Legal Options When Your Workers’ Compensation Isn’t Enough

Legal Options When Your Workers' Compensation Isn't Enough The Pennsylvania workers’ compensation process can be overwhelming. You are a hard worker and did not expect to suffer an injury while on the job. Now, you are trying to navigate the process without jeopardizing your job.

Sometimes, workers’ compensation payments are insufficient to cover your losses. This leaves workers in a stressful situation. You have options when your workers’ compensation payments aren’t enough. Speak to a Lancaster workers’ compensation attorney to discuss the best option for you.

How is the settlement value of my claim determined?

You might be wondering how the insurance company determines your settlement value. This is important, as it can help you determine whether to settle when your weekly payments are not sufficient. There are two primary factors the insurance company will consider when evaluating your case value. They will review your average weekly wage and your medical expenses. When reviewing your average weekly wage, they will look at the last four completed quarters of work. This will be used to calculate how much you will receive each week for your case.

The second factor is your medical costs. The higher your medical costs, the more you will need to cover them. The settlement value of your case may be higher if you will face ongoing medical treatment. If your work injury results in ongoing care, your settlement should account for these losses. The insurance company will say they cover reasonable and necessary expenses. While this sounds fair, they often offer less than your actual treatment costs.

Negotiating a settlement

You may negotiate for more before making a final decision regarding your workers’ compensation claim. The initial offer may not represent all of your needs. It could be lower than your medical costs and lost wages. The insurance company hopes you are ignorant of your legal options so they can get away with these low offers. A Lancaster workers’ compensation attorney can negotiate for a fair settlement. KBG Injury Law can provide expert opinions, medical records, and other supporting information during negotiation.

Reopening a claim

In some instances, you can reopen a worker’s compensation claim. The most common reason for reopening a claim is that your case is not fully closed or your condition has worsened. This often happens when a person returns to work and re-injures themselves or their case is not fully closed. You can often reopen a case by filing a Petition to Reinstate Compensation Benefits. However, there are limits to when you can reopen a case.

The first exception that can lead to you reopening your claim is if your condition worsens. However, this is a significant hurdle because you must trace your injury to the original workplace incident. If your physician notes that your current treatment is a temporary fix, that may also qualify you to reopen your case. If you injure yourself during a workplace activity, you may be eligible to reopen your case. If your condition worsens from other factors, you may be ineligible to reopen your claim. A situation that may disqualify you is if you have signed a Compromise and Release agreement. If you did sign these documents, you likely are unable to reopen your case.

When you are eligible to reopen a claim, your Lancaster workers’ compensation attorney will help you file a Petition to Reinstate Compensation Benefits. These petitions can only be done within the statute of limitations, typically three years. Discuss which deadlines apply to your case with KBG Injury Law.

When a third-party claim is possible

Sometimes, you can obtain additional benefits by seeking damages through a third-party claim. When workers’ compensation is available, you are typically ineligible to file a lawsuit against your employer. However, if a third party was responsible wholly or in part for your injury, you can seek additional compensation.

This may not apply to all workplaces or situations. It often applies to factories, construction sites, and transportation industries. If your case meets this criteria, a Lancaster workers’ compensation attorney can help you determine whether you can get additional compensation from a third party for creating an unsafe working condition or causing your injury.

Your claim was undervalued

Since there is no exact formula to calculate your case value, you may find that settlements vary drastically in each case. When evaluating your case, our team will consider the following:

  • Injury severity
  • Medical expenses
  • Estimated future medical expenses
  • Permanent disability or impairment
  • Impact of the injury on your ability to work
  • Duration of temporary disability benefits
  • Your age and work history

The insurance company may consider some of these factors but could come up with a lower settlement offer. In other cases, they might not think about your ongoing care costs. The insurance company wants to save money, which may result in them undervaluing your case. KBG Injury Law can review your offer and see if your case is undervalued. We can then review your legal options for more compensation.

When your employer doesn’t have insurance

While most employers are legally required to carry workers’ compensation insurance, some fail to carry workers compensation insurance. While generally you cannot sue your employer for your injuries, if they fail to carry workers compensation insurance, you may take civil action against the employer in these instances. They broke the law, and you deserve compensation for your injuries.

KBG Injury Law helps clients throughout all of South Central Pennsylvania. When you are injured at work, speak to our Lancaster workers’ compensation attorney during a free initial consultation. Call our office or submit our contact form today.