Friday, February 2, 2018

What Can I Expect to Receive in a Workers' Compensation Settlement?

A question often asked by clients when meeting for the first time is "how much is my claim worth?" While there is no hard and fast rule when it comes to estimating the value of a Minnesota workers' compensation claim, there are a variety of factors in every claim that help determine a fair settlement value or range.

1. How long have you been receiving wage loss benefits?

Most wage loss benefits in the workers' compensation system have temporal caps. For example, you can only receive 130 weeks of temporary total disability benefits (TTD) for injuries occurring on or after October 1, 2013. In addition, you can only receive 225 weeks of temporary partial wage loss benefits (TPD) or approximately four and a half years. Because these wage loss benefits are capped, the number of weeks you have received benefits will affect the value of a Minnesota workers' compensation claim.

2. Average weekly wage, i.e., how much were you earning on your date of injury?

If the injured person is a high wage earner, the value of the claim will be greater than someone earning a lower wage. The average weekly wage for a claim is calculated based upon average earnings for the six months preceding the date of injury. As such, it is important to have an accurate average weekly wage calculation and to be using the most recent date of injury to ensure the greatest possible settlement from workers' compensation is received.

3. Did the insurer accept or deny your workers' compensation claim?

When a workers' compensation claim is accepted by the insurer, you generally have a stronger position going into a settlement conference or mediation. This is true because many times the insurer is paying the employee ongoing benefits. If your claim is accepted, there will still be a dispute with the insurer with regard to the "nature and extent" of the injury and the amount of the benefits owed but the insurer has admitted responsibility for the injury when a claim is accepted.

On the other hand, if a claim is denied and litigation is pending, the insurance company knows that there is a chance that they will not have to pay anything for the claim. If you go to court, there is a chance the insurance company will win, and this is factored into the insurance company's exposure analysis for your claim. For example, let's say you have a 50% chance of winning your claim. The insurance company will typically look at the overall exposure for your claim, calculate how much you would receive if your case went to hearing and we won on each of the claims then reduce that amount by 50%, (i.e., the estimated chance of success for the claim).

4. Did you sustain a permanent or temporary injury? 

This concept is relatively straightforward. If you sustained a serious injury and are issued permanent restrictions, the insurance company will understand that you will likely collect most, if not all, of your wage loss benefits. In addition, you will likely be entitled to a benefit known as permanent partial disability (PPD) for the loss of use or functioning of the affected body part. This benefit is not available to employees that have sustained minor injuries. Conversely, if you sustained a relatively minor injury, the claim will likely have a limited settlement value because the injured person is expected to make a full recovery and return to the date of injury employer at full wage earnings.

5. How strong is your medical support?

If there is medical support from a treating physician, linking the injured individual's current condition to a work-injury, the claim tends to be stronger. This is especially true if the treating physician is an experienced, well-respected specialist, such as an orthopedic surgeon, in the relevant area. Remember, the burden of proof in a workers' compensation claim is on the employee. This means that the injured employee is responsible for providing medical evidence to support the claims if the matter goes before a judge. As such, if a claims adjuster or a defense attorney gets a persuasive narrative report from a treating physician that supports your claims, they will understand that you will be much more likely to be successful at hearing, which adds value to your claim.

6. Who is representing you?

If you choose to represent yourself, you will be at a serious disadvantage when it comes to settling your claims. Minnesota workers' compensation is a complex, confusing area of the law and you will not know whether you are getting all the benefits to which you are entitled unless you have an experienced workers' compensation attorney. In addition, your employer will be represented by a claims adjuster or attorney that has significant experience in the area and they will not be looking out for your best interests.

If you are thinking about settling your Minnesota workers' compensation claim, it is of utmost importance that you check with a workers' compensation attorney before you do. This is especially true if you are a police officer or firefighter and also entitled to PERA or MSRS benefits because there are certain, applicable offset provisions that will apply to any workers' compensation settlement. A wrong decision could cost you thousands of dollars. Contact Meuser Law Office, P.A. for a free no-obligation consultation and claim evaluation. At Meuser Law Office, P.A. we keep our clients informed of the process as well as what to expect each step of the way. Call us today at 1-877-746-5680.

Ashley Biermannby Ashley Biermann
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