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Calculating Your Workers’ Comp Benefits

Episode 14: Louisville workers’ compensation attorney Scott Scheynost discusses issues that impact the value of a case.  It’s a common question, but the actual answer can be complicated. Let’s talk about calculating your workers’ comp benefits.

In Kentucky, the Kentucky Department of Workers Claims has a website that can provide an estimate of what your workers’ compensation case is worth.  It primarily uses permanent partial disability in calculating the amount.  There are many other variables and considerations, but this may provide you with a basic idea.  Click here to visit the DWC PPD Calculator.

Six Factors to Know about for Your Calculations

  1. The date of your injury
  2. Your AMA impairment rating
  3. Your average weekly wage
  4. Your date of birth
  5. Your age at the time of your injury
  6. Your formal education level

The above factors are used in the online calculator.  There are 3 levels of benefits related to the following scenarios:

  • You go back to work at your old wage
  • You don’t go back to work at your old wage
  • You can’t go back to work at your old wage

Scott explains that the factors can be disputed.  He’s had legal disputes over his client’s age, education and a person’s average weekly wage.  This last one is very commonly disputed. Determining the correct answers are critical in calculating your workers’ comp benefits.

calculating your workers' comp benefits

There’s More to the Value than PPD Benefits

Scott discusses how injured workers often focus on the permanent partial disability benefits.  However, there are other benefits that actually impact the real value of your Kentucky workers’ compensation claim.

Kentucky allows for Temporary Total Disability benefits (TTD).  This is generally 2/3 of your average weekly wage during your recovery. 

You have the right to reopen your case, in Kentucky.  This may result from a surgery that changes your impairment rating.  There’s a chance you could reopen the case to get an increase in benefits based on that new impairment rating.  Scott provides the example of someone who sustains a knee injury and may need a knee replacement down the road.  The same goes for back injuries.  Scott comments that there is currently a 4-year window to reopen you case.

Kentucky also provides an injured worker the right to medical expenses

These other factors are not included in the PPD Calculator’s estimate of the value of your case.  It’s why the answer is never as simple as it seems, when you or your attorney is calculating your workers’ comp benefits.

Another important consideration is how your workers’ compensation benefits could impact your social security disability benefits.  There is an offset involved.  Your attorney should be able to work out the resolution so that your workers’ comp benefits don’t erase your SSDI benefits.  Unfortunately, it can and does happen.  This is why an experienced Kentucky workers’ compensation attorney should be consulted.

The Burden of Proof

Scott explains that in Kentucky, it’s the injured worker (usually with the help of an attorney) who must prove he or she is entitled to workers’ compensation benefits.  The worker must prove the injury happened at work.  He/She must prove their average weekly wage amount.  Lost work due to the injury and any disability must also be proven. 

Scott has spoken about the problem with using the company doctor for your evaluation and impairment rating.  Often, these doctors tend to issue a much more conservative rating, which negatively impacts your benefits.  They may do this to maintain a relationship with the company that’s sending them patients. 

As a skilled, Kentucky workers’ compensation attorney, Scott Scheynost is aware of the games that are sometimes played to reduce an injured worker’s benefits.  He can help you to work with other doctors who may be more objective.  It’s also important to have him argue the need for specific tests and/or medications.  Both of these are often disputed by the insurance adjuster, in an effort to reduce the benefit costs.

A Lower Education Level Could Mean Higher Benefits

In Kentucky, workers’ compensation benefits take into consideration a person’s formal education.  Interestingly, the more educated you are, the better chance you have of finding another job or profession after your injury.

However, many workers only have a high school education or less.  This may make it more difficult for you to find a job requiring less physical activity.  If you’ve been injured and have an impairment restricting your ability to perform certain times of manual labor, you may not be able to find a job with the same or similar wages.  For this reason, your education level impacts your benefits.

As you can probably see, just using a simple calculator to determine how much your case is worth doesn’t really take into account many of the variables needed to present the full picture.

Before we close, Scott mentions the possibility of a Third-Party Claim.  This is a situation in which a worker is injured by a sub-contractor, a vendor or other person who isn’t employed by the same company (i.e. a third party).  When this happens, the person may have a workers’ compensation claim and a separate personal injury claim against that third-party.  Again, the calculator is only focusing on the permanent partial disability benefits.

What if your company doesn’t have a valid Kentucky workers’ compensation insurance policy?  In Episode 13, we discussed how this is handled via the involvement of the Kentucky Uninsured Employers Fund.

It Cost You Nothing to Speak with Scott

Contact Scott Scheynost at (502) 937-5287.  This podcast is meant to provide information and is not legal advice.  Scott’s principal office is located at 7619 Dixie Highway, Louisville, KY 40258.  Co-host Jim Ray is a non-attorney spokesperson.  This is an advertisement.