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How Do You Settle a Workers’ Compensation Claim?
Story Updated: Aug 7, 2013
How Do You Settle a Workers' Compensation Claim?
There are several ways to settle a workers' compensation claim, depending on whether the injured worker returns to work with his employer.
An employee who returns to work can settle for his or her PPD or "rating" benefits by using an Industrial Commission Form 26A. Under the Form 26A, the employee is paid rating benefits based on the permanent impairment rating assigned by his doctor. When settling on a Form 26A, the injured worker has two years, from the date the last payment of compensation is made, to reopen his claim for disability benefits or medical compensation. If the two-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 an Industrial Commission form. The worker is entitled to choose the more favorable remedy, or the benefits that pay the most money - PPD benefits or TPD "wage-loss" benefits.
Finally, an injured worker, particularly one who has not returned to work, can enter a final settlement, or "clincher" agreement, for payment of future disability benefits and medical compensation. Insurance companies are motivated to "clincher" a claim, which closes the case forever, and will often pay the injured worker a lump sum of money for a clincher agreement. Once the injured worker and the insurance company enter a clincher agreement and the agreement is approved by the North Carolina Industrial Commission, the claim cannot be reopened.
Importantly, an injured employee who remains out of work and continues to receive disability benefits has no obligation to settle his workers' compensation claim. If an employee is permanently disabled from any type of employment, he or she may be entitled to receive weekly disability benefits for life.
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