By GNGF Design/Development on November 9th, 2023 in
If you recently got hurt or sick on the job in Illinois, you’re likely wondering how to calculate your potential workers’ compensation settlement. Your medical benefits should be covered in full if you have a valid claim. But if you miss time at work, your wage replacement benefits will vary depending on factors like your typical income and the severity of your condition.
Calculating these workers’ comp benefits accurately is essential because once you agree on a settlement, there’s no turning back to ask for more money.
Here are the factors you should understand:
Waiting Until You Reach Maximum Medical Improvement (MMI)
Before you negotiate a workers’ compensation settlement, you’ll want to wait until you reach maximum medical improvement (MMI). Sometimes that is not possible because a denial of workers’ compensation benefits results in a request for an emergency hearing in front of the arbitrator. In that case, you will likely have two hearings: a Section 19(b) “emergency” hearing, and a full and final hearing after you reach maximum medical improvement. MMI is the point at which your doctor decides your condition has stabilized and will not improve significantly with further treatment. Once you reach MMI, your doctor will release you from care with any final permanent restrictions you face and an assessment of how your body functions at its “new normal.” The treating physician’s various diagnoses and medical opinions become a key piece of evidence in determining the value of your workers’ comp settlement.
Settling before you reach MMI is risky because it’s easy to underestimate the long-term impact of your injuries, including the need for future surgeries, medication, and other costly medical care. This could leave you without enough money to handle future medical expenses or changes in your earning capacity.
Calculating Your Average Weekly Wage (AWW)
Your average weekly wage (AWW) is key to determining your workers’ comp benefits. It is calculated based on your earnings over a specified period leading up to the injury, typically the 52 weeks prior. There are several different methods of calculating AWW, and you should speak with an attorney to determine which is appropriate for you.
Insurance companies use the AWW determination to calculate your wage replacement benefits. In Illinois, you can usually claim up to two-thirds of your AWW in wage replacement benefits if you miss a certain amount of work. These benefits are subject to limits based on the statewide average weekly wage (SAWW). There are some exceptions and special rules for police officers and other occupations, overtime calculations, and second jobs, so you should speak to an attorney about whether any special rules apply to you.
Permanent Partial Disability
In some cases, employees do not fully recover from their injuries. At times, employees are put on permanent restrictions concerning lifting, bending, squatting, and the like after a major injury. At other times, employees do not regain the full use of their injured body parts, for example, lacking range of motion or strength after a fracture and surgery.
All of these residual injuries at MMI are insured events. Your attorney can sit down with you and review how these “partial” loss of function impact your settlement for the permanent residual deficits you are facing from your injury.
Illinois uses a schedule of body parts to calculate partial disability benefits. This schedule assigns a specific number of weeks of compensation to different body parts based on their importance for performing work activities.
For example, losing a finger is worth a certain number of weeks, while losing a leg is worth significantly more. If you have a permanent partial disability, you can apply your permanent impairment rating to this schedule to calculate the number of weeks of benefits you’re entitled to. Permanent partial disability benefits are calculated using 60% of your AWW multiplied by the number of weeks of benefits you’re owed.
Determining Your Permanent Impairment Rating
Your permanent impairment rating is another key factor influencing your workers’ comp settlement amount. (Treating doctors rarely do this), Independent medical examiners will often do this at the behest of insurance companies. The rating is expressed as a percentage, usually once you reach MMI. This percentage represents the degree to which you are impaired or disabled due to your work-related injury and is often a hotly contested point of litigation. The higher the percentage, the more significant your impairment and, likely, your settlement.
Talk to a Trusted Workers’ Compensation Lawyer Now
Reaching a workers’ comp settlement can be complex and stressful, and a slight miscalculation could cost you in the long run. Don’t face this challenge alone. Let the Noll Law Office assist you in calculating your claim’s worth and demand the benefits you are due. Contact them now at 217-414-8889 for your free consultation.