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

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  1. #1
    Join Date
    Jan 2012
    Posts
    3

    Default Should You Settle a Workplace Back Injury Claim

    I'm a 36 year old Female and was injured in 2009. I injured my back and was sent for surgery. Now I can't work, use a walker, can't dress myself, have assistance for everyday living activities. The doctor gave me a MMI rating of 45%. the doctor also told me that I will never work again. He even wrote that I was unable to do any work including sedentary type work.

    I still go to the doctor and medication is prescribed to me that total 2100.00 monthly. I receive 500.00 a week in comp. checks. They also provide me with attendant care. At first mediation they offered 200,000.00 which was the first offer they made. They really wanted me to take this offer and i declined. Now I get bills from doctor where they wait months to pay, they make me wait weeks on some medications and even though most of the medications have been prescribed for a couple of years now they will not authorize them for days and weeks, but they eventually do. There are also weeks they hold my checks and finally pay me what they owe.

    This all seems like they are trying to make my life even harder than it is. Why is that? I did not have all these problems until I would not agree to the money they offered.

    They really wanted to settle this issue. Did I make the right choice or should I settle?

    I mean they know my age and expected life expectancy. They know my rating and that I can never work again. They know what doctors I use and what medications i will need and they know they have to provide attendant care as long as the doctor don't change the order. The attendant care issue was ordered by the IC. They also sent me to 4 different work comp only doctors and they all say the same thing. I will never work again.

    Can anyone give me some advice or at least let me know if i'm doing the right thing. Cause after all 200,000.00 is a lot of money.

  2. #2
    Join Date
    Sep 2011
    Posts
    35

    Default Re: Work Comp. is Trying to Get Me to Settle My Back Injury Claim. Should I Do It

    Hello, I am so sorry for your situation May I ask what type of surgery you had ? and did you have an attorney who helped you get that far and if you did are they still helping you trying to get more than the 200,000 ? becuz say ur drug bills for a year are 25,200 per year unless once you settle do you have to pay your own drugs I know you wil have medical for life, but not sure bout meds. But I know what you mean I am on at least 8 meds myself for a back injury and fixin to lose my employer ins, and have not had my surgery yet, I am not getting paid from workers comp at all currently from an attorney screw up. I personally dont see that amount of money lasting anyone the rest of their life unless you own your home then maybe. I pray for the best sweetie try to think about your future there you will find your answer God Bless you.

  3. #3
    Join Date
    Jun 2009
    Posts
    23

    Default Re: Work Comp. is Trying to Get Me to Settle My Back Injury Claim. Should I Do It

    sure they want you to settle. in your case i would never settle. 200,000 is really no money at all. for you it is just less than 8 years of weekly benefit checks with no medical then what? i have back injury and i am on sedentary restrictions with 25% rating and insurance wants me to settle for 100,000. i am on meds and have not found a job yet. why would i settle. chances of me finding a job making close to what i was making doing sedentary work is not to likely, i am getting 500 week in wc and that is tax free and on meds every day. if i stay on meds every day as i have been for last 3 years since my surgery wc will never be able to settle my case. if they go 14 days past paying you your weekly benefits at any time make them pay you your 10% late fee as required of them. you should never settle unless it would be in your great favor and in your case i don't see where that would be the case unless god forbid you where to get something like stage 4 cancer then i would settle for my families sake and if they knew you had that they wouldn't want to settle then. always think long term what is best for you long term. remember this you hold all the cards because they are paying you, you are not paying them. make sure you know all your rights. you have nothing else to do with your time now but educate yourself on your rights so be sure to know all of your rights and what and what not you should be doing. good luck to you and as that old saying goes "don''t cut of the hand that feeds you".

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Work Comp. is Trying to Get Me to Settle My Back Injury Claim. Should I Do It

    If you haven't already applied for SSDI...you should do that NOW.
    They really wanted to settle this issue. Did I make the right choice or should I settle?
    IMHO, based on the info you provide here... no, you should not accepte that 200K. You won't have any income once that is gone. You'd be paying out of pocket for those meds... and any future medical you may require.

    With a 45%PD, you are not 100% disabled... that would indicate you are capable of some type of sedentary work.

    You need to have a face to face discussion with your attorney, get a clear picture of what this claim entails... message boards are not a good substitute for valid legal advice, no matter what other IW's may have experienced. No two claims or situations are ever the same.

  5. #5
    Join Date
    Feb 2007
    Location
    Charlotte, NC
    Posts
    3,076

    Default Re: Work Comp. is Trying to Get Me to Settle My Back Injury Claim. Should I Do It

    You apparently have not hired a competent work comp lawyer to help you, so I will give you a little free info here. An offer of only $200,000 is laughable for your facts. If you cannot work and you need attendant care for the rest of your life, then your case has a settlement value that is likely measured in multiples of that amount. And the 45% rating is irrelevant to your settlement numbers, simply because you are unable to work. Are you aware of your right to elect the most lucrative benefits?

    You need to talk to some good work comp lawyers. And you are not required to settle.
    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

  6. #6
    Join Date
    Jan 2012
    Posts
    3

    Default Re: Work Comp. is Trying to Get Me to Settle My Back Injury Claim. Should I Do It

    I understand that this is not the place is not a substitute for hiring an attorney, but out of curiosity can you let me know what you are meaning by electing the most lucrative benefits.

    Cause with the attendant care portion I had to gripe and moan to my attorney before he would take the doc. order to the commission due to the carrier not wanting to pay it. He told me they would never agree to pay for attendant care. I did some research on my own and knew it was the right thing to do and he finally did it. Now they provide me with someone that comes everyday and helps with my activities.

    He seems to think that the offer they made was really good considering its the first offer and wanted me to jump on it. I just didn't think that was wise due to the cost of having attendant care, scripts, doctors visits and my pay. All of the doctors have said there is no other surgeries or options and pain mgt. is all that is left. I just thought that they should have made a better effort at mediation.

    He also tells me that if I can make it off the money they provide do not file for SS Disability. He says that would be a big mistake on my part. I'm not sure why, I have read a lot of post and it seems like this is something I should do, but I dont really know. I hardly ever hear from my attorney and he never returns my calls or answers my questions. He did however call to let me know about the mediation and was happy to talk then, but since then we have spoke very little.

  7. #7
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Work Comp. is Trying to Get Me to Settle My Back Injury Claim. Should I Do It

    He also tells me that if I can make it off the money they provide do not file for SS Disability. He says that would be a big mistake on my part.
    Your atty is not giving you sound advice. Waiting to apply for SSDI could cause a loss in valuable benefits that may be past due, and you have only FIVE years from the date you stopped working to file.
    That is the SSA statue of limitations...

    Your atty doesn't want to deal with Medicare and CMS mandate on the potential need for the WCMSA/setaside arrangement in the unlikely event you will be made an acceptable offer.
    Talk to another, certified WC attorney. You can change any time, there will be but one fee...and there is no cost for another consult.

  8. #8
    Join Date
    Feb 2007
    Location
    Charlotte, NC
    Posts
    3,076

    Default Re: Work Comp. is Trying to Get Me to Settle My Back Injury Claim. Should I Do It

    You have a lawyer? Based on your original post, I had no idea you had a lawyer. You will need to get your lawyer to explain your options, if he can.

    To answer your election question, a person in your situation has the Gupton election between benefits under GS 97-29, 97-30 or 97-31. The weekly TTD is the benefit under 97-29 and for a person hurt before 6-24-2011 it will run until the worker either goes back to work at a suitable job or dies.

    The rating is the 97-31 benefit. With a 45% to the back, it will pay 135 weeks from the week in which the rating was assigned by the doctor. So if it was assigned two years ago, and TTD has been paid since then, the rating no longer has much value. It has been mostly used up under the Collins (credit) case. And it has nothing to do with your restrictions, which are the primary factor that determines whether you can get a job or not.

    The benefit under 97-30 only applies if the worker has gone back to work making less money than before the injury, due to the injury, and then it is limited to 300 weeks from date of accident.

    What you seem to describe is a case that would be compensable under 97-29 which will be a lot more money for you than the rating. You get to choose the 97-29 benefits instead of the rating if it is more money. Medicare, should you apply for SSDI and get approved, will not pay for attendant care, so if you settle, who will pay for that? What is it going to cost you to cover that expense for the rest of your life?

    Why does your lawyer think the 200k is a good offer? Did he explain that? You have the right to insist that he explain why he thinks that is a good offer.

    Have you calculated the life expectancy Present Value of the TTD checks you are getting? Has your lawyer made that calculation? The attendant care adds a lot of potential settlement value to that PV amount.
    Last edited by complwyr; 01-22-2012 at 05:27 PM.
    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

  9. #9
    Join Date
    Jun 2009
    Posts
    23

    Default Re: Work Comp. is Trying to Get Me to Settle My Back Injury Claim. Should I Do It

    question? how can you apply and get ssdi when the doctor has not stated you are disable?

  10. #10
    Join Date
    Feb 2007
    Location
    Charlotte, NC
    Posts
    3,076

    Default Re: Work Comp. is Trying to Get Me to Settle My Back Injury Claim. Should I Do It

    You can apply. You may not get it. And the doctor can be asked what your residual functional capacity is (post-injury) and sometimes that will show that you are disabled. Consult with a Social Security Disability lawyer about it--they can explain further.
    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

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