One of the most common questions that we receive is “How much is my claim worth?” Well, the answer depends on many things. In Georgia’s workers’ compensation, these are the only three aspects that are permitted for a workers’ compensation claim settlement.
- Weekly income benefits
- Any PPD rating
- An amount for medical care closure costs
The bulk of the value of the claim is when permanent work restrictions are assigned and unable to be accommodated by the employer. In this case, the employer has liability for weekly income benefits from 400 weeks from the date of accident or 350 weeks if released to light duty. The exact amount depends on the person’s weekly workers’ compensation rate which depends on their average weekly wages 13 weeks prior to the date of the accident.
The second aspect of a workers’ compensation claim settlement is any permanent impairment rating. This is determined by the AMA Guides, 5th Edition, in theory. However, most doctors, admittedly, just estimate this amount. Occasionally you may be sent for an actual functional capacity evaluation with a PPD rating assigned by the examiner and signed off by the authorized treating physician. Once the amount is determined or estimated, a formula is used to calculate the amount that that impairment is worth. This also depends on what your weekly compensation rate is.
The final aspect that goes into a workers’ compensation claim settlement is an amount that is considered for the closure of your medical care costs. Please remember that the insurance company does not really care how much it costs you, they are looking at their exposure and paying a portion of it. Frequently we rely on industry standards to determine the amount of money that will be allocated for medical care closure costs in a claim.
Unfortunately, there is no compensation for pain and suffering involved in a workers’ compensation claim settlement. There is the exclusive remedy doctrine in Georgia which states that an injured worker may not bring a cause of action for negligence against their employer or co‑worker. In other words, you cannot sue in tort.