Evans Agrapidis Explains How Workers’ Compensation Claim Values Are Determined

Evans Agrapidis
4 min readJun 17, 2021

Workers’ compensation insurance protects businesses and their employees in the case of on-the-job injuries. Each state sets the value that an employee can collect if they lose wages due to the accident, go through medical and rehabilitation expenses, or experience a fatal injury.

The valuation process for workers’ compensation claims is somewhat different from the process followed during personal injury law cases. The value of a workers’ compensation claim depends on how severe the injuries are, how much time the employee loses on the job, and the dollar amount of wages he regularly makes at work. In fact, in New Jersey there is a price list or menu for injuries to specific body parts.

Jersey City-based attorney, Evans Agrapidis, explains how workers’ compensation cases are valued and the criteria that may cause workers to receive more or less from the insurance company.

Attorney Evans Agrapidis Explains How Workers’ Compensation Claims Are Valued

Medical Expenses

Workers’ compensation insurance pays medical expenses up to the state-determined limit. Different types of covered expenses include dental and doctor visits, testing, hospitalization, surgery, and medications. If employees need adaptive equipment to drive to work or to be able to do their jobs, insurance should cover this as well. In some cases, workers’ compensation policies pay for counseling, pain relief therapy, and acupuncture. Workers’ compensation typically does not cover experimental therapies or medications.

Lost Wages

A workers’ compensation insurance policy typically pays between 60 to 80 percent of the employee’s wages and the total amount is capped. The employee receives tax-free payments from the claim. Examples of time that counts as lost hours or lost wages include an employee’s medical care and travel to and from it, time taken from work, and any sick days or vacation time that the employee used for medical reasons. To file a lost wages claim, doctors must document why the employee lost time on the job.

Death Benefits

When an employee dies on the job or as a direct result of an accident at work, the surviving family members may be owed death benefits. The state determines how much money a family receives as a death benefit, and it also depends on wages.

Pain and Suffering

Some injured employees are taken aback to discover no provision for pain and suffering in workers’ compensation law. However, lump sum permanency awards are allowable and are calculated based upon the percentage of permanency as documented by an independent medical examination.

Case Valuation and Settlement Amounts

Attorney Evans Agrapidis On Case Valuation And Settlement Amounts

In the case of workers’ compensation settlements, there is far less leeway for damages to be awarded. Most workers’ compensation claim components are directly related to the costs of medical care and certain percentages of the employee’s regular wages and are governed by a price list based on percentage of permanency.

This does not mean that there is no place for a qualified workers’ compensation attorney in the settlement process. Having an attorney like Evans Agrapidis on your side may mean the difference between a vanishingly small claim and an amount of money that will make a positive difference in your life after the accident.

The Keys to a Strong Workers’ Compensation Case

When you are building your workers’ comp case, there are many factors that you should take into consideration. The first thing that you must do is prove that the injury happened at work. You must also prove that the injury has caused enough damage that it restricts your ability to work.

Documentation is one of the number one considerations for a workers’ compensation claim. You must do all of your paperwork according to a certain timeline, or your claim may be denied. If you do not give the workers’ compensation doctor a full account of your entire medical history, you may be left disappointed by your claim as the opposing doctors and attorneys will attempt to pin your current problems on your past injuries.

If You Have a Workers’ Compensation Claim

If you have been injured at work, document everything. Even if you don’t feel that you will need a lawyer to deal with your employer’s workers’ compensation insurance provider, you should consult with a qualified attorney as soon as possible after your injury. Many workers’ compensation cases are straightforward, but when companies and their insurers fight back against the truth of your case, it can be extremely difficult to receive a fair settlement.

Injured parties should know that they have rights and responsibilities under the workers’ compensation law. In each state, the laws and coverage amounts are different, so it is necessary to do your research and determine the minimum and maximum figures that you should be able to receive for your claim.

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Evans Agrapidis
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Personal Injury and Accident Lawyer in Jersey City, New Jersey.