While the laws governing workers' compensation vary with every state, knowing what you're eligible for can help you reach a fair settlement. In many cases, you can figure out what your settlement should be by adding your medical bills to the the amount of lost income that the insurer should be compensating you for, and then deciding which type of settlement you are willing to accept.
Types of Workers' Compensation Settlements
Workers' compensation settlements can generally take on three different forms: voluntary payments, full commutation and partial commutation. With voluntary payments, the insurer makes an offer and the worker accepts it without dispute. A full commutation happens when the worker disputes the insurer's offer and they agree on a compromise, while the worker releases the insurer from any future claims. In some states, this is also called compromise and release. A partial commutation, which can also be called a stipulated award, is when both parties agree on a compromise, but the the worker does not release the insurer from future obligation. In most cases, this stipulation is that future medical coverage will be paid by the insurer.
In addition to these settlements, the insurer and worker may go to court, or seek mediation, and a judge can decide what settlement, if any, should be awarded to the worker.
Understanding Cash Benefits
Workers' compensation can pay a worker for medical expenses and time lost from work. When death has resulted from an injury, workers' compensation can pay a burial expense and an amount representing the worker's loss of income to the surviving family. In most cases, all medical expenses are paid by the insurer up to a maximum amount usually set by law. Burial expenses are usually a flat amount, also set by law.
Calculating Income Loss
Workers' compensation benefits don't usually pay a worker for a disability, but rather for the amount of income he has lost because of it. For example, if you work at a desk and break your arm at work, but are able to return to the office the next day without any reduction in pay, your benefits would probably only cover medical expenses. This is the case in states like New York, which do not pay anything for the first week of lost work, unless the disability lasts for more than fourteen days, in which case they will compensate you for that first week.
The amount you receive is based on how much you earn, with a maximum payment that is adjusted for inflation each year. In New York, the weekly maximum in 2017 is $864.32. They pay two-thirds of your average weekly wage if you are fully disabled. If you are partially disabled, your payment is reduced. For example, if you made $500 on average each week, your payment would be $333.33. If you were deemed to be 50-percent disabled, your payment would be $166.66.
If you are able to return to work, but are unable to earn the same wages you did before your injury, you may receive a benefit that is two-thirds of the difference. For example, if you normally earned $500 per week and your work was reduced so you only earned $420, you could be eligible for two-thirds of the $80 difference, which would be a payment of $53.33.