Workers' Comp Settlements in North Carolina

Workers' comp claims may be settled by agreement, but a copy of every settlement agreement must be filed by the employer with the North Carolina Industrial Commission and approved by it. The Commission may approve a settlement only if it finds the agreement fair and just, taking into account the interests of all parties and of any health plan that paid the worker's medical bills, and only if other statutory conditions are met; for example, the agreement must list the worker's known medical expenses related to the injury, including disputed ones, and state which the employer will pay, unless the employer agrees to pay all such expenses through the settlement date. Once approved, the settlement is final and cannot be reviewed or collaterally attacked, except that the Commission may set it aside if a party shows it resulted from fraud, misrepresentation, undue influence or mutual mistake.

Temporary total disability benefits are limited to 500 weeks from the date of first disability. A worker may apply for extended compensation beyond 500 weeks only after 425 weeks have passed since the first disability, and (unless the parties agree) must prove a total loss of wage-earning capacity, meaning the complete elimination of the capacity to earn any wages. Partial incapacity benefits are limited to 500 weeks of payments, and weeks paid for total disability count against that total. Lifetime benefits, including medical compensation, are available only for permanent total disability in listed catastrophic cases, such as the loss of both hands, arms, feet, legs or eyes (or any two of them), severe spinal cord injury, severe brain injury, or burns covering 33% or more of the body; in no other case is a worker eligible for lifetime permanent total disability compensation.

All attorney fees in North Carolina workers' compensation cases are subject to approval by the Industrial Commission, and a request must be submitted for each fee. Taking any fee or gratuity without Commission approval, or soliciting workers' compensation clients, is a Class 1 misdemeanor. The Commission judges reasonableness using factors such as whether the fee is fixed or contingent and the customary fee for similar services, and its decision can be appealed to the full Commission and then superior court.