Category: North Carolina Workers Comp

What Is the Average Workers’ Comp Shoulder Injury Settlement?

Posted on by Ali Overby

Getting injured at work can be painful and overwhelming. Shoulder injuries in particular can affect your productivity while also being very uncomfortable. If you’re entitled to a lump sum workers’ compensation settlement from your employer’s insurance company, you want to make sure it’s a fair one. So, what’s the average shoulder settlement in workers’ comp?

How much you can expect to receive from a possible shoulder injury settlement is more difficult to answer than it may seem. In this article, I’ll draw on my experience as a workers’ comp attorney to explain why. I’ll also lay out the factors that can contribute to determining your potential shoulder injury settlement amount.

For a free case evaluation with no obligation, call 1-866-900-7078 today!

The “Average” Workers’ Comp Settlement Amount Is Meaningless for Your Case

Your possible settlement amount is based on the workers’ compensation benefits you may receive for your shoulder injury claim. If approved, workers’ comp benefits generally consist of:

  1. Medical benefits: to cover all past and ongoing medical expenses arising from your injury.
  1. Wage loss benefits: to help make up for your lost income while you’re unable to work.
  1. Impairment rating, if applicable: Your treating physician may assign an impairment rating to your injured body part once you reach maximum medical improvement (MMI).

Each state determines workers’ compensation settlements in its own way. But even if we limit the discussion to just North Carolina and South Carolina, there’s no “average” settlement value for your shoulder injury because each detail can make a world of difference.

Said another way, several factors go into determining workers’ comp settlement amounts, and what you may be owed completely depends on the unique circumstances (and sometimes the smallest detail) of your case.

They include:

  1. Your average weekly wage (AWW) based on the 52 weeks prior to your injury
  1. The severity and location of your injury
  1. Your medical needs
  1. Any permanent disabilities that remain after you’ve reached MMI

 
Workers' comp benefits generally consist medical & wage loss benefits and impairment ratings.
 
There’s no judge or jury to decide how much you may receive according to any objective criteria – that’s yet another reason why it’s so difficult to calculate an average workers’ comp settlement amount. The number should be negotiated between you and your attorney and the workers’ compensation insurance company – both sides must agree or there’s no deal.

Did You See These Numbers Online?

We’ve seen some websites offer average workers’ comp settlement amounts based on uncertain criteria. One common amount that often appears online is around $20,000 per case, plus or minus a few thousand dollars. Another number we’ve encountered refers to data from the National Safety Council and is nearly $40,000 per case.

However, this information might give you the wrong idea about what your possible settlement amount could be for your individual case, so it’s best to approach these numbers with at least some skepticism. The amount you ultimately may receive could be in the $20,000 to $40,000 range – or significantly more or less.

How the Call Gets Made for How Much You May Get Paid

After you’ve suffered an eligible injury at work in North Carolina or South Carolina, your employer’s workers’ compensation insurance provider appoints the doctor who’ll provide treatment. The insurance company will then pay the cost of all authorized medical expenses that arise.

Since your treatment and how your body responds to it are unique to you, the settlement amount you may receive for ongoing and future medical care depends on the costs associated with the treatment the doctor recommends.

The next piece of the settlement puzzle is possible wage loss benefits to make up for the time you’re unable to work. These benefits are based on two-thirds of your Average Weekly Wage. For example, if you made $60,000 annually, your AWW would be approximately $1,153 (60,000/52 weeks) and so your wage loss benefit amount could be about $769 (.667 X $1,153).

Here’s the point where figuring out your possible settlement amount can get even trickier. How long you can receive wage loss benefits is based on how much the injury prevents you from working. Specifically, what your authorized doctor has to say about how the injury prevents you from working.

To summarize, if you have an eligible injury, these are some (but not all) of the factors that may go into determining your possible final settlement amount:

  • Medical expenses
  • Type of injury
  • Severity of injury
  • Scarring or disfigurement
  • Location of the injured body part(s)
  • Impairment rating
  • Permanent work restrictions
  • Your average weekly wage (AWW)
  • Your work history
  • Your education level

 
A construction worker with a hurt shoulder, with a list of possible factors that could affect your final settlement amount.
 
Heads up! Once a claim is settled and approved, it likely can’t be reopened. If the amount you settled for is inadequate, you may have no other options. That’s why it’s important to discuss your case with an experienced workers’ compensation lawyer before you agree to anything.

Get a free case evaluation of your shoulder injury workers’ compensation claim. Contact us online or call 1-866-900-7078 today.

The Doctor’s Role in Determining Your Possible Shoulder Injury Settlement Value

What type of treatment you get and are prescribed going forward, as well as your permanent work restrictions and impairments after reaching Maximum Medical Improvement, play an enormous rule in what you may be owed in a settlement. Each of these elements is determined by your doctor – who is chosen by your employer’s workers’ compensation insurance company.

Once you’ve completed your treatment for your shoulder injury, the doctor will indicate whether you have any permanent work restrictions (such as: cannot lift more than 50 pounds) and assign an impairment rating from 0-100 to indicate your shoulder’s level of permanent disability.

If you’re not happy with the insurance company’s doctor for any reason, you can seek a second opinion, and an experienced workers’ comp lawyer can help. Contact a workers’ comp attorney as soon as possible if you feel you’ve been given an inaccurate diagnosis, inadequate care, or have been cleared to go back to work too early.

In one case, I had a client whose first doctor cleared him to work before he felt he was ready. He got a second opinion from a doctor who said he was still injured and needed to continue treatment. In that case, the insurance company simply accepted the second opinion without objection. Knowing how and when to request a second opinion can be important leverage in your case.1

How a Workers’ Comp Shoulder Settlement Amount Might Be Determined: An Example1

To give you an idea of how a shoulder settlement might work in the real world, let’s consider the following hypothetical situation:

Jennifer, who makes $60,000 a year, hurts her shoulder one day while on the job in North Carolina. She successfully applies for workers’ compensation benefits and receives treatment. While she is out of work due to her injury, she is paid benefits of about $769 per week (2/3 of her average weekly wage of $1,153.85).

After following her doctor’s recommendations and finishing her treatment, she learns that she now has permanent work restrictions which prevent her from being able to do her old job. The doctor also assigns her shoulder an impairment rating of 40% and says she’ll need 12 sessions of physical therapy as well as ongoing steroid injections, hydrodilation, and shoulder manipulation at the hospital.

After discussing her situation with her workers’ compensation lawyer, Jennifer decides to settle her claim for a lump sum based on the following criteria:

  • Value of the impairment rating – In North Carolina, a shoulder is worth up to a maximum of 240 weeks of pay at two-thirds of your Average Weekly Wage. Jennifer received a 40% impairment rating for her shoulder.

40% of 240 weeks = 96 weeks of benefits, at a rate of about $769, which equates to about $73,824. But before Jennifer agrees to a settlement at that amount, her attorney wants to investigate anticipated lost wages in the future.

  • Future lost wages – This is an estimate of the length of time the insurance company might have to pay for Jennifer’s benefits before she finds a new job with the work restrictions from her injury.

Jennifer’s attorney estimates that it will take her two years to find another job that can accommodate her work restrictions. In Jennifer’s case, this equates to about $80,000. Because this amount is higher than the value of the impairment rating ($73,824), Jennifer should pursue a settlement based on the future lost wages number.

  • Future medical treatment – based on Jennifer’s need for physical therapy and ongoing steroid shots, hydrodilation, and shoulder manipulation within a hospital setting, her attorney estimates future medical treatment costs of approximately $12,000.

Jennifer’s estimated total workers’ comp settlement value1: $92,000

Avoid These Pitfalls That Can Reduce Your Possible Shoulder Injury Settlement

When you injure your shoulder on the job, these pitfalls can result in the reduction or denial of workers’ comp benefits and your possible settlement:

  • Being unprepared to deal with the insurance company: Your employer and their workers’ compensation insurance company are protecting their interests, not yours. An experienced workers’ compensation lawyer will deal with the insurance company for you and knows how to counter delay and deny tactics.
  • Failing to seek or follow medical treatment: Following your doctor’s orders isn’t just important in helping you recover from your shoulder injury, it’s also crucial to your case for compensation for two reasons:
    1. It shows that your shoulder really is badly injured and that you’re doing everything you’re supposed to do to recover and get back to work.
    1. It creates a well-documented paper trail of medical expenses that you can use to try to demonstrate your need for maximum compensation.
  • Not organizing your medical records: Along with completing medical treatment, it is also crucial to keep all your shoulder injury medical records together. Failing to do so could mean that you miss out on receiving all the compensation you may deserve for your medical treatment.

 
Avoid these pitfalls that may reduce your shoulder injury settlement.
 
We’ve helped numerous clients avoid these pitfalls and maximize their workers’ compensation settlement amounts.1 Speak to an attorney when you’ve been injured at work. Even if you have a good relationship with your employer and you trust them to do the right thing, their insurance company generally makes more profit by paying out less.

If you’ve been offered a settlement from the insurance company and don’t have an attorney, please get a free case evaluation before you agree to anything. Even if you’ve experienced one of these pitfalls, we may still be able to help you. Call 1-866-900-7078 now.

How a Workers’ Compensation Lawyer Can Help with Your Shoulder Injury Claim

An attorney can significantly increase your odds of success by:

  • Guiding you and being your advocate every step of the way
  • Leveling the playing field with the insurance company, who do this every day
  • Fighting for every dollar you may be owed

 
Ways in which an attorney can significantly increase your odds of success.
 

Find Out What Your Case Is Really Worth

The workers’ compensation team at James Scott Farrin includes attorneys with “other side” experience working for insurance defense firms. We understand what motivates insurance companies and how to negotiate with them.

My firm was named to the U.S. News 2023 list of “Best Law Firms,” with a Tier 1 ranking – the highest – for workers’ compensation.3

The Law Offices of James Scott Farrin received 4.8 stars out of more than 3,000 reviews.

Contact the North and South Carolina workers’ compensation lawyers at James Scott Farrin today for a free evaluation of your shoulder injury case. You can reach us online or by calling 1-866-900-7078 right now.

 

Frequently Asked Questions



Is my settlement in workers' comp determined by an FCE?

A Functional Capacity Evaluation can help your doctor determine if you’re ready to go back to work and what restrictions you might have. It involves performing a series of physical tests to determine your ability to work.

Your FCE can be a significant factor in determining your possible settlement amount, but is not the deciding factor, nor is it used in every case. If you’re asked to take an FCE and don’t already have an attorney, get a free case evaluation before you do anything.

Does surgery increase a workers' comp settlement?

If you needed surgery to treat a work-related injury, this can increase the overall amount of your potential workers’ comp settlement. Authorized medical expenses, including surgical procedures, should be wholly covered by workers’ compensation.

When will workers' comp offer me a settlement?

Workers’ compensation settlements occur when all parties reach an agreement. Each case is unique, and the length of time it takes a case to resolve can depend on how long treatment lasts. While there is no absolute limit to the amount of time a case can last, in my experience, it’s uncommon for cases to go beyond 18 months without resolution.

How long do I have to file a workers’ comp claim?

There are some deadlines you need to be mindful of when you prepare to pursue your workers’ compensation claim:

  1. You need to inform your supervisor in writing within 30 days of the incident.
  1. You need to file your claim within your state’s statute of limitations for workers’ compensation claims. The statute of limitations in North Carolina and South Carolina is generally two years, but the sooner you file your claim, the better. The longer you wait, the more compensation you may be losing out on.

Safe to Give Recorded Statement to Workers’ Comp Adjuster?

Posted on by Josh Smith

What a lot of clients are surprised to learn when they come to us is that sometimes the insurance company who is supposed to help when you are sick or injured on the job, may use your words against you to deny benefits.

Sad, but true.

I’m referring to one of the first moments of truth an injured worker faces after an injury – the recorded statement.

Seems innocent enough, you reason. I’ll just tell them in my own words what happened. Tell the truth, you think. Think again. The words you use can (and often are) used against you by the very entity you expect to help you in your time of need.

Farrin doesn't allow recorded statements without guidance. We won't allow unfair, leading, or inappropriate questions.

What Is a Recorded Statement?

The recorded statement is an approach the insurance company uses to investigate your workers’ compensation claim to determine if they will accept or deny your claim.

One of the very first things the insurance company often does after you report an injury is to proceed with a recorded statement.

Most insurance companies are looking to pay you as little as possible. A James Scott Farrin workers’ comp attorney can deal with the insurance company for you.

 

What’s Wrong With Giving a Recorded Statement?

Based on our experience, you need to know a few things about the recorded statement:

    • The questions can sometimes be asked in such a way as to give the insurance company ammunition they may need to deny your claim.

 

    • If you don’t agree to a recorded statement, your claim may very well be denied because the insurance adjuster could potentially argue that you refused to cooperate with their investigation. And as a result, there was insufficient information with which to make a determination.

 

    • The insurance adjuster most likely already knows more about your case then you suspect.

 

    • The insurance adjuster has a better understanding of North Carolina workers’ compensation law than you.

 

If you agree to give a recorded statement, proceed with caution. A wrong answer could damage your case and result in denying you benefits.

How Might an Innocuous Statement Hurt Me?

“I’m fine, thank you”

Let’s say you recently suffered a traumatic injury at work. The adjuster calls and states that the call will be recorded. You acknowledge that. After that, the adjuster might start the recorded statement by asking something like “How are you today?”

Naturally, it is good old-fashioned common courtesy to give a rhetorical response along the lines of “I’m fine; thank you.” or “I’m doing OK today.” However, your response may not be considered rhetorical to the adjuster. It’s gospel! The adjuster could very well take those words to mean that you really are fine and the traumatic injury you reported was not that traumatic after all.

“Nothing unusual“

Some workplace injuries do not fall under the protections of our state’s workers’ compensation laws – and insurance companies are keenly aware of this. Let’s say, for example, you injure your arm after lifting a box at work. If lifting a box is a normal part of your job then there’s a good chance the injury will not be compensable.

During the recorded statement the adjuster might ask “What happened?” They already know your likely answer will be, “I injured my arm lifting a box at work.” The next question might be “Did anything unusual happen?”  You might think the insurance adjuster is asking if there was a fire, a power outage, maybe an equipment malfunction – something out of the ordinary. Those seem like unusual events to you. But what the insurance adjuster may really be asking is a very pointed question that could potentially be designed to steer your claim toward a quick denial.

Let’s go back to the injury sustained while lifting the box. “Unusual” by their definition might mean that this particular box was heavier or lighter than other boxes. Or perhaps the box slipped from your grasp and your arm was injured as you tried to save it from crashing to the ground. This is very important information that injured workers may not consider “unusual.” And it is something that could potentially help your case. The adjusters know this! And we know they know it.

Our NC Workers’ Comp Lawyers Help With Recorded Statements

The recorded statement is almost always taken over the phone, often because people that participate in the recorded statement live in different cities and states. We find that’s a disadvantage to you because the insurance adjuster does not have the opportunity to view you physically to see, firsthand, the difficulties you are experiencing as a result of your workplace injury.

Instead, the insurance adjuster will have to rely on what you say in response to the well-crafted questions they ask you.

If your case is denied because you would not offer a recorded statement, you need to immediately contact an experienced workers’ comp attorney to pursue your case and to try to ensure that your rights are protected. By understanding what information the insurance company wants to obtain, we can better equip you to provide honest responses that may reduce the likelihood of your case being denied. We can not only prepare you for the recorded statement, we can also be present with you during your statement to try to ensure your rights are protected.

TIP! As a general rule, experience has taught us the best plan of action when you are asked to give a recorded statement is to immediately contact an experienced workers’ comp attorney.

Get a FREE Evaluation From an NC Workers’ Compensation Lawyer

Not only do we have many experienced workers’ comp attorneys who deal with these issues every day, we have six North Carolina Board Certified specialists in workers’ comp law. And we have a number of team members who used to work for the insurance companies – and two who worked at the NC Industrial Commission! So we have a pretty good bead on their game.

Before you proceed with a recorded statement, contact us or call us at 1-866-900-7078. If the insurance company isn’t there for you in your time of need, we will certainly do our best to try to help. Call us anytime 24/7.

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You May Also Be Interested In

3 Ways Your Workers’ Comp “Recorded Statement” Can Trap You

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Management Has More Influence on Number of Workplace Injuries, Study Says

Posted on by Law Offices of James Scott Farrin

s or haven’t followed samale manager of a company sits at a desk with hands claspedWorkers can often be blamed for their injuries on the job. Employers may assume that they have been careless or haven’t followed safety protocols. Yet, according to a new study by the University of Georgia, it turns out that upper-level management may have much more influence on workplace safety and the rate of workplace accidents.

The study – published this month in the Journal of Safety Research – found that when management fostered the perception of a positive safety climate among employees, the number of workplace injuries went down 32 percent. Day-to-day practices were more influential than written safety protocols.

When employees felt that a company ran smoothly and that there were minimal constraints on their performance, the injury rate dropped as much as 38 percent, the study found.

“Injury is a failure of management,” said study co-author Dave DeJoy, a professor of health promotion and behavior at UGA. “Organizations who blame individuals for injuries do not create a positive safety climate.”

The study, co-authored by DeJoy and recent doctoral graduate Todd Smith, is one of the first to examine the perceptions of workplace safety climate among a diverse sample of occupations and workers.

Work-Life Balance

In addition to the culture of workplace safety that employers establish, an imbalance between work and family life was also found to affect the rate of workplace injury. The study found that when workers felt that their work life was interfering with their family life – or vice versa – the rate of injuries rose 37 percent.

“We used to think work was one thing and family was another, but now there is a realization that work-life balance affects performance and productivity,” DeJoy said.

The study looked at nine factors that may influence workplace safety: relations between management and employees, safety climate, the effectiveness of the workplace, type of work, the potential for promotion or other advancement, the adequacy of resources, employee work-life balance, support provided by management, and worker participation. The study also considered the ethnic background of workers.

To see the full study, visit sciencedirect.com.

North Carolina Workers’ Compensation Lawyers

The study shows how important it is for employers to create a positive safety culture for employees – one that doesn’t just put safety measures in place but that actively promotes the importance of safety. If you or a loved one has been injured on the job, you may be able to receive compensation for your injuries. Contact the Law Offices of James Scott Farrin for a free and confidential evaluation of your case.

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