Pennsylvania Worker's Compensation - Help For Injured Pennsylvania Workers

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  1. #1
    Join Date
    Apr 2008
    Posts
    66

    Default Workers Comp Settlements in Pennsylvania

    can someone tell me what they consider when the w/c ins carrier wants to know if you are interested in settleing your case? what do they determine when they or you come up with an amount? is it better for you to come up with the first dollar figure or wait for them to do it? i really dont want to settle, but there comes a time when you just cant do your job any longer without pain 24/7. so if anyone can tell me what all is considered when approached about a settlement would be appreciated. and by the way, i know i am not looking at getting rich or anywhere near close to it, not even considering anything like that, i know the ins carrier is only looking out for themselves, not me.

    also, i know this comes with a resignation, would i be able to collect unemployment if i agree on the settlement and the resignation that comes with it?

  2. #2
    Join Date
    Dec 2007
    Location
    Tunkhannock, PA
    Posts
    1,103

    Default Re: Settlements in Pa

    Pennsylvania does not have a specific formula to calculate settlement value. The practical reality is that the carrier is not going to agree to pay more in a lump sum then they believe they would be required to pay over the life of the claim. In calculating the value of your claim, focus on what the IC is actually paying not what you would have earned but for the injury. Similarly, you can not calculate the value of your medical based upon what you would pay for the treatment, but rather what the IC would have to pay which would be substantially less. It is a rather complicated process, and if you do not have a lawyer you may want to consider obtaining one to assist you in the settlement negotiation. The truth of the matter is that even after the attorney's fee, you are likely to net more money with a lawyer negotiating your settlement then if you attempt to settle the claim yourself.

    As to the resignation, if it is properly worded, it is certainly possible to receive the lump sum and Unemployment. Assuming you would otherwise qualify for unemployment, your resignation must be for a reason of necessitous and compelling nature. I am not aware of an appellate decision specifically on point, but I know that the local referees consider a condition of settlement to be a necessitous and compelling reason to resign.
    Timothy D. Belt, Esquire
    Helping injured workers in Northeast Pennsylvania.
    belt-law@belt-law.com
    www.belt-law.com

    DISCLAIMER: This post is intended as general information applicable only to the state of Pennsylvania. The information given is based strictly upon the facts provided. This post is not intended to create an attorney client relationship, or to provide any specific guarantee of confidentiality.

  3. #3
    Join Date
    Apr 2008
    Posts
    66

    Default Re: Settlements in Pa

    awww, thanks Tim, big relief with the unemployment issue. i believe PA unemployment can run up to 99wks, so that alone will be a big help to finding a job i can do if i decide to go through with the settlement. medically, three surgerys and no improvement so not really much more can be done at this point without more surgery. thanks alot!!!

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Settlements in Pa

    ...three surgerys and no improvement so not really much more can be done at this point without more surgery.
    Just MHO... but you should not consider closing the medical in your claim if you are considering significant medical care. You can't afford it.
    IW's can negotiate medical care if there is that opportunity. But IW's are not automatically entitled to pay for medical at the contracted fee schedule IC's enjoy. IE... my last stay/surgery cost 325K to the hospital in "usual and customary" fees... the carrier paid about 80K on the OMFS/Official Medical Fee Schedule... which is approx 120% of Medicare approved fees.

    As to the indemnity benefits... Congress did IW"s a favor some years ago. You can settle the indemnity portion of your claim by Structured Settlement (agreement) It's a C&R too, but funded by annuity. IW's can be paid a lump sum of cash up front, as well as pre determined monthly benefits... tax free for life. It's good because you cannot take the cash and generate the same weekly benefits/TD when you take inflation and taxes into consideration. The interest is fully taxable, and the indemnity lump sum is not enough to generate that kind of income.

    Think very carefully about closing the claim. Explore all of your options before getting involved in the negotiation process.

  5. #5
    Join Date
    Aug 2010
    Posts
    45

    Default Re: Settlements in Pa

    Haha, I going through this process right now. I've been out around a year, had a few procedures & done all my pt. I'm still in pain, but it's stabilized. My attorney gave me all my options & I directed him to seek a full C&R settlement. I just want to be done with this case & walk away from it.

    I'm a union trade worker making 60.00 a hour, so even at max ttd payment it still falls short. I'm not complaining though, comp did what it was supposed to do. It took care of me while I was injured & now I want to move on. I guess every iw will be different in their needs, but I wish you best of luck. I mentioned earlier my settlement is being figured out on a 5 year scale. My lawyer is pretty confident that he can get what he's asking for.

  6. #6
    Join Date
    Apr 2008
    Posts
    66

    Default Re: Settlements in Pa

    thanks BvIA, i am going to think long and hard, cause the ins comp is approaching my lawyer about this, I personally am not ready to settle, and i finally have trust in this lawyer. Just cant get alot of info out of her yet. She just started on this case. And right now she is concentrating on another issue with the claim so we actually didnt talk to much about the specifics about settlement cause i told her i wasnt really interested, but if the price is right and they leave medical open I will consider it. was hoping i could collect unemployment for a while till i found another job. I have to have a loooooong sit down with my lawyer before i ever sign another piece of paper. Thank you and Tim for the help.

  7. #7
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Settlements in Pa

    ... but if the price is right and they leave medical open I will consider it.
    I don't recall your state... but in most, outside NY where commutation of indemnity is permitted in full, you will have a problem getting the ER/IC to pay the full value of the indemnity due, and leave the medical open. That is part of the negotiating process and an incentive for them to close out the claim. You agree to accept further liability for the injury, a C&R... both sides ''compromise'' on the outstanding issues, and you "release'' them from all further claim for benefits.

    Thats why you see me say over and over, WC is all about paying benefits, not cash settlements. YOu cannot force a cash payment to close the claim. The ER/IC free to pay out the indemnity based on your PD rating, and leave the medical open.
    They do that for a couple years post MMI to see just how much medical care the IW will actually seek.

    Statistics show that most IW's, once paid the cash lump sum don't seek nearly the level of medical care as they do before the claim is closed. The arguement is...when the ER/IC is paying the bills...medical care is an entitlement... when paying out of pocket... 'dont think I need so much after all'.

    Good luck to you.

  8. #8
    Join Date
    Dec 2008
    Location
    Lancaster, PA
    Posts
    46

    Default Re: Settlements in Pa

    If you're not able to work, can you even collect unemployment? If you can, why aren't you going back to work at your previous job?

  9. #9
    Join Date
    Dec 2007
    Location
    Tunkhannock, PA
    Posts
    1,103

    Default Re: Settlements in Pa

    Unemployment is a different standard from workers' compensation. An injured worker who was performing heavy labor could be released to light duty work and still be unable to do his time of injury job resulting in an entitlement to workers' compensation. However, that same injured worker is able and available to return to work at another job which is all that is required for unemployment.
    Timothy D. Belt, Esquire
    Helping injured workers in Northeast Pennsylvania.
    belt-law@belt-law.com
    www.belt-law.com

    DISCLAIMER: This post is intended as general information applicable only to the state of Pennsylvania. The information given is based strictly upon the facts provided. This post is not intended to create an attorney client relationship, or to provide any specific guarantee of confidentiality.

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