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.
WRAL in Raleigh has been breaking news on the “consent to rate” homeowner’s insurance issue in NC for some time now. I am tempted to call this a scandal but that might be a little overly dramatic at point.
Anyway, some large NC insurance companies have been sending select policy holders “consent to rate” letters. These letters seek consent from the insured for the insurer to raise the cost of their homeowners insurance above that allowed by NC law. Many believe these insurance companies are taking improper advantage of an old law designed to allow insurers to raise the rates for high risk homeowners so that they can provide insurance. North Carolina Insurance Commissioner Wayne Goodwin certainly feels this way.
One thing homeowners can do is to shop their coverage around. One Raleigh couple recently reported to WRAL that they had saved over 60 percent on their homeowners insurance by seeking other offers then allowing their own insurance company to beat it. That, my friends, is a smart strategy.
As a Cary NC personal injury attorney I can tell you that homeowner’s insurance is much more than fire coverage. One very important but often ignored aspect of homeowner’s insurance is the general liability provision. This provides coverage for an insured’s non-automobile related negligence, like if your turkey fryer gets out of controls and burns your neighbor’s house down, or if your dog bites a traveling vacuum cleaner salesman. Many people that think carefully about their liability for personal injuries that can come from an automobile accident fail to think at all about other kinds of personal injury liability.
In addition many homeowner’s policies include “medical payments” or “medpay” coverage. This is no-fault, no-deductible coverage for medical expenses that arise from the use of the home. This is usually a small limits policy, typically somewhere between two and five thousand dollars. The coverage pays in addition to any other medical insurance. Again, it is “no fault” which means it covers practically any injuries that occur in the insured home. It is similar to automobile insurance medpay.
I also recommend that folks buy an umbrella policy that sits on top of their automobile and homeowner’s liability coverages. A million dollar umbrella policy can cost just a couple hundred dollars a year.
As a NC personal injury lawyer I understand better than most the importance of having good protection against negligence lawsuits, including suitable general liability coverage in your homeowner’s insurance policy. So, get the coverage, just don’t overpay for it. Shop around every few years and you might find substantial savings.
As always, please call or email if you have a question about a Cary, NC, personal injury or workers’ comp issue. I am glad to offer a no fee consultation in my Cary NC law office.
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.
I was surprised to learn recently that medications are the top cause of child poisoning. According to Safe Kids Worldwide, in 2011, 67,700 kids were seen in emergency rooms for medication poisoning.
Many North Carolinians who have been injured in an automobile accident or have a NC workers’ comp case are prescribed medications. These typically include muscle relaxers, pain killers and anti-inflammatories. Most of the time the injured person is advised to take these medications as needed, and not all of the pills are used. Frequently these leftover medications will sit around in a drawer or medicine cabinet for years. This can be too tempting for a curious child, to whom the medicine may look like candy.
If you were injured in an automobile accident in NC, or if you have a NC workers’ comp claim, please make sure to properly dispose of your unused medications. Fortunately, Insurance Commission Wayne Goodwin is helping to make this easy, through participation in Operation Medicine Drop.
Safe Kids Worldwide provides these additional tips for handling medications:
- Put all medicines up and away and out of sight including your own. Make sure that all medicines and vitamins are stored out of reach and out of sight of children. In 3 out of 4 emergency room visits for medicine poisoning, the child got into medicine belonging to a parent or grandparent.
- Consider places where kids get into medicine. Kids get into medication in all sorts of places, like in purses and nightstands. In 67% of emergency room visits for medicine poisoning, the medicine was left within reach of a child, such as in a purse, on a counter or dresser or on the ground.
- Consider products you might not think about as medicines. Most parents store medicine up and away – or at least the products they consider to be medicine. They may not think about products such as diaper rash remedies, vitamins or eye drops as medicine, but they actually are and need to be stored safely.
- Use the dosing device that comes with the medicine. Proper dosing is important, particularly for young children. Kitchen spoons aren’t all the same, and a teaspoon or tablespoon used for cooking won’t measure the same amount as the dosing device. Use the dosing device that comes with the medicine to prevent dosing errors.
- Put the toll-free Poison Help Number into your home and cell phone: 1-800-222-1222. You can also put the number on your refrigerator or another place in your home where the babysitters and caregivers can see it. And remember, the poison help number is not just for emergencies, you can call with questions about how to take or give medicine.
Social media is now officially everywhere . Literally billions of people everywhere share personal information on Facebook, Twitter and Google+, not to mention a dozen other sites mostly popular with young people. Not surprisingly, insurance companies have put these sites to good use in defending Cary personal injury and workers’ compensation claims.
In my own practice, I have seen insurance companies use information found on Facebook:
- to locate a workers’ comp claimant for the purpose of doing surveillance (ironically, the video surveillance was helpful to us at trial);
- to impeach a potential witness;
- and to attempt to show that an injured party was able to work.
I have also used information from social media sites against defendants in several cases, including one situation where the defendant in a Cary automobile accident bragged about using illegal drugs on his Facebook page. And then there is this massive kerfuffle.
If you file a claim because you are injured in an automobile accident in Cary or on the job then you should assume that the insurance company on the other side will at least comb the large social media sites for information about you. Expect them to look for pictures of you smiling to show you are not in pain, being active to show you are not injured, or simply cavorting around to undermine your credibility. Keep this in mind: their point here is not to get a full understanding of you. It’s to find a single photo, video or comment that will in some way impeach you. I represented a very nice lady whose mental disability claim was denied in part simply because she went to a birthday party.
So, what to do? Here are a few tips so that will help you not wreck your personal injury or workers comp claim with your social media posts.
- Be honest. Be honest with your lawyer and while online. Don’t tell your lawyer you are not working if you are, and don’t tell your friends online that you are working if you are not.
- Avoid Social Media. I would prefer you avoid social media entirely while your claim is pending. I know you will not do it, but I feel better having said it.
- Use the Privacy Settings. If you insist on posting make full use of the privacy settings.
- Limit your Posts. Avoid pictures and video of you. Do not go on excessively about your awesome workout routine. And please do not post anything about your case or that your lawyer told you.
- Beware of Strangers. Do not accept friend requests from people you do not know.
It’s a scary new social media world. Be careful. Don’t let social media ruin your Personal Injury case.
Many people who are badly injured in a car accident or workers’ compensation accident end up in the hospital, sometimes for an extended period of time. I know it is stressful and even frightening when a loved one is hospitalized for treatment of a serious injury or illness. It can be even scarier when you consider the prevalence of of of health care-associated infections and the potential for medical errors. Hospital patients are already vulnerable. And nobody want things to get worse. Fortunately there are 10 simple ways to protect your loved one while in the hospital.
- Be there and be aware. The physical presence of a loved one with a patient means a lot. The vast majority of caregivers, including nurses and doctors, badly want to provide quality care. But they see many patients a day and it is easy to let quality lapse. Wake up and every time any medical provider walks in the room. Being present with watchful eyes is perhaps the most important thing you can do to help your loved one.
- Show somebody loves this patient. Fill the room with flowers, balloons and cards. Encourage friends and family who can not visit to send a card or other reminder. Make sure the patient always has clean clothes and ample personal items. This will lift the spirits of the patient and, just as importantly, show the medical providers that this person is special and is being monitored.
- Ask questions. I can not emphasize this enough. Try to understand what is wrong with your loved one and what is being done to address it. Ask for the names of medications when they are administered and ask why procedures are necessary before they are done. Be polite, but don’t be shy. If a medical provider seems to resent your questions, watch them carefully and keep asking questions.
- Keep a notebook. Document the medications your loved one is taking, upcoming procedures, the names of treating physicians, and other information. It’s easy to forget things especially with extended treatment.
- Research. Identify reliable sources of information on your loved one’s condition and learn about it. The National Institute of Health, the Mayo Clinic, and the Centers for Disease Control are a good start.
- Monitor all visitors. It is normal for people to want to visit and show support. But be sure these visits do not interfere with the patient’s rest or cause unnecessary anxiety. Make sure all visitors wash their hands with soap and water AND use an alcohol based hand sanitizer.
- Delegate. Ask someone in your church, neighborhood, family or other concerned groups to take charge of that group’s efforts. Encourage them to have everyone go through them and then support that when people reach out to help. You do not want ten people from the neighborhood calling to ask how things are going and what they can do.
- Help with housekeeping. Keep the room clean and neat and free of obstacles that can trip the patient. Take it upon yourself to clean doorknobs, bed rails and other frequently touched surfaces with bleach based cleaners.
- Stay positive. Keep a positive attitude around the patient. Listen to their complaints but respond with positive thoughts.
- Take care of yourself. Try to share the burden with a trusted friend or loved one. Eat healthy, exercise, and try to sleep. Sometimes, you just have to go home and take a break.
As a lawyer in Cary, North Carolina, I hope these 10 simple ways to protect your loved one while in the hospital have been useful.
If you have questions about a car accident or workers’ compensation claim, please feel free to call Cary Lawyer Kevin Bunn for your free consultation.
According to an article on WRAL, When East Millbrook school officials started sensing tension among their students they brought in Professor Jon Powell and the Campbell Law School Juvenile Justice Project which he leads. The Campbell Law School Juvenile Justice Project is a group of Campbell law students who work with Wake County school children to help them resolve conflicts. The Project partners with several Wake County middle and high schools and is funded through the Campbell University Norman Adrian Wiggins School of Law.
An anonymous eighth grader at East Millbrook complained that students just “didn’t get along.” “It was like he-she said stuff.” The law school mediators focused on the harm that had been done and how that harm could be addressed in a positive way. Mediators first talk to the students separately, then together, to help keep a conflict from escalating into a fight. Professor Powell and the law students’ goal is to get both sides to understand the root of the problems so it doesn’t build up again. “We just worked it out that day” said the eighth grade student.
The Campbell Law School Juvenile Justice Project has dealt with about 80 cases in the last school year. In the last ten years 95% of the students who completed the mediation didn’t offend again. A vice principal at East Millbrook said that the students behavior after the program was “calmer, not necessarily best friends but at peace.”
One of the major changes in the practice of law over the past twenty years has been the increased use of mediation to resolve conflicts. Practically every NC automobile accident, personal injury or workers’ compensation case that is filed is ordered to mediation. There are many NC personal injury lawyers who now limit their practice to working as a mediator. And most NC automobile accident lawyers spend more time in mediation that in trial.
So it’s probably a good idea to start training lawyers in law school to mediate conflict. And I guess if they can mediate a middle school spat they can mediate anything.
Increasingly, parties to a lawsuit or claim are demanding confidentiality clauses in NC personal injury and workers’ comp cases, as well as breach of contract, discrimination claims and even divorce actions. Many employers now require a separate “resignation and release” as a condition of settling a NC workers’ compensation claim, and these agreements often include a confidentiality clause. The reason is pretty straightforward — employers and businesses are reluctant for their employees and competitors to know what they have paid on a claim. My own view is that in the vast majority of cases nobody except the parties much cares what is paid, and its better to not have any remaining post-settlement obligations between the parties. But defendants frequently feel differently.
Recently, the breach of a confidentiality provision cost an age discrimination claimant his $80,000 settlement. Patrick Snay, the former Head of School at Gulliver Preparatory Academy Miami, Florida, filed an age discrimination claim against his employer after his 2010-11 contract was not renewed. The case settled for the payment of $10,000 in back pay plus $80,000. Unfortunately, Snay apparently told his teenage daughter about the deal and she could not resist posting the result on Facebook, advising her 1200 Facebook followers that “Mama and Papa Snay won the case against Gulliver. Gulliver is now officially paying for my vacation to Europe this summer. SUCK IT.” Needless to say, word of the the post got back to Gulliver officials, who promptly advised Snay that he had broken the confidentiality agreement and would not be receiving his settlement. The Third District Court of Appeal for the State of Florida sided with the school, holding that Snay’s disclosure of the settlement to his daughter violated the confidentiality clause.
Of even greater concern is the potential tax liability associated with including confidentiality clauses in NC personal injury and workers’ compensation cases. 26 U.S.C.A. section 104(a)(2) provides that “gross income does not include the amount of any damages (other than punitive damages) received (whether by suit or agreement and whether as lump sum or as periodic payments) on account of personal physical injuries or physical sickness.” So in general, workers’ compensation and personal injury proceeds are not taxed. However in 2003 the IRS ruled that money paid to secure a confidentiality clause is not compensation for personal injuries or physical sickness and so is taxable. Amos v. Commissioner, 2003 Tax Ct. Memo, LEXIS 330 (2003). (We have Dennis Rodman to thank for that. Look it up if you don’t believe me.) So if you have to sign a confidentiality agreement in your NC personal injury or NC workers’ compensation case consider assigning a specific amount of the settlement to that provision, and plan on paying taxes on that amount.
Finally, here are a few tips if you are considering entering into a confidentiality clause along with your personal injury or workers comp case:
- Raise the issue of any confidentiality agreement during settlement discussions.
- Be sure you are allowed to discuss the settlement as required to receive tax and legal advice, meet any obligations to business partners or insurers, or and to comply with any future court orders.
- Know exactly what is confidential. Does the non-disclosure apply to the terms of the settlement, the nature of the dispute itself, information exchanged between the parties?
- Understand the consequences of any breach of the confidentiality agreement. Most confidentiality agreements contain a “liquidated damages” clause, setting specific amount of money as the damages for breach of the clause.
Please call or email if you would like to discuss confidentiality clauses in NC personal injury and workers’ comp cases in North Carolina.
The Wilmington City Council recently voted to reduce Workers’ Comp Benefits in Wilmington NC for firefighters and police officers who are injured in the line of duty. Previously, injured safety workers could draw up to 100% of their pre-injury wages through the city’s workers’ comp program. The change reduced the compensation to the minimum required by the North Carolina Workers’ Compensation Act.
These 100% reimbursement plans are generally referred to as salary continuation. Many state law enforcement officers continue to be eligible for salary continuation through the State of North Carolina’s workers’ compensation plan. Teachers may also be eligible if they are injured in an episode of violence.
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.