If you’ve been in a workplace accident that results in an injury or illness, you may be eligible for workers’ compensation benefits. In Pennsylvania, injured workers can receive payments for lost wages, medical care and specific loss benefits that will protect them financially if they are unable to work due to their injuries.
If the injury or illness results in your death, your surviving dependents can receive compensation to replace the income you’re no longer able to provide. In short, workers’ comp can help you and your loved ones avoid a financial catastrophe if an injury or illness prevents you from earning a living.
Video – Workers’ Comp Settlements
Workers’ Compensation Settlements for On-The-Job Injuries in PA
If you have been injured at work in Pennsylvania, you can file a claim for workers’ compensation. If your employer accepts your workers’ comp claim, you may receive coverage for all of your related medical expenses and up to two-thirds of your average weekly pay. In Pennsylvania, there is a maximum limit of $1,081 on your weekly workers’ compensation as of 2020. This figure factors towards your PA workers’ comp settlement limits.
The Workers’ Compensation Act works for both the injured employee and their employer. Because workers’ comp is a no-fault system, you’re eligible for workers’ comp benefits no matter who is responsible for the injury. This part of the system favors the employee, as they can still receive compensation even if they’re responsible for causing the injury or if there is no fault at all by anyone.
However, employers also benefit from the workers’ compensation system because employees are not allowed to sue them for work-related injuries — that means employers can avoid facing an expensive lawsuit after an employee receives an injury as the result of an employer’s negligence.
The payments two types of payments you may receive are Temporary Total Disability or Permanent Total Disability:
- Temporary Total Disability: You’ll receive TTD payments until you return to work or if you return with workplace restrictions or job modifications.
- Permanent Total Disability: If you cannot return to work at all, you may be eligible for Total Disability payments. You can receive total disability benefits for up to 500 weeks. In some cases, where the injury causes serious permanent impairment, you could receive total disability benefits even beyond 500 week.
In some cases in Pennsylvania, injured workers can receive a settlement. Not every worker gets a settlement offer, but when there is a permanent injury and it makes sense for both the employer and the employee, you may negotiate one between yourself, your employer and your employer’s insurance company.
Before a case can be settled, a judge must approve it. The workers’ compensation judge will review the proposed settlement to ensure you understand the terms of the settlement and legal implications of the settlement. If the judge approves, you’ll receive your settlement offer. If they don’t approve, the case will return to negotiations or any pending litigation will continue.
Types of Settlements in Workers’ Compensation and How They Work
How does a workmans’ comp settlement work? In Pennsylvania, injured workers can receive a settlement in one of two forms — lump-sum or structured. Both types come with their benefits and disadvantages:
A lump-sum settlement occurs when you and your employer agree on the value of your claim, and your employer then provides a payout for your injury. A lump-sum settlement in Pennsylvania — called a Compromise and Release Agreement — must be approved by a Pennsylvania workers’ compensation judge before your employer can pay it.
In return for a lump-sum payout, you can waive rights to future wage loss or medical benefits for your work injury. You may be able to settle only your wage loss claim, only your medical claim or both. If you settle both your wage loss and medical claims, you will be paid the lump-sum amount and no longer receive workers’ comp payments from your employer. If your injury takes longer to heal than expected or becomes worse, you won’t receive any additional compensation.
You may want to consider a structured settlement if:
- You’re concerned you may quickly spend a lump-sum payment and not have enough money to cover all your future expenses.
- You’re concerned about the tax implications or the effect on your Social Security Disability Insurance benefits from receiving a lump-sum payment.
If you’re concerned you’ll spend your lump-sum workers’ comp settlement too quickly, you may work with your lawyer to restructure it. You can adjust it in a way that allows you to receive payments according to a schedule agreed upon by you and the insurance company.
If you’re receiving Social Security benefits along with your workers’ compensation benefits, you may also worry about what that could mean for your taxes or the impact of a settlement on your social security disability payments. Though workers’ comp benefits are not taxed at the federal or state level, receiving Social Security benefits along with your workers’ comp could create tax problems for you.
Your combined Social Security Disability Insurance and workers’ compensation benefits can’t be more than 80 percent of your pre-injury income. If they are greater than the limit, the Social Security Administration will cut them by the amount above 80 percent. However, you will still be taxed on your original total Social Security Disability Insurance benefits, including the amount you’re no longer receiving.
By accepting a settlement, you are making a trade-off. You receive money to help with expenses and avoid any risks of litigation from your employer, but you also lose the possibility of long-term compensation. If you’re unsure whether to accept a settlement offer or make one yourself, discuss your situation with a workers’ compensation lawyer. They can help you determine which type of settlement is best for you and what amount you should ask for from an offer.
Will I Be Offered a Settlement?
How do you get a settlement from workers’ comp? Receiving workers’ comp benefits does not necessarily mean you will receive a settlement offer. Rather, numerous factors play into this decision. Your company may think you’ll be back on the job quickly or that you’re able to do some work, which can determine whether you receive a workers’ comp settlement offer. Circumstances under which you may want to take the settlement include:
- When you’re tired of waiting for the workers’ compensation process to finish.
- When your doctor doesn’t think you’ll recover further.
- When you’re no longer progressing in your recovery.
- When you’re in litigation against your employer.
- When either you or your employer no longer get along and want to part ways.
- When your injury requires you to start over.
- When you’re worried you may lose your claim.
If you’ve reached Maximum Medical Improvement, you may want to consider a settlement. You’ve reached MMI when your physician informs you that you’ve healed as much as possible, and you’ll see no further recovery. Waiting until you’ve reached MMI will allow you to anticipate your future medical expenses, so you can negotiate a settlement.
You may also prefer to have the money accessible to you now instead of having it paid out over weeks or months. Dealing with the insurance company can sometimes feel like a hassle on top of your recovery. If you do receive a settlement offer, you’ll no longer have to worry about the insurance company keeping tabs on you or trying to prove you’re faking your injury, which can feel invasive and upsetting for many people.
When Will I Be Offered a Settlement?
You may receive a settlement offer at any point. Sometimes, companies propose an initial settlement amount when you first make a claim. If you suffered a serious injury and may be out of work for several months, your company may be eager to lay the matter to rest quickly. Other times, it can take longer for an employer to put a settlement on the table. You may fight for months or even a year before you get a settlement offer — every case is different.
So, when will you get a workers’ comp settlement? Overall the timing may vary. You could be offered a workers’ comp settlement at any time during your case. It may come early on or when you are filing an appeal. Your lawyer can advise you on timing.
Why Do Employers and Insurers Offer Settlements?
When you file a workers’ comp claim, the employer and insurer will likely attempt to find grounds for denying it. Perhaps you didn’t follow all filing or reporting procedures to the letter, or maybe they’ll try to say your injury wasn’t related to your job. In other situations, they may determine their best recourse is to offer you a lump-sum cash amount to settle your claim.
Upon first inspection, a settlement from workers’ compensation insurance might seem like a financial windfall, especially if the amount reaches six figures. In truth, the insurer is probably offering you a settlement to mitigate its costs.
A settlement may help an employer save money over time. If your employer fights against your claim and wins the case during a hearing in front of a workers’ compensation judge, then they may no longer have to continue paying your workers’ compensation. If your employer fights against you and loses, however, they lose money from the expenses leading up to the hearing and from your workers’ comp benefits after. Settling your workers’ compensation case is often better for the employer’s long-term finances.
How to Win a Workers’ Compensation Settlement
Work with a workers’ compensation attorney to help you win your case. When you work with an attorney, you can estimate how much is a fair amount for your settlement and ensure you get the full compensation you’re entitled to.
What Is a Fair Amount for a Settlement?
So, what can you expect for body part prices for a workers’ comp settlement? How do you negotiate a workers’ comp settlement? If you receive a PA workers’ compensation offer of settlement, the first thing you should do is contact an experienced workers’ comp attorney. Your attorney will have the expertise to evaluate the offer and determine its fairness based on your situation. This entails determining the expected costs of ongoing medical treatment and the amount of lost wages you may need to recapture over time.
In the typical workers’ comp settlement, amounts originate from two-thirds of your average weekly pay and the 500 weeks that injured workers in Pennsylvania are eligible for benefits. For example, if two-thirds of your average weekly pay was $500, then you’ll multiply $500 by 500 weeks for a total of $250,000. You aren’t likely to receive this entire amount because your employer or their attorneys will not likely agree with your evaluation if they feel that they can prove that you have the ability to work or will recover from the injury. So that’s why there are negotiations to determine if an agreement can be reached to settle based upon those factors and a fair settlement amounts. If you have ongoing medical treatment, you’ll also have to account for medical expenses.
To get an idea of an average workers’ comp settlement in Pennsylvania you may receive, you can check out our case results. For example, for lower back injuries, our clients have received award amounts ranging from $52,000 to $439,677.
Please note that what you receive from your settlement depends on the specific circumstances of your situation.
Should I Accept a Settlement?
What should you do when you receive a workers’ compensation settlement offer? Ultimately, the answer lies in your circumstances and what might improve or not improve by taking the offer.
You may want to take the offer if your recovery is on hold, and your health is not improving. You may wish to accept a settlement if you want to move on from a workers’ comp case. You may prefer a settlement to the hassles and uncertainties of litigation that often occur in Pennsylvania workers’ comp cases. You should consider these factors before making your decision:
- Will you need more surgery?
- Does the settlement provide enough for a financial peace of mind?
- How challenging is it to deal with the insurance company?
- Will you be out of work for months or years?
What Happens If I Settle?
When you accept a workers’ comp settlement, you receive a one-time lump-sum payment. That means you won’t get any more money from your employer for this injury. You waive your rights to any future claims, which is why Pennsylvania and other states make a judge look over the case to ensure your understanding.
If you need another surgery after you accept the deal, you can’t get compensation for it from your employer. Ideally, the settlement will give you financial security. Think about it before you accept any deal. Better yet, consult a lawyer, so you can discuss the merits of the offer and what it would mean for you down the road.
Who Pays the Workers’ Comp Settlement?
Just as you take out insurance policies to cover your home, car or life, your employer carries insurance to pay for workers’ compensation claims. If you’ve ever had an auto accident and filed a claim with your insurance company, you may have experienced a subsequent increase in your premium.
A claim represents an expense to an insurance company, so they attempt to recover that cost by raising premiums for claim filers. Similarly, a workers’ comp claim creates an expense for the insurance provider, which they often pass on to the company in the form of higher costs.
Where Can I Get Help With a Settlement?
If you’ve received a workers’ comp settlement offer in PA, contact Frommer D’Amico today to schedule a no-obligation initial consultation. Our team of attorneys consists of certified workers’ compensation experts who can review your situation and help you determine whether you should accept the offer or pursue further legal action. We offer low fees and can come right to your location for an appointment.
Joe D’Amico has more than 20 years of experience fighting for injured workers. He is Certified as an Expert in Pennsylvania Workers’ Compensation Law by the Supreme Court of Pennsylvania. Joe is one of the very few Pennsylvania workers’ compensation attorneys who have obtained a recovery in excess of $1.5 million for an injured worker.
Reviewed by Joe D’Amico.