Workers Compensation: What to Do If You’ve Been Given an Offer to Settle

Workers’ Compensation in North Carolina is not easy to understand or navigate. There are about 60,000 claims filed every year. Some of these claims result in a worker getting the treatment they need and going back to their regular job, in some cases, even if they have permanent damage because of their injuries. In other cases, it may be difficult or impossible to return to the same job. Before accepting any settlement offer, it is critical to contact an experienced workers’ comp lawyer as soon as you can to learn what your rights are and whether you are being given a fair offer.

In this blog, you will learn answers to these questions:

• What should an injured worker do if they have been asked to settle?
• How soon will the first settlement offer arrive?
• What are the risks of accepting a low initial settlement offer?
• Can an employee reject a worker’s compensation settlement offer?
• What is the statute of limitations for worker’s compensation in NC?
• How do I pay for a worker’s compensation attorney?

Below is more information on what to do when you receive a worker’s comp settlement offer.

How soon will the first settlement offer arrive?

It really depends on you and how your recovery goes. Most of the time in cases where the insurance company accepts your claim and pays for medical treatment and/or lost wages, the carrier will wait until you reach Maximum Medical Improvement (MMI). MMI is the point in the case where the doctor says you are as good as you can get from a medical standpoint.

Most of the time, when you get to MMI, a doctor will give you a “disability rating” which can be calculated into a monetary award. Once you get a rating, the insurance company will likely send a Form 26A for you to sign to get this money. What the insurance carrier WILL NOT tell you is that by signing this Form, you are potentially giving up a lot of money as it relates to your workers’ compensation claim. If you get a Form 26A from an insurance company, DO NOT sign it until you have spoken with an experienced workers’ compensation attorney. An experienced lawyer can double and even triple settlement numbers beyond what was offered on Form 26A. Consultations at many firms are free, and if the lawyer determines the offer is fair, you should be told so and not charged a dime.

In other cases, an insurance adjuster may offer you a lump sum of money called a “clincher agreement”. These agreements completely end your workers’ compensation case, and the insurance company will no longer be responsible for your medical care or lost wages after the agreement is approved. Plenty of cases settle this way, and it can be the best option to settle. That being said, there is a lot of information to consider, including lost wages, the value of future medical treatment, the potential for job retraining, prescription costs, medical equipment, and even potential things like home modifications and attendant care. An experienced workers’ compensation lawyer will know how to maximize the value of your claim and get you the best results.

There are also times when the insurance company completely denies your claim and will not offer you anything. If this does happen, DO NOT give up! Many times, a claim will be denied because it is a “close call” whether or not the insurance company should be responsible for your claim. Other times, the insurance company is just flat out wrong. An experienced workers’ comp attorney will know how to explain the law to the insurance company and push them to settle the claim or go to a hearing where a deputy commissioner will make a decision about who is responsible.

The risks of accepting a low initial settlement offer

When you receive your first settlement offer, you may be very tempted to accept it, in order to “close the chapter” on your injury and move on with your life. However, this would be a big mistake and why you need the expertise of an injury lawyer. Your injuries may turn out to be much worse, or more complicated, than they initially feel following the accident. It might take weeks or months for certain symptoms to manifest. Even if the full extent of the injury is assessed correctly, there may be complications during recovery—like an infection—that prolong the pain and discomfort.

As discussed above, whether the case is settled by a “clincher agreement” or any kind of Form Agreement, an injured worker will relinquish some or all of their rights as it relates to their work injury. Therefore, it’s important not to accept an offer without the guidance of an expert attorney to make sure that you fully understand how serious your injury is; how long it will take to recover; and how it will impact all areas of your life for the weeks, months, and years ahead.

Can an employee reject a worker’s compensation settlement offer?

Yes! Insurance companies often present settlement offers as “now or never” agreements, which the victim must accept, or else receive nothing at all. However, as noted above, a settlement offer is the beginning of a negotiation process, not an end. You are fully within your rights to reject a claim or make a counteroffer for higher compensation. Your attorney will handle the necessary negotiations and paperwork for you.

Basic steps in a worker’s comp settlement negotiation

While every worker’s compensation settlement negotiation will vary, here is a simplified outline of what you can generally expect:

1. Your worker’s compensation attorney will send a demand letter to the insurance company with the amount that you seek for settlement.
2. The insurance company may agree to meet the demands or make a counteroffer of its own.
3. The two parties will continue this process until an agreement is reached. There is no set time table as to how fast a case can settle once negotiations start. It may take days or months to get the insurance company’s best offer.
4. Your attorney will submit the agreed-upon settlement terms to the N.C. Industrial Commission—our state’s governing authority for worker’s compensation—for final approval.
5. Once the Industrial Commission approves the settlement, they will enter an Order and the insurance company will then cut the settlement checks.

What is the statute of limitations for worker’s compensation in NC?

Another key thing to understand before you accept or reject a worker’s compensation offer is the statute of limitations or the legal deadline by which you must settle your claim or file a lawsuit. North Carolina is a little unusual here. Officially, there is no actual “statute of limitations” for workers’ compensation claims. That being said, the Industrial Commission forecloses jurisdiction over a claim if it is not filed within two years from the date of the injury. You can call it what you want to, but the bottom line is that you will lose your right to recover compensation for your injuries if you don’t file the claim quickly. In addition, there is a law that states that an injured employee “shall immediately ” give written notice of the accident to the employer. Failure to give proper notice could result in losing all benefits to which you may be entitled.

Make absolutely sure that you tell your supervisor that you got hurt, put it in writing, keep a copy for yourself, get to the doctor, and then call an experienced workers’ comp lawyer for help.

How do I pay for a worker’s compensation attorney?

If you are still reading this article, you are probably strongly considering hiring a worker’s compensation lawyer in Sanford, NC—but are worried that you will not be able to afford the legal costs involved. However, laws surrounding worker’s compensation are designed to ensure that everyone, regardless of financial status, can receive the compensation to which they are entitled. Attorneys who represent injured workers accept cases on a “contingency fee” basis, meaning that their payment will be a percentage of whatever settlement amount is won. If the case is unsuccessful, you may have to reimburse your lawyer for legal expenses that were incurred during the case (like filing fees, for instance), but you will not have to pay the attorney’s fee.

Be aware, too, that the legal fees attorneys may charge for handling workers’ compensation must be approved by the NCIC. This means that most NC workers’ compensation attorneys charge the same customary percentage contingent fee (25% of any settlement or award). Therefore, you should focus on hiring an attorney based on his or her reputation and experience rather than costs. Your lawyer will have a strong incentive to obtain the maximum benefits possible for you, as a percentage will go to him or her.

Finding a workers’ compensation lawyer in Sanford, NC

If you have sustained a workplace injury and are searching for a workers’ compensation attorney in Sanford, NC, the law office of Wilson, Reives & Doran is here to help. Our experienced Sanford personal injury and workers’ compensation lawyers have helped hundreds of clients receive the compensation they deserve, and we are here to guide and support you, too. We are offering all interested parties a free legal consultation in which we will assess your case, inform you of your options, and help you decide what to do next. To set up your free consultation, please contact us here or call us at (919) 928-5839.