How Much Will I Be Able to Keep From My Workers’ Compensation Claim

Money from workers compensation claim

How Much Will I Be Able to Keep From My Workers’ Compensation Claim

Have you filed a workers’ compensation claim after getting injured at work or suffering from a work-related illness? You’re likely going to have to go through a series of settlement negotiations, appeals, and quite a lot of time before you’ll have a case that is fully resolved. Eventually, you’ll usually get your benefits or settlement; however, you won’t be able to pocket all that money and keep it for yourself. In fact, other parties will have a claim on those benefits or settlement money, and those can include your doctors, lawyer, and even some government agencies. Instead of waiting to be surprised once your cut of the money comes in, you can understand what will be deducted from the sum and what you’ll be able to keep for yourself.


Here are a few sample costs and fees that you might need to pay:


Attorney Fees

In many states, your lawyer or attorney will charge a “contingency fee” when working on a worker’s compensation case. That means they’ll receive a specified percentage of the money you get in your benefits or settlement. If you do not win your case, you do not have to pay any contingency fee.


Some states limit the percentage of the contingency fee and the total attorney fees for workers’ compensation cases. In most cases, a judge will have to approve these fees. Some states might even have guidelines on which parts of the benefits or settlement count toward calculating the fee. It’s also possible for states to only allow portions of the award to be part of the attorney fees, and these can include the compensation included in the dispute or even unpaid benefits that might be owed.


Aside from the contingency fee you might pay your workers comp attorney. You’ll also have to reimburse them for any payments they may have made in advance, such as hiring expert witnesses, copying medical records, and even hiring court reporters to transcribe depositions. Many times, lawyers will deduct these costs before any attorney fees are calculated.


Outstanding Medical Bills

The judge can order the insurance company to pay your outstanding medical bills for you if your workers’ compensation claim was denied and if you win on an appeal. This will be considered part of your award. If you’ve already paid your own medical bills, you’ll keep this money.


There can also be doctors that agree to postpone medical bill payments until you’ve been awarded your worker’s compensation, which is referred to as a “doctor’s lien.” In this case, the money awarded will go to paying those bills.


Your workers’ comp attorney can also negotiate to have the insurance company pay specific medical bills directly as part of your settlement. However, in most cases, the lump sum will be included in the settlement for medical bills. The attorney will typically withhold a portion of it to resolve the outstanding medical bills. Your attorney can also try to negotiate with the medical providers to have the bills lowered, which can help you keep more of your settlement money.


Unpaid Child Support

If you have overdue child support expenses, either all or part of your worker’s compensation award or settlement can be used in order to pay the owed amount. Some states limit the amount of the settlement that can be removed for child support.


Set-Aside from Medicare or Medicaid

Federal law states that Medicare won’t cover medical expenses if they’re covered under worker’s compensation. However, Medicare can pay for medical bills conditionally if there is a dispute regarding worker’s compensation liability. This means that if you’re eligible for Medicare, a portion of your settlement can go to the government.


You’ll first have to repay Medicare for the conditional payments that they made during your appeal. Then if you have money for future medical expenses awarded to you in your settlement, you’ll have to be sure that Medicare’s financial interests are protected. This is often done by putting a portion of the settlement money in a Medicare Set-Aside Account or MSA, specifically for paying future medical treatments related to your work injury.


Hire a Lawyer to Help

Most worker’s compensation settlements or awards can typically have significant legal and financial consequences. You might find it tough to cover all the bases and consider any potential problems unless you use a workers comp attorney. Once you know how much you’re going to have to pay after your settlement, you’ll be able to determine roughly how much of your workers’ comp claim you’ll be able to keep.


Find a Workers Compensation Lawyer in Your Area




Workers Comp FAQ

Worker’s compensation insurance (often referred to as worker’s comp) aims to protect businesses and their employees from financial loss due to injuries on the job or sickness from a work-related issue. This type of insurance helps protect employees from potentially devastating costs following work-related issues - while at the same time protecting employers from crippling bills based on workers comp claims.
Another common question is, what type of injuries are included in worker’s comp insurance? It usually covers medical expenses, ongoing care costs, lost wages, and even funeral expenses in the unlikely event of an employee getting hurt, becoming sick, or dying due to a work-related illness or accident.
Although the goal of worker’s compensation is to help businesses and workers in the event of a covered loss, some situations can occur at the workplace that are not covered by the insurance. These typically vary from state to state, but below are several examples that are generally not covered by most worker’s compensation plans: ● Injuries that were sustained due to the employee being intoxicated while on the job ● Injuries received during a fight that the employee started ● Injuries that an employee gets intentionally ● Emotional damages that were not caused and accompanied by a physical workplace trauma
Businesses that don’t pay for benefits usually purchase this type of insurance to take care of the benefits for employees. Except for Texas and New Jersey, where worker’s comp is elective, the other states require businesses to carry such insurance. It’s not the responsibility of employees to pay for worker’s compensation benefits. The cost of this coverage largely depends on several factors, including: ● Business size ● On-the-job risks ● State laws ● Type of work employees have to perform
The best time to report an injury is as soon as it happens. You need to immediately notify your direct supervisor, your HR department, and your employer. Sometimes, you may not realize you’ve been injured until days after the accident, so it’s generally best to notify your employer within the first two weeks of the incident. Since worker’s comp is no-fault, you have no reason to wait, and you don’t have to worry about collecting evidence and building a case. All you need to do is report what happened to your supervisor and employer and get medical treatment quickly.
Typically, there is a two-year maximum period that applies to worker’s compensation claims. The time is calculated from the moment the injury or illness occurred or the date of the last compensation payment (whichever is the more recent event). If the claim is related to a long-term condition or illness, the claim must be filed within the first two years of the affected employee becoming aware of that condition. For example, if you have suffered hearing loss due to working at a noisy workplace, this means you have two years from the date you realized your problem to file a claim. What happens if my employer denies my worker’s compensation claim? If your employer’s insurance company rejects your claim, you will usually be notified by a letter detailing the reasons for the denial. The letter will ideally include more details about the process of appealing as well. If it doesn’t, it’s likely that you can find that information on the insurer’s website. Be sure to check all details, especially the deadline for filing an appeal, so that you don’t miss your opportunity to appeal. The most common reasons for an insurance company to deny a worker’s compensation claim include: ● You failed to report your injury on time ● There were no witnesses to the injury ● Your medical records show you had alcohol or drugs in your system when the accident happened ● Your accident report and medical records are inconsistent ● You didn’t cooperate with the insurance agency or sign necessary authorizations ● You filed a claim after you were laid off or fired In addition to these, there are other reasons why an insurance company would deny your claim based on the specifics of your case.