Are you considering settling your North Carolina workers’ compensation case? Has an adjuster or an attorney representing the workers’ compensation insurance company asked you to settle or “clincher” your workers’ comp claim? If you are thinking about settling your NC workers’ comp case then there are a few very important things to consider. Unfortunately there is no workers’ compensation settlement calculator. Each case must be carefully evaluated based on a number of factors.
A workers’ comp settlement in North Carolina is often referred to as a workers’ compensation clincher agreement. A settlement or clincher resolves all of the issues in your North Carolina workers’ comp case. This includes all past, present and future wage replacement or disability benefits, as well as all medical treatment. After your workers’ comp case is settled the employer or its workers’ comp insurance company will pay no further benefits.
Not every workers’ compensation case in North Carolina should settle. In fact some cases should never settle. A badly injured worker who will never work again and will likely require ongoing medical treatment will often do better by letting the workers’ compensation insurance company pay ongoing disability and medical benefits. This may be especially true if the worker is not eligible for social security disability or has no way to get medical treatment other than workers’ comp. While it may be tempting to clincher your workers’ comp case, it might be a mistake in the long run.
The decision on whether to settle or not should include a careful evaluation of the benefits you are giving up. For this reason in most cases it is better to wait until you have received most or all of the required medical treatment, and reached the end of your healing period, which is called Maximum Medical Improvement (MMI), before looking at settling your NC workers’ comp case. Before your treatment is complete it is difficult to determine the cost of future medical needs, including doctor’s appointments, medicine, physical therapy and surgeries. You do not want to settle your case and then realize you need surgery and have no way to pay for it. So it is usually better to complete most treatment and the healing period before settling your workers’ comp case, especially in accepted cases, and where there are not other health coverage options.
In addition to medical benefits you should also consider the value of the disability, or wage replacement benefits you are giving up by settling. This should include any remaining Temporary Total Disability (TTD), Temporary Partial Disability (TPD), Permanent Partial Disability (PPD) and Permanent Total Disability (PTD). This requires an accurate calculation of the Average Weekly Wage.
An injured worker who is considering settling their NC workers’ comp case should also think about the effect on other benefits that may be available. This includes Medicare, Medicaid, private health insurance, Social Security disability, and private long term or short term disability policies.
A workers’ compensation settlement must take into account any interest Medicare may have in payment of future medical expenses related to the workers’ comp injury or condition. Medicare disapproves of an injured worker settling his or her workers’ comp case and then asking Medicare to pay for treatment related to the injury. In some cases it is best to carve out part of the settlement and place it into a special Medicare Set Aside arrangement. In other cases this is not necessary.
Social Security disability payments may be greatly affected by a workers’ compensation settlement. However the proper use of a Social Security disability offset may limit or even eliminate this problem. There are several methods for calculating Social Security disability offsets and the injured worker is allowed to pick the one that helps them the most. But you get one chance at it. Social Security will not recognize an amended agreement intended to correct a botched calculation.
As you can see many times the bad effects of a settlement on other benefits can be reduced or even eliminated through careful planning. But settling a workers’ compensation case in North Carolina without considering how it may affect other benefits is a serious mistake.
Finally, do not confuse the payment of a workers’ compensation disability rating with a settlement. Payment of a percentage rating does not automatically end your right to medical treatment. But it may start the clock ticking on the end of both wage replacement and medical benefits. Often it is not a good idea for an injured worker to accept the payment of a disability rating in a North Carolina workers’ comp case.
Whether to settle your workers’ comp case in North Carolina workers’ comp case is one of the most complicated question your will face in your case. If you are considering settling you should consult a Board Certified Expert in North Carolina Workers’ Compensation Law. Please call or email for your free consultation with NC workers’ comp lawyer Kevin Bunn. Kevin practices workers’ compensation law in the Raleigh area.
According to a study by AAA reported in the Charlotte Observer three people die each day in automobile accidents in NC. And some places are much more dangerous to drive than others. But Cary and Apex, NC, don’t make the list.
Graham County, deep in the Appalachian mountains, is the most likely place to be in a fatal car accident in NC. Pitt County, which includes Greenville, NC, is the most likely place to be in any type of car crash in NC, and the second most likely for accidents that involve injury. Warren County has the lead in highest ratio of pedestrian deaths. New Hanover County, where Wilmington, NC, is located, is the third most likely location for an injury crash. Bladen County is fourth for fatality crashes. Wake County, where Raleigh, NC, Cary and Apex, NC, are located did not make the list for automobile accidents.
The AAA rankings take into account the number of deaths and miles driven by county.
The article quotes David Parsons, CEO and president of AAA Carolinas, as saying that while accidents are decreasing, North Carolina still “ranks third behind Texas and California in the number of traffic deaths on noninterstate highways.” “It’s great to see a decrease in road deaths, but it’s still a concern when you consider that more than three people still die every day on North Carolina roads,” Parsons said.
Data from the Charlotte Observer article:
All crashes: 1. Pitt; 2. New Hanover; 3. Vance; 4. Person; 5. Stanly.
Injury crashes: 1. Graham; 2. Pitt; 3. New Hanover; 4. Gaston; 5. Hoke.
Fatal crashes: 1. Graham; 2. Alleghany; 3. Alexander; 4. Bladen; 5. Vance.
All crashes: 1. Graham; 2. Stokes; 3. Transylvania; 4. Swain; 5. Hoke.
Injury crashes: 1. Graham; 2. Stokes; 3. Transylvania; 4. Hoke; 5. Swain.
Fatal crashes: 1. Graham; 2. Pamlico; 3. Camden; 4. Dare; 5. Yancey.
All crashes: 1. Anson; 2. Northampton; 3. Greene; 4. Bladen; 5. Hyde.
Injury crashes: 1. Anson; 2. Northampton; 3. Richmond; 4. Scotland; 5. Gates.
Fatal crashes: 1. Gates; 2. Hertford; 3. Ashe; 4. Cherokee; 5. Northampton.
Fatalities: 1. Warren; 2. Yancey; 3. Currituck; 4. Pamlico; 5. Cherokee.
All crashes: 1. Polk; 2. Haywood; 3. Camden; 4. Jackson; 5. Swain.
Injury crashes: 1. Camden; 2. Tyrrell; 3. Currituck; 4. Swain; 5. Perquimans.
Fatal crashes: 1. Pasquotank; 2. Warren; 3. Washington; 4. Chowan; 5. Tyrrell.
Given that older drivers are more likely to be involved in automobile accidents, what can we do about it? The National Institute on Aging provides the following questions on helping older drivers assess whether they should consider stopping driving:
- Do other drivers often honk at me? Have I had some accidents, even if they are only “fender benders”?
- Do I get lost, even on roads I know?
- Do cars or people walking seem to appear out of nowhere?
- Have family, friends, or my doctor said they are worried about my driving?
- Am I driving less these days because I am not as sure about my driving as I used to be?
- Do I have trouble staying in my lane?
- Do I have trouble moving my foot between the gas and the brake pedals, or do I confuse the two?
What can an older driver do to ensure they are as safe as possible? The NIH has some suggestions on helping older drivers with that as well.
- Drive a vehicle with an automatic transmission, large mirrors, and extensive safety equipment, including side air bags and traction control;
- Stay active and exercise to keep strength and flexibility;
- Have your vision checked regularly and stay current with prescriptions, including glasses;
- Avoid driving at night if you have difficulty seeing in the dark;
- Have your hearing checked regularly. Get a hearing aid if you need it and use it when you drive. Keep it as quiet as possible in the car when you drive;
- Leave extra space between your car and the car in front of you;
- Brake early when you need to stop;
- Avoid congested areas if you can. Plan your route to avoid complicated intersections;
- Drive in the right-hand lane, where traffic moves more slowly;
- Take a driving safety or refresher course. The AARP, and AAA can help you find a class nearby;
- Talk to your doctor or a family member about any concerns, especially you become confused while driving;
- Pay careful attention any warnings on your medications;
- Don’t drive if you do not feel well or if you feel light-headed or drowsy;
- Avoid driving in bad weather.
Many families struggle to decide when and how to approach helping older drivers, especially with the decision about continuing to drive. It can be difficult balancing the independence driving brings with the clear dangers associated with older drivers. The AARP has some excellent suggestions if you need to have “the talk.”
North Carolina, like many states, has special rules for older licensees. North Carolina drivers who are 70 years of age or older when their driver’s license expires generally must renew their license in person at a DMV office. Licenses issued to North Carolina drivers aged 54 and older are valid for five years.
Finally, in North Carolina, anyone, including doctors, family members and law enforcement officers may report potentially unsafe drivers of any age to the Department of Motor Vehicles’ medical evaluation program. The NC DMV can revoke licenses, require medical reports, or impose restrictions on trips and time of operation.
If you are involved in a car accident in Cary, NC, or Raleigh, NC, or elsewhere in North Carolina call Cary Personal Injury Attorney Kevin Bunn for your free consultation.
According to a News and Observer article the Division of Employment Services is taking longer to issue NC unemployment benefits. Many workers are waiting more than three weeks to receive benefits. Unemployment benefits are temporary payments made to tide over employees who are fired. Employees who are fired because of their bad conduct are generally not eligible for unemployment benefits.
According to the article the backlog has increased from 7296 claims in July to about 12,000 in January. Employment Security officials blame the backlog on increased efforts to ensure that payments are made to employees entitled to the benefits, and the fact that many employers fail to timely submit needed paperwork. Up to 40% of employers do not report the reason an employee was separated from their employment.
Federal standards require the payment of 87% of claims within 21 days. The U.S. Department of Labor is also pressuring the state to not overpay or improperly pay benefits. Under a new state law Employment officials are required to attempt to recoup any improper payments.
Claims where the employer and employee disagree on the reason for the separation must be heard, or “adjudicated,” by the ESC. Typically ESC will make an initial decision based on reports from the employer and the employee. If the stories match up, and the employee is eligible for benefits, then payments begin. If there is a dispute between the parties as to how the separation from employment occurred then benefits may be denied. Either party can appeal and request a more formal hearing before a hearing officer.
NC unemployment benefits can play a critical role in a NC automobile accident or other personal injury case. An employee who is fired because he or she is unable to return immediately to work because of injuries sustained in an automobile accident can claim unemployment benefits while they recover. While unemployment benefits will not replace lost wages then can provide some short term support for an accident victim. Unemployment benefits can provide a similar benefit in a denied North Carolina workers’ compensation case. While the employer may get a credit for unemployment benefits if the workers’ compensation case is later determined to be covered the benefits can at least provide some income during a period of disability.