What Constitutes an “Injury by Accident”?

What Is an “Accident” in North Carolina Workers’ Compensation Law?

In everyday conversation, the word “accident” is generally used to describe an unintended and unexpected event that causes damage or harm. However, North Carolina workers’ compensation law outlines a more precise definition (N.C.G.S. § 97-2(6)).

The state defines an accident as an unusual or unexpected event that interrupts the regular work routine and results in an injury (Harding v. Thomas & Howard CO., 256 N.C. 427, 428, 124 S.E.2d 109, 110-11 (1962)). This means that if the employee is performing their regular duties in a routine way, that may not qualify as an injury by accident unless something out of the ordinary occurred.

Some examples of workplace injuries that result from an accident include:

A warehouse worker trips over a box and tears a ligament.

A construction worker falls off a ladder and breaks a leg.

A delivery driver suffers a concussion in a car accident while working.

A factory worker’s finger is amputated when a machine malfunctions.

However, even if you think your injury doesn’t qualify, it’s important not to make any assumptions about your case, as there are exceptions. For example, a strained back from lifting something may be eligible under the “specific traumatic incident” exception, and carpal tunnel syndrome from typing may qualify as an occupational disease.

Typically, the injury needs to involve some kind of slip, trip, fall, malfunctioning tool, unpredictable action by a third party, or a deviation from the normal job routine. These are all characteristics of work-related injuries caused by accidents and may qualify you for workers’ compensation.

Elements Required to Prove an Injury by Accident

For a workers’ compensation claim involving an injury by accident to be approved, the injured worker typically must prove the following three key elements.

The Injury Resulted from an Unexpected or Unusual Event

There must be some deviation from the regular work routine when the accident occurs. This could include:

A slip or trip on a wet floor
Machinery malfunction
A sudden requirement to perform an unfamiliar task
An unexpected movement during regular duties

These events and actions are all outside the normal scope of the job. Performing a routine task, no matter how strenuous, without anything unusual happening will not usually qualify.

The Injury Is Work-Related

Another key component of a workers’ comp claim is that the accident must happen in the “course and scope” of employment. Injuries sustained in an accident while on the employer’s premises, performing assigned duties, or fulfilling a work-related request generally qualify. If you’re injured while on lunch break offsite or while doing something non-work-related, it may not be covered.

There’s a Connection Between the Accident and the Injury

You must draw a clear connection between the accident and the injury sustained. This generally requires medical evidence such as a doctor’s testimony and medical records. That’s why it’s critical to seek immediate medical attention after an accident. Not only does seeing a healthcare provider as soon as possible protect your health, but it also creates a vital document linking your injury to the accident.

Exceptions to the Accident Rule

While most claims for workplace injuries must show bodily injury by accident, there are several notable exceptions under North Carolina workers’ compensation law.

Back Injuries

Back injuries are treated differently under workers’ compensation law (N.C.G.S. § 97-2(6)). A worker who suffers a back injury while performing their duties does not need to prove it was an accident. They only need to show that the injury was the direct result of a “specific traumatic incident” of their assigned work. Even if the lifting was part of routine duties, you may still qualify for benefits if you can link it back to a certain harmful event.

Hernias

Workplace hernias have unique requirements to qualify for a workers’ compensation claim (N.C.G.S. § 97-2(18)). The hernia must:

Appear suddenly
Immediately follow an accident or a specific traumatic event
Not be pre-existing

If a worker meets all these criteria, they may be eligible for workers’ comp benefits even if the event that caused the hernia wasn’t outside of their normal routine. If you have a work-related hernia, seek medical attention and contact an experienced workers’ comp lawyer as soon as possible.

Occupational Diseases

Some work-related conditions can be classified as occupational diseases rather than an injury by accident. These conditions may qualify you for workers’ compensation benefits even if there was no one specific event or accident that caused them. Examples include:

Carpal tunnel syndrome – This occupational disease is caused by repetitive hand and wrist motions. It’s common among office employees, assembly line workers, and others who perform constant, repetitive manual tasks.
Hearing loss – Long-term exposure to loud environments, such as construction sites or manufacturing plants, can cause permanent hearing damage.
Respiratory conditions – Exposure to dust, chemicals, or toxic substances can cause respiratory conditions such as asbestosis, silicosis, and chronic obstructive pulmonary disease. Exposure to fumes and molds in places like schools, warehouses, or chemical labs can also cause asthma and other breathing issues.

For an occupational disease to qualify for workers’ compensation, you must prove that your job duties or environment both 1) caused your injury and 2) put you at increased risk of developing the condition compared to the general public (N.C.G.S. § 97-53; Rutledge v. Tultex Kings Yarn, 308 N.C. 85, 93, 301 S.E.2d 359, 365 (1983) and Booker v. Duke Univ. Med. Ctr., 297 N.C. 458, 471-72, 256 S.E.2d 189, 198 (1979)). An experienced workers’ comp attorney can help you build a case to show this connection and seek your benefits.

Common Accidents Covered by Workers’ Comp in North Carolina

A bodily injury by accident in the workplace might occur in many ways. Some of the most common in North Carolina include:

Slips, Trips, and Falls

Slips, trips, and falls in the workplace are classic examples of injuries by accident. These can occur due to:

Wet floors
Uneven surfaces
Loose cords or tools
Cluttered walkways
Weather-related hazards

If a slip, trip, or fall at work results in injury, you may qualify for workers’ comp benefits.

Machinery or Equipment Malfunctions

Sudden equipment failures or malfunctions at work can cause severe injuries. Whether it’s a conveyor belt malfunction, brake failure, short-circuiting power tool, ladder collapse, or unexpected ejection of material, resulting injuries are often substantial grounds for a workers’ comp claim.

Motor Vehicle Accidents

Many workers, such as delivery drivers or transport workers, drive as part of their job, while others may be asked to drive occasionally. If a crash occurs during the course of employment, it may qualify as an accident under North Carolina workers’ compensation law.

Unexpected Physical Movements

When an unexpected movement outside the normal scope of the job causes an injury, it may qualify as an injury by accident. Some common examples include:

Jumping to avoid injury
A sudden misstep while carrying a load
Twisting to avoid a collision
Performing an unfamiliar task at a supervisor’s request

These motions are not part of regular work duties, making them “unexpected” – a key component of injury by accident under North Carolina workers’ compensation law.

Denying Workers’ Compensation Due to Lack of an “Accident”

Unfortunately, many valid workers’ comp claims are denied by insurance companies on the grounds that they do not meet the “accident” requirement. A claim may be denied when:

The employee was performing routine tasks in a routine way.
Medical records do not support a traumatic cause.
There is no clear documentation of the incident.
The worker delayed reporting the injury.
The employee mistakenly claimed there was nothing out of the ordinary.

These denials can be devastating for workers facing daily pain, limited mobility, time out of work, and significant medical expenses. That’s why working with an experienced workers’ comp attorney is crucial when submitting your initial claim or appealing a denial.

Get in Touch with Our Workers’ Compensation Lawyers in Raleigh, NC

If your workers’ compensation claim was denied on the grounds that there was no injury by accident, Younce, Vtipil, Baznik & Banks, P.A. can help. You may still have a valid claim, but you’ll want the help of a skilled workers’ comp attorney to build your case and fight for your appeal.

We have over 90 years of combined experience and a reputation backed by millions in settlements and verdicts, including a $2.625 million workers’ comp settlement and $600,000 for a denied workers’ compensation claim (although each case is different and past results cannot guarantee future outcomes). As one satisfied client wrote:

“Only positive feedback when it comes to me. They are such a good team. Blessed to have them as my family now. Check in with these guys and get the help you deserve.” – Melissa N.

You don’t have to face a workers’ compensation denial on your own. Contact us today for your free consultation.