How the amount of workers’ comp benefits are determined

How the amount of workers' comp benefits are determinedWorkers’ comp benefits vary by state, but there’s more to the claim than where it’s being made. Each claim is unique, because of what the injury entails, who the worker is, what happened, and how it was handled. Despite the many variables, employers pay billions of dollars in workers’ compensation benefits every year.

How to Calculate Workers’ Compensation Benefits – Average Weekly Wage (AWW)

The Average Weekly Wag (AWW) is used to calculate the amount of workers’ compensation you’ll receive, but each state uses different guidelines to calculate the average. Then, the insurance companies use the averages to determine the weekly money you’ll receive. The amount may not be what you’d expect, but there are specific steps the insurance companies follow to figure out your benefits.

Depending on whether you’re partially or fully disabled, you will receive the half or full amount as calculated via the AWW. The calculation is based on the extent to which the illness or injury has affected your ability to return to week and at what level of previous job tasks you are able to perform.

How to Calculate Workers’ Compensation Benefits Broken Down into Weekly Payments

In order to calculate what the AWW and the insurance company’s decision factors into the money you will receive from workers’ compensation benefits, you first look at your AWW calculation and the level of disability, as determined by your doctor.

  • Multiply your AWW by 2/3.
  • Multiply that calculation by the disability level (percentage), as determined by your doctor.

Based on those calculations, you should have an estimation of your weekly benefit amount. Of course, your situation may vary depending on your situation. Once the calculation of your workers’ compensation benefits is determined, it should remain the same regardless of statewide changes to the AWW.

How to Calculate Workers’ Compensation Benefits Based on Paycheck Frequency

Your workers’ compensation benefits will typically be issued either every other week or every week, depending on your state’s policies and procedures. The amount of the check will vary depending on the level of disability. Here are the three statuses used to calculate the amount of workers’ compensation.

  • Temporary partial disability: If you can work some hours, but you’re not able to work 40 hours/week, you’ll typically be eligible for temporary partial disability.
  • Temporary total disability: You would receive temporary total disability while you are injured and unable to work. The workers’ compensation benefits will typically stop when your doctor determines that you’re able to return to work.
  • Permanent partial disability: When an injury or workplace illness is so severe that you’re disabled for life, you’ll typically receive permanent partial disability, even after the temporary disability payments stop.

Fully disabled workers can typically apply for and receive Social Security benefits for disability. Or there may be other grants or funding options available, depending on your health factors, age, etc.

How Long Can You Receive Weekly Benefits?

As with most things related to workers’ compensation, the length of your benefits will vary depending on which state you’re in. Some states are more friendly to the claimant. In general, workers’ compensation benefits can last from three to seven years, depending on the level (percentage) of disability and the determination of the doctor and the insurance company.

The length of time allowed for permanent disabilities also varies by state, with some states not allowing for permanent partial disability benefits. Other states allow for permanent partial disability benefits, but the benefits end when you reach 65 years old. While each state handles the situation differently, it’s important to know how it works in your state, so you can make decisions that are best for you and your family.

What About Pain and Suffering?

The goal of workers’ compensation is not to address issues related to pain and suffering. Instead, workers’ compensation focuses on the remediation of income for individuals who are not able to work for a period of time because of workplace injuries or illnesses.

To pursue additional factors related to a case of injury on the job, you might consider consulting with a lawyer about the viability of a personal injury case or other avenues of legal recourse. If you’re unable to return to work, and you’re in severe, debilitating pain, your lawyer may advise you to pursue compensation via other channels beyond just workers’ compensation.

What About Medical Treatment?

While you have the right to have your medical treatment paid for if you were injured on the job, acceptable medical expenses can get convoluted. The insurance company may refuse to continue paying if they determine that the care is taking too long, that the care is not a proven medical treatment, or that the treatment is no longer necessary.

It’s important to understand what’s included in the covered medical treatment, so you will hopefully be able to avoid huge and unexpected medical bills for treatment you thought was covered.

You May Qualify for Legal Assistance

One of the worries you may face as you attempt to navigate the workers’ compensation system is that you don’t have the money or resources to get help. That’s why workers’ compensation lawyers typically work on contingencies. So, you only pay the lawyer if they win the case and deliver the fair compensation you deserve.

There are so many ins and outs with a workers’ compensation case that it’s impossible to know how to proceed, which is why a qualified lawyer who has your back in the best decision you can make for yourself, your family, and for your future.

Next Step: Schedule a Free Consult to Learn More About Workers’ Compensation

If you’ve been injured in a workplace accident, or you’ve experienced a workplace-involved illness, you’re entitled to Compensation for Workplace Injuries. More than just the compensation, though, you need an experienced lawyer who can answer your questions and make sure that your best interests are being served.

That’s why we always recommend that you schedule a free consultation. You’ll learn more about what workers’ ‘compensation is and how it will affect your life and work both now and in the future. You need to know what steps you should take and who you should turn to for help with doctor referrals, physical therapy, battles with the insurance companies, and so much more. You deserve a lawyer who’s on your side.

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