Wolf, Baldwin & Associates, P.C.

Mega claims on the rise for good reason

It was not long ago when a $10 million workers compensation claim would have been shocking. Now $40 million for a claim is nothing more than noteworthy. According to a new study by the National Council on Compensation Insurance (NCCI), there were 10 of these so-called "mega claims" of $10 million or higher in 2016, which is the most since 2001.

Common types of injuries that lead to these claims

According to the NCCI, the most common reasons for these large claims are injuries to the head, neck and spine. Seventy percent of these injuries are result of motor vehicle accidents or falls from elevation. The other reasons are usually related to slip, trip or fall.

Why are these mega claims so large?

The driving force for these larger claims are varied, but 75 percent of them involve workers under age 40. Workers' comp advocates also point out that the goal of workers' comp is to cure or alleviate the complications from the injury, which is different from group insurance's role of providing payment for care, services and medication. Also, it is important to remember that in Pennsylvania workers' compensation claims, pain and suffering damages are not recoverable. According to workers' compensation analysts, other cost drivers to help the injured include:

  • Improved treatment from better equipped first responders
  • Motor vehicles' safety improvements mean more injured workers are surviving accidents
  • There have been many medical advancements, but they come with a higher price tag
  • Better accommodations for those disabled, including designs for modifying homes and equipment such as prosthetic legs or wheelchairs
  • Better treatment can lead to a longer life involving full- or part-time care

Results of a claim will vary

The circumstances surrounding each claim involve many variables, which mean results will differ. Nevertheless, a knowledgeable attorney who regularly works on workers' compensation cases here in Southeastern Pennsylvania can provide invaluable insight and ongoing support during this long and sometimes difficult process.

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