13 Apr, 2023

How Does the Workers’ Comp Settlement Chart Affect a Claim?

Author Todd A. Strong
Lawyer hand showing paperwork for signing, agreement contract and settlement offer in law firm office
Lawyer hand showing paperwork for signing, agreement contract and settlement offer in law firm office

Money received from a successful workers' comp claim can cover the medical costs of treating your injuries. The settlement can also cover lost wages and disability benefits. The Illinois Workers' Compensation Commission must approve your claim before the money gets disbursed. 

What Costs Does the Average Worker’s Comp Settlement Cover in Bloomington?

You might qualify for a workers’ compensation settlement if you get hurt or sustain a medical condition at work. The compensation will cater to your financial losses arising from the on-the-job injury or illness. The average settlement amount you can collect from a workers' comp claim is about $20,000. If a work-related accident causes injury to several body parts, the average amount can be $62,859, as the National Safety Council reports. Your employer’s workers' compensation insurance company is responsible for covering these financial losses. 

Since you cannot sue an employer for a work-related injury or disability, you can pursue compensation through the Illinois workman's compensation system. The extent of the injury, disability, or illness will determine your compensation. 

The compensation amount varies with the type of work injury, the severity of the injury, and whether you are working with a lawyer or alone. You can receive the settlement amount as a lump sum or a structured payment. A structured payment involves the insurer disbursing a specific amount over a given duration of time. A lump sum payment, on the other hand, involves the insurer disbursing the full amount at one time. 

A workers' compensation lawyer in Bloomington can help you file the claim and reach a reasonable settlement agreement with your employer and workers’ comp insurer. The settlement amount can cover the following costs: 

Medical Expenses 

The settlement amount can help pay for your medical expenses if you are undergoing medical treatment. But, you must provide proof of treatment or hospitalization before claiming this benefit. 

Lost Wages or Earnings 

A workers’ comp settlement can also cover your lost wages or reduced earning potential. This is especially true if the work injury prevents you from performing your job duties temporarily or permanently. These benefits also apply if the injury reduces your ability to earn your previous income. 

Vocational Rehabilitation Costs 

Workers’ comp benefits can also cover the services required to help you learn new skills or regain the ability to perform your job duties and return to work as soon as possible.

Death Benefits 

You might be entitled to death benefits if your loved one gets killed on the job. 

Workers' compensation benefits are limited in coverage. As such, they cannot cover pain and suffering or emotional distress stemming from a work-related accident. 

What Is the Workers' Comp Settlement Chart?

After a workplace injury, you need to know what to anticipate from a workers' compensation claim. A workman's comp settlement chart is a go-to reference for this type of information. It usually covers the following elements:

Maximum Medical Improvement (MMI) 

In workers' compensation claims, “maximum medical improvement” is a degree of recovery in which you cannot expect any physiological or functional changes with further treatment. When you reach this point, you will have attained maximum medical improvement. As such, your medical expenses and the costs of your injuries become calculable.

When your workers' compensation claim gets approved, you will receive a settlement after reaching the maximum medical improvement. You can still seek temporary partial disability benefits when undergoing further rehabilitation for the injury. These benefits help you recover about two-thirds of your lost wages. 

Permanent Impairment Rating

The permanent impairment rating is the medical assessment that determines the level to which an on-the-job injury has impaired a worker. The Illinois workers' compensation system has benefit limits for each injured body part. These limits dictate the amount of money you can receive weekly as lost wages after sustaining a work injury. 

Workers’ comp covers body parts such as the thumbs, first, second, third, and fourth fingers, toe, hand, arm, and elbow. It also covers the shoulder joint, knee, hip joint, eye, ears, and testicles. Workers’ comp also pays for the replacement of body parts when you lose a foot, leg, hand, arm, eye, or tooth. These replacements may include braces or artificial arms and legs. You can seek this type of compensation whether you are getting reduced wages while out of work or have resumed work. 

Your employer still needs to compensate you, even when you can comfortably return to work on light duty. You can still recover lost income until you reach maximum medical improvement if you decide to go back to work and earn less. A workers' compensation lawyer can collect and organize evidence required to maximize a workers' comp settlement while you recover from your injury. 

Calculations Used to Determine an Employee’s Wage Replacement Benefits

The Illinois workers' compensation system mandates employers to compensate their injured workers. It considers employers liable to pay for medical treatment and rehabilitation to help the victim recover. 

Your wage replacement benefits after an injury can be calculated in different ways. The calculations consider the following factors:

Scheduled Injuries

You can get compensated for injuries that affect multiple body parts. Each injury will have a certain amount of wage replacement benefits. 

You can obtain the weekly compensation by multiplying 60% of your average weekly earnings by the weeks your employer assigned to a specific body part. 

Percentage of Loss of a Person as a Whole

The wage replacement calculation will depend on your lost ability to carry out tasks. This loss has to stem from a work-related injury for these calculations to be valid. 

To calculate your compensation, multiply the loss percentage by 500. The answer will be the number of working weeks you expect to be compensated. 

Once you determine the number of compensation weeks, multiply it by 60%. You will get what your wage replacement compared to wages should be. 

Disfigurement

The term disfigurement in workers' compensation claims refers to a permanent or significant change in appearance. You can suffer a disfigurement from a work injury, increasing the need to pursue compensation. 

Illinois law requires your employer to work with you in setting the weekly compensation amount. However, the payout should not go beyond 162 weeks. 

Once you agree on a weekly compensation amount, multiply it by 60% of the average weekly wage paid by the employer. The result is your total compensation. 

Wage Differential

For an injury that makes you opt for another job that pays less, you can seek 66.67%, or two-thirds, of the income difference between the new and old jobs. However, the wage differential should be within the Illinois average weekly wage. 

Temporary Total or Partial Disability

A work-related injury can result in a temporary total or partial disability. When this happens, performing work duties will be difficult. 

Illinois law considers temporary total disability as a disability that eliminates your ability to work for more than three days. A partial disability simply reduces your working capacity, rather than eliminating it. So, you can get compensated on the fourth day of having the disability. You may earn the benefits during the entire period of the temporary disability. 

The compensation process will start from the date you sustained the injury for a temporary total disability, which goes beyond fourteen days. You can determine the compensation amount by multiplying two-thirds of your average weekly wage by 40 hours. If you have a child or spouse, the percentage will increase by 10%. 

Permanent Total or Partial Disability

If you cannot work after sustaining an injury at your workplace, you may be eligible for a permanent total disability. The disability may also present as losing the use of your hands, feet, legs, or eyes. If you can still work, but your working capacity is permanently reduced, you may qualify for permanent partial disability.

With this type of disability, you can seek permanent disability benefits weekly. The benefits will constitute two-thirds of your average weekly wages. However, it should be within 133.33% of the Illinois average weekly wage. 

How Are Settlements Typically Paid Out?

Under the Illinois workers' compensation system, a settlement is a legally binding agreement between an insurance company and the injured worker. It requires the insurer to pay the worker a certain amount of money. Once the money gets paid, the insurer will get absolved of all or some of the responsibility for the work injury. 

Expect to receive the settlement as a lump sum payment. But, if the insurer uses a structured method to disburse it, you may receive the amount in portions. 

Workers' compensation settlements may be paid in bits if you earn less from your job than you did before the injury. In this case, a wage differential claim will require the insurer to pay you in installments. 

A disability may also qualify you for a settlement paid in bits. The payout will reflect your inability to resume work due to a work-related injury. 

When to Settle Your Claim

Knowing when to settle a workers' compensation claim can help prepare you for the outcomes of the settlement. As such, you should make this decision when you achieve maximum medical improvement. Settling the claim before reaching this level is risky. The risk stems from inability to tell whether you will need future medical treatment or the severity of your injury. 

If you have yet to recover from the injury, but would like to settle the claim, consult a workers' compensation lawyer about the legal options. Ask the lawyer if a workers' compensation settlement agreement that accommodates future medical expenses is attainable. 

How a Settlement is Reached and Approved

Settling requires brief exchanges between the injured person and the workers' compensation insurance company. As such, you have to issue the insurer with a valid settlement demand. You can do this with a lawyer's help. 

The insurer may present you with a settlement offer too, but there's no legal requirement to accept the offer.

Both parties in the claim need to agree on an appropriate settlement offer. One of the legal representatives will then draft a legally-binding settlement contract after reaching an agreement. A settlement contract specifies the agreement terms, like wavering certain rights.

The Illinois Workers' Compensation Commission usually oversees the approval of workers' compensation settlements. It does this through an arbitrator, who reviews the contract for errors and determines if it's reasonable. The arbitrator may ask both parties to correct any errors or instances of unfairness in the contract if they exist. 

Steps After Settling 

Settling a workers' compensation claim will waive your full rights to a hearing. The Illinois workers' compensation system considers the settlement terms final once the arbitrator approves the contract. So, you can never reopen the case, unless your case qualifies for exceptions to this rule.

When Can You Reopen a Workers’ Comp Case?

The Illinois workers' compensation system only allows you to revisit the contract terms under unique circumstances. For instance, revisiting the terms will be accepted if the contract has clerical errors. 

Illinois law prevents you from reopening a claim to include future medical expenses. 

You can only reopen the claim if the injury worsens your medical condition. The time limit for this is 30 months after getting the settlement approved. 

Why You Should Hire a Bloomington Workers’ Compensation Lawyer

The settlement contract is legally binding, making any terms you agreed to final. Without a lawyer's input, understanding the legal terms of the contract can be difficult. As such, you risk agreeing to terms that may lock you out of essential benefits. So, hire a workers’ compensation lawyer soon after suffering a work-related injury or Illness.

About The Author

Photo of Todd A. Strong
Illinois workers’ compensation and personal injury lawyer Todd A. Strong is the founder of Strong Law Offices in Peoria, Illinois. Todd brings considerable legal knowledge, experience, and skill to the table to ensure injured victims throughout the state are treated with respect, dignity, and fairness.