August 16, 2023 1:44 am
Deciding whether to accept a Workers’ Compensation settlement. Understanding the basics of a Workers’ Compensation claim before making this decision is crucial.
A Form Agreement is a type of settlement where the injured worker receives weekly benefits and medical treatment costs. The insurance company agrees to pay for all future medical treatment related to the injury as long as it’s necessary and related to the original injury. Note closely the language on page two, as the medical treatment is only available two years after signing, but each time you return to the authorized treating physician resets the two year clock.
For example, if you suffered a back injury at work that requires ongoing physical therapy and possibly future surgeries, a Form Agreement would ensure that the insurance company covers these medical costs, so long as you continue your treatment and don’t let two years elapse between visits.
A Clincher Agreement, on the other hand, is a complete and final settlement. This means that the worker gives up any future claims related to the injury in exchange for a lump sum payment. This includes both weekly benefits and future medical treatment costs. The defendants are “buying out” your claim.
For instance, if you had a work-related knee injury and received a Clincher Agreement offer, you might receive a lump sum of $50,000. However, by accepting this, you would be responsible for all future medical costs related to your knee injury.
It’s important to carefully consider the long-term implications before accepting a Clincher Agreement. While the lump sum might seem attractive, you should consider whether it will cover all future medical costs and lost wages.
In both cases, it’s crucial to consult with an experienced Workers’ Compensation attorney to ensure that your interests are adequately protected. They can help you understand the implications of each type of settlement and guide you in making the best decision based on your individual circumstances.
The value of Workers’ comp claims in North Carolina can vary greatly. Factors such as the severity of the injury, the expected future medical costs, and the impact on your ability to work are all considered. You might find our Workers’ Compensation future medical buyout calculator useful in this regard.
The severity of your injury plays a significant role in determining the value of your claim. More severe injuries typically result in higher settlements because they often require more extensive medical treatment and result in more time off work. For example, a traumatic brain injury would likely result in a higher settlement than a sprained ankle.
Another critical factor is the expected future medical costs related to your injury. If your injury requires ongoing treatment, such as physical therapy, surgeries, or medication, these costs should be factored into your settlement. Our Workers’ Compensation future medical buyout calculator can be valuable in estimating these costs.
The impact of your injury on your ability to work also affects your claim’s value. If your injury results in permanent disability or impairs your ability to perform your job duties, this could significantly increase your settlement amount. For instance, if you were a construction worker and a work-related injury resulted in the loss of a limb, this would drastically impact your ability to continue in your current line of work, and your settlement should reflect this loss.
If your injury has caused you to miss work or will result in future lost wages, these should also be included in your claim. For example, if you could not work for six months due to your injury, you should be compensated for those lost wages.
In some cases, an injury might require you to change careers. If this is the case, the cost of retraining or vocational rehabilitation should be included in your settlement.
Evaluating a Workers’ Compensation claim can be complex, and it’s essential to have an experienced attorney to help you navigate this process. They can ensure that all relevant factors are considered and that you receive a fair and just settlement.
If your claim has been denied, keep hope. There are many instances of successful appeals of denied Workers’ Compensation claims. It’s essential to understand the appeal process and your rights.
Claims can be denied for a variety of reasons. Common reasons include:
Understanding the reason for your claim’s denial is the first step in planning your appeal.
The appeal process typically begins with a request for a hearing before the North Carolina Industrial Commission. This hearing is similar to a trial in court. You’ll be able to present evidence, call witnesses, and make legal arguments to support your claim.
Having an experienced Workers’ Compensation attorney represent you is highly beneficial. They can help gather and present evidence, cross-examine the insurance company’s witnesses and make persuasive legal arguments on your behalf.
If the Industrial Commission rules in your favor, the insurance company may be ordered to pay all past-due benefits, cover necessary medical treatment, and pay for any future benefits to which you’re entitled. If the Industrial Commission does not rule in your favor, you can appeal the decision to the North Carolina Court of Appeals and, ultimately, to the North Carolina Supreme Court.
Remember, a denied claim does not mean you are out of options. You can fight for the benefits you deserve with the right approach and legal guidance.
We understand that this process can be confusing. That’s why we’ve compiled a list of Workers’ Compensation FAQs to help you navigate through this journey.
Deciding whether to take a Workers’ comp settlement is a personal decision that should be based on your individual circumstances. It’s always a good idea to consult with a professional who is well-versed in NC Workers’ comp laws to guide you through this process.