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How Are Workers' Comp Settlements Calculated

If you have suffered an injury at your workplace in California and are currently applying for workers’ compensation benefits, knowing what you’re eligible for can help you obtain a fair and reasonable settlement.

In many cases, you can calculate a workers comp settlement by adding your medical bills to the amount of lost income which the insurance carrier should be compensating you for, and then deciding which type of settlement is acceptable based on your standards.

The following is a detailed breakdown of how to calculate a fair workers’ comp settlement:

  • Assess medical expenses - The first set of payments that you are entitled to receive is payment for medical treatment. According to state law, the California Division of Workers’ Compensation (DWC) provides that an injured employee will receive all necessary medical care to “cure or relieve” the effects and symptoms of the injury, with no deductible or out-of-pocket costs to the worker. This includes all doctor/hospital/rehabilitation expenses. Keep in mind, your employer’s insurance company is liable for paying up to $10,000 of your medical costs, even if it ultimately rejects your claim.
  • Evaluate lost workdays - The second set of payments and reimbursements that you are entitled to receive is “temporary disability” payments, which is designed to replace some of the wages lost due to your injury. If you miss three days of work or more, you are eligible to collect temporary disability. The state provides for replacement of two-thirds of your average weekly wages during the time you are considered temporarily disabled and not able to perform the required functions of your job duties. Additionally, you can receive temporary disability payments even if you are working part-time if your physician has restricted your hours.
  • Determine the degree of permanent disability - If you are permanently unable to return to the job that you held before your injury, or you have an impairment that remains, you are eligible for weekly permanent disability benefit. Similar to temporary disability payments, you are entitled to two-thirds of your average weekly wage. Remember, your permanent disability benefit is substantially less than the temporary disability benefit. If you settle your workers’ comp claim by accepting a lump sum, you can also ask for anticipated future medical payments.
  • Supplemental job displacement benefit - If your employer doesn’t offer you alternative or modified work, and you do not return to work for your employer within 60 days of losing temporary disability, you are entitled to supplemental job displacement benefit. This is used to be known as vocational rehabilitation retraining, consisting of a voucher for education-related training.

In many cases, a workers’ compensation attorney can negotiate a higher settlement offer with the insurance company compared to going through the process on your own. Our Orange County lawyers at Alvandi Law Group can evaluate your case and calculate the amount of compensation you deserve.

Contact us and request a free consultation today.