Figuring out how much your workers’ comp claim is worth can get complicated. So, let’s break it down—what really affects the value of your claim? We’ll go over the key factors, national stats, and real examples to give you a clear picture.
Nationwide data from 2019 to 2020 shows that motor vehicle accidents top the list for the most expensive workers’ comp claims, averaging $85,000 per claim. Burns and falls come next, each averaging around $50,000. Most other work-related injuries fall between $25,000 and $45,000 per claim.
A big chunk of these costs go toward medical expenses, while the rest covers disability or lost wages.
The type of injury plays a big role in how much a workers' comp claim is worth. Amputations are the most expensive, averaging around $120,000 per claim. Fractures, crushed bones, and dislocations come next, with claims averaging about $60,000.
For less serious injuries that don’t need surgery, settlements usually fall between $5,000 and $20,000.
When it comes to workers’ comp costs by body part, head and central nervous system injuries are the priciest, averaging around $93,000 per claim. Injuries that affect multiple body parts come next at $62,000, followed by pelvis, leg, and neck injuries, all averaging about $60,000.
Arm and shoulder injuries usually run around $50,000, while other injuries fall between $21,000 and $38,000 per claim.
Big workers’ comp claims—those over $1 million—make up about 10% of total benefits paid nationwide. Believe it or not, slip and falls are the biggest reason for these massive payouts, making up nearly 30% of them, with car accidents coming in second at 22%.
Most $1 million+ claims involve multiple body parts, usually because of the severity of the accident. Head and brain injuries also account for a big chunk. But while these cases are extremely costly, they’re rare—only about 0.2% of all claims—and usually involve 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.
The value of a workers’ comp case mainly comes down to three things: wage benefits, medical care, and compensation for permanent disability.
In New York, you won’t get paid for pain and suffering, lost quality of life, or punitive damages—workers' comp only covers the basics.
Your wage benefits are based on two-thirds of your average weekly pay, multiplied by your disability percentage. Your weekly wage includes gross earnings, overtime, and tips from the 52 weeks before your injury.
For example, if you made $900 a week and are 100% temporarily disabled, you'd get $600 per week while you recover.
Permanent disability payouts depend on which body part is injured. In New York, this is called a Schedule Loss of Use (SLU) award. Each body part has a set number of weeks tied to it.
For example, a 100% disability to an arm is worth 312 weeks of benefits. If you're 25% disabled, you'd get 25% of 312 weeks, which is 78 weeks of pay. Multiply that by two-thirds of your weekly wage (let’s say $600), and your total award would be $46,800.
For injuries not on the SLU chart—like those to your spine, heart, lungs, or brain—your benefits are based on how much your injury affects your ability to work in the future. A judge decides this percentage after you hit maximum medical improvement (MMI).
For example, if you’re found to have a 55% loss of wage-earning capacity, you’d get 350 weeks of benefits, calculated at 55% of two-thirds of your average weekly wage.
If you need assistance with your claim, feel free to reach out to me, Rex Zachofsky, for a free consultation at 212-406-8989.
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