13 Factors That Determine Case Value in Pennsylvania Workers Comp

There are 13 keys factors that go into determining settlement value of a Pennsylvania workers’ compensation case.  We will discuss them here.

Often times, I have clients try and compare what they are being offered with what their neighbor, friend, or relative received in a settlement.  Comparing settlement values to others is really a futile effort.  All cases are different.  Anyone of these factors that may be different will likely impact case value.  Here are the 13 factors.

1. Type of injury. This factor applies to not just severity but body part as well.  Is a case involving a low back worth more than a case involving a finger?  Certainly can be.
2. Severity of injury. The more serious the injury generally provides a higher case value.  If the injury does not permit the injured worker to return to pre-injury job, then the case has higher value.  A case that has involved a surgery(s) could cause case value to be higher.   These kinds of factors are important.
3. Future medical. What are the anticipated future medical costs?  Are there significant medications required in the future?  Is there a potential surgery recommended? Potential future medical expenses create significant, unknown liability for an insurance carrier.
4. Average weekly wage. The higher the average weekly wage, the higher the settlement value.   Calculations for settlement purposes are based on the injured worker’s compensation rate.  Two different injuries can be the exact same with all the same factors, but the person with a higher average weekly wage will receive more than a person with lower wages.
5. Currently receiving benefits. When an injured worker is out of work and actually receiving wage loss benefits the settlement case value will be higher.  Those weekly wage loss benefits are liability to the insurance carrier and they would like to stop those benefits.
6. Case posture. Has the claim been accepted or denied?  Is the case in active litigation?  If an injured worker is receiving wage loss benefits and the case is not in litigation, the claim value may be higher.  If the insurance company has evidence, such as surveillance, an independent medical examination, or a medical record from the treating doctor that is suspect, then the case value may be lower.
7. Judge assignment. The Judge assigned to the case may impact value.  While all Pennsylvania workers’ compensation judges are fair, some judges are known to be more ‘employee friendly’ meaning they may give more benefit of the doubt to the injured worker.  That may lead to a higher case value.
8. Doctor credibility. Most litigated cases involve testimony from doctors.   Having a doctor supportive of the claim is extremely helpful.  Having a doctor familiar with workers’ compensation and providing deposition testimony is helpful.  Having a doctor that has a history of good credibility before workers’ compensation judges is helpful.
9. Medical records. When an injured worker goes to the doctor, the doctor is listening and putting in the medical records certain things that are said.  That can impact case value.  Being non-complaint with medical treatment can impact case value.  Gaps in medical treatment can impact case value.  Exaggerating symptoms can impact case value.  Medical records are extremely important.
10. Work restrictions. Can the employer accommodate work restrictions?  Is the employer willing to accommodate work restrictions?  Does the employer have light duty?  Are the restrictions permanent?  These all can impact case value.
11. Willingness to litigate. How willing is the injured worker to fight the claim long term?  Is the claimant willing to go without pay and fight?  It impacts case value.  Insurance companies are more than willing to fight.  Is the injured worker?
12. Individual impact. Injured workers can harm their own case value.  Does the insurance company have surveillance that shows contrary evidence?   Are there emails or text message sent by the injured worker that shines a bad light?   Are there social media posts that contradict the restrictions or medical condition?  Injured workers can certainly harm case values.
13. Choosing an attorney.   The attorney the injured worker chooses can impact case value.  Workers compensation experience is critical when selecting an attorney.  Having an experienced and proven attorney that understands the process, the medical condition, the litigation process,  the Judge, experience with  insurance companies and defense attorneys can have a major impact on case value.  Attorneys who do not exclusively practice in workers compensation can certainly recover less.  Do your research.

At Mooney Law, you get an experienced, proven, and trusted attorney on your workers compensation case.  Attorney Mark Buterbaugh, a managing partner at Mooney Law,  practices exclusively in Pennsylvania and Maryland workers’ compensation.  Before joining Mooney Law more than a decade ago, he worked on the defense side for insurance carriers.  He understands their processes and approaches to cases.  He has been elected a Super Lawyer and a Rising Star in Pennsylvania for his representation of injured workers across Pennsylvania. Your workers’ compensation case will be assigned to Attorney Buterbaugh.

If you have been injured at work, call Mooney Law today for an absolutely FREE consultation.  We have 15 offices scattered throughout central Pennsylvania and Northern Maryland to serve your needs. We aren’t just a personal injury firm looking for a quick fee, we are a full service law firm looking out for our client’s best interests.  Many of our clients are clients for life, assisting them in their various legal needs.  It makes us different.  Call today at 717-200-HELP or 717-632-4656 to schedule your free consultation.