The Average Workers’ Comp Settlement in Pennsylvania

Workers’ Compensation sees thousands of injured workers make claims for their medical care and lost wage benefits each year.  There are metrics assigned to these claims, capping certain parts of the claim and ensuring fair values are paid to everyone.  However, people often want to know what they can expect in their case by looking at average values.

In Pennsylvania, average payouts are not tracked very well.  Workers’ Comp pays for both medical care costs and lost wages, and the amounts paid can vary widely.  First, medical care costs should be paid to cover even small injuries at work, let alone life-altering injuries with years and years of medical bills.  As such, this value varies so much that looking at averages is unhelpful for determining your possible benefit.  Second, payouts for weekly benefits are capped at the value of the statewide average weekly wage, so that value is more helpful as an indicator of your potential benefit, but your benefit will not usually equal the average.

For help with your particular case, call our Certified Pennsylvania Workers’ Compensation Lawyers at Cardamone Law today at (267) 651-7945 to get a free case review.

What is the Average for Workers’ Compensation Claims in Pennsylvania

Different websites will give you different values for the average settlement, with some claiming it is somewhere in the $20,000-$30,000 range and others breaking things down based on how many limbs are injured or whether the final claim value came from a jury verdict or not.  Because so many settlements are made out of court and because many of them are confidential, it is impossible to determine what the true average is in cases across the Commonwealth.

This might not be the answer you want to hear, but if you are more interested in determining how much your specific claim might be worth, our Philadelphia Workers’ Compensation lawyers can provide a lot more specific information about how claim values are determined and how to go about calculating a settlement for your case.

Average Workers’ Comp Settlements by Injury Type in Pennsylvania

Although we might not have good average statistics on the settlement end, insurance carriers and associations of these carriers do track some of the financial payouts they make, publishing the details.  A non-profit organization, the National Safety Council, tracks national injury data provided by the National Council on Compensation Insurance.  From a particular data sheet (third tab), we have some relatively reliable numbers for the average cost of claims from the years 2021 through 2022 (the most recent years with published data).  Again, this information usually comes from the pay on the insurance carrier’s side, so it includes monthly payouts and settlements.  This data is also broken down into what ends up being paid for medical care versus what gets paid for indemnity (wage-loss benefits).

Keep in mind with averages that most cases are, definitionally, not average.  More serious injuries are also much rarer, with less serious injuries – thus cheaper injuries – being far more common.  This means that most averages for injury payouts are going to skew lower, given that most payouts are for smaller injuries.  If you do have a more serious injury, it is possible it could easily be double or even triple the average.  As such, take all of these averages with a grain of salt.

The following are each of the injury types discussed in the table and the average payouts for those injuries.

Head Injuries and Central Nervous System Injuries

Injuries to the head and brain, as well as to the spinal cord and the rest of the central nervous system, are all tracked together.  These injuries are often some of the most serious in that they can affect the whole body and the whole person.  Unsurprisingly, this is one of the highest averages on the list, with an average of $60,174 being paid for medical care and $31,670 for lost earnings ($91,844 total).

Realistically, around $60,000 is low for many serious traumatic brain injuries, but remember that the average care for a “head injury” would also include concussion workups and other outpatient care that might be much less costly.

As you will see on this list, as the injuries decrease in severity, the cost of medical care drops, but the cost of wage-loss payouts stays quite high for some of the more serious injuries.  This is because there are caps on wage-loss benefits, and permanent total disability will only potentially cost so much to reimburse.  On the other hand, medical care has no cap, so these values are considerably higher even when indemnity benefits are not.

Injuries to Multiple Body Parts

Injuries to multiple body parts are tracked as a separate entry.  Unsurprisingly, these injuries also cost more on average than many specific, singular injuries because there are more injuries to treat.  As such, this is second-highest on the list, with an average medical payout of $37,195 and an average wage-loss payout of $34,450 ($71,645 total).

When you face injuries to multiple body parts, they might both start healing at the same time, but your ability to return to work will often be dictated by the most serious injury.  As such, accidents that involve at least one serious injury, along with any number of minor injuries, will drag up the average payout for indemnity/wage-loss benefits in this category.

Neck Injuries

Neck injuries are next on the list.  This is again unsurprising that these injuries can result in such expensive medical care and indemnity benefits because these injuries can come close to brain and central nervous system that leave you paralyzed or with life-altering disabilities, limiting your ability to ever return to work even if they do not arise to the level of nervous system injuries.  At the same time, many neck injuries involve whiplash, a condition that is often relatively inexpensive to treat – at least in comparison to total paralysis – with physical therapy and chiropractic care.

Neck injuries average a medical payout of $35,690 and an indemnity benefit of $32,331, for a total of $68,021.  As with the injuries discussed thus far, permanent disability is possible with neck injuries, so maxed out, life-long total disability damages are more often paid in this category than with some of the following injuries.

Hip, Thigh, and Pelvis Injuries

This category essentially covers all injuries to the lower part of your torso and the upper part of your legs, with a note that injuries to the sacrum (lowest section of the spine) and coccyx (tailbone) are also counted here.  Many of these injuries result from crashes, crush injuries, and falls.  Because this area of your body is so essential to walking, moving around, and carrying/lifting, injuries to this area can keep you away from physical activity for a long time.  However, unlike the injuries listed above, these have a higher chance of healing fully, and thus permanent disability is less common.

The average medical payout for hip, thigh, pelvis, sacrum, and coccyx injuries is $36,696 – which is actually higher than neck injuries – but the indemnity benefits are lower at $25,414 on average.  This total average of $62,110 still makes these injuries one of the top five most expensive averages.

Leg Injuries

Like with the category above, leg injuries can stop you from getting around, walking, lifting, carrying, and performing all sorts of job tasks.  As such, they round out the top five most expensive injuries with a total average payout of $59,994.  However, the average wage-loss payout is lower at $22,553 – considerably lower than the medical average of $37,441, which was above some of the previous entries here.

One reason that we see the average wage-loss benefit drop with leg injuries is that many jobs can be done from a seated position to begin with.  This means that once the pain has subsided, you can often return to work without losing wages while your injuries heal.  Additionally, many careers and industries include some kind of alternative or light-duty work you can do while seated, allowing you to still make some of your wages back while you are on indemnity benefits, resulting in a lower overall indemnity payout before you return to full-duty work.

Another thing to consider is that these injuries can range broadly in severity, from things like broken bones to amputation.  These can result in vastly different needs, as some broken bones merely require a cast, while some will require surgery.  Lastly, keep in mind that the bones in your leg are pretty strong, with the femur being one of the single strongest bones in the body.  As such, more leg injuries are going to involve the joints – your hip, your knee, or your ankle.  All of those injuries are tracked separately from this category.

Arm and Shoulder Injuries

While the arms and shoulders are involved in more jobs – even desk jobs – many of the injuries to the arms and shoulders can heal up to a point where you can return to your job in a much quicker time.  Additionally, even something as serious as amputation is unlikely to lead to permanent total disability that keeps you on benefits for the rest of your life.  Most injuries are going to include something far less serious, like a broken bone or a tear that might see you return to light duty work within a couple of weeks and full duty work within a few months, depending on your job.

As such, the average medical care payout for arm and shoulder injuries is lower at $26,690, and the average wage-loss benefit is $25,060 for a total of $51,750.

Lower Back Injuries

Lower back injuries are one of the most common reasons for missed work and injuries that require disability/Workers’ Comp payments.  At the same time, treatment for back injuries is often relatively cost-effective, with chiropractic appointments and rehabilitation often costing far less than the more serious surgeries related to spinal cord injuries.  While many low back injuries also affect the spinal cord, it seems that those injuries are not included in this category, being lumped under the central nervous system injuries discussed above.  That means that lower back injuries on this chart probably focus more on musculoskeletal injuries, misalignment, and the kind of haunting “bad back” issues that linger without needing much medical treatment.

Because medical care is often quite inexpensive, but the effects of a back injury can be quite debilitating, this is the first of two entries on this list with a higher average indemnity benefit than medical benefit.  The average medical payout for lower back injuries is $18,087, while the average wage-loss payout is $22,322, for a total of $40,409.

Another common issue with lower back injuries that can drive up the cost of indemnity benefits is that these injuries can heal and be “better” for a while but reemerge after a new reinjury, repetitive stress/strain, or even just a “bad day” for your back.  As such, people who have been on total disability or partial disability in the past for a back injury may need to go back on benefits if their injury gets worse again.

Upper Back Injuries

Upper back injuries face the same kinds of issues as lower back injuries, with the effect on your body and your ability to work often overshadowed by the actual cost of medical care.  As such, this is the second of the two entries on this list with a higher average wage-loss benefit than the average medical benefit.  The average medical payout for upper back injuries is $17,588, while the indemnity payout is $19,732 (total $37,320).

While lower back injuries often occur from a specific injury like lifting or carrying, upper back injuries are more likely to stem from repetitive use or an injury like a fall off a ladder.  When your upper back hurts, it can make it hard to even sit at a desk and use a computer, which rules out a lot of potential light-duty work, resulting in more instances of total disability payouts.

Many of the same considerations with low back injuries also apply to upper back injuries regarding potential reinjury, injury flare-ups, and additional time away from work later down the road.

Knee Injuries

Knees are more prone to injury compared to the rest of your leg.  Strong bones in your thigh and lower leg are harder to break and can take a lot of punishment, but your knee is more likely to give out.  These injuries can happen from something as simple as walking down a flight of stairs with a heavy box and feeling something “go pop” to injuries from falls or on-the-job auto accidents.

For many knee injuries, the solution will involve surgical care.  Tears are one of the more common serious knee injuries, from tears of the meniscus to the ACL to the MCL.  These injuries often result in expensive surgery, but the turnaround time before you can return to light-duty work might not be that long.  As discussed above, even with a leg injury, many people can still perform their desk jobs or a reduced duty position while they recover.  It can often take a solid 6 to 9 months to fully recover from knee surgery, depending on the specific procedure you needed, which means that workers with high-impact jobs might not get back to full duty work for a while.

All in all, this is the ninth most expensive injury to treat, with an average total payout of $36,581.  This breaks down into an average of $18,388 for medical care and $18,193 for wage-loss benefits.  However, it is important to remember that something as serious as an ACL tear that might put you out of work for 9 months could still pay benefits over $45,000 if your average weekly wage is high enough, despite what these averages show.

Face, Teeth, Mouth, and Eye Injuries

Our tenth-place injury is an odd category of injuries, as it makes sense to include the entire face as one area of injury, but the types of injuries vary widely.  It is clear from the delineation of categories that any facial injuries involving the head more generally or any traumatic brain injuries would instead fit under the “multiple body parts” or head/central nervous system category, so that gives us one clue as to why this is so far down the list: all of these injuries are comparatively less serious.  However, there is quite a range in severity when we compare chipping a tooth to something like a broken orbital or a lost eye.

On average, injuries to the face, teeth, mouth, and eyes include $18,305 for medical payouts and $16,255 for wage-loss benefits, for an average of $34,560, but it is important to break down how this range of injuries works.

Dental injuries are often not too expensive to treat, and they are unlikely to interfere with your ability to work.  As such, these have both a low average medical cost and a low average indemnity rate.  Eye injuries similarly do not need medical treatment in many cases, and simply wearing an eyepatch and allowing your eye to heal from a small injury could be enough to get you back to work without much expense.

Of course, there are very serious injuries in this category, too: facial lacerations requiring expensive plastic surgery, total loss of vision requiring surgery, severe dental and jaw injuries, loss of an eye, and more.

One thing to consider with these averages is that they are talking about medical and indemnity benefits only.  There are additional benefits workers can receive in Pennsylvania for “specific injuries,” which include amputation, total loss, lost hearing, and – relevant to this category of injury – loss of vision/loss of an eye and serious facial scarring.  As such, your benefits might be higher with these injuries than these statistics might account for.

Ankle Injuries

As mentioned with regard to leg and knee injuries, the joints are more likely to face injury than the rest of the leg itself.  Ankle injuries can include a twisted ankle that puts you out of work for a day or a sprain that might put you out of full duty work for a few weeks.  This might be why this is the first injury on the list with an average indemnity benefit under $15,000.  However, like with most of these averages, ankle injuries can also include serious tears, amputation, or injuries needing a total joint replacement.

As mentioned, the average indemnity is lower at $14,739, and the average medical cost is $16,946 (total $31,685).  Medical bills here are often low because these injuries can typically be treated as outpatient injuries (no hospital stays required), and you might not even need to see a specialist.  Many Workers’ Compensation insurance carriers like patients to go to “coordinated care organizations” and panel doctors who might not even be M.D.s or D.O.s (i.e., the two major types of “physicians”), lowering the overall cost of treatment.

These injuries are also less likely to even keep you out of work for enough days to trigger indemnity benefits, which start after the seventh day of incapacity.  They are also less likely to cause permanent disabilities.

Multiple Trunk/Abdomen Injuries

This is a broad category of injuries, covering basically anything from the waist to the bottom of your ribcage that does not involve internal organs.  This may include multiple injuries – which are common in many car crashes, falls, and other blunt-force injury cases.  It can also involve penetrating injuries, impalement, bruising, and more.  It is unclear if broken ribs fit here or in the chest injury category.

Injuries to your torso/trunk area can lead to temporary incapacity because it is quite hard to do anything if moving hurts your ribs, ab muscles, or other parts of your torso.  Additionally, many of these injuries lead to time away from work because you need surgery.  However, they often heal up enough to get you back to work – at least on light duty – in only a few weeks.  The biggest risk after returning to work from one of these injuries is often that you will pop your stitches or reopen a wound.

Even so, these are averages, and much more serious injuries can obviously occur that make the average medical pay of $17,683 and average indemnity pay of $12,485 (total $30,168) seem very low.

Foot and Toe Injuries

Injuries to your feet or toes can make it hard to walk, lift, carry, or perform basically any physical labor, but there are many jobs that do not need this in the first place.  Dropping something heavy on your foot or otherwise injuring it in a small accident might not lead to much need for medical care and may involve no time at all away from work, resulting in lower medical payouts averaging $15,359 and indemnity benefits averaging $13,717 (total $29,076).

Like with some of the facial and eye injuries discussed above, these injuries sometimes include specific loss benefits for amputation, which are obviously more serious than the average numbers here might imply.  Even so, the cost of treatment for an amputation might not be too high overall, and you might be able to return to your job if it doesn’t involve being on your feet anyway or the loss of a toe does not stop you from doing your job.  Even so, additional specific loss benefits might be available.

Chest and Organ

Injuries to the chest and organs have a high potential of being fatal, but this still accounts for a statistically small number of injuries.  Instead, most chest and organ injuries are going to be things like broken clavicles, broken ribs, and blunt-force trauma injuries that can heal up surprisingly quickly and might not interfere with certain job tasks.  However, broken ribs can also puncture lungs, and any injury to the spleen, heart, stomach, intestines, or any other organ can require massive surgery with a long recovery time.

Even so, the average injury in this category is not too serious, with an average medical payout of $14,464 and an average wage-loss payout of $13,492 (total $27,956).

Hand, Finger, and Wrist Injuries

Broken wrists, broken fingers, sprains, strains, and carpal tunnel are all common injuries to the hands, fingers, and wrists.  Some injuries – especially amputation – can lead to time away from work, but many of these injuries are the kinds of things you can work through without having to take too many days away from work.  As such, this is the least expensive category of injuries for medical and indemnity benefits.

Again, insurance may pay specific loss benefits separately from these, but the average medical payout for hand, finger, and wrist injuries is $14,791, and the average wage-loss payout is $12,281 for a total average payout of $27,072.

What is the Average Weekly Wage for Workers’ Comp Claims in Pennsylvania

When workers get injured and cannot work, Workers’ Compensation pays wage-loss benefits as long as you are out of work for over 7 days.  These wages are paid on a weekly basis according to specific rules, allowing you to much more easily anticipate what your wage-loss benefit will be in your case.

Pennsylvania bases weekly wage-loss benefits on the “average weekly wage” (AWW).  This is calculated by looking at the worker’s wages before their injury and taking the average.  This is simple for many workers and can be calculated from weekly pay, pay every other week, or even monthly or yearly salary amounts.  There are also special rules for how to calculate the worker’s AWW if they are seasonal workers or are new to their job.

If you are still able to work after a work-related injury, but earning less than your pre-injury average weekly wage, then you will have a claim for a partial disability check which is 2/3 of the difference between your pre-injury average weekly wage, and any post injury earnings.

Once you have your personal AWW, you can compare it to the rules for caps and pay rates that Pennsylvania uses.  These are instead based on the statewide average weekly wage, which the government sets every year.  In 2024, this statewide weekly average is $1,325.

Cap for High Earners

Workers’ Comp sets the statewide AWW as the cap on wage-loss damages, meaning that your weekly benefit cannot go over this amount.  Typically, wage-loss benefits are paid at 2/3 of your AWW, so this capped amount will be paid to any claimant making $1,987.50 or more per week.

Cap for Middle Earners

The next value to look at is 50% of the statewide AWW: $662.50.  If 2/3 of your salary would be below half of the statewide AWW, then you make that much as your benefit instead, potentially boosting you over 2/3 of your AWW.  This means that if your wages range from $736.11 through $993.75, your weekly benefit will be $662.50.

Cap for Low-Wage Earners

Lastly, the Workers’ Comp Act puts the floor at the lesser of $662.50 or 90% of your AWW.  So if 90% of your AWW is actually under that amount, you will make 90% of your AWW as replacement wages instead.

Average Medical Expenses for Workers’ Comp Claimants in Pennsylvania

Medical care costs paid through Workers’ Comp vary so widely that capturing an average amount will hardly be helpful in projecting how much should be paid in your case.  Workers’ Comp is supposed to cover emergency care for all sorts of injuries, potentially ranging from something like stitches for a cut to casting a broken bone to reattaching a lost limb to years of cancer treatment.

Most injuries are, thankfully, mild to moderate.  This will also skew down the average since most claims will deal with lower-cost injuries.  This provides an unrealistic picture of what Workers’ Compensation can and should cover: everything.

Medical care should be covered in full at no cost to you when you make a Workers’ Comp claim.

Calculating Settlements for Workers’ Compensation in Pennsylvania

When you settle your claim in what is called a “global settlement,” you settle for both the ongoing wage-loss benefits and the total cost of medical care you will need now and going forward, along with any other benefits you should receive.  Because this is such a fact-sensitive assessment, it will require looking at the specific facts of your case rather than looking at averages.

When calculating how much your settlement should cover, we need to project the total cost of medical treatment.  For injuries that will “get better” or improve to 100%, there will be a somewhat predictable end date for the treatment, making calculations easier.  For ongoing care like cancer treatment, this could be a hard calculation and might require talking with doctors and financial experts to help calculate it.

The same is true with wages: if your disability will end, we can project when it will end and calculate the wage-loss benefits through that date.  With ongoing wage-loss benefits, calculating the end date is harder.

The other thing to consider is that many injuries pay additional compensation for specific losses – i.e., amputation or loss of function in a body part.  Because these are listed in the statute as a set number of weeks for each injury, these are much easier to account for in a settlement calculation.

Call Our Workers’ Compensation Lawyers in Pennsylvania for Help Today

For a free case evaluation, contact Cardamone Law’s Bucks County Workers’ Compensation lawyers immediately at (267) 651-7945.