How is Workers Comp Calculated?

In the US, workers compensation is implemented at state levels. So if you’re wondering, “how is workers comp calculated?” the short answer is it depends on the laws of your state.

In general, however, workers comp benefits are calculated based on three factors:

  • the severity of your condition
  • how many days you’ll miss work
  • how much you were earning before your injury

Also, you need to remember that workers comp in most states cover medical benefits, lost wages compensation, and death benefits. Your total workers comp settlement will ultimately depend on how much of these benefits you’re entitled to.

So to answer your question of how workers comp is calculated, you need to understand how each of these benefits is calculated.

How Workers Comp is Calculated in General

As mentioned, each state has different workers comp laws. So the formulas used to calculate workers comp benefits can vary. In general, here’s how workers comp is calculated:

Medical Benefits

Workers comp medical benefits in most states cover everything necessary for the injured workers recovery. This includes:

  • medications
  • medical supplies
  • doctor’s fees
  • emergency treatment
  • surgery (if necessary)
  • orthopedic devices (if necessary)

Obviously, the more severe your condition is, the more costly the treatments will be. As such, the higher the medical benefits you’ll receive.

For instance, if your injury only requires a few stitches and some painkillers, you may not have to stay in a hospital room for days. So your medical benefits will only be minimal.

But if you broke your arm, you may need surgery. This can obviously raise your total medical costs. Meaning, your medical benefits will be higher too.

In most states, however, workers comp laws require that your medical provider be accredited by the state or your insurance carrier. Otherwise, your claim can get denied.

Lost Wages Compensation

In most states, a work injury is classified into four types to calculate lost wages compensation:

  • temporary partial disability
  • temporary total disability
  • permanent partial disability
  • permanent total disability

Each of these classifications has a corresponding rate which is multiplied against your average weekly wage. The resulting figure will be your weekly wage loss benefits.

If you’re not familiar with the term, your average weekly wage refers to your earnings from before you got injured. We’ll discuss how it’s calculated later in this post.

Death Benefits

As the name suggests, death benefits are the benefits paid to the surviving dependents if a worker dies due to a work-related injury or illness.

Each state has different provisions on workers comp death benefits. But in most cases, it will include burial expenses and benefits to dependents.

Burial expenses usually have a cap amount. The total benefits paid to dependents also depend on how many there are. For young dependents, the payout will usually continue until they’ve reached a certain age.

So, all in all, the total death benefit amount is calculated depending on the worker’s number of surviving dependents.

An attorney uses a workers' compensation claim form and a calculator to calculate workers' comp.

How is Workers Comp Calculated in Florida?

In Florida, workers comp benefit calculation follows the same format as most other states. Albeit with certain exceptions. It also covers medical, wage loss, and death benefits.

Medical Benefits

Like most states, medical benefits in Florida workers comp covers all necessary medical expenses. However, you won’t receive a single cent of it. Your insurance carrier will pay all medical bills directly to your medical provider.

Lost Wages Compensation

There are many factors to consider when calculating lost wages compensation in Florida.

For one, you won’t be paid lost wages for the first seven days of your injury if your absence from work doesn’t exceed 21 days. If you do get paid, the rate will depend on your injury and your average weekly wage.

Here’s a quick summary of lost wages rates per type of disability:

  • temporary partial disability (TPD) = 64% of average weekly wage
  • temporary total disability (TTD) = 66 and 2/3% of average weekly wage but not to exceed the statewide maximum weekly compensation rate
  • permanent partial disability = depends on your impairment rating
  • permanent total disability = 66 and 2/3% of average weekly wage

These benefits are paid biweekly. But for temporary benefits, the payment will stop after 104 weeks or when you reach maximum medical improvement (MMI), whichever comes first.

Permanent benefits, on the other hand, will only be paid after you’ve reached MMI.

For instance, if the doctors declare your injury to be temporary and partial, you’re entitled to TPD benefits. If your average weekly wage is $1,000, your lost wages benefits will be $640 per week ($1,000 x 64%).

When you return to work, your TPD benefits will stop if you’re earning at least 80% of your pre-injury average weekly wage. But if you’re earning below 80%, your TPD benefits will make up for the difference.

Picking up from the example above, let’s say you return to work and are currently earning $600 per week. This means your earnings are below 80% of your average weekly wage. Your TPD benefits will only cover the difference between $600 and $800 (80% of $1,000). So your weekly TPD payment will be reduced to $200 ($800 – $600).

How is the Average Weekly Workers Compensation Calculated?

In Florida, the average weekly wage is calculated by averaging your weekly wages from the 13 weeks before your injury. Note that it will only consider the actual wage you received during that period. It doesn’t matter if you received overtime or missed a few days of work.

For instance, let’s say this is your summary of earnings for 13 weeks prior to your injury:

1 week before your injury: $1,000

2 weeks before your injury: $1,600 including overtime

3 weeks before your injury: $600 (you missed a few days of work)

4 weeks before your injury: $1,100 including overtime

5 weeks before your injury: $1,050 including overtime

6 weeks before your injury: $1,000

7 weeks before your injury: $1,000

8 weeks before your injury: $1,000

9 weeks before your injury: $1,000

10 weeks before your injury: $1,000

11 weeks before your injury: $1,000

12 weeks before your injury: $1,000

13 weeks before your injury: $1,000

With this, your average weekly wage should be $1,026.92.

If you’re new to work and haven’t yet worked for 13 weeks before you got injured, your average weekly wage will be based on the earnings of another employee with the same job as you.

Also, if you have more than one job and your injury prevents you from doing your other jobs, your earnings from those jobs will be included in the computation too.

VICTOR MALCA – Florida Workers Compensation & Social Security Disability Attorney

Victor Malca P.A. has over 27 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. His experience and continued success when fighting for his clients puts him among the most trusted workers’ compensation attorney’s in Florida. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits.

Book a free consultation today. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida.

About The Author

Judy Ponio is a writer and editor for the Victor Malca Law P.A. website and blog. She enjoys helping people in need with questions about social security disability and workers compensation law. She has a passion for helping those in need and the elderly with accurate legal information that can make a positive difference in their lives.