After a serious injury on the job, many people may assume that they will be able to return to their life as it was prior to the injury. They may believe they will be able to regain their health 100%, keep their same job, and live relatively symptom free. And they may be tempted to rush the process and either negotiate a settlement on their own or accept an early settlement offer from the insurance company. For most workers’ comp cases, I usually advise against these two courses of action.
Your Employer May Want You to Settle Your Workers’ Comp Claim
History tells us the reality is often much different when there is a significant trauma or a serious injury that requires an extended period of time to recover. People are often surprised to learn that:
- employers may not be obligated to hold their jobs until they reach a full recovery
- doctors may not let them return to the type of work they performed prior to getting hurt
- doctors may release them to return to “full duty” or work with “no restrictions” when their injuries prevent them from doing their regular job duties
What comes next for many of these injured workers can be even more surprising. They are often contacted by the insurance company or their employer about settling their workers’ compensation case.
However, even if things have been going smoothly up to this point (benefits have been coming in regularly, medical treatments have been paid on time), there is no guarantee that the employers’ interests are aligned with what’s best for their employees when it comes time to settle.
Can the Court Make Me Settle My Workers’ Compensation Case?
The court, which is the North Carolina Industrial Commission in workers’ compensation claims, cannot make parties settle a claim. The law does not require an injured worker to enter into an agreement to resolve their case. So why, then, do insurance companies and employers sometimes put pressure on injured workers to close out, or settle, a workers’ comp claim? They may instead be looking to end their exposure as quickly as possible.
As a basic rule, a settlement is a complete end to a worker’s rights for further workers’ compensation benefits. This means the insurance company would not have to pay for any further medical care or benefits, even if an employee cannot return to work due to the injury.
I strongly urge you to have legal representation when negotiating a workers’ comp settlement.
Do I Need a Lawyer to Settle My Workers’ Comp Claim?
Based on my experience, the goal of many insurance companies when settling is to try to reduce their liability to the injured worker to as little money as possible. If you have been injured at work and don’t have legal representation fighting for you – someone who knows workers’ comp laws and its many interpretations and nuances – this could mean you’ll be left without adequate health care protection.
We’ve seen situations where people have settled workers’ compensation cases on their own, not realizing the long-term consequences, and have put their entire family in a downward financial spiral. And we’ve heard of others being left without enough money to cover their living expenses until they can find another suitable job.
When Is a Workers’ Compensation Settlement the Best Option?
There are times when an injured worker may benefit from a workers’ comp settlement. It may allow them to move on from a difficult work situation. It can take away the uncertainty of a court result. It may allow an injured worker sufficient resources to get treatment on their own without dealing with the insurance company’s doctors. It can also give an injured worker sufficient resources to pursue training for a new occupation. Under these circumstances, settlement can make sense for the injured worker if the settlement is fair.
If you are approached by an insurance company or employer with an offer to settle your claim, we urge you to question whether it is fair and in your best interest. At my firm, we provide a free case evaluation (with no obligation to hire us). I encourage you to give us a call at 1-866-900-7078 before you accept a settlement offer.
Is the NC Industrial Commission Looking Out for the Injured Worker?
The purpose of the workers’ compensation system is to help restore an injured worker as near as possible to their pre-injury earning capacity – both medically and in terms of actually returning to a job. The NC Industrial Commission administers the Workers’ Compensation Act with a mission of ensuring that all parties are treated fairly and equally in accordance with NC law. This is not the same thing as making sure that injured workers get what they need or deserve. The law also places the burden on the injured workers to prove their entitlement to benefits.
The insurance company and employer may tell you that the NC Industrial Commission has to approve a settlement and will determine whether the settlement is fair and in your best interest. While this is technically true, read on to learn of some of my experiences working at the NC Industrial Commission.
My Experience Working at the NC Industrial Commission
I worked as a Special Deputy Commissioner at the Industrial Commission prior to joining James Scott Farrin as a workers’ compensation attorney. I often approved settlement agreements in which an injured worker did not have an attorney and accepted the employer’s settlement offer. My responsibilities were not necessarily to ensure that the injured worker got the best deal, but instead, to see that they received at least the minimum required by law.
There were certainly times when I sent a proposed settlement agreement back to an insurance company and injured worker indicating that I could not approve the settlement as being fair because the amount was too low. But even in those cases, I could not tell the parties what I thought a reasonable amount was.
More importantly, I could not tell injured workers whether I thought they were getting everything they may have been entitled to under the Workers’ Compensation Act. People sometimes accepted settlement amounts that did not consider:
- their future medical needs
- how long it would take them to find new jobs
- whether they needed money for retraining
- how to make up future lost wages
So what seems like a fair settlement to the injured worker may actually be a bargain basement deal for the insurance company.
What Laws Protect Me If I Am Injured at Work?
While North Carolina’s workers’ compensation laws provide some protection, a workers’ compensation lawyer who thoroughly understands these laws may be needed to help ensure that you are adequately and properly protected.
For example, you may not be able to return to the type of job you had before you got hurt. The law states that consideration must be given concerning the possibility for re-training, further education, or vocational rehabilitation before injured employees return to a job suitable to their new restrictions.
North Carolina workers’ compensation laws make these and other services available to injured workers if they cannot return to their pre-injury position. When negotiating a settlement, a skilled attorney takes into account:
- permanent work limitations and/or restrictions that could impact a worker’s ability to return to work full-time
- retraining, education, and job rehabilitation benefits
The law also states that you are allowed to obtain a second opinion with a physician of your choice. If you need further treatment, you can apply for medical care even if the doctor your workers’ comp insurer sent you to releases you from medical care. An experienced workers’ comp attorney knows the value of involving doctors who are able to adequately explain any future complications you may face because of your injuries. Without this type of medical opinion, there is often no way to receive compensation for those potential future medical needs.
How a Second Medical Opinion May Help Your Workers’ Comp Case
Let’s say you injured your knee at work. The doctor your insurance company sends you to may treat your current injury and release you from further treatment. As your attorney, I may advise you to seek another opinion from a doctor of your choosing.
This other doctor (the one you chose) may point out that your injury has made it more likely you will need a knee replacement at some point in the future as a result of your work-related injury. This could be a surgery that workers’ compensation insurance would be responsible for covering – whether that replacement occurs two months after the initial injury or two years.
Insurance companies might suggest that you get a second medical opinion. But they might also tell you which doctor you should see – sometimes without seeming regard for whether the doctor has the expertise you may need. I know of a situation where an injured worker had a severe wrist injury, an operation which resulted in an extended healing period. She wanted a second opinion, and the workers’ comp insurance company sent her to an allergist!
How Can an Attorney Help Me Settle My Workers’ Compensation Claim?
If you are considering settling your claim or have been contacted about settling your workers’ comp claim, we strongly urge you to have an experienced North Carolina workers’ compensation attorney review your case to determine whether thorough consideration has been given to the complexities of your injuries and their impact on your ability to return to work at your same wages.
A settlement for a discounted amount could leave you and your family facing long-term financial difficulties if your interests were not adequately addressed by the insurance company or protected by an experienced workers’ comp lawyer.
When Is the Best Time to Settle a Workers’ Comp Claim?
Every case is unique, of course, but often it makes the most sense to settle after your major medical treatment is done. I advise you to be wary if your employer or the insurance company seems to be pushing you towards a premature settlement – that often is in their best interest and may not be in yours.
Our Workers’ Comp Lawyers Have Clients’ Best Interest at Heart
As a North Carolina State Bar Board Certified Specialist in Workers’ Compensation law representing injured workers at the Law Offices of James Scott Farrin, I try to look out for all of my clients’ potential needs. In fact, that is one of the most important aspects of my role as an attorney – to make sure I try to consider and address each and every need in settlement negotiations.
Before advising our clients, our workers’ compensation attorneys strive to have a comprehensive understanding of:
- our clients’ medical conditions
- the injury’s impact on work abilities
- the local job market
This sometimes means trying to obtain a second opinion to provide a comprehensive overview of our clients’ medical conditions. We also often calculate varied cost projections on medical and disability exposure. And we consider all the various types of workers’ comp benefits that may apply. We do not want any of our clients to enter into a settlement agreement unless they feel that it makes economic sense and is in their best interest for their future health.
Why Choose Us When It Comes to Workers’ Comp Settlements?
There are many good workers’ comp lawyers here in North Carolina. So why us? Here are five heartfelt reasons that don’t have a lot to do with fancy credentials and memberships in organizations or affiliations. Here are reasons to choose our workers’ compensation team that do have to do with credentials and memberships in organizations or affiliations. We think both of these are important to consider.
James Scott Farrin Offers Free Workers’ Comp Case Evaluations
If you are contacted by an insurance company about a workers’ compensation injury settlement, we urge you to contact us or call 1-866-900-7078. We offer a no-cost case evaluation regarding your claim. It may be that the insurance company is being fair with you. We have seen that happen – although it shouldn’t be relied on, in our experience. That is why I hope you take the time to give us a call so you can make that decision for yourself.