This is a question that I am asked frequently, by my own clients and often by people who don’t have an attorney and are dealing with an insurance company on their own. Unfortunately, there is no simple answer to this question because every case is different and the value of a claim is based on many different factors. These are just a few of the factors which determine what a “fair settlement value” might be:
How much were you earning on the date of injury?
The value of a claim for a high wage earner is ordinarily going to be more than for someone earning a lower wage. Your average weekly wage (AWW) on the date of injury controls the amount of wage loss benefits you will receive during the course of the claim. It stands to reason that if you are earning $1000 per week on your date of injury, your claim is likely worth more than that of a person earning $200 per week. Whether you are receiving total wage loss benefits (TTD) or partial wage loss benefits (TPD), the higher your wage on the date of injury, the more your claim is probably going to be worth.
How long have you been receiving benefits?
There are limits on the number of weeks that you can receive various types of benefits. For example, you can only receive 130 weeks of Temporary Total Disability (TTD) for injuries occurring on or after October 1, 2013. Similarly, you can only receive 225 weeks of partial wage loss benefits (TPD). Therefore, the value of a potential settlement will depend upon how many weeks of benefits you have already received and how many potential weeks of benefits remain available to you. This is one of many factors which the insurance company will consider when evaluating a claim for settlement purposes.
For more information about the various types of benefits available in a Minnesota work comp claim, see our previous post entitled “How long do wage loss benefits last in a Minnesota work comp claim?”
How seriously are you injured?
If you have a minor injury and can expect to make a full recovery and return to work with no ongoing wage loss, your claim may not have significant value for settlement purposes. On the other hand, if you have a serious injury and will have prolonged disability with permanent restrictions, your claim may represent significant exposure for the insurance company into the future and will have more value.
Was your claim accepted or denied?
If the claim was accepted as covered by work comp, the insurance company is responsible for benefits so long as they are supported by the medical evidence. This may still lead to disputes with the insurance company over the nature and extent of your injury, whether you remain disabled, whether a particular medical procedure is reasonable or necessary, etc.
However, if your claim was denied and is in litigation heading toward a hearing, the insurance company knows that they may not have to pay you anything if they win the case. Under those circumstances, you may have a 50/50 chance of winning at hearing and the insurance company will consider that they have less potential exposure and your claim may have less value.
How strong is the medical support for your claim?
If you have a good, experienced doctor (preferably a specialist such as an orthopedic surgeon) who is supporting your claim and has provided you or your lawyer with a solid report, your claim is generally going to be stronger. The burden of proof in a work comp claim is on you, the employee. This means that you must prove your claim with medical and other evidence if the matter goes before judge or if you are trying to persuade a claims adjuster or defense attorney that your claim has value.
How experienced is your attorney?
If you don’t have an attorney and are representing yourself, you are at a serious disadvantage. The claims adjuster or attorney representing the insurance company will have significant experience and is not looking out for your interests. Even though every settlement must be approved by a workers’ compensation judge, you are much less likely to receive fair value for your settlement if you are representing yourself.
If you are represented by an experienced work comp attorney, someone who knows the system, has credibility with defense lawyers and judges and is not afraid to take the case to trial, you are much more likely to receive a fair settlement offer and ultimately a better settlement.
These are just some of many factors which come into play when trying to value a claim and reach a fair settlement. My suggestion is always that you should consult with an experienced attorney if you are injured at work, engaged in a dispute with the work comp insurer, have any questions or concerns about your claim or are considering settlement.
If you have been injured on the job and have questions about your claim or the Minnesota work comp system, please don’t hesitate to give us a call. You can contact us, anytime, with questions about your case or to arrange an absolutely free consultation. It won’t cost you anything and we will always give you our honest assessment about whether you need a lawyer to represent you. If you have questions about how much it costs to hire a lawyer for a Minnesota workers’ compensation case, you can check out this previous post.
Remember, you are dealing with an insurance company which handles hundreds or thousands of claims every day. They have experienced claims adjusters and attorneys managing their files. Even if you don’t need a lawyer at the moment, a little information about the work comp system can make a big difference for you in your dealings with the insurance company. At Bradt Law Offices, we have been providing assistance to injured workers all across northern Minnesota and the Iron Range for more than 34 years.
As always, thank you for visiting our blog and please tell your friends that we are a good source of work comp information and assistance for workers injured in northern Minnesota and anywhere on the Iron Range.