How Are Workers’ Compensation Settlements Calculated in Pennsylvania?

Many people never have reason to consider how they would be compensated if injured at work. However, when you are injured, your compensation becomes a key concern. Workers’ Compensation can seem confusing since there are different types of benefits and ways to calculate the money offered based on your injury and how long you are affected by it. If an insurance company offers a lump sum settlement, you may wonder if the offer is fair.

Workers’ Compensation settlements are calculated based on the amount of money you are entitled to under the Workers’ Compensation law (77 Pa.C.S.). Several factors impact how much compensation the law offers employees, including the specific injury suffered, how severe it is, the impact of the injury on your life, the length of time you are unable to work, and whether you are partially or fully disabled.

Determining the amount of compensation you are entitled to and evaluating if a settlement is fair is an exercise in examining your circumstances. Our Pennsylvania Workers’ Compensation lawyers at Lerner, Steinberg & Associates can review your case and help determine its worth. Call (215) 355-6400 to speak to a lawyer and receive a free case review.

Types of Workers’ Compensation Benefits

Before figuring out how much in Workers’ Compensation you can receive, you must establish which types of benefits you can receive. Our Philadelphia Workers’ Compensation lawyers can help you determine what benefits you are eligible for.

Medical Expenses

The first category of compensation is medical expenses. Generally, any medical expense from a qualified work injury is paid through Workers’ Compensation. The specific medical expenses covered vary greatly and depend on the required treatment for the injury suffered. For example, a simple broken bone can result in bills from a physician for diagnosis, the cost of X-rays, the cost of a cast plus its placement and removal fees, and maybe even the cost of medication for pain management. Contrast that with a severe knee injury that results in a meniscus tear. Such an injury can result in fees for several specialist doctors, costs of major surgery, fees for time spent in a hospital, and months of physical therapy.

Lost Wages

The next category of Workers’ Compensation is lost wages, which pays a portion of your weekly wage when you cannot work. Commonly called disability payments, there are two situations where lost wages are paid. The first is when you are fully disabled and cannot work at all, and the second is when you are partially disabled. Partial disability covers when you can work reduced duties or have a reduced earning capacity. Whether you are partially or fully disabled is determined by a physician’s evaluation and assignment of an impairment rating. If you disagree with a partially disabled designation, our Bucks County Workers’ Compensation lawyers can help you appeal the decision.

Specific Loss

If your workplace injury has resulted in the permanent loss or loss of use of a body part, you may be entitled to payment for that loss. Loss of a (or part of a) thumb, finger, hand, arm, toe, foot, or leg is covered by this compensation section, as is the loss of sight or hearing. Additionally, specific loss encompasses permanent disfigurement from the neck upwards.

Death Benefits

Finally, benefits are available to the employee’s dependents if an injury is so severe that it causes death.

How Much Workers’ Compensation Can I Get for My Injury in Pennsylvania?

Once you narrow down which categories of Workers’ Compensation you may be entitled to, you can focus on specific compensation amounts. These are highly fact-specific and require examining the situation surrounding your injury. The insurance company will complete such a determination to figure out how much to offer in a settlement. Our Delaware County Workers’ Compensation lawyers can work with you to determine if the settlement amount is fair and potentially negotiate for more.

Medical Expenses

Reasonable medical expenses incurred as a result of the injury are provided. As described above, many services and costs fall under medical expenses. It is important to see a physician and follow their instructions to treat the injury to ensure Workers’ Compensation coverage. Some employers will have a list of approved medical providers to use in cases where Workers’ Compensation is being sought. If this is the case, be sure to see an approved medical provider or your compensation claim could be at risk.

Lost Wages

Payments for lost wages when you are totally disabled are equal to 66 2/3% of your average weekly wage, up to a weekly maximum, which changes annually. The weekly maximum for 2023 is $1,273.00. The total amount of lost wages payments will depend on how long you are out of work, which is a function of how severe your injury is. While there is no limit on the amount of time you can receive full disability, after 104 weeks, your employer can require a doctor’s examination to see if you may qualify for partial disability instead.

If you can return to work with restrictions on what you can do or accept a lower-paying job that is within your abilities, you can receive partial disability. Partial disability is capped at 500 weeks, so even if you continue to be partially disabled after that time, your compensation will be limited.

Specific Loss and Death Benefits

77 Pa.C.S. § 513 lists a schedule of compensation for each type of permanent injury. Generally, these amounts of money are a lump sum equal to 66 2/3% of your weekly wage for a certain number of weeks. The number of weeks depends on the body part lost, as defined in the law. For example, the loss of a hand will receive compensation of 66 2/3% of weekly wages for 335 weeks, but the loss of a little finger will receive the same amount for only 28 weeks. In addition, disability payments are made for the time required to heal, with maximum amounts of time defined for each body part.

77 Pa.C.S. § 561 lays out the amounts to be paid as death benefits to any surviving dependents. The exact amount is a percentage of the deceased employee’s weekly wage, which fluctuates depending on how many dependents exist.

Call Our Pennsylvania Workers’ Compensation Lawyers Today

Estimating the exact value of a Workers’ Compensation claim is different for each case, and our Montgomery County Workers’ Compensation attorneys have experience with a wide array of situations. Call us at (215) 355-6400 to discuss your case in a free case review.