One of the questions we often hear from injured workers is whether they should accept what the workers’ comp insurance company is offering to pay them, based on a rating of the injured person’s body part or parts.
That’s a good question. The answer can often depend on your unique circumstances. And sometimes on how much a doctor knows about North Carolina Industrial Commission (NCIC) ratings guidelines. We had a case a while back that illustrates this point.
A hip replacement is generally considered to be worth a 40% rating, according to NCIC guidelines. Surprisingly, not all doctors know about these NCIC guidelines. One doctor who did not know about the NCIC guidelines gave our client a rating significantly below 40% for a hip replacement. We sent the client for a second opinion with a knowledgeable doctor who assigned the more appropriate rating of 40%.
Just about every body part that you can imagine is named in the Workers’ Compensation Act, and is given a value in weeks of compensation. Here’s an illustration of hand, arm, leg, eye, hearing, and foot injury ratings, according to the North Carolina Industrial Commission (NCIC) ratings guidelines. (It is interesting, and in my opinion somewhat disturbing, to know that every finger on your hand has a value.)
NCIC Payments for Various Body Parts
|First or index finger||45 weeks|
|Second or middle finger||40 weeks|
|Third or ring finger||25 weeks|
|Fourth or little finger||20 weeks|
|Hearing (one ear)||70 weeks|
|Great toe||35 weeks|
|Hearing (both ears)||150 weeks|
|Any other toe||10 weeks|
Whether You Should Settle Depends on Your Circumstances
Many people contact us with questions about whether they should settle based on a rating, and the answer to that question will vary depending on your circumstances. Here are some of the things we consider:
- Do you intend to continue working with the employer where your injury occurred?
- Are you receiving a weekly check from the workers’ compensation company?
- Do you have a substantial need of medical treatment?
- Have you undergone a functional capacity evaluation, and has your employer offered you employment that is appropriate for your injury?
- Have you been informed about your rights to file a Form 18M (an Employee’s Application for Additional Medical Compensation)?
- Is the impairment rating given by the doctor (often chosen by the insurance company) reasonable in light of your injury?
- Would you benefit from a second opinion by another doctor that is agreed upon by both you and the insurance company, and is paid for by the insurance company?
When You Settle Your Workers’ Comp Claim
The first step to resolving a case based solely on an impairment rating is by signing a Form 26A. A Form 26A is an employer’s admission of the employee’s right to permanent partial disability to a body part or parts. We urge you to contact an experienced workers’ comp attorney before settling on a rating. You simply don’t know what you don’t know. One recent case comes to mind that illustrates this point.
We represented an injured worker who enjoyed her job and was looking forward to going back to it.3 The workers’ comp insurance company stood in the way of that goal however. Its guidelines for a full settlement of the claim stated that you must also resign from the company where you were working when you got hurt. Our client did not want to resign. So she decided to settle based on a rating alone. This would not have been in her best interest, so we embarked on extensive research that uncovered a gold nugget of information, which subsequently favored our client. Because of this new information, our client received much more than she would have otherwise based on her rating alone.1 And she got to go back to a job she loved!
N.C. Workers’ Comp Lawyers Offer Free Case Evaluation
Case evaluations are free. Furthermore, we work on a contingency basis, which means if we don’t get you compensation, you don’t owe us an attorney’s fee.2 We urge you to contact us if you are considering settling based on a rating – or settling period.
P.S. There are lots of good N.C. workers’ comp attorneys you could choose from. Here are five important reasons we believe you should consider hiring us.
3Client identity has been removed or changed to protect client’s privacy.