The value of a workers’ compensation case in Pennsylvania varies depending on many factors. Here are the most common factors:
1. Your wages. Yes, that sounds odd. But your wages are important because the more you earned before the injury, the more weekly workers’ comp you get. If you are paid $500 per week more than another worker with the same injury who earned less than you, you will likely settle your case for more money because you are costing more money to the insurance company for every week you are paid workers’ comp checks. One worker who gets paid $800 per week from workers’ comp with a permanent low back injury may settle his case for well over $100,000, but another worker with the same exact same injury may settle his case for only $50,000 if he had low wages when injured or worked part time.
2. Your restrictions. If you have a serious injury that results in ongoing or permanent restrictions that prevent you from returning to your prior job, your case will likely have more value than a worker who is recovered or is able to return to work full duty. If you have restrictions, the workers’ comp carrier must continue to pay your wage loss benefits until you fully recover or other work is found or available within your restrictions, and may still have to continue paying you partial wage loss benefits if you are not able to earn your pre-injury wages. This means that case will cost the insurance company a lot more money. So this case has more value than a worker who can return to work sooner or at higher paying jobs that are available.
3. Employer’s modified duty work availability. Some employers have little or no light duty work for injured workers, so the insurance company usually has to keep paying the injured worker for a longer period of time. However, some employers will go out of their way to find any light duty position and offer it to injured workers, even if the work pays less, had nothing to do with their original job, or is totally demeaning. If there is no realistic light duty available, or if it’s only available for a temporary time frame, that case may have more value because the insurance company has to pay more money each week to the injured worker who has not yet returned to work in any capacity.
4. Your earning capacity. If your employer has no modified duty work available, the insurance company can still try to lower or stop your comp checks if they can prove that you have an earning capacity. For older workers with a work history of heavy labor, they probably don’t have a significant earning capacity and the insurance company might have a tough time trying to stop or lower their checks if there are little or no jobs for such a person. If so, the comp carrier will likely pay more in a settlement if they recognize that some workers are not employable or would only earn minimum wages in another job. However, a younger worker who is savvy with computers and has some management experience may have the ability to earn more money even outside of their pre-injury job. For those people, the insurance carrier will want to pay less of a settlement because they hope to prove a higher earning capacity. If the insurance company can prove that a worker has a high earning capacity even outside of their old job, that costs them less over time and the case will likely have less settlement value.
5. Legal Challenge. If there are no pending legal fights over your claim, your case may have more value than an identical worker who is fighting in court to have their claim accepted or in court to fight off a doctor who was paid to testify that the worker is fully recovered. There are many legal challenges that insurance companies file every day against injured workers. If the legal challenge has little merit, your settlement value may not be effected. However, if the legal challenge has some risk of the denial of benefits, or if you are before a Judge who has a reputation that favors insurance companies, the value of your claim could be negatively impacted.
6. Conclusions. As you read this, you should get a better understanding of why lawyers cannot simply put a calculator on line for people to determine the value of a claim. Each one of these factors is different, and a skilled and experienced lawyer can minimize the negative factors and maximize the positive factors for their clients to get them the best possible settlement.