No. In fact, your case might be worth more, but it could be less. South Carolina workers’ comp cases are like the people they help: every one is unique. The settlement amount depends on a variety of factors. This gives us a great chance to discuss the basics of a typical workers’ comp settlement.
The Starting Point: Your Average Weekly Wage
Your average weekly wage sets the dollar amount to value your settlement.
- "Average weekly wage" defined. Your average weekly wage sets the dollar amount to value your settlement. It’s usually based on your wages for the last 4 quarters before you got hurt, excluding the quarter you got hurt. If you worked less than that, it’s based on the time you worked, as long as it’s fair to you and the employer.
- Weekly check amount. You’re eligible for a “weekly check”, called temporary total disability (TTD), if you miss work 8 calendar days due to your injury. This amount is called your “comp rate.”
For example, let’s imagine your average weekly wage is $600. That makes your weekly check $400. Now we move to the next factor in valuing your settlement, which is a bit odd.
Typical Settlement Limits and the “Scheduled Loss” Law
It sounds strange, but South Carolina's workers’ compensation law lists the body parts most often hurt at work, along with a limit in weeks for each. This sets the maximum value for a total loss of that body part.
In your case, the maximum value for the arm is 220 weeks. To get the highest settlement amount for the total loss of your arm, we multiply your average weekly wage of $400 by 220 weeks to equal $88,000. But since you won’t lose your arm, we go to the next factor—what we at Holland & Usry call the “wild card” because it’s different for everyone, as shown below.
The Wild Card: Impairment and Disability Ratings
The workers’ comp system usually requires a percentage of loss of use to reach a settlement amount. This percentage is based on a permanent impairment rating given to you by the doctor. That percentage is then used to arrive at a disability rating. Here’s how those two ratings work:
- Medical impairment rating generally measures permanent loss of mobility and strength caused by your injury.
- Workers’ comp disability rating reflects how your medical impairment hurts your ability to work. The disability rating accounts for lost ability to do your job caused by medical impairment. Disability should be higher than the impairment rating.
We call this the “wild card” because disability is different for everyone depending on what job they do. For instance, if you’re a brick layer who lifts, carries, and reaches up with heavy loads at work, a 25 percent impairment rating to your arm is a much higher work disability than an office worker with the same rating, because it’s much harder to do your job with a permanently damaged arm.
This is the hardest part of your case to value. It’s also the part that has the greatest potential to maximize your compensation. But before settling, there may be another major factor: whether to protect your rights to future medical treatment.
Medical Treatment: Keep It Open, Walk Away, Or Keep Getting It?
There are three basic options for future medical treatment in the typical workers’ compensation settlement:
- Keep your options open. Keep your right to medical treatment open for one year after the full payment of your settlement. But beware! Not going to the comp doctor for over a year likely forfeits this right, too. This is called a Form 16 settlement for the form signed to do it.
- Walk away: the clincher. A clincher means you give up the right to comp insurance paying for future treatment for your injury. This usually gets you more money, because you take the risk of paying for future treatment, and the insurance company will pay extra to get off the hook. There's three key reasons my clients have given over the years on why they wanted to clinch:
- Control over medical care. If you clinch, medical care is your responsibility, but you do get to control it. Health insurance will cover it, and so should Medicare, although Medicare can affect your workers' comp settlement. That means no more asking an adjuster for permission to go to the doctor, plus you get more freedom to choose your doctor.
- Get the workers' compensation insurance company out of your life. Many people just get tired of the delays in getting care. Going to the doctor is enough of a chore without calling an adjuster to ask if you can, then waiting on their response which might take a few more phone calls, before finally getting an appintment weeks after you first requested it.
- Additional money. This is an attractive option for many, especially in cases where you don't expect any future medical care, or you're just sick and tired of messing with the workers' compensation insurance company.
- Rare option: Post- Maximum Medical Improvement (MMI Care) for Non-Totally Disabling Injuries. In workers’ comp lingo, these are called “Dodge medicals” for the court decision authorizing them. This allows you to get specific medical care, even after you reach MMI, if it helps you reduce disability. For example, if you got severely hurt but are not totally disabled, you might be able to get Dodge medicals for painkillers you need to get through the day at work and doctor visits for flare ups. These benefits can be for life.
But there’s a catch: it requires expert medical evidence stated to a reasonable degree of medical certainty. And here’s the other catch: these benefits aren’t handed out generously; in fact, it’s quite uncommon to receive them. To qualify for these benefits requires getting the proper evidence arranged in the proper way.
This Is Complicated And Important. Let A Professional Handle It.
Even a basic workers’ compensation settlement can be complicated. It requires thorough knowledge of your medical diagnosis, treatment, and prognosis, and knowledge of workers’ compensation law. It’s only harder if you’re hurt really bad or just don’t feel like dealing with all the phone calls and the tiny details to protect you and your family under comp law.
And we haven't even covered what might be the single most important dcument to move your case toward settlement- the demand letter and the process required to create an efffective one.
At Holland & Usry, an experienced Spartanburg workers' compensation attorney can take that pressure off you, and work with you to arrive at a proper settlement amount. To arm yourself with info you need about your case, download our FREE book I wrote for folks like you- The Hurt Worker's Toolkit. For specific questions, you can also call toll free at 888-230-1841 or fill out a Get Help Now form. To get an idea what it's like to work with us, check out these unscripted, unedited reviews on a website we don't own.