The average workers’ compensation amounts vary. The amount an individual receives depends on the severity of the injury. In workers’ compensation claims, injuries can range from cuts and broken bones to brain damage and lost limbs.
In a workers’ compensation case the employer is not necessarily responsible for the injuries. Since workers’ compensation is a no-fault system, an employee may receive payment even if they caused the accident that led to the injuries. Because the employer may not have been liable, the injured person may receive a smaller amount of compensation than someone who was injured because of another party’s negligence.
Pros and Cons of Accepting a Settlement
Your employer’s workers’ compensation insurance company does not have to offer you a settlement. If they offer one, you do not have to accept it. Negotiating a settlement can help you avoid the time and stress associated with going to trial.
You may receive compensation for your losses so far, as well as money for medical treatment that you may or may not need now or later. For instance, if you need surgery down the road, you can have funds for that in the settlement. If you do not need to have the operation, you can use the money for other purposes.
If you accept a settlement, you may be required to give up the ability to seek more workers’ compensation benefits in the future. That may be risky since your condition may change. You may realize that your injuries are more serious than you thought they were, or your condition may worsen over time. Then, you may need to undergo surgery or other medical treatment.
You may need to have a nurse care for you in your home or move to an assisted living facility. If the compensation you received from the settlement is not enough to cover those costs, you may not be able to request more money.
How You May Receive Funds from a Settlement
If you have suffered a severe injury while on the job and you were left permanently disabled, you may receive weekly workers’ compensation payments, or you may choose to pursue a settlement. If you accept a settlement, you may opt to receive the money in a lump sum of several thousand dollars, or you may select a structured settlement that will divide the funds into payments over a period of one or more years.
Reasons Why Your Settlement May Be Reduced
Your attorney will deduct a percentage of your settlement for legal fees. The amount may vary from one firm to another and may be capped by state law. States have different rules on which portions of a settlement are subject to attorney’s fees.
Your lawyer will also be reimbursed out of your settlement for costs associated with handling your case. Those may include payments to independent medical experts and fees to copy records. Some attorneys deduct costs before calculating their fees, and some take their fees from the total settlement amount and deduct costs after. The American Bar Association (ABA) says that some lawyers’ fees are typically around one-third of your settlement.
If You Have Medicare
If your workers’ compensation claim was originally denied and you have unpaid medical bills, they may be paid out of your settlement. If you have Medicare, it is illegal to pay for medical costs related to a workers’ compensation claim. Medicare may, however, cover bills conditionally while a workers’ compensation claim is being reviewed and resolved. If Medicare paid any of your medical bills, it has to be reimbursed from your settlement.
According to the Centers for Medicare & Medicaid Services (CMS), if the settlement includes money for future medical care for your work-related injury, you will have to put a portion of the funds in a separate, interest-bearing Workers’ Compensation Medicare Set-Aside Account (WCMSA) to protect Medicare’s interests.
Medicare will only pay for care associated with your work-related injury after you have used up the funds in the WCMSA, Medicare may consider all the money from the settlement to be intended for future care for your work-related injury. It may not cover any medical bills associated with your injury unless you have used up all the money from the settlement first.
If you have Medicaid, it may have made conditional payments for your healthcare while your workers’ compensation claim was being processed. If so, you may have to reimburse Medicaid with money from the settlement.
If you began receiving permanent disability payments before your claim had officially been settled, those payments may be deducted from your settlement.
Seek Legal Help with Your Claim
A workers’ compensation attorney can explain your state’s laws and help you seek a settlement. Contact Ben Crump Law, PLLC at (800) 603-4224 to discuss your case with a member of our staff.