When it comes to workers' compensation claims, understanding the potential worth of your injury can be a bit complex. Here, we'll break down the key factors and data that influence the value of these claims, based on national statistics and specific examples.
According to data collected nationwide from 2019 to 2020, motor vehicle accidents result in the highest average workers' compensation claims, around $85,000 per claim. Following closely are burns and falls, both averaging approximately $50,000 per claim. Other types of accidents generally range from $45,000 to $25,000 per claim. It's important to note that a significant portion of these costs are medical expenses, with a smaller portion covering indemnity or disability payments.
The nature of the injury also significantly impacts the claim's value. Amputations are the most costly, with an average claim value of nearly $120,000. Fractures, crushed, and dislocated body parts follow, averaging about $60,000 per claim. Minor injuries treated without surgery typically settle between $5,000 and $20,000.
When breaking down costs by body part, head and central nervous system injuries are the most expensive, averaging approximately $93,000 per claim. Injuries affecting multiple body parts come next at around $62,000 per claim, followed by injuries to the pelvis, leg, and neck, all averaging about $60,000. Arm and shoulder injuries average around $50,000, with other body parts ranging from $38,000 to $21,000.
Claims exceeding $1 million account for about 10% of all workers' compensation benefits paid nationwide. Surprisingly, slip and falls top this category, comprising almost 30% of these high-value claims, followed by motor vehicle accidents at 22%. Injuries involving multiple body parts are the majority of claims over $1 million, often due to the nature of the accidents. Head and brain injuries also contribute significantly to high-value claims. Despite their high cost, claims over $1 million represent only about 0.2% of all claims filed nationwide, typically involving severe, permanent injuries.
The average workers' compensation settlement is about $21,800, with most settlements ranging between $2,000 and $20,000. To determine if your case might be worth more, it's crucial to understand how these values are calculated.
In general, the value of a workers' compensation case boils down to three main components: wage benefits, medical care, and compensation for any permanent disability. Here in New York State, benefits do not include pain and suffering, diminished quality of life, or punitive damages.
Your wage benefits are calculated by taking two-thirds of your average weekly wage and multiplying it by your overall disability percentage. Your average weekly wage includes gross earnings, overtime, and tips for the 52 weeks leading up to your accident. For example, if your weekly wage is $900 and you're 100% temporarily disabled, you would receive $600 per week while recovering.
Permanent disability awards are based on the body part injured. In New York, this is referred to as a Schedule Loss of Use (SLU) award. Each body part has a maximum number of compensation weeks. For instance, a 100% disability to an arm is worth 312 weeks of compensation. If you have a 25% disability, you multiply 312 weeks by 25% to get 78 weeks of benefits. Multiply 78 weeks by two-thirds of your weekly wage (e.g., $600) to get a total award of $46,800.
For injuries not listed on the SLU chart, such as those to the spine, heart, lungs, or brain, benefits are based on your loss of future wage earning capacity. A judge will determine this percentage once you've reached maximum medical improvement. For example, a 55% loss of wage earning capacity entitles you to 350 weeks of compensation benefits, calculated at 55% of two-thirds of your average weekly wage.
Understanding the full value of your case involves more than just basic calculations. That's why it's essential to consult with a workers' compensation lawyer. They can help ensure you receive the maximum benefits you're entitled to. On average, workers who hire a lawyer receive 30% more in benefits than those who don't. Consultations are free, and lawyers only get paid if they help you secure a higher settlement.
For more detailed tips on maximizing your workers' compensation claim, check out our video on the topic. And if you need assistance with your claim, feel free to reach out for a free consultation at 212-406-8989.
Understanding these elements will give you a clearer picture of what to expect from your workers' compensation claim and ensure you're adequately prepared to pursue the benefits you deserve.
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