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How Much is a Workers’ Compensation Settlement?

How Much is a Workers’ Compensation Settlement?

Workers in North Carolina have two options when it comes to receiving workers’ compensation benefits. The first (and most common) option is to have medical expenses covered as they arise and to receive weekly payments for disability benefits (for those who qualify).

The second option is to settle the workers’ compensation claim for a one-time lump-sum payment. Negotiating a settlement can be beneficial for a variety of reasons, as long as you know how much you are entitled to recover.

So, how is a workers’ compensation settlement calculated in North Carolina?

The workers’ compensation law in North Carolina entitles eligible employees to two main types of benefits: medical and disability. When calculating an appropriate settlement value, it is necessary to approach each type of benefit separately.

Calculating Medical Benefits in a Workers’ Compensation Settlement

Medical benefits cover the cost of diagnosing, treating, and recovering from a job-related injury. Injured employees who are eligible for workers’ compensation are entitled to receive medical benefits until they either fully recover or reach maximum medical improvement (MMI). An injured employee is considered to have reached MMI if additional treatment and/or therapy is no longer effective in improving their condition.

When calculating a settlement, it is critical to have a comprehensive understanding of your medical needs. In this regard, it is important not to rely solely on the advice of your employer’s designated healthcare provider.

Unfortunately, this provider won’t necessarily have your best interests in mind. Instead, the provider may be more focused on getting you back to work as quickly as possible (and at the littlest cost for your employer), even if this means sacrificing certain aspects of your recovery.

What Do Your Medical Benefits Cover?

Generally speaking, a workers’ compensation settlement should include an amount that is sufficient to cover your medical expenses now and in the future. This amount should be separate from your disability benefits.

By working with your providers, a workers’ compensation lawyer can calculate an appropriate medical benefits settlement that covers your:

  • Medical appointments
  • Diagnostic testing (i.e., X-rays, ultrasounds, MRIs, lab work, etc.)
  • Surgical procedures
  • Physical therapy
  • Vocational rehabilitation
  • Other forms of treatment
  • Medical supplies and medical devices
  • Prescriptions

As you can probably imagine, these costs can add up quickly. With this in mind, it is important not to rush the settlement process. In fact, until your doctor can provide a comprehensive assessment of your long-term medical needs, you should not consider any offers to settle your workers’ compensation claim.

Calculating Disability Benefits in a Workers’ Compensation Settlement

Calculating disability benefits for a settlement is an entirely different process from calculating medical benefits. While medical benefits are determined based on the injured worker’s needs, disability benefits are calculated based on the injured worker’s income (among other factors).

In North Carolina, per the North Carolina Industrial Commission (NCIC), the general rule is that eligible employees can receive weekly disability benefits calculated at two-thirds (or 66.67%) of their average weekly wage for as long as they are unable to work. For employees who are able to work in a limited capacity, disability benefits are calculated as two-thirds (or 66.67%) of the difference between their current income and their pre-injury weekly wages.

Permanent Partial Disability Benefits in Settlement Calculations

When an employee suffers a permanent partial disability (i.e., the employee reaches MMI instead of making a full recovery), then his or her benefits may be calculated based on a permanent impairment rating instead. As a result, to calculate the value of these benefits your attorney must have knowledge of:

  • Your average weekly wage for the relevant time period
  • Whether you have reached or are likely to reach MMI instead of making a full recovery
  • Whether you are able or will be able to work in a limited capacity
  • How long you will be partially or totally disabled

If you qualify for Social Security Disability Insurance or other benefits, this could impact the amount of your settlement as well.

Workers’ Compensation Cases Require Thorough Knowledge of State Laws

In short, calculating a workers’ compensation settlement is an involved process that requires a clear understanding of your medical needs and your rights under North Carolina law. As a result, it is not advisable to try to negotiate a settlement on your own. If you have been injured on the job and would like to know how much you may be entitled to recover, it is in your best interest to speak to a workers’ compensation lawyer as soon as possible.

Why Hire a Workers’ Compensation Lawyer?

In North Carolina, it’s possible to file a workers’ compensation claim without hiring a lawyer. However, several types of challenges frequently stump those who attempt to handle this process alone, including the following:

  • Calculating workers’ compensation benefits: As noted already, the process for determining the value of a workers’ compensation claim is complicated, as it usually involves several moving parts. If this is your first time submitting a claim, you may run into problems as you try to estimate the total value of your losses.
  • Claim denials: Every type of workers’ compensation claim can be denied. While you have the right to appeal these denials in North Carolina, you’ll need to go through a multi-step process to reverse an unsatisfying decision. It may be difficult for the average person to figure out whether their claim denial was justified and take steps to repair any issues with their claim.
  • Managing your case’s workload: Working through a workers’ compensation claim is time-consuming and challenging, particularly if you’re facing a denial. Add in difficulties associated with a serious or disabling injury, and successfully settling your case alone might feel impossible.

If it weren’t for these challenges, workers’ compensation lawyers wouldn’t exist. Yet, workers’ compensation claims remain uniquely tricky, so even experienced lawyers have their work cut out for them.

Who Can I Trust With My Workers’ Compensation Case?

Above all, seek a firm that can confidently deal with any hang-ups associated with your case, from appealing denials to untangling your confusion about the claims process. Generally, you can rely on an experienced workers’ compensation lawyer to provide the following services:

  • Building a strategy to secure the best outcome possible
  • Managing all communications associated with your case
  • Frequently updating you on the status of your case
  • Advising you on your next steps and best options
  • Representing you during the appeals process, if your claim was denied
  • Calculating the value of your injuries and settlement

It can be difficult to tell a workers’ compensation lawyer from an attorney who sometimes does workers’ compensation. That’s why you should keep an eye out for additional qualifications in your chosen attorney, including:

Is a Workers’ Compensation Settlement Right for You?

At Whitley Law Firm, we get it. Workers’ compensation claims are an unpleasant mix of serious injuries and complicated busy work. While we can’t snap our fingers and make your injury go away, we can address your unique needs and fight to protect your future. We want working alongside our team to feel like one big hug.

We are tenacious negotiators and legal representatives willing to go the extra mile for our clients. But our tenacity is only one part of The Whitley Advantage. The quality of our services makes up the other, large part of our brand. At the core of the Whitley Advantage? We care – truly care – about our client’s case outcomes. To us, you aren’t just a case number, you’re family.

To ensure you never feel left out or confused, we can provide you with the phone number of the lawyer assigned to your case, promptly return your calls, and make your concerns our highest priority. If you’re struggling with a workers’ compensation claim, call our offices at (919) 785-5000 to learn about what makes Whitley Law Firm different.