What steps do I need to finalize and close my workers comp benefits?

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What steps do I need to finalize and close my workers comp benefits? - North Carolina

Short Answer

In North Carolina, you generally close a workers’ compensation claim in one of two ways: (1) a Form 26A agreement that pays your permanent partial disability and usually leaves medical open for two years, or (2) a “clincher” settlement that resolves all benefits and closes the claim, both of which require Industrial Commission approval. After the last payment, the insurer files a closing report. Be sure you understand how your medical rights and timelines change before you sign.

Understanding the Problem

You want to know how to finish and close a North Carolina workers’ compensation claim so benefits are paid correctly and the file is truly closed with the North Carolina Industrial Commission. You have received some benefits already, and your attorney is negotiating with the insurer to wrap up the case. The key decision is how to finalize the claim in a way that fits your medical status and future needs.

Apply the Law

North Carolina workers’ compensation cases are overseen by the North Carolina Industrial Commission. To close a case, parties either submit a compromise settlement agreement (often called a “clincher”) or use a Form 26A when a permanent partial disability rating is accepted. Any settlement must be reviewed and approved by the Industrial Commission. The timing often turns on when you reach maximum medical improvement (MMI), receive a rating (if applicable), and complete required filings.

Key Requirements

  • MMI and rating (if applicable): You typically need to reach MMI and have an impairment rating before using a Form 26A to resolve permanent partial disability.
  • Choose the closure path: Form 26A pays the rating and usually leaves medical open for two years; a clincher settlement resolves indemnity and medical and closes the claim.
  • Industrial Commission approval: The Commission must approve any settlement to ensure it is fair and protects your rights.
  • Complete documentation: Agreements must clearly state benefits paid, any future medical treatment rights, wage information, and how liens are handled.
  • Post-payment reporting and deadlines: After the last payment, the insurer files a closing report; the clock for requesting additional medical typically runs from the last compensation payment if medical is not closed.

What the Statutes Say

Analysis

Apply the Rule to the Facts: Because you have already received partial benefits, the next step is to confirm whether you have reached MMI and, if so, your impairment rating. If you and your attorney accept the rating and want to keep medical open for a period, a Form 26A can close indemnity while allowing additional medical within the statutory timeframe. If you prefer to end all rights and resolve future medical now, a clincher settlement can be negotiated and submitted for Commission approval.

Process & Timing

  1. Who files: Your attorney (or the insurer) submits either a Compromise Settlement Agreement (clincher) or a Form 26A to the North Carolina Industrial Commission. Where: Industrial Commission electronic filing portal or by Commission-accepted delivery. What: Clincher agreement with required disclosures and supporting documents, or Form 26A (Employer’s Admission of Employee’s Right to Permanent Partial Disability). When: After you reach MMI and terms are finalized.
  2. The Industrial Commission reviews the filing for fairness and completeness. Review often takes a few weeks, depending on workload and whether the Commission requests clarifications or revisions.
  3. Once approved, the insurer issues payment under the order and files a closing report (Form 28B) after the final payment. Keep the approval order and filings as proof your claim is closed.

Exceptions & Pitfalls

  • Signing too early: Settling before MMI or a clear rating can understate permanent impairment or future medical needs.
  • Medical rights: A clincher typically closes medical; a Form 26A usually leaves medical open for a limited time. Know which path you are choosing.
  • Average weekly wage errors: Incorrect wage calculations change benefit amounts; verify wage and compensation rates before signing.
  • Liens and offsets: Unresolved medical or benefit liens can delay payment; address them in the agreement.
  • Medicare considerations: If you receive Medicare or are likely to soon, settlement papers should account for Medicare’s interests.

Conclusion

To finalize and close a North Carolina workers’ comp claim, you either file a Form 26A after MMI to accept a rating (usually keeping medical open for a limited time) or submit a clincher settlement that closes all benefits. The Industrial Commission must approve either path. After the last payment, the insurer files a closing report, and the clock for additional medical runs if medical stays open. Next step: confirm MMI and rating and submit the appropriate agreement for Commission approval.

Talk to a Personal Injury Attorney

If you're dealing with how to finalize and close your North Carolina workers’ comp claim, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at [919-341-7055].

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.

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