Calculating the Four Types of Benefits
Learn about the Workers’ Compensation Benefits Available to You
The workers' compensation benefits system can be confusing and frustrating. The legislation governing this issue is not easy to understand. At Solomon, Berschler, Campbell & Thomas, P.C., in Montgomery County, PA, we pride ourselves on our knowledge and experience when it comes to determining the amount of workers' comp benefits and helping clients maximize the amount of compensation they are entitled to for these types of claims.
What are the Four Types of Worker’s Compensation?
Our legal team can help you calculate and apply for the following types of benefits:
- Wage loss benefits – The formula used to calculate this standard income benefit is to take the average of the highest three of the four quarters of pay before the injury occurred. This figure is called your average weekly wage (AWW). Two-thirds of the average is the benefit rate that you are eligible to receive. There are minimums and maximums defined by law for this calculation, and the insurance company may try to use an alternative method to arrive at this amount or may miscalculate the average weekly wage, which is why it is beneficial to have an attorney who can help you calculate the amount correctly.
- Medical expenses – You must be able to prove that the medical expenses you ask to be reimbursed are reasonable, necessary and causally related to the accident you sustained at work. In addition, if your employer's workers' comp insurer denies a medical bill benefit that would ordinarily be covered under your health insurance, your health insurance must pay that claim. Our lawyers can make sure you submit these claims properly to ensure payment.
- Specific loss – This includes the loss of use or amputation of an appendage, such as fingers, hands, arms, toes, legs appendages. You are entitled to a specific number of weeks for each type of appendage by law, but once the statutory benefit runs out, you cannot apply for continued compensation. Specific loss also applies to loss of hearing or vision as well as disfigurement of the head, face, or neck.
- Death benefits – Your family can receive modest funeral expenses. In addition, a widow can receive 50 percent of their spouse's wages. Furthermore, the dependent children of the deceased are entitled to benefits as well.
We are here to assist you through the entire process when it comes to determining the amount of workers' comp benefits you may be entitled to under the law. Whether you are appealing a denied decision or need help proving the benefits you are entitled to after an insurer has already reduced the amount, we can properly evaluate your claim.
Call (610) 624-2006 for a free initial consultation.
Workers’ Compensation Settlement Evaluation
Usually, a settlement involves releasing the insurance company from their obligation to pay all benefits. However, sometimes an injured worker may retain some types of benefits (typically medical) and that would reduce the value of the settlement, but may be in the best interests of the injured worker.
When you are injured, the insurance company calculates your "average weekly wage" (AWW). This is the single most important factor in valuing your claim. If it was miscalculated, it can reduce the value of the settlement. One of the benefits of having our attorneys on your side is that we will evaluate whether the benefits you are owed were calculated properly. If you have two injured workers with identical jobs and identical injuries, but one earns more than the other does, the one with the higher AWW has a higher valued settlement.
The benefit rate is calculated based upon your AWW. The attorneys in our firm can help you prove your benefits may have been miscalculated if the AWW is not accurate or your employer submitted incorrect information to their insurance company.
When it comes to your earning potential, this needs to be compared to your pre-injury AWW to determine the likelihood and amount of future benefits. The greater the disparity the greater the value.
Why You Should Hire a Workers’ Comp Attorney
Many people believe that if they have been injured on the job, applying for workers' compensation will automatically entitle them to benefits for their injuries. This is not the case. Like any other insurance claim, your employer or the insurance company may challenge your claim and seek to deny you compensation, which is why it is important to hire a lawyer for your workers' compensation case.
The following are several reasons why you should hire a lawyer for your workers’ compensation claim:
- We can help make sure you are receiving the right amount of money – Your employer and their insurance company initially determine what you are owed in workers' compensation benefits, but they are often incorrect. You may be entitled to a retroactive increase plus interest. Even a small change per week can make a big difference over a long period of time. In addition, it can affect the size of a potential settlement as well.
- We advocate on your behalf – Our experienced workers' compensation lawyers will act as a go-between with the insurance company and advise you regarding independent medical examinations, vocational rehabilitation, return to work issues, etc. If your check is late or your bills are not being paid, your lawyer will assure that you are paid by stepping in and contacting the appropriate parties. When you hire a lawyer for your workers' compensation case, it alerts the insurance companies that you are ready to hold them responsible for all of their actions.
- We are here to stay one step ahead of your employer's insurance company – If and when the insurance company files a petition to alter your benefits, you will already have an attorney ready to defend you who is familiar with your case and is ready to negotiate on your behalf.
- We can help maximize the value of your workers' compensation benefits – One of our lawyers will explain how insurance companies' value claims and how we will negotiate the highest possible settlement.
Ready to Help You Today!
The decision to settle a workers' compensation claim requires careful analysis, which is why we are here to help you with every aspect of a workers' compensation claim. Having our experienced attorney who can evaluate your options and help you make a decision can be a critical asset when deciding which path to choose.
Contact us today for more information about our firm. Get 40+ years of experience on your side!