Workers compensation contract with Hugh D. Cox, Attorney in Greenville NC, proudly representing the disabled for rightful veterans benefits, Social Security benefits and Workers Compensation throughout North Carolina
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Workers
Compensation |
I take pride in my common sense
contracts with clients which I make available to anyone who requests one. Some attorneys
treat contracts as "trade secrets". I feel strongly that clients as good
consumers should have the right to study and examine any contract before signing. This
writing is simple and plain so that clients are confident of the actual costs involved. We
use the same contract with each client.
All Workers Compensation Contracts must be approved by the North Carolina Industrial Commission:
Below is my Workers Compensation
Contract:
WORKERS COMPENSATION LEGAL REPRESENTATION AGREEMENT
This contract and agreement for
Workers Compensation benefits is entered into between the undersigned client
________________________________________________________________, hereinafter referred as
"Client", and Hugh D. Cox, Attorney at Law, 321 Evans Street Mall Suite 102, P.
O. Box 154, Greenville, North Carolina 27835-0154, hereinafter referred to as
"Attorney". Client and Attorney agree as follows:
1. Legal Services to be Provided: Client retains Attorney to
represent Client before the North Carolina Industrial Commission, Court of Appeals or
Supreme Court for award or increase of award of workers compensation benefits either by
hearing or appeal.
Date of Workers Compensation Injury: ________________________ .
Client seeks to secure all benefits reasonably available through the workers
compensation statutes. Client agrees that a copy of this contract/agreement shall be filed
with the Industrial Commission of North Carolina.
2. Contingency Fee Agreement: There shall be no attorney fees
except those expenses set forth in paragraphs 3 and 4 herein owed by Client to Attorney if
there is no recovery of workers compensation benefits for Client by Attorney. Client shall
pay Attorney a contingency fee of TWENTY FIVE PERCENT (25%) of the gross amount of any
workers compensation award or settlement recovered by Attorney as workers compensation
benefits to Client whether by award, judgment, settlement or administrative action if
recovered at the hearing level before the Industrial Commission, or (2) if there is an
appeal to the Court of Appeals or Supreme Court, Attorney shall be entitled to THIRTY
THREE AND ONE THIRD PERCENT of the gross amount of any workers compensation award or
settlement recovered by Attorney as workers compensation benefits to Client whether by
award, judgment, or settlement. Client directs that the Industrial Commission withhold 25%
of benefits payable to Client for attorney fees. Client gives Attorney a lien on Client's
claim and award recovered whether by judgment, settlement or administrative action to the
extent of Attorney fees, expenses or other amounts due to attorney due under this
agreement. Client agrees that Attorney shall have all general, possessory, special,
charging or retaining liens known to the common law or to the law of the State of North
Carolina in accordance with this paragraph or paragraph 6.
3. Expenses Related to Representation: In addition to fees and
retainers discussed above, Client agrees, regardless of recovery or no recovery, that
Client is responsible for and will pay for all out-of-pocket expenses incurred by Attorney
in connection with this agreement. Client agrees that these out of-pocket expenses may
include, but are not limited to, court costs, photocopying at $.10 per copy, postage, long
distance telephone and FAX, messenger and delivery services, retaining of medical and
vocational experts and other reasonable expenses deemed necessary by Attorney related to
Client's claim.
4. Billing for Out-of-Pocket Expenses: Client agrees to pay
within three (3) days for all out-of-pocket expenses prior to Attorney advancing such
money upon telephone or written notification of Client by Attorney. Client agrees to go to
each of client's medical facilities to request medical records at the request of Attorney
prior to Attorney requesting such medical records directly from medical facility. When
impractical to give advanced notification of out-of-pocket expenses to Client, Attorney
will bill Client for payment of out-of-pocket expenses. Client agrees to promptly pay for
such out-of-pocket expenses within ten (10) days of receipt of the bill from Attorney.
Attorney agrees to give advanced notification to client of all anticipated expenses in
excess of $50.00 prior to Attorney advancing such sums.
5. Client's Information to Attorney and Cooperation with Attorney:
Client agrees to sign any and all necessary forms in order for Attorney to obtain medical,
official file and procedural information on this case. Client agrees to locate and contact
witnesses and provide documents requested by Attorney. Client agrees to cooperate with
Attorney by meeting with him when requested and to attend required hearings or
examinations when scheduled. Client further agrees to keep Attorney advised of current
address and telephone number as well as necessary information on someone else who can
always contact client. Client agrees that Attorney may designate other Paralegals,
Attorneys, and Research Assistants for portions of Client's case if, in the judgment of
Attorney, that such services are in the best interest of Client and Attorney. Client and
Attorney agree that the designation of any such Paralegals, Attorneys, and Research
Assistants may require that Client be billed for additional out-of-pocket expenses under
Paragraph 7 above. Attorney agrees to notify Client in advance of any expense exceeding
Fifty Dollars ($50.00).
6. Client's Discharge of Attorney and Resulting Lien upon Award of
Client: Client may discharge Attorney upon written notice to Attorney. After the
Attorney has entered an appearance before the Industrial Commission, the Commission or
court may require Attorney to continue to represent the Client until Attorney's appearance
in the proceeding is terminated by the Commission or court. If Client discharges Attorney
without good and adequate cause after the Attorney has fully performed, substantially
performed, or contributed in any way to the results finally obtained by the Client, the
Client shall be liable for payment of the Attorney's fees and expenses per a quantum
meruit amount of attorney fees based upon the time invested by Attorney in this matter at
a rate of ONE HUNDRED FIFTY DOLLARS ($150.00) per hour or upon other reasonable standard
decided by the Industrial Commission based upon applicable law of North Carolina. Client
agrees that such attorney fees based upon quantum meruit shall constitute a lien upon
Client's award or settlement as awarded by the Industrial Commission and Client consents
that Attorney shall be paid separately for his services at such time of award.
7. The Attorney's Withdrawal From Agreement and Right to Not Pursue
Appeal: The Attorney does not anticipate any problems that would require
withdrawal from this Agreement, and the Attorney intends to pursue Client's matter to the
best of his ability. If, however, circumstances (such as non-cooperation) arise that
necessitate withdrawal in accordance with the Code of Professional Responsibility, the
Attorney will (a) notify the Client in writing of the withdrawal from this Agreement, and
(b) take reasonable steps to avoid foreseeable prejudice to the rights of the Client.
Client agrees that Attorney shall not be required to pursue a further appeal after the
first level of decision of this case if, in the opinion of Attorney, such appeal is not in
the best interest of Attorney or Client.
8. Settlement Offers: The Attorney will advise the Client of
all settlement offers and no dismissal or settlement of any claim or claims will be made
without the consent of the Client.
9. Complete Integration, Binding Upon All Parties: This
Agreement of One page contains the entire agreement between the Client and the Attorney
regarding this matter and the payment of fees and expenses. This Agreement shall not be
modified except by written agreement signed by the Client and the Attorney. This Agreement
shall be binding upon the Client and the Attorney and their respective heirs, executors,
legal representatives, and successors.
10. No Promises or Guarantees About Outcome and Statute of Limitations:
The Client has read and understands this contract and agrees that the Attorney has made no
promises or guarantees regarding the outcome of this matter. Client agrees that he has
been informed by Attorney that the Statute of Limitations for this matter is two years
from injury if no benefits have been paid or two years from the date of last benefits paid
directly to Client or one year from the date of last medical benefits paid on behalf of
client and that this claim will be barred and prevented if Client or Attorney fail to file
a Form 18 and/or Form 33 within those time periods.
11. Interpretation of Agreement: The Client and the Attorney
understand that the meaning of any term of this Agreement shall be governed by the laws of
the State of North Carolina. The Client further agrees that, if there is recourse to the
judicial process to resolve a dispute about this Agreement, he will submit to the
jurisdiction of the appropriate courts and will permit the dispute to be adjudicated by
said courts.
12. Mutual Agreement: We agree that the above agreement and
contract of One page represents our complete mutual agreement.
___________________________________________________
__________________________
Client
Date
___________________________________________________
__________________________
Hugh D. Cox
Date
