If you are covered by your employer’s workers’ compensation insurance in Arizona, you can receive a variety of benefits if you suffer an eye injury at work. These include reimbursement for related medical expenses, temporary partial wage replacement compensation, and possibly long-term or even permanent compensation once you reach your point of maximum medical improvement.
How much compensation you can receive in an eye injury settlement depends on several factors, which can make the calculation of an average workers’ compensation settlement complicated.
Depending on the source, including the National Safety Council, typical workers’ compensation eye injury settlements range from a few thousand dollars for a mild corneal abrasion to almost $50,000 for permanent vision loss.
Matt Fendon Law Group represents injured Arizona workers with workers’ compensation benefits claims and settlement negotiations. In this blog post, we examine some of the considerations that go into reaching a fair settlement with a workers’ compensation insurance company if you have suffered an eye injury on the job.
To learn more about how we can help you with your eye injury or any other work-related injury claim, call us at (800) 229-3880 or contact us online.
Who is Eligible to Receive a Workers’ Compensation Eye Injury Settlement?
To receive a workers’ compensation settlement in Arizona, you need to be eligible for workers’ compensation benefits. This means you must be an employee of a covered employer, and your injury must be connected to your employment.
Workers who do not qualify for workers’ compensation in Arizona generally include independent contractors and certain exempt domestic workers; immigration status does not bar eligibility.
What Goes Into Calculating the Value of an Eye Injury Workers’ Compensation Settlement?
One of the considerations that factors into what you can receive in settlement of your eye injury claim is how much you could receive through workers’ compensation benefits.
Compensation for Relevant Medical Expenses
Workers’ compensation will cover your past and future medical bills for treatment that is medically necessary for job-related eye injuries. There is no time limit on the reimbursement of reasonably necessary medical costs.
Temporary Compensation for Lost Wages
Depending on work restrictions, you may receive temporary total disability benefits equal to 66⅔% of your average monthly wage, or temporary partial disability benefits equal to 66⅔% of the difference between your pre‑injury wages and what you are able to earn.
Permanent Disability Benefits
Once you have reached maximum medical improvement, you may be able to receive scheduled permanent disabilities under Arizona Revised Statutes (ARS) Section 23‑1044(B). Subsections 16, 17, and 21 of this statute state that you can receive 55% of your average monthly wage for the following eye injury conditions:
- 30 months for the loss of an eye by enucleation (surgical removal of the eye)
- 25 months for the permanent and complete loss of sight in one eye without enucleation
In circumstances where a scheduled eye injury prevents a return to your date‑of‑injury job, compensation is based on 75% of the average monthly wage.
For a partial loss of sight, you can receive payments based on the number of months the partial loss lasts in proportion to the 25-month figure above. For example, if you lose 60% of your vision in one eye, then you can receive disability benefit payments for 15 months (60% of the 25 months you could receive benefits for the permanent and complete loss of sight in one eye).
If you already had a prior permanent impairment, or your eye injury combines with another permanent impairment arising from the same work injury, then your eye injury may become unscheduled. If this happens, the compensation you receive is based on your loss of earning capacity.
If you are permanently and totally disabled as a result of your work-related injury or illness, including the complete loss of sight in both eyes, you may receive benefits for the rest of your life at the same rate as temporary total disability.
Understanding how the Arizona workers’ compensation benefits system works for eye injuries is important because it provides a baseline to calculate what you can seek in a workers’ compensation settlement agreement.
How Do You Prepare to Negotiate an Eye Injury Workers’ Compensation Settlement?
Now that we have a general sense of how workers’ compensation pays benefits for an eye injury, we can consider the factors that go into preparing you to negotiate with a workers’ compensation insurance company adjuster.
Preserve Your Workers’ Compensation Claim
If you lose the right to receive benefits under Arizona workers’ compensation, you will lose the ability to negotiate with a workers’ compensation insurer. This means taking the following steps to make sure you keep your right to make a workers’ compensation claim:
- Report your injury to your employer. Arizona workers’ compensation law requires you to report your eye injury to your employer “forthwith.” This basically means, “as soon as possible.” If you unreasonably delay in reporting your injury, this may jeopardize your claim.
- Get medical attention for your eye injury. By seeking medical attention for your eye injury, you contribute to the evidence gathering that you will need to support your workers’ compensation benefits claim and your negotiating position.
- Comply with your medical treatment plan. Your treating doctor will typically prepare a treatment plan for you to follow. You need to stick with this treatment plan. If you disregard it or deviate from it, the insurance company might use it against you in negotiations.
- Document your communications and treatment. Additional evidence to support you in negotiations comes from keeping copies of your communications with your doctor, any doctor your employer hires to examine you, and insurance companies.
- Consult with an Arizona workers’ compensation lawyer. Having an experienced lawyer to guide you through the workers’ compensation claim process can help you avoid errors that delay or compromise your claim. It can also help you avoid making mistakes that the insurance company could use in settlement negotiations to minimize your settlement compensation.
Be Prepared for Common Issues that Arise in Settlement Negotiations
Negotiations with workers’ compensation insurance companies often involve common issues that you can anticipate and prepare for. The better prepared you are in advance, the stronger your negotiation position can be.
Here are some of these typical issues that your workers’ compensation benefits attorney can help you to be ready for:
- What was your average monthly wage before the workplace accident occurred?
- How long has your eye injury kept you from work?
- Can you return to your pre-injury job? Will you be able to work in another capacity?
- When did you reach maximum medical improvement? Will you still require long-term or permanent disability benefits afterward?
- What ongoing or future medical care will you require to treat your eye injury?
- Have you suffered any other work-related injuries from the same accident that led to your eye injury?
- How much evidence do you have to back up your claims for how the injury occurred, your eye injury diagnosis, and the treatment it requires?
The importance of being well-prepared for insurance company negotiations on a workers’ compensation settlement lies in understanding how these companies approach negotiations. Generally, the more serious your eye injury, and the more likely it becomes that you will need extensive medical treatment and long-term or permanent care, the more likely it becomes that you will encounter resistance.
If the insurance company claims adjuster decides to fight your settlement claims, that person can use an assortment of passive and active strategies to get you to settle for less. These measures can be as simple as offering you a settlement right away that is usually worth much less than the full potential value of your claim, or constantly demanding that you provide more evidence, or deflecting blame for your injury onto third parties.
More aggressive tactics can include hiring private investigators to follow you in your daily life activities and to monitor your social media accounts, challenging the necessity for some of your medical treatment or its costs, or arguing that your eye injury was a pre-existing condition or even that you played a role in causing it.
What Form of Settlement is Best For You?
Settlements with insurance companies can take different forms. The most common types are structured settlements and lump sums. Lump sums often form the foundation for a full-and-final settlement.
Structured Settlements
A structured settlement is payable to you in installments over time. These can be monthly, quarterly, or based on any other negotiated frequency. Structured settlements can be combined with partial lump sum payments. They may also be part of a full and final settlement.
A structured settlement often takes the form of the insurance company taking your settlement compensation amount and buying an annuity with it. Your structured payments then come from the annuity.
The main purpose of a structured settlement is to provide you with long-term financial security. This makes a structured settlement a good choice if you are suffering from a permanent disability, long-term wage loss, or ongoing medical support needs.
Full-and-Final Settlements
A full-and-final settlement is ordinarily a lump-sum payment, based on valuing all your present and future medical expenses, along with a future indemnity to cover lost wages.
The Industrial Commission of Arizona (the ICA) must approve a full-and-final settlement. Once this approval is obtained, this form of settlement will permanently close your workers’ compensation claim.
- The main advantages of a full-and-final settlement are that you receive all of your money up front, and you are not restricted in how you spend that money.
- The main disadvantage of the full-and-final option is that if you underestimate your future medical needs, you waive your right to reopen the claim to cover additional medical treatment costs or to rearrange any permanent disability benefits you receive.
Your workers’ compensation attorney can help you to decide which of these options is best for you in your eye injury settlement strategy.
Do All Settlement Negotiations Result in a Settlement Offer?
Your employer’s workers’ compensation insurer is not obligated to reach an agreement with you that results in a settlement offer. It is possible that settlement negotiations will fail. In this case, your usual recourse is to pursue workers’ compensation benefits for your work injury claim through Arizona’s workers’ compensation system.
What Should You Do if You Receive a Settlement Offer?
When negotiations reach the point where the workers’ compensation insurance company makes you a settlement offer, then you will have three options:
- You can accept the settlement.
- You can reject the settlement and continue receiving benefits through Arizona workers’ compensation.
- You can try to negotiate for a better settlement offer.
Your workers’ compensation attorney can give you guidance on whether you should accept the settlement offer or choose an alternative response to the insurer.
Have You Suffered an Eye Injury at Work?
Our purpose in this blog post is to familiarize you with some of the basic factors and considerations that go into negotiating a fair settlement amount for workplace eye injuries, and to give you a basic idea of how the average compensation for an eye injury works.
It is difficult to say for certain what you might receive in an “average” workers’ compensation settlement for a serious eye injury. How much compensation you receive from a settlement depends on how well you and your workers’ compensation lawyer navigate the process of preparing your claim, gathering the evidence you need to support it, and presenting a strong negotiating posture with the insurance company.
At Matt Fendon Law Group, our law firm’s attorneys have decades of combined experience representing injured workers in seeking fair compensation through settlement negotiations. We understand the key issues you need to address and how to counter insurance company tactics, whether subtle or hardball.
Integral to our representation of your interests in your workers’ compensation eye injury settlement, your Matt Fendon Law Group lawyer will provide you with the following services:
- Facilitating communication with your health care providers about your ongoing medical treatment
- Negotiating with the insurance company
- Handling the paperwork and administrative tasks regarding your claim
- Representing you in court if necessary
To speak with an experienced Arizona workers’ compensation settlement lawyer, call our office at any time at (800) 229-3880 or reach us online to schedule a free consultation with our legal team to evaluate your eye injury compensation claim.
