North Carolina Worker's Compensation - Help For Injured North Carolina Workers

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  1. #1
    Join Date
    Jun 2011
    Posts
    9

    Default Approched by W/C to Settle a Claim

    We have been dealing with workers comp for over 6 yrs in the state of North carolina, My husband was permanently injured at work. W/C has been paying all his medical and giving him a weekly check since 2005. We have an attorney, who has called us and told us W/C wants to settle with us. My husband is 46 yrs old. They want to settle with a check for around $500,000.00. We have also been told they will give me (his wife) a paycheck and health ins to take care of him. Our attorney has told us to think about this offer and come up with any questions we may have... We are not sure what to ask, what we should do, What kind of advice can you give us as to things we should ask to make sure we are covered. My husband will never work again in his life, he collects Social Security Disability also. Will that stop if settle because of the lump sum, and I am assuming it will be a lump sum payment. We are now living in Florida because I am also taking care of his elderly parents if that makes any difference. We do not know what types of questions to ask our lawyer.
    This is the first offer we have been given by workers comp. Is that the limit of what can be offered according to NC law? Yes it is a good amount of money BUT... This is the rest of his life. What about any future surgery he may need or his $2000.00 a month prescriptions. Our house is in his Dads name because of his credit being poor because of not being able to pay things before w/c finally stepped in and started paying him, which was a year after his injury and surgery.
    Any input will be greatly appreciated. If you need more info please let me know.
    Thanks Me

  2. #2
    Join Date
    Sep 2008
    Posts
    77

    Default Re: Approched by W/C to Settle a Claim

    I just wanted to say choose carefully, and cover your tail. Also good luck and God bless!

  3. #3
    Join Date
    Jun 2011
    Posts
    9

    Default Re: Approched by W/C to Settle a Claim

    Thanks, BUT that is why I put the post up, A little input on how to choose carefully and to cover my tail!

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,021

    Default Re: Approched by W/C to Settle a Claim

    , he collects Social Security Disability also. Will that stop if settle because of the lump sum, and I am assuming it will be a lump sum payment.
    The SSDI can be adversely affected in a lump sum cash payment...but, and it a big BUT...you should/cannot settle the claim with out addressing Medicare interests...which goes to What about any future surgery he may need or his $2000.00 a month prescriptions. , a WCMSA should be considered, and a proposal sent to CMS for review/approval before the claim is resolved.

    There are MSA vedors who calculate these setaside arrangements and submit to CMS. Your atty should be fully versed in this-and advising you before you consider any cash settlement.
    You have more to be concerened with here that info on a message board can provide... please schedule an appt, sit down with the atty handling your claim and fully understand the ramifications of cashing out the benefits there may be available.

    You cannot use a private pay or group health plan to pay for services to a work injury. Nor can you use his Medicare.
    Medicare will not pay benefits until any future medical reimbursement in a settlement has been exhausted. If your current atty is not versed in Medicare and the Secondary Payor Act, or SCHIPP... find another one.

  5. #5
    Join Date
    Jun 2011
    Posts
    9

    Default Re: Approched by W/C to Settle a Claim

    Thank You for your information, heres another question, we have had this attorney for 5 yrs, we have a contract with him, For workers comp He is NOT a social security attorney, when we applied for SSI we had to get a different attorney to help with that claim, At one time we were not happy with our attorney so we tried to get another one and since he was in the case for so long we couldnt find an attorney who would take the case. Our attorney told us we have until Monday to give him an answer, and ask any questions we may have. I will ask him about this important information you have provided and Thank You for taking the time to send a response, Any other info you can give will be greatfully appreciated!!!!

  6. #6
    Join Date
    Jun 2011
    Posts
    5

    Default Re: Approched by W/C to Settle a Claim

    Insurance for him is your main question and as far as the SS if you keep that income and get insurance full coverage the 500,000.00 is a good payment if he was working add up how much he could make in the years left in his life half a mill is a pretty good settlement with ss and insurance coverage is they say no on insurance then it is not a good settlement I wish I had 30,000.00 offered to me for my injury but we are jumping through hoops over here just trying to get this knee injury repaired they are disputing our claim with no income no insurance as of now and it is frustrating but for real the half mill with insurance and SS is a great settlement do you have kids/grandkids if so you my want to think of a higher number due to the fact he can not enjoy time with them doing active things and will have to pay for them to have fun meaning he can not take them fishing on shore needs a boat can not go in the yard and play football he will need to take them to football games so on and so forth good luck and hope all turns out the best for you and yours

    ---------- Post added at 10:20 AM ---------- Previous post was at 10:15 AM ----------

    I do not know the laws where you are at and you need to call ssi and ssd to see if your income will be affected by a settlement here in michigan it is not as for the settlement it is a good one as long as they continue to pay for his insurance cover him if not do not take the settlement Insurance and ss income are your two main questions

  7. #7
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,021

    Default Re: Approched by W/C to Settle a Claim

    Insurance for him is your main question and as far as the SS if you keep that income and get insurance full coverage the 500,000.00 is a good payment if he was working add up how much he could make in the years left in his life half a mill is a pretty good settlement with ss and insurance coverage is they say no on insurance then it is not a good settlement
    The way I have understood this offer is "payment including health coverage for you"... not your husband... for home services for him.

    You cannot purchase health coverage for the work injury... and Medicare will not pay until any money you may receive in the settlement, allocated to future medical care, has been exhausted.
    From the info you provide here... you MUST take Medicare interests into account if you cash out the medical in this claim.
    add up how much he could make in the years left in his life
    WC indemnity benefits are paid base on the physical loss of earning capacity..not actual wages going forward. There is no money in a settlement for "lost wages".

    it is frustrating but for real the half mill with insurance and SS is a great settlement do you have kids/grandkids if so you my want to think of a higher number due to the fact he can not enjoy time with them doing active things and will have to pay for them to have fun meaning he can not take them fishing on shore needs a boat can not go in the yard and play football he will need to take them to football games so on and so forth
    jaydawg... there is no money in settlement of a comp claim for loss of enjoyment. WC just doesn't work that way.

  8. #8
    Join Date
    Jun 2011
    Posts
    9

    Default Re: Approched by W/C to Settle a Claim

    Once again Thank you all for your input. ALL advise will be used in considering settling his case. They offered Me health insurance since I would be the one taking care of him and all his needs, (not that I dont do that already for free), If I am understanding correctly... They are also offering him Health insurance that would ONLY cover anything to do with his injury. Which is why we need his disability to stay intact for all his other health issues, high blood pressure, cholesterol things like that and things to come with just aging. I do not know if SS will continue we have it now But his settlement might change that.

  9. #9
    Join Date
    Feb 2007
    Location
    Charlotte, NC
    Posts
    2,954

    Default Re: Approched by W/C to Settle a Claim

    I do not want to be in the position of giving you advice that may be contrary to what your attorney may be giving you.

    But your post about the offer raises some questions in my mind. Is the insurance company going to provide you with health insurance? I have practiced work comp law for 20 years and I have never heard of that settlement term. You may want to make sure about that.

    It sounds like you are going to be paid to provide your husband with attendant care. That can add up to an awful lot of money over time.

    The insurance company is making that offer simply because that is the cheapest way for it to get out of the case. They are spending less by settling, and you and your husband are getting less than you might if he lives something close to a normal life span. You need to make sure that both of you understand that concept.

    Your questions are all questions that you need to discuss at length with your lawyer. I am sure he or she will try to answer all your questions.

    I don't understand why you have a Monday deadline to make a decision. Trying to make a quick decision on such a massive question can result in a bad decision.

    Good luck to you. I hope you have an excellent NC Work Comp lawyer.
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney at Law

  10. #10
    Join Date
    Jun 2011
    Posts
    9

    Default Re: Approched by W/C to Settle a Claim

    @ complwyr, I was miss informed by my husband, when I questioned about the monday deadline he told me... HE told the attorney we will call him monday with a decision. Please rest assure there will be NO decision made monday. There will be a lot of questions asked and looking for a lot of answers. I am understanding they were going to provide him health ins, However I could be wrong I have been before. I will get that cleared up. I hope our attorney is a good one too, He has won a few battles along the way with W/C they say no and we would take them to court and we would leave with a yes, However it was for certain medications they say w/c does not cover.
    We did ask our attorney about his SSI and his answer to that was he did not know. I hope he is finding out.

    Does anyone know if there is a limit to the amount the state will allow for w/c injury?

    I am looking for other questions we should ask our attorney. Things I may need to ask for in his settlement that is not being offered at this time.
    And I do want to mention again, They approached us, we told them 3 yrs ago we were happy go lucky with things and how thing were working.

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