Issues in the Workers’ Compensation Settlement Process
Lawyer shows usually feature dramatic and emotional courtroom showdowns. But the legal system in general, and the workers’ compensation system in particular, is built on compromise. Over 95 percent of workers’ compensation claims settle out of court. Usually, liability, or legal responsibility for injury, is not disputed in these cases. Damages, or the amount of benefits, is another matter. More on that below.
The emphasis on settlement and compromise means that a Tampa workers’ compensation lawyer must be a good negotiator, as well as a good litigator. In fact, negotiation skills may be more important than litigation skills. Good negotiators know when to compromise and when to stand firm. If they don’t the settlement is unduly delayed or isn’t for the maximum possible amount. Either one of those outcomes is unacceptable for us.
Lost Wage Replacement
Most victims receive two-thirds of their average weekly wage (AWW) for the duration of a temporary or permanent disability.
The AWW may be one of the most hotly-contested issues in a workers’ compensation settlement. Most insurance companies take the victim’s net pay from the past three paychecks, divide by three, and presto, that’s the AWW.
However, the calculation is more complicated. The AWW also includes non-cash compensation, such as matching retirement account contributions, expense reimbursement, and employee benefits, like free lunches. These items may seem like nickels and dimes. But over the course of a long-term disability, the nickels and dimes add up to quarters and dollars.
Furthermore, the AWW must account for future wage increases or wage spikes. Frequently, a job-related injury forces a victim to miss a scheduled pay increase. The AWW must increase as well if that happens. Occasional spikes usually include missed overtime opportunities.
On a related note, the disability onset date may be an issue for a Tampa workers’ compensation lawyer. Hearing loss, one of the most common occupational diseases, is a good example. The disability onset date may be months, or even years, before the filing date. This difference could affect the amount of lost wage compensation available.
Medical Bill Payment
Most workers’ compensation insurance policies pay for all reasonably necessary medical bills. Insurance company lawyers and Tampa workers’ compensation lawyers almost always disagree as to what’s “reasonable” in a certain case.
Frequently, the medical standard of care helps establish this standard. For example, if Bill breaks his arm, the medical standard of care is usually a physical examination, X-rays or other diagnostic tests, treatment, follow-up care, and physical therapy. Depending on the severity of the brake, the cars at any particular phase may be greater or lesser than the “standard” care.
So, attorneys usually partner with independent doctors as well. These doctors provide the necessary evidence on this point, so the expense is a covered expense.
Medical bill payment is also forward looking, just like lost wage replacement. This same doctor often evaluates the victim and estimates the need for future medical treatment. This estimate is a critical component of a settlement. Without it, when future medical expenses pop up, the victim may be financially responsible for them.
Connect With a Dedicated Hillsborough County Lawyer
Injury victims are entitled to important financial benefits. For a confidential consultation with an experienced workers’ compensation lawyer in Tampa, contact Kobal Law. Virtual, home, and hospital visits are available.
