Losing your sight can be a result of exposure to chemicals at work, sudden trauma to the eyes or face, or even brain injuries and neurological conditions. In any case, this is an area of “specific loss” injuries that leads to additional compensation and can complicate your case.
In most Workers’ Comp claims, any work-related injuries are covered. This pays for medical treatment and wage-loss benefits. However, vision loss is not always totally disabling, and you may be able to keep working or return to work. Even so, additional “specific loss” damages may be paid because of your vision loss. If the condition worsens as you go, additional benefits may be available.
For help with your claim, call the Certified Pennsylvania Workers’ Compensation Lawyers at Cardamone Law today at (267) 651-7945.
What Causes of Vision Loss Are Covered Under Workers’ Comp?
Workers’ Compensation covers any work-related injuries, including any cause of vision loss. This means it could cover any of these, and more:
- Head injuries causing lost sight
- Damage and injury to the eye itself
- Loss of an eye/total enucleation
- Loss of vision over time from exposure to smoke or chemicals.
Causes
Whether the injury is caused by work conditions, injuries during work tasks, or even assault or workplace violence, the injury should be covered.
Fault
The person who causes the injury also does not make a difference. Workers’ Comp covers injuries caused by
- Employers
- Coworkers
- The injured worker
- Outside parties.
Fault is not an issue; any accidental injury is covered. However, you cannot file a claim for injuries you intentionally caused yourself.
Benefits for Vision Loss in Pennsylvania
When you file a Workers’ Comp claim, you can get benefits for all work-related injuries you suffered. If your accident involves multiple injuries, you might get additional benefits in certain areas to treat your specific needs. In any case, vision loss, on its own, often leads to these three areas of benefits:
Medical Benefits
Medical benefits cover the full cost of treating your injury. For vision loss, this can include
- Diagnostic testing
- Surgeries
- Specialist appointments
- Medical supplies (eyepatches, prostheses)
If your accident involves other injuries, things like physical therapy and rehabilitation are also covered.
Wage-Loss Benefits
Workers’ Comp can pay around 2/3 of your lost wages while you are totally unable to work. This calculation is based on your average weekly wage (AWW) before the injury.
If you can work partially, you instead get 2/3 of the difference in pre- and post-injury AWWs. There are caps at the statewide AWW and floors at half that value or 90% of your AWW, whichever is lower.
Specific Loss Benefits
Total enucleation or loss of vision pays additional “specific loss” benefits. These equal 2/3 of your AWW, capped at the statewide AWW and with a floor at half the statewide AWW.
These benefits pay for 275 weeks for one eye. Loss of use of an eye qualifies the same as physical loss of the eye. Additionally, loss of both eyes (or loss of vision in both eyes) qualifies as total disability and keeps you on benefits indefinitely.
What is a Healing Period?
Workers’ Comp has a list of injuries, including amputation and total lost function, known as “healing periods.” When the listed injury is the only injury you suffer, it is expected that it will take about that long to heal from the injury, so you can only be on “total disability” for a maximum of that time. It can be even shorter if you heal and return to work sooner.
Specific Loss Benefits
After that period, your wage-loss benefits end and you switch to specific loss benefits only. As noted, these last 275 weeks for loss of one eye.
Other Disabilities
If your accident included other disabilities, then you can stay on wage-loss benefits on account of those disabilities longer than the limited healing period for disability based solely on the eye injury.
Your specific loss benefits usually come in after the disability period ends.
Total Disability
If you lose both eyes, you are considered totally disabled. There is no healing period and you can continue getting benefits as long as you are unable to work. You still get the specific loss benefits of 275 weeks of 2/3 of your injury for each eye lost.
If you are undergoing your healing period for one eye injury, then you lose the other eye because of worsened conditions, you switch to total disability.
Settlements for Lost Vision
If you lose both eyes or lose sight in both eyes, then you are totally disabled. This means that it your wage-loss benefits would last at the same rate through your retirement age. This makes calculations simple, and you may be able to settle the claim.
Calculating Settlements
Your wage-loss rate is set in stone, as it is based on your pre-injury AWW. This means we can project the total wage-loss benefits you would face.
The cost of eye prosthetics and other ongoing care is also possible to calculate from the beginning if your lost vision is the only injury. If other injuries are present, these calculations need to take into account other medical care costs and potential complications with that care, too.
With loss of one or both eyes, the specific loss benefits of 275 weeks of 2/3 your AWW (for each eye) are also simple enough to calculate.
Structured Settlements vs. Lump Sums
You may be able to settle your case with a lump sum of one amount or for a structured settlement of payments over time. Which you choose is usually up to you, and our Delaware County, PA Workers’ Comp lawyers can help you determine what is best for you.
In many cases, future medical care needs (if there are any) may need to be put in a Medicare set aside if you are nearing retirement age or will go on Medicare because of your disability. There are also considerations about what money you need now and whether a fixed income is appropriate for your lifestyle and family structure.
Requirements to File
To file a Workers’ Comp claim, you must:
- Get immediate medical care
- Report your injury to your employer within 21 days
- Treat with your employer’s chosen doctors for the first 90 days of care (unless you need unlisted specialists)
- Continue getting medical care
- Attend IMEs and other medical exams with doctors your employer chooses
- File a Claim Petition if your employer denies your claim (filed within 3 years of your initial injury).
Also, always work with a lawyer.
Call Our Pennsylvania Workers’ Comp Attorneys for Your Free Case Review
Call Cardamone Law at (267) 651-7945 for a free case evaluation with our Montgomery County, PA Workers’ Comp lawyers.
