Value of Arm and Elbow Workers' Comp Cases

What’s an Arm?

The entire arm, as you understand it, may be different than the view of the Maryland legislature. For purposes of workers’ compensation benefits, what constitutes an arm is relatively straightforward under Maryland law—an elbow is considered part of the arm, but the wrist and shoulder are not.

This is important because workers’ compensation permanency awards are based on a specific formula depending on which part of the body is injured. For example, arm injuries are worth more than hand injuries. Rather than being viewed as part of the arm, the wrist is considered part of the hand. In addition to the elbow, the arm consists of the remainder of the upper extremity—above the wrist, all the way up to just below the shoulder.

How much are Arm injuries worth?

The monetary value of workers’ compensation awards can differ tremendously on a case by case basis. The more serious the injury, the higher the award—a broken bone is worth more than a contusion. Permanency awards can also fluctuate based on the amount of treatment that a particular injury required—surgical cases are worth more than injuries that are resolved after a course of physical therapy. In addition to the elbow, other common arm injuries involve biceps, triceps and the forearm above the wrist.

Some statistics on Arm injuries

According to the Comp Pinkbook, which studied comp awards in Maryland over an 18-month period, arm injuries had an average value of $13,494 for permanency awards, and $20,936 for full and final settlements.

A full and final settlement closes a comp case forever. This means that the insurer would not be responsible for future medical treatment or compensation due to a worsening of condition. In contrast, when cases are not settled and instead are litigated before the Workers’ Compensation Commission, an injured workers retains the right to reopen his or her case due to a worsening of condition for a period of 5 years from the date of the last compensation payment. That is why the average settlement value is significantly higher than the average permanency award—because of the rights that an injured worker agrees to give up when deciding to settle their case.

How much are Elbow injuries worth?

Although the elbow is valued as an arm for purposes of workers’ compensation permanency awards, the Comp Pinkbook reports data that reflects how elbow injuries differ in value relative to other kinds of “arm” injuries. For example, the average permanency award for elbow injuries is actually less than the average permanency award for other types of arm injuries. Interestingly, however, the average settlement value for elbows was greater than the average settlement for other parts of the arm.

According to the Comp Pinkbook, the highest permanency award for an elbow only case $135,000. Oftentimes, work place injuries involve more than just one single injured body part. Obviously, this would increase the value of your case. For example, the Comp Pinkbook reports an award of $414,000 for a case the involved injuries to the back, shoulder

Some statistics on Elbow injuries

The elbow is consider an arm for purposes of workers’ compensation benefits. According to the Comp Pinkbook, which studied comp awards in Maryland over an 18-month period, elbow injuries had an average value of $9,610 for permanency awards, and $23,631 for full and final settlements.

How exactly are awards for Arm & Elbow injuries calculated?

Permanent partial disability (“PPD”), also known as permanency compensation, is calculated based on an injured worker’s average weekly wage (“AWW”) and the nature and extent of a particular injury. In Maryland, the arm is valued at a maximum of 300 weeks of compensation. This figure reflects the total loss or loss of use of an arm.

It is also possible to have a serious injury deserving of compensation even where there has not been a total loss of use. Generally, in such circumstances, an injured worker will get a disability rating from a doctor who is familiar with Maryland Workers’ Compensation. The rating will be in the form of a percentage. Thus, if a doctor gives a permanency rating of 50% to the arm, this would be worth 150 weeks of compensation, because 50% of 300 is 150.

It is important to note that PPD awards are capped at a certain percentage of the state average weekly wage (“SAWW”) for the year in which an injury occurs. In 2016, the SAWW is $1,027. In Maryland, PPD awards are based on a three “tier” system:

The Three Tiers of Permanency

A tier one award is due when, based upon a permanency rating, an injured worker is entitled to less than 75 weeks of compensation. A tier one award is only worth one-third of the individual’s average weekly wage (not to exceed 16.7% of the SAWW or $172.00), multiplied by the total number of weeks of compensation that the employee is due. Therefore, if an injured workers sustained a 10% loss of the arm, he/she would be entitled to 30 weeks of compensation at a tier one rate. Assuming the award is capped at the SAWW, then a 10% PPD award for an arm injury would be worth $5,160–i.e. 30 weeks x $172.

A tier two award is due when an injured worker is entitled to PPD for a period of time ranging from 75 to 249 weeks of compensation. A tier two award is worth two-thirds of the employee’s average weekly wage (not to exceed one-third of the SAWW or $343.00), multiplied by the total number of weeks of compensation that the employee is due. Therefore, if an injured workers sustained a 50% loss of the arm, he/she would be entitled to 150 weeks of compensation at a tier two rate. Assuming the award is capped at the SAWW, then a 50% PPD award for an arm injury would be worth $51,450–i.e. 150 weeks x $343.

A tier three award is referred to as “serious disability” and is warranted when an employee is due at least 250 weeks of PPD. A tier three award equates to two-thirds of the employee’s average weekly wage (not to exceed 75% of the SAWW or $771.00), multiplied by the total number of weeks of compensation that the employee is due. Serious Disability is particularly beneficial to injured workers because it provides an additional one-third of the total amount of weeks of compensation that an employee is due. For example, if an injured worker is due 300 weeks of compensation because of a total loss of use of an arm, then the actual PPD award would be for a total of 400 weeks of compensation—i.e. one-third of 300 is 100, and 100+300=400. Therefore, if an injured workers sustained a 100% loss of an arm, he/she would be entitled to 400 weeks of compensation at the SD rate. Assuming the award is capped at the SAWW, then a 100% PPD award for an arm injury would be worth $308,400–i.e. 400 weeks x $771.

It is easy to see how much permanency awards differs between the three tiers of compensation. Consider this: a 25% rating to the arm or elbow is worth 75 weeks at the tier two rate. Assuming the award is capped at the SAWW, a 25% PPD award would be worth $25,725. However, a 24% rating to the arm or elbow equates to 72 weeks of compensation at the tier one rate. Assuming the award is capped at the SAWW, a 24% PPD award would only be worth $12,384. Simply put, the value of a 25% ratingis worth more than double the value of a 24% rating. That is kind of crazy when you think about it.

Which brings me to my final point: the injured worker ALWAYS has the ability to obtain their own permanency rating. Oftentimes, when an injured worker is proceeding with a comp claim without the assistance of an attorney, the workers’ comp insurance company will obtain a permanency rating from a doctor hand-selected by the insurance company. However, the insurer’s rating is not the end-all, be-all. The injured worker can get their own rating from a doctor of their choosing. Then, if necessary, the case can be litigated before the Workers’ Compensation Commission (“WCC”). In such cases, the WCC makes the final determination, and generally assigns a final permanency rating that is somewhere in between the respective ratings of the injured worker on the one hand, and the employer/insurer on the other.