Clients often ask me if the insurance company can force them to settle. That’s a good question, and one that, like many involving workers’ comp, does not have a simple yes or no answer. But let me try to simplify the answers.
There are two parts to this answer because there are generally two types of settlements in workers’ compensation claims in North Carolina.
Types of Workers’ Comp Settlements in North Carolina
Two types of settlement payments in North Carolina’s workers’ compensation statutes are:
- Payment of permanent partial disability benefits
- Payment of a settlement that will close your workers’ comp case
Settling Your Workers’ Comp Case – the Clincher Settlement
Payment to close your case in North Carolina is called a “clincher” settlement. This type of settlement generally resolves the entire case so that further workers’ compensation benefits are not going to be owed once the settlement is paid and finalized. Essentially you would receive one payment closing out your case if the settlement is reached and approved.
This type of settlement must be approved by the North Carolina Industrial Commission (the workers’ comp “court”). However, your employer cannot force you to accept the settlement or go to the Industrial Commission to try to have them force you to accept a settlement of your entire claim.
But, some may try to bully you and back you into a corner so you will feel pressured to settle. We’ve seen this happen – over and over.
We had a workers’ compensation client whose insurance company told him that if he didn’t settle his case for the amount they were offering, they would discontinue his weekly checks. When he contacted us, he’d gone two weeks without being paid, and we immediately called the adjuster. She said he “fell off the system” and that she would mail his check that day. After that, we got him a second opinion on his injuries and he needed surgery, which meant his case was worth a lot more than what the insurance company was offering.3
It’s sad, but we have often seen adjusters try to bully our clients into a workers’ compensation settlement. Bullying is wrong. But it can work in the early stages before a client gets an attorney on their side..
Payment of Permanent Partial Disability (PPD) Benefits
If you have been injured on the job and the injury is significant enough to cause permanent damage to a specific body part, you may be entitled to benefits for permanent partial disability (PPD). These benefits are provided under Section 97-31 of the North Carolina General Statutes, and may be paid once your medical treatment is complete and you have been able to return back to work earning wages similar to those before your injury.
Your treating doctor will generally assign you a PPD rating if your injury warrants one. The insurance carrier will then likely contact you and want you to accept payment based on that rating to “settle” your case. If you do not agree to settle, the insurance carrier may attempt to force you to accept payment by asking the North Carolina Industrial Commission to approve the rating which allows them to pay you the rating benefit.
Benefits of Receiving PPD Benefits
There’s a reason they may want you to accept this type of settlement sooner rather than later. Once you are paid PPD benefits, your right to other benefits generally only lasts two more years. If nothing changes in your case after payment during the two-year period, your right to further benefits for medical treatment or time out of work typically ends. And they’re off the hook.
When considering PPD benefits, it’s important to know that you have a right to a second opinion by the medical provider of your choice at the insurance carrier’s expense. So if your treating doctor says your knee is only 10% disabled, and you feel like it’s more like 30%, you can ask for a different doctor’s opinion.
PPD does not necessarily mean your case is closed. What many people don’t realize is that PPD may be only a fraction of the final workers’ compensation settlements you may potentially be due.
If you’re in a situation where you have been assigned an impairment rating and the insurance company is trying to make you accept a settlement payment, my experience suggests it is prudent to contact a workers’ compensation attorney who can help you understand your legal rights and try to obtain the best outcome for your unique situation.
At our firm, we do these kinds of initial evaluations for free – 1-866-900-7078.
2021 U.S. News – Best Lawyers® “Best Law Firms” List
Here are just a handful of very good reasons we believe you should consider the Law Offices of James Scott Farrin to help you with your workers’ comp claim.
Our firm received the highest tier ranking by the 2022 U.S. News – Best Lawyers® “Best Law Firms” for workers’ compensation in the greater Raleigh area.3
Our workers’ comp attorneys include several North Carolina State Bar Board Certified Workers’ Compensation Specialists. One is a former North Carolina state senator and former Deputy Commissioner at the North Carolina Industrial Commission. Others used to work for workers’ compensation insurance defense firms, and several of our paralegals and other administrative staff have also worked for insurance companies. That means inside knowledge you can use.
Get a FREE Evaluation From North Carolina Workers’ Comp Attorneys
With an experienced workers’ comp attorney fighting for you, we’ve seen these kinds of bullying tactics by the insurance companies backfire. If you are in a situation where the insurance company is contacting you about settling your worker’s compensation claim, and you are confused or simply want an opinion about your options, contact us and we can evaluate your situation to try to help you determine your options. Call 1-866-900-7078 any time, 24/7.
3 Visit www.usnews.com for more information about criteria for inclusion.