How does the North Carolina workers’ comp settlement chart work?

What Is The North Carolina Schedule Of Injuries?

N.C. Gen. Stat. § 97-31 lists body parts and assigns each a number of weeks. For the loss of that body part, or its total loss of use, the statute pays sixty-six and two-thirds percent of the worker’s average weekly wage for that number of weeks, in addition to the temporary benefits paid during the healing period. The compensation is in lieu of all other compensation for that injury, including disfigurement. Partial loss, which is what most ratings describe, is paid as the same proportion of the weeks that the partial loss bears to total loss. The weekly payments are subject to the same maximum and minimum as temporary total disability under N.C. Gen. Stat. § 97-29.

How Do You Turn The Schedule Into A Dollar Figure?

Three inputs. First, the average weekly wage, which is generally what you earned in the 52 weeks before the injury, divided by 52. Second, the compensation rate, which is two-thirds of that wage, capped at the maximum the Industrial Commission sets each year and floored at thirty dollars under N.C. Gen. Stat. § 97-29. Third, the impairment rating, a percentage a physician assigns when you reach maximum medical improvement. Multiply the schedule weeks by the rating, then by the compensation rate.

A worked example with made-up numbers: a worker earning $900 a week has a compensation rate of $600. The doctor assigns a 15 percent rating to the back. The back is 300 weeks, so 15 percent of 300 is 45 weeks, and 45 weeks at $600 is $27,000 in scheduled compensation. Change the wage to $600 a week and the same injury pays $18,000. The figures are illustrative only; nothing about them is a prediction of any real claim, and the annual maximum can cap the rate for higher earners.

Where Does The Rating Come From, And Can It Be Challenged?

The rating comes from the treating physician, usually the one the insurer chose under the Act’s rule that the employer directs medical care. It is the single most contested number in a permanent-injury claim, because the schedule multiplies it. N.C. Gen. Stat. § 97-27 lets either side obtain an examination; a worker who believes the rating is low can seek a second opinion on the rating, and the Commission resolves the dispute if the parties cannot. The rating also has an alternative. A worker whose injury leaves them unable to earn the same wages may be better off claiming continuing disability under the wage-loss provisions than accepting a scheduled payment, and the Act lets the worker choose the more favorable remedy.

Fault plays almost no part. Workers’ compensation is paid without regard to who caused the accident, and North Carolina’s contributory negligence rule, which bars an ordinary injury claim when the injured person shared fault, is not a defense to a compensation claim. The exceptions are the forfeitures in N.C. Gen. Stat. § 97-12 for intoxication, controlled substances, and willful self-injury.

What Is In A Workers’ Comp Settlement, And Who Has To Approve It?

A scheduled award is one component. A full settlement, often called a clincher or compromise agreement, closes the entire claim for a lump sum and usually includes the scheduled compensation, the value of any future weekly benefits, and the projected cost of future medical care the insurer would otherwise owe. Because the worker is giving up the right to future medical treatment, the settlement must be submitted to the Industrial Commission and approved as fair and in the worker’s best interest; an unapproved agreement does not bind anyone.

The Commission approves a fair agreement; it does not negotiate one. The rating, the wage calculation, the future medical estimate, and the decision to settle at all are where a claim is won or lost, and where a North Carolina workers’ compensation lawyer earns the fee the Commission must also approve.