Settling A Claim

How do workers' compensation claims get settled?

There are several ways to settle a workers' compensation claim, depending on whether the injured worker can return to work with his employer.  An employee who returns to work can settle his claim using an Industrial Commission Form 21.  Under this form, the employee is paid rating benefits based on the permanent impairment rating assigned by his doctor.  When settling by a Form 21, the injured worker has a 2-year window, from the date the last payment of compensation is made, to reopen his claim for diability benefits or medical compensation.  If the 2-year period lapses with no further action, the claim ends.

An employee who returns to a job that pays lesser wages can still settle his claim by Form 21.  The worker is entitled to his more favorable remedy between rating benefits or TPD benefits.  

Finally, an injured employee who has not returned to work can enter a final settlement, or "clincher" agreement, for payment of anticipated future disability benefits and medical compensation.  Many insurance companies want to "clincher" a claim, which closes the case forever.  The insurance company will usually pay some amount of cash in a lump sum to close the case.  A clincher precludes the right to ever receive additional medical treatment or disability benefits, or to ever have a hearing before the North Carolina Industrial Commission.

An injured employee who remains out of work is under no obligation to settle his workers' compensation claim.  If an employee is permanently disabled from any type of employment, he may be entitled to receive weekly disability benefits for the rest of his life.

What happens if I settle my claim and then my condition worsens?

If a worker has settled his case by any means other than the clincher, he or she has two years from final payment of compensation to ask the Industrial Commission to reopen the case for additional disability benefits or medical treatment.