If you’ve been hurt at work, you’re probably juggling medical bills, missing paychecks, and wondering how much support you’re actually going to get. That’s what we're breaking down: the key things that go into figuring out the value of your workers’ comp case. Your injury, your income, your timing—it all plays a part. Let's get into it.
Let’s start with the biggest factor: your injury. What it is, how bad it is, and whether it’s going to stick around long-term all play a major role in how much your case is worth.
How Serious Is the Injury?
The more serious it is, the more your case is usually worth. A sprained ankle that heals up quickly isn’t worth nearly as much as, say, a back injury that leads to surgery or long-term pain. And if it’s permanent? That tends to bump up your value even more.
Got More Than One Injury?
That can help too. If you hurt multiple body parts—like your shoulder, wrist, and knee—each one could count separately and get added together, especially in states that use a “schedule of injuries” to calculate value.
Your Disability Rating Matters
You’ll be given a disability rating based on how much the injury affects your ability to work. A higher rating means a bigger payout, especially if the injury is permanent.
Will You Need Ongoing Treatment?
If you’re expected to need more care—like therapy, injections, or future surgery—that increases the value of your case. The insurance company knows they might have to cover those costs unless they settle now.
And if you’re on (or eligible for) Medicare or Social Security Disability, your case might need something called a Medicare Set-Aside (MSA) to estimate those future costs. Even if you don’t, your lawyer should still calculate them—it’s a strong negotiation point.
When You Settle Matters
Once you’ve finished treatment and your condition isn’t expected to improve, you’ve reached Maximum Medical Improvement (MMI). That’s often the sweet spot for settlement—right before or just after MMI, when there’s still some unknowns about future care. Once doctors say you're done, your case value can start to drop, so timing matters.
Several financial factors play a big role in what your settlement ends up being, and getting them right can make a big difference.
Your Average Weekly Wage (AWW) Is a Big Deal
This is probably the most important number in your whole case. Your benefits are based on a percentage of what you were earning before you got hurt, so the higher your AWW, the more you get paid—and the bigger your settlement.
Even small mistakes in calculating it can cost you. A few bucks off each week might not sound like a lot, but over months or years? That adds up fast. A good lawyer won’t just accept the insurance company’s number—they’ll double-check the math and make sure you’re not getting shortchanged.
Lost Wages Can Help—But It Depends on the Case
If you’ve missed time at work, that can add value to your case. But how much it helps depends on the type of claim:
Reduced Earnings Count Too
If you’re back at work but earning less—maybe because you’re on light duty or limited hours—that wage difference can be part of your payout. Just make sure to save your pay stubs so your lawyer can show the numbers.
Expected Future Costs Matter
If there’s a chance you’ll need pricey care down the road—like surgery or long-term treatment—that raises the stakes for the insurance company. They may be willing to pay more now to avoid those future bills later. It’s one more reason to make sure all potential medical needs are clearly on the table during settlement talks.
Legal details can have a big impact on your settlement—especially things like how strong your case is, the kind of deal you make, and how the insurance company plays it.
Case Strength
Solid medical records and doctor support give your lawyer leverage. But even a shaky case can have value if your lawyer knows how to fight—and wins.
Type of Settlement
Timing Around MMI
MMI (Maximum Medical Improvement) is usually when your case is worth the most. Settle too early or too late, and you could lose out.
Insurance Company Tactics
Some insurers lowball from the start hoping you'll accept. Others just delay to wear you down. But the longer your case stays open, the more it costs them—which gives your lawyer some leverage, especially if they’re ready to take it to court.
It’s not just about injuries and legal rules—you and your approach matter, too. Your mindset, your lawyer’s strategy, and even your money situation all play a part in what you end up with.
Be Willing to Negotiate
Settlements rarely start high. You’ve got to be open to back-and-forth—and trust your lawyer to handle it. They know when to push and when an offer’s actually fair. Flexibility helps, but don’t fold too fast.
Be Willing to Fight
Sometimes, going to court is the best move. Insurers count on people taking the first low offer just to be done. But if your lawyer’s ready to fight, it can raise your case’s value—especially with every small win along the way.
Use Leverage Where You Can
Insurers hate setting legal precedent, being in the news, or racking up court costs. If your case hits any of those nerves, your lawyer might be able to use it to squeeze out a better offer.
Your Money Situation
If you need the cash now, you might settle for less just to get something fast. No shame in that—it’s real life. But if you’ve got time and can afford to wait, you can usually hold out for more.
Pick the Right Lawyer
The right lawyer makes a huge difference. Someone who knows the system, knows the players, and isn’t afraid to push can often get you way more than you’d get on your own. It’s not just paperwork—it’s strategy.
If you’ve got questions about your case, want a second opinion, or just need someone to walk you through your options, give me, Rex Zachofsky, a call. No pressure, no strings—just a real conversation about what might make sense for you. You can reach me at 212-406-8989. I’m always happy to talk and see how I can help.
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