Evaluating Your Workers’ Comp Case
There are numerous factors and variables that go into the equation for determining how much your workers’ compensation case is worth under the South Carolina Workers’ Compensation Act. There are three primary ways to recover under the act.
- 42-9-10 – Total Disability
- 42-9-20 – Partial Disability (Wage Loss)
- 42-9-30 – Scheduled Member (no wage loss required)
So how do you know which one makes the most sense for your case? These questions should help you have a better understanding of how your case is valued:
- How much time did you miss from work?
- What kind of treatment did you receive?
- Are you able to return to work in the same capacity?
- If you have to find a new job, how much does it pay in comparison to your old one?
- Do you have any permanent restrictions? If so, what are they?
- Do you have disfigurement?
- Did your injury cause permanent total disability?
- What sort of future medical treatment will you require?
As every case is different, it is difficult to assess how much each individual case is worth. The more complex the case the more difficult it is to value a claim. Below is a sample case depicting how a claim can progress:
- You return to your previous employment at full duty with no restrictions
- You are earning the same amount as you did before the accident
- Your case will settle based on one or more of the injuries
Section 42-9-30 of the South Carolina Workers’ Compensation Act is called the “Schedule of Period of Disability and Compensation.” It assigns each body part a number of weeks under the Act. Once you reach maximum medical improvement (MMI), your authorized treating physician (doctor) will then assign an impairment rating for the injured body part(s) on a Form 14B. The doctor will assign you a rating using the AMA Guidelines. Along with a rating, the doctor also will list whether you have any restrictions and/or any necessary future medical care.
Using the above information, along with other case specific factors, the impairment rating is used to form a disability rating from which the commission will use to determine the value of your case.
Calculating The Value of Your Claim
Let’s look the previous example to calculate the value of a workers’ compensation claim. You tripped over a pallet at work and broke your arm on May 4, 2015. You required a cast for a few weeks then underwent physical therapy, but no surgery, and now you’re back to work. Your doctor assigns a 3% impairment rating to your arm with no restrictions and no future medical care. The Workers’ Compensation insurance adjuster offers to settle the case for 5% to the arm. The entire arm is worth 220 weeks of benefits, and your average weekly wage is $600 which corresponds to a Compensation Rate of $400.02 ($600 x .6667 = $400.02). So what is your settlement offer worth?
5% x 220 x $400.02 = $4,400.22
This seems like quite a low settlement offer; however, remember this is how you calculate the value of a claim based on the Schedule of Period of Disability and Compensation. This stems from Section 42-9-30 talked about above and the impairment rating given under the AMA Guidelines. Employers would choose the AMA Guidelines to be the only factor considered if they had their way. In fact, Employers are starting to force doctors to utilize the AMA 6th Edition which can significantly reduce the value of your claim compared to AMA 5th Edition. Using just these guidelines alone will considerably reduce value of a workers’ compensation claim. This is an important reason to find a skilled Charleston, SC, workers’ comp lawyer to handle your claim and get you the benefits you deserve. Each work injury is different and there is no clear cut way to ensure you get the full benefits you deserve. An attorney who is well versed in South Carolina workers’ compensation law will have a much higher success rate in getting clients the benefits they deserve.
Now if we change our example a bit and the injury resulted in you going to work for a lower wage than before the injury, then it’s likely that your case would be settled under 42-9-20 using a wage loss calculation. While it may sound clear-cut just remember your employer has a big insurance company with an army of attorneys defending them with the goal to pay you as little as possible.
Contact The Thumbs Up Guys
An experienced workers’ compensation attorney is ultimately the best option to getting you the benefits that you deserve. Many people are adamant that they do not need an attorney, or that they can handle the claim themselves. In truth, we hope that people can handle their claims with just a little bit of knowledge and a lot of caution, but we always say if you need heart surgery where are you going to go? More than likely you will go to a heart surgeon. So why trust your case to just any attorney? Contact the Thumbs Up Guys today at (843) 885-8000 or fill out our online form to schedule a free case evaluation.