How Much Is My Workers’ Comp Case Worth?

The “value” of your workers’ comp case in NC depends on several factors.

First, what is your injury date? If you were injured on or after June 24, 2011, then the Workers’ Comp reforms passed by the NC General Assembly after the Republicans took the majority in the 2010 election, depress or reduce the value of your claim compared to an identical claim for someone who was injured on or before June 23, 2011. This is because the legislature put a duration limit on Temporary Total Disability benefits, limiting it to 500 weeks, unless you qualify for “extended benefits.” It is extremely difficult and almost impossible to qualify for “extended benefits.” I am only aware of maybe three people in the entire state who have qualified for extended benefits as of June 2023.

Secondly, how much is your “compensation rate?” Your “comp rate” is the single most important number in your case. For that reason, when a new client signs up with me, I always investigate to make sure the compensation rate has been calculated correctly. Many times it is miscalculated, usually due to an oversight or an honest error. If you were a high earner, you might be subject to the “maximum comp rate” for the year of your injury. The maximum rate goes up each year, and in 2023 it is $1.254, but once your comp rate is determined, it stays the same for the life of your case. There is no cost-of-living raise on the comp rate.

Third, how severe are your work-related injuries? More to the point, how severe are the injuries that the insurance company has accepted as part of your case and covered the medical treatment? The more severe injuries, such as herniated disks in the spine, badly torn rotator cuffs in the shoulders, and crushing injuries to the hands or feet, tend to cause the most restrictions and activity limitations after the healing period has ended. The more severe the injury, the more likely you are to have ongoing, long-term disability.

Fourth, how severe is your “disability” due to the injuries? “Disability” is defined in the Workers’ Compensation Act as “incapacity because of the injury to earn the wages which the employee was receiving at the time of injury in the same or any other employment.” [N.C.G.S 97-2(9)]. If your work-related injuries prevent you from doing any work at all, then you are “temporarily totally disabled.” If you are able to do some work, but not earn as much as you were making before the injury, then you are “temporarily partially disabled.” After you have reached the end of the medical healing period for your injuries, and been declared at “MMI” or “maximum medical improvement” you will typically get a “permanent partial disability rating” from the treating doctor that is expressed as a percentage of the injured body part. For example, after a rotator cuff repair, your doctor might give you a “10% to the shoulder” impairment rating, which would be a 10% PPD or Permanent Partial Disability rating. Permanent disability is usually associated with permanent restrictions from the treating doctor.

But, here is the deal on permanency, and the insurance company folks are not going to tell you this — You get to choose whichever form of disability pays you the most, if you qualify for more than one disability benefit. For instance, you might be rated and released with a 10% to the shoulder, but your permanent restrictions from that injury might prevent you from going back to your old job of, for example, driving a tractor trailer. And it may be that you are now 45 years old and all you have ever done, since you turned 18 years old, is drive trucks. Now you cannot do it anymore due to this injury. In that case, you would be entitled to choose between the 10% rating to the shoulder, which is worth 24 weeks times your compensation rate, or you can choose ongoing TTD (temporary total disability) payments every week while you look for new career or go back to school to learn some new job skills. If it takes you a year and a half to learn new skills and get a new job, that is about 75 weeks of benefits, which is worth three times more than your rating of 10%. If those are the facts of your case, then you would want to choose the ongoing benefits, because you get to choose the one that pays you the most money. Now, let’s say you found a new job quickly, but it paid only half what you used to make. In that example, you could choose ongoing “temporary partial disability” which is calculated by taking the Average Weekly Wage you earned before your injury and subtracting the average weekly gross wages in the new job, and two-thirds of that difference is your weekly “TPD” check from the workers’ comp insurance company. So, if you made $1,500 per week gross before you were hurt, and your new job pays only $900 per week, then the difference is $600 per week, and that is your “loss of earning capacity.” Two thirds of $600 is $400, so in addition to your earnings of $900 per week, we can make the insurance company pay you an income tax-free workers’ comp check of $400 per week too.

So, what is your workers’ comp case worth? We have to analyze all these factors to come up with a fair settlement value. If you have a high compensation rate, a surgical injury, and permanent restrictions that prevent you from returning to the type of work you did when you were injured, then we can sometimes get our clients settlements that exceed $100,000. I have personally settled workers’ compensation cases for truck drivers who could no longer drive commercially for as much as $920,000. Every case is different, of course, but over the years I have settled a number of cases for sums ranging from $150,000 to $275,000 for clients whose injuries prevented them from returning to their previous line of work. But the insurance company is not going to just drop that kind of money into our laps. We have to work for it. Typically the injured worker has to endure years of medical treatment and perform a job search, and often getting the best settlement requires litigation over any disputes in the case and multiple mediated settlement conferences. Under the 2011 changes to the Workers’ Comp Act, the settlement values of cases have gone down somewhat, because the insurance companies don’t believe that any injured worker should ever be able to get “extended benefits” beyond the 500 week limit.

If you have an open workers’ compensation case and you want some help figuring out how much your case is worth, give me a call. If you are not represented by another lawyer I will be happy to give you a free consultation and help you work through this analysis. No obligation on your part; if you later choose to sign up with me, that is great, but I am happy to talk with you regardless. You know the insurance company is not on your side, so don’t let them tell you what your case is worth. Their goal is to save as much money as possible. They are not even required to tell you the truth or deal with you in “good faith.” So don’t hesitate to get in touch for a free consultation! Bob Bollinger