at that number?

It may seem arbitrary to you. But the insurance company isn’t reading tea leaves or consulting a crystal ball to calculate your workers’ comp settlement amount. They are actually making a number of calculations behind the scenes to decide how much to offer you.

And unless you know what’s influencing their decision, you won’t be able to decide whether the offer is a fair one.

So let’s take a look at what your workers’ comp settlement should cover and how you can decide whether or not to accept it.

 

What Your workers’ comp settlement Should Cover

It’s important to note that your workers’ comp settlement is a one-time payment. In most cases, accepting a settlement will require that you release the insurance company from any future liability in your case. This means you will not be allowed to come back and ask for more money if you run out.

This is why it’s so crucial to understand exactly what your workers’ comp settlement is based on.

The insurance company will examine multiple different factors before deciding what they are willing to pay to settle your case. You and your workers’ compensation attorney should consider each of these factors as well, so you can make an educated decision about whether the settlement offer is fair.

hand with bandaged thumbs up

Medical Expenses

Treatment for workplace injuries can get expensive, but it isn’t just past medical bills that require compensation.

It is easy to calculate the amount you spent treating your injury in the past. What’s more difficult is estimating how much your injury will cost you in the future.

Unfortunately, not everyone completely recovers from their workplace injury. You may require ongoing treatment, rehabilitation, or even surgery. Your anticipated medical expenses should be factored into your workers’ comp settlement in addition to the bills that have been piling up.

Lost Wages

Workplace injuries cost you in many different ways. In addition to paying for expensive medical treatments, equipment, and doctor’s visits, you may also be earning less.

If your injuries prevent you from performing your regular job duties, you may be forced to take a reduced paycheck or stay home entirely. The workers’ compensation program is designed to compensate you for any lost wages, at a rate based on your Average Weekly Wage. (Here’s how your Average Weekly Wage is calculated.)

empty wheelchair in waiting room

But again, it’s important to consider the loss to your earning potential as well as any past wages you might have missed out on. If you are rendered permanently disabled—either partially or completely—this should be factored into your workers’ comp settlement.

Further, your workers’ comp settlement should also cover any vocational training and education that may be needed to learn a new trade.

Legal Fees

Any and all expenses relating to your workers’ comp claim should be taken into account when calculating your settlement. Even legal fees.

At the Law Office of Brian D. Tadros, you will never have to pay an upfront charge or retainer to hire us. If we successfully obtain a settlement for you, we get paid fees and costs out of the total settlement amount. However, sometimes we get paid by the insurance company if they provide something to you because of successful litigation by our firm.

This risk of what we call an Employer/Carrier paid fee can increase the value of your case from a settlement perspective, and therefore needs to be considered when evaluating the value of your case.

Strength of Claim

The strength of your claim also has an impact on the amount you’re offered for your workers’ comp settlement.

Strong claims typically result in a larger percentage of the expected exposure on a claim being paid for settlement.

 

It’s Not You…It’s The Insurance Company

“I had lots of medical bills, lost wages, legal fees, and a strong claim…why wasn’t I offered more?”

You may view your workers’ comp settlement as compensation for money lost, but the insurance company doesn’t see it that way. Rather, they will make the decision to offer a settlement or not based on how much your continued care and lost wages will cost them, not you.

Your workers' comp settlement is not based on your financial situation, but the insurance company's.

The insurance company will sit down and chart out what they expect your case to cost them if it remains open and not settled. This process is a literal calculation of what they estimate they will pay for future medical treatment and future lost wages. Additionally, if litigation is pending, they will evaluate what they believe their chances are of losing and what the potential attorney’s fees and costs are that they may have to pay to your attorney.

All of this collectively is what we call the insurance company’s exposure on your case.

Once they have calculated their exposure, they will offer you a percentage of their exposure to try to settle your case with you. If you do not know how to properly evaluate what they could have to pay on your case if it stays open and does not settle, you cannot make a determination about whether what they are offering you is fair.

Remember, you are never compensated for pain and suffering or loss of enjoyment of life. No amount of sympathy from a judge and no amount of lawyering can ever obtain this for you. It is simply not something that the Florida Workers’ Compensation Law entitles you to be compensated for.

Your employer’s workers’ comp insurance company is a business just like any other. They’re focused on profits and have an entire legal team devoted to upholding their interests. It is nearly impossible to get a fair settlement amount without a workers’ comp attorney of your own.

 

Should You Accept a Workers’ Comp Settlement?

It’s hard to resist a $30,000 lump sum. But remember, this is a one-time payment meant to last the rest of your life. Whether and when you decide to accept a settlement offer is up to you. But you should never settle for the first number the insurance company gives you and you should seek the assistance of an experienced workers’ compensation attorney to ensure that any settlement reached is a fair one.

It is best to wait until your authorized treating physician has determined that you have reached maximum medical improvement. This will give you a better idea of your future medical needs and the costs involved. If you settle too early, you may not know the extent of your expenses down the road.

The initial settlement offer shouldn’t be the end of the conversation, merely the starting point for negotiations.

Make sure you work with a workers’ comp attorney as early as possible in the process. An experienced attorney will be well qualified at negotiating a fair settlement offer.

 

Conclusion

Your workplace injury is more than a painful condition. There are bills, lost wages, and other pitfalls that have all contributed to a major lifestyle change.

When it is all said and done, if you wish to settle your case, your workers’ comp settlement should be a fair compromise whereby you give up your rights to receive continued ongoing benefits for your workers’ compensation claim in exchange for a one-time payment representing a percentage of what those continued benefits would have cost the insurance company if your case remained open and was not settled.

And your best bet for doing that is with a workers’ compensation attorney.

At the Law Office of Brian D. Tadros, there are never any upfront legal fees you have to pay to hire us. Any legal fees you could have to pay us will be paid out of your workers’ compensation settlement amount so that you never pay out of your own pocket. Contact us today for a free consultation so we can help you get the settlement you deserve.

Brian Tadros

Brian Tadros

Mr. Tadros has been a member of the Florida Bar for over 15 years. Over the course of his legal career, Mr. Tadros has represented injured workers, employers, and insurance companies. This wide variety of experience provides him with a unique perspective which assists him in achieving the best possible outcome for his clients.