Benefit Calculation Worksheet



This page contains a link to software provided by the Nebraska Workers’ Compensation Court. The Benefit Calculation Worksheet may be downloaded and stored for future use or accessed directly from our website.

Disclaimer

This worksheet is a product of the Nebraska Workers’ Compensation Court and is provided to assist in calculating workers’ compensation benefits. The court does not represent that this calculation worksheet will be appropriate in every case. Questions pertaining to the functionality of this worksheet may be directed to the court’s Legal section. Please note, however, that we cannot provide legal advice or a legal opinion.

The contents herein are provided on an “as is” and “as available” basis. The court will not be liable for any loss, injury, or damage incurred as a consequence, directly or indirectly, of the use or application of the contents herein. We will not be liable for direct, special, incidental, or consequential damages, even if advised of the possibility of such damages.

Instructions

The file consists of three tabs, located in the lower left-hand corner of the worksheet. The “Worksheet” tab allows you to enter relevant information such as average weekly wage, dates of temporary disability, extent of impairment, and amounts already paid. Detailed instructions for completing the Worksheet tab are located within the spreadsheet directly below each category of benefits. The software will then calculate amounts owed based on the information you entered.

The “Summary” tab generates a one-page summary of the resulting calculations which can be printed and included with a lump sum settlement application.

The “Instructions” tab contains a copy of these instructions for quick access while using the worksheet.

Practice pointers

  • The worksheet was designed to calculate benefits for a single date of injury. You can enter information for more than one date, but the calculations may not be accurate. You may also enter information on multiple sheets for multiple dates of injury, but this approach will not account for interaction of the benefits due for each separate date of injury, if any.
  • The worksheet uses the current date (the date you are using the worksheet) to delineate between past and future weeks for purposes of commutation.

Download the Benefit Calculation Worksheet.