An summary of the North Carolina workers’ compensation settlement procedure.
Most North Carolina workers’ compensation cases are ultimately settled. Depending on the circumstances of your claim, you may opt to settle because you want immediate cash to pay your expenses or to avoid the nuisance of a workers’ compensation hearing. Whatever the reason, be certain you understand exactly what rights you’re giving up in return for the settlement payments.
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What Is a North Carolina Workers’ Compensation Settlement?
There are three forms of workers’ compensation settlements in North Carolina: compromise settlement agreements, Form 26A settlements, and Form 21 settlements.
Settlement Agreements on Compromise
A compromise settlement agreement, sometimes known as a “clincher,” is a complete and final settlement of your workers’ compensation claim. In other words, you agree to give up all of your rights to a workers’ compensation claim in return for a monetary payment.
The majority of compromise settlement agreements include a lump sum payout. Insurance companies, on the other hand, may occasionally agree to pay the settlement monies in installments over time (sometimes called a “structured settlement”). Structured settlements are more typical when a claim includes severe injuries that render the worker completely handicapped and need long-term care.
Settlements on Forms 26A and 21
If the insurance company accepts your permanent partial disability rating, you may resolve your claim by submitting an Employer’s Admission of Employee’s Right to Permanent Partial Disability Benefits form (Form 26A). The insurance company pays the amount of your permanent disability rating in weekly installments under a Form 26A settlement. You give up your claim to future permanent disability benefits in return. A Form 21 settlement, like a Form 26A settlement, settles your claim for temporary disability payments.
Form 26A and Form 21 settlements, unlike clinchers, do not completely resolve your claim. Medical benefits will continue for two years from the date of your final compensation payout. If you need treatment beyond that time, you must apply before the two-year term expires. If there is a significant possibility that you may need more treatment, your request will be allowed. Similarly, if you can demonstrate a significant change in your health, you may apply to reopen your case for extra disability compensation.
This sort of settlement is not in the best interests of every worker. In North Carolina, you have the option of receiving continuous wage loss compensation rather than a permanent disability award. If you are experiencing considerable continuous pay loss, you should seek the advice of an experienced workers’ compensation attorney before settling into a settlement.
How Much Will I Be Awarded in a Settlement?
Calculating the settlement value of your claim is more of an art than a science. To assess your settlement, first calculate the entire amount of benefits you might get from your workers’ compensation claim. (For an indication of how much it may be, see our page on North Carolina workers’ compensation payouts.) Then, take into account any information that undermines your claim, such as contradicting medical reports or prior diseases that contribute to your handicap. However, numerous additional variables influence the value of a workers’ compensation claim. Only a workers’ compensation lawyer who is acquainted with your situation can provide you with a meaningful evaluation.
Certain deductions will be made from your settlement cheque. These expenses may include the following, depending on the nature of your claim:
attorney’s fees and court expenses (See our page on workers’ compensation attorney expenses.)
medical costs that have not been paid
child support owed, as well as a Medicare set-aside account (money to cover future medical expenses related to your work injury, which must be spent before Medicare will cover treatment).
Read our post on how much of your settlement you will get to retain to learn more about these deductions.
How Do Settlements Get Approved?
All workers’ compensation agreements must be approved by the North Carolina Industrial Commission. When you and the insurance company reach an agreement on settlement terms, you will submit a series of paperwork with the commission. If you have a lawyer, he or she will go through these papers with you in detail. If you do not have a lawyer, you should contact one before signing any settlement form, particularly one that demands you to give up all rights to your workers’ compensation claim.
North Carolina, unlike several other states, does not hold settlement hearings. The Industrial Commission will instead analyze your signed paperwork and approve the settlement if it seems fair and equitable.
Is it possible for me to change my mind?
You may always terminate a settlement before it is approved by the Industrial Commission. A settlement, however, is final once it has been accepted. As a result, you should never agree to a settlement if you are unhappy with its conditions.
When Will My North Carolina Workers’ Compensation Claim Be Resolved?
You have the option of settling your workers’ compensation claim at any moment. However, while you are still recuperating, it might be difficult to accurately evaluate a settlement. That is why most employees wait to settle their claims until they have reached maximal medical improvement—when their health is stable and unlikely to improve further with therapy. At that time, it will be evident how serious your injury is and if it will interfere with your capacity to work.