Workers Comp Settlement Calculator

Workers' comp settlements combine several categories of benefits, each calculated using specific formulas:

1. Temporary Total Disability (TTD) Paid while you're completely unable to work due to your injury.

• Rate: Typically 2/3 (66.67%) of your average weekly wage (AWW)
• Duration: From date of injury until Maximum Medical Improvement (MMI)
• State caps apply: $1,200-$1,800/week maximum in most states
• Example: $900/week AWW × 66.67% = $600/week TTD × 26 weeks = $15,600

2. Temporary Partial Disability (TPD) Paid when you can work but earn less due to restrictions.

• Rate: 2/3 of the difference between pre-injury and post-injury wages
• Example: Earned $900/week, now $500/week → 2/3 × $400 = $267/week TPD

3. Permanent Partial Disability (PPD) The largest component of most settlements, paid after reaching MMI.

• Formula: Impairment rating × weeks per point × benefit rate
• Varies dramatically by state and body part
• Example (California): 15% impairment × 4 weeks × $290/week = $17,400
• Example (Ohio): 15% impairment × 3 weeks × $400/week = $18,000

4. Permanent Total Disability (PTD) For catastrophic injuries preventing any work (less than 1% of claims).

• Lifetime benefits at 2/3 of wages (with caps)
• Can be worth $500,000-$2,000,000+ over a lifetime
• Some states allow lump-sum buyouts

5. Medical Benefits

• All reasonable and necessary treatment related to the work injury
• Includes surgery, therapy, medications, medical equipment
• Future medical costs must be estimated for settlement
• Can be "open" (insurer pays ongoing) or "closed" (lump sum buyout)

Settlement values vary significantly based on injury severity, permanence, and impact on earning capacity:

Factors That Increase Settlement Value:

• Higher permanent impairment rating (each % point = thousands more)
• Need for future surgeries or ongoing medical care
• Significant loss of earning capacity
• Pre-existing conditions aggravated by work injury
• Multiple body parts affected
• Employer safety violations (may enable third-party lawsuit)
• Young age (more years of lost wages/medical needs)

Workers' comp benefits vary dramatically by state. Here's how the top 10 states compare:

State System Types:

1. Schedule States: Fixed weeks of benefits for specific body parts
2. Whole Person States: Rating based on total body impairment
3. Loss of Earning Capacity States: Based on actual wage loss
4. Hybrid Systems: Combination of approaches

Best States for Injured Workers: California, Illinois, New Jersey, Pennsylvania Worst States for Injured Workers: Texas, Georgia, Mississippi, Alabama

Note: "Best" and "worst" are generalizations - individual cases vary significantly.

When settling a workers' comp claim, you typically choose between two options:

Lump Sum Settlement (Compromise & Release/Full & Final)

Pros:

• One-time payment - you control the money
• Closure - case is completely finished
• Investment potential - can invest for growth
• Freedom - no ongoing reporting or restrictions
• Can be used for any purpose

Cons:

• No future benefits for this injury - even if it gets worse
• Typically discounted 15-25% from total value
• Risk of spending too quickly
• Must manage medical costs yourself
• Medicare set-aside requirements if applicable

Best if: You want to move on, have other health insurance, are confident in your recovery, or need cash for specific purpose (debt, business, home)

Structured Settlement (Stipulated Finding/Award)

Pros:

• Ongoing medical care may remain open
• Can reopen if condition worsens
• Guaranteed income stream
• Protected from being spent too quickly
• May receive more total value over time

Cons:

• No lump sum payment
• Less control over funds
• Ongoing relationship with insurer
• Subject to future disputes
• Can't invest the money

Best if: You need ongoing medical care, condition might worsen, prefer guaranteed income, or have difficulty managing money

Medicare Set-Aside (MSA) Considerations If you're a Medicare beneficiary or expect to be within 30 months:

• CMS may require a Medicare Set-Aside account
• Money must be reserved for future injury-related medical
• Typically reduces cash settlement by $20,000-$100,000+
• Required to protect Medicare's interests
• Must be properly administered and reported

Understanding the broader workers' compensation landscape helps contextualize your claim:

National Workers' Comp Statistics (2024)

• Total benefits paid annually: $100.2 billion
• Number of workers covered: 141.2 million
• Non-fatal workplace injuries: 2.8 million per year
• Fatal workplace injuries: 5,190 per year
• Employer costs: $1.12 per $100 of payroll (average)

Claim Outcomes

Average Time to Settlement

• Simple claims (no surgery): 6-12 months
• Moderate claims (surgery, recovery): 12-24 months
• Complex claims (permanent disability): 24-36 months
• Disputed claims (litigation): 36-48+ months

Attorney Involvement Impact

Most Common Workplace Injuries

1. Overexertion/bodily reaction (33%)
2. Falls, slips, trips (27%)
3. Contact with objects (26%)
4. Transportation incidents (6%)
5. Violence and injuries by persons/animals (5%)
6. Exposure to harmful substances (3%)

Insurance companies employ trained adjusters whose job is to minimize payouts. Here's how to negotiate effectively:

Before Negotiating

1. Reach Maximum Medical Improvement (MMI) first
2. Get your own impairment rating from a QME or IME
3. Calculate your total damages (lost wages + medical + future care)
4. Research settlements for similar injuries in your state
5. Document all symptoms, limitations, and impacts on daily life

Negotiation Strategies

Opening Position:

• Start 2-3x higher than your minimum acceptable amount
• Present itemized demand letter with documentation
• Include future medical cost projections from your doctor

During Negotiation:

• Never accept the first offer (typically 40-60% of fair value)
• Counter with specific reasons for your valuation
• Reference comparable settlements and verdicts
• Highlight employer safety violations if applicable
• Emphasize ongoing symptoms and limitations

Common Insurance Tactics to Counter:

When to Hire an Attorney

• Claim is denied
• Employer disputes injury is work-related
• You have a permanent disability
• Settlement offer seems unfair
• You have pre-existing conditions
• Retaliation from employer
• Third-party liability possible (defective equipment, negligent third party)

Workers' comp attorneys typically charge 10-20% contingency - but settlements with attorneys average 2-3x higher than without.

Avoid these costly errors that can significantly reduce your workers' comp settlement:

Mistake #1: Not Reporting the Injury Immediately

• Most states require reporting within 30-90 days
• Delayed reporting creates suspicion of non-work cause
• Always report even if injury seems minor - it may worsen

Mistake #2: Not Seeking Medical Treatment

• Gaps in treatment suggest injury isn't serious
• Insurance will argue you recovered
• Follow all treatment recommendations, attend all appointments

Mistake #3: Posting on Social Media

• Insurers hire investigators to monitor social media
• Photos of activities can be used against you
• Even old photos can be misrepresented

Mistake #4: Accepting the Insurance Doctor's Impairment Rating

• Company doctors often rate impairment 5-15% lower
• Always get an independent evaluation
• The rating directly determines settlement amount

Mistake #5: Settling Before MMI

• You don't know the full extent of your injury yet
• Condition may be worse than initially thought
• Settlement releases all future claims

Mistake #6: Not Considering Future Medical Needs

• Surgeries, therapy, medications add up
• Arthritis and complications may develop later
• Get a life care plan for serious injuries

Mistake #7: Giving Recorded Statements Without Preparation

• Adjusters are trained to get damaging admissions
• Statements can be used to deny or reduce claims
• Consult an attorney before giving recorded statements

Mistake #8: Not Documenting Everything

• Keep copies of all medical records
• Document work restrictions and how they affect you
• Save all correspondence with employer/insurer
• Photograph visible injuries

2026 Maximum Weekly Benefit Rates by State:

The following states have updated their maximum weekly benefit rates for 2026:

Key 2026 Changes:

• COLA adjustments range from 2.5-4% in most states
• Several states have expanded coverage for mental health claims
• Telehealth appointments now broadly accepted for treatment
• Some states increasing PPD benefits for schedule injuries
• Medicare Set-Aside thresholds remain at $25,000 (total settlement) or $250,000 (future medicals)

Social Security Disability Integration (2026):

• SSDI max monthly benefit: $4,018 (up from $3,822)
• SGA limit: $1,730/month (up from $1,620)
• Blind SGA limit: $2,890/month
• Workers comp offset rules remain the same: combined benefits cannot exceed 80% of pre-disability earnings

Important Note: Workers compensation rates and rules are constantly changing. Always verify current rates with your state's workers compensation board or an attorney familiar with your jurisdiction.