Is there a right to lump sum workers’ compensation settlements?

In general, there is no right to a lump sum settlement for a workers’ compensation injury in Pennsylvania. Settlements are typically the product of negotiation or, in some cases, mediation with a workers’ compensation judge. This is unlike in some other states where there is a right to a lump sum settlement based upon one’s degree of permanent bodily impairment.

What is specific loss? Am I entitled to a lump sum for an amputation?

The one exception to the general rule in Pennsylvania is the area of the law known as “specific loss.” Specific loss simply refers to a “schedule” of benefits for the loss of a body part. This could be a finger or a part of a finger, an eye, or an entire limb (such as an arm or a leg). This “schedule” of benefits is expressed in the number of weeks of compensation to which the victim is entitled. Thus the higher the worker’s compensation rate, the greater his or her compensation will be for a specific loss.

It is important to understand that an actual amputation is not necessary in order to be entitled to a lump sum. If there is medical evidence that the worker has lost the use of the body part “for all practical intents and purposes” it may be possible to obtain specific loss benefits.

Workers’ Compensation for Scarring and Disfigurement

Specific loss also includes disfigurement of the head, face or neck. To be compensable, the disfigurement must be permanent and unsightly. This is one type of injury that is not covered in the schedules. If the parties are unable to reach a settlement, a workers’ compensation judge will view the disfigurement and award a number of weeks of compensation which the judge feels is appropriate.

It is also important for a worker who has suffered a specific loss to understand that it is referred to as a “sword and shield” under the law. While specific loss benefits might at first seem attractive, often an injured worker’s disability is far more extensive than the schedule of benefits allows. In some cases, the insurance company will use the specific loss as a “shield” and argue that their obligation is limited to the specific loss rather than ongoing weekly benefits.

Do I need a lawyer?

Depending on the facts of your case, it may be possible to establish that disability arises from a condition other than the specific loss, thus maximizing benefits. Proper evaluation of a claim involving a specific loss is essential in order to make certain that the client receives the benefits to which they are entitled by law. We are always happy to discuss your claim at no cost or obligation. We will tell you if we think a lump sum settlement is possible. The major factors that affect the value of a settlement are the age of the claimant, the seriousness of the injury, the extent or permanence of the disability, and the compensation rate. Call our office for a free consultation to discuss whether or not you should get a lump sum.