Payments on Workers Compensation Claims

Payments on Workers Compensation Claims Image

One question an injured worker has about Compensation claims is how much will they receive, and how do the payments work. The answer varies by state but, all of the following are considerations.

1. Lost Wages Compensation
When a worker is unable to work for a period of time due to a work-related injury it is called “temporary total disability”. He/she will generally be entitled to some compensation for lost wages. Each state is different as far as how many days of work must be missed due to the injury before they are entitled to receive compensation for lost wages but, after he/she has missed work for the required number of days, the lost wages benefits are generally retroactive back to the first day of work that was missed because of the work-related injury.

2. Amount of Workers’ Compensation Benefits Paid
The amount of lost wages compensation for a Workers’ Compensation claim is based on previous earnings from the employer. The injured workers’ weekly earnings will generally be averaged by looking at what was earned during prior months. Each state determines how many weeks’ or months’ pay will be taken into account when calculating a worker’s average earnings but, the average amount of the weekly or biweekly Workers’ Compensation benefit check is around 2/3 of the gross average weekly earnings. Typically, this is considered non-taxable income.

3. Medical Payments
During medical treatment for work-related injuries, the Workers’ Compensation insurance company pays the medical bills. Payments for medical care are paid directly to the health care provider(s). If an injured worker must travel a significant distance to obtain the necessary medical treatment(s), he/she might apply and receive a reimbursement for mileage.

4. Specific Loss Benefits and Scars
Benefit amounts for certain losses of specific body parts may be payable. The amount varies, as do the benefit amounts from state to state. Generally speaking though, the benefit amount for losing a leg would be more than the benefit amount for the loss of a fingertip. There may also be a benefit amount assigned under state law for permanent and significant scars or disfigurement as a result of a work-related injury.

5. Death Benefits
In the unfortunate circumstance when a worker dies in a work-related accident, a lump sum death benefit to the estate of the deceased worker may be paid. The amount of the death benefit depends on several factors including state law and the number of dependents the deceased worker had. A set amount of burial expenses for the deceased worker may also be paid. In some cases, the worker may have had medical treatment after the work-related accident, but later died. In those cases, the medical expenses prior to the worker’s death are also generally covered by Workers’ Compensation insurance. Permanent Partial Disability or PPD Permanent partial disability (PPD) benefits may be available for a permanent loss of functional use of a body part. Permanent Total Disability or PTD Workers’ Compensation insurance may also pay permanent total disability (PTD) benefits when the injury has:

1. Reached maximum medical improvement,
2. Results in a permanent disability and he/she will never be able to return to any type of gainful employment. PPD and PTD will be discussed in our next article