North Carolina Workers' Compensation Benefits
Workers’ compensation is a type of insurance that pays certain benefits to employees who are injured on the job or who develop work-related diseases. Most employers in North Carolina are required to have workers’ compensation insurance to protect employees in the event of a workplace accident. Special rules apply to trucking companies and to construction contractors. View our resource to find out if you NC employer carriers worker’s compensation coverage.
The types of workers’ comp benefits that injured employees may receive include:
- Reasonable medical and rehabilitation expenses and reimbursement for mileage to doctor’s appointments
- Cash benefits for time off work if you are temporarily disabled
- Lump sum payments for disfigurement, loss of an important body part or loss of hearing or vision
- Death benefits to dependents
How Does Workers’ Compensation Work?
The goal of the workers’ compensation process is to provide health care to restore an injured employee as nearly as possible to the fitness and ability to work that the employee had before the injury.
Workers’ compensation claims are generally administered by an insurance carrier representing the employer. If an employer is self-insured, the company’s human resources office may have a claims administrator who handles claims.
An injured employee is responsible for reporting his or her injury to the employer. Employees should report any on-the-job injury or work-related disease orally to their supervisor as soon as possible.
A written report detailing the time and date of the injury and how it occurred should be made within 30 days of the injury or diagnosis of a work-related condition. If you cannot fulfill this requirement, you should have a spouse or loved one do it for you. It is a good idea to keep a copy of the letter with your records.
If the employer or the employer’s insurance administrator agrees that the injury is covered by workers’ compensation, then the injured worker should have paid medical care and start receiving lost-income compensation checks once they have been out of work on a doctor’s excuse for more than seven days. The income benefits continue until the worker is able to return to work full duty. If the injured worker returns to work on light duty and does not make as much money as before, the injured worker may be entitled to additional cash benefits.
The employer or employer’s insurance carrier directs the workers compensation medical care though the worker may ask for second opinions under certain conditions.
The injured employee should inform the doctor that the injury is work related. The injured worker should follow the doctor’s orders and keep all follow-up appointments
What if the Workers’ Comp Claim is Not Approved?
Many legitimate claims are initially disputed or denied by employers and their workers’ compensation insurance administrators.
If the employer disputes the claim, then the worker has a right to appeal the denial. The appeals process has multiple steps and can be complicated. If the claim is disputed, the worker should have a knowledgeable workers’ compensation attorney review the details of the accident and provide guidance as to whether the injury should qualify for workers’ comp coverage.
Our knowledgeable attorneys can help you determine whether your employment status entitles you to claim workers’ compensation benefits.
What Are the Cash Benefits Available?
If a worker is off work for more than seven days as a result of a workplace injury, he or she may be entitled to disability compensation to replace lost wages.
The disability payment is calculated based on two-thirds (66 2/3 percent) of the injured worker’s average weekly wage with a maximum weekly payment of $992, effective January 2018. The maximum benefit is adjusted annually.
The cash benefits should continue until the injured worker is cleared by the doctor to return to work full duty. If the injured worker returns to work on light duty and does not make as much money as before, the injured worker may be entitled to additional cash benefits.
What Are Death Benefits?
A deceased employee’s dependents may be entitled to compensation if a loved one’s death occurred as a result of a workplace accident or a work-related disease. The amount of compensation and who is eligible to receive compensation depends on the facts and circumstances of the injury and the application of workers’ compensation rules and regulations to the specific claim. Some limited payment of funeral expenses also may be available.
Can I Sue My Employer after a Workplace Injury?
As a general rule, an injured employee’s options are limited to filing a workers’ compensation claim if available.
You may in limited circumstances sue an employer if the employer does not have workers’ compensation.
An injured worker may be able to file an injury lawsuit against another company working on the same job site, if the other company created conditions that led to a workplace accident. An injured worker may receive workers’ compensation and also seek compensation from another company that is liable for a workplace injury.
Understand Your Legal Rights
Injured employees must follow certain procedures and regulations to obtain workers’ compensation benefits. Some valid claims are turned down initially. Appealing a disputed workers’ comp claim is a complicated process that includes specific filing deadlines, compiling complex medical evidence and going before a judge at a hearing. You will have a greater likelihood of success if you have a seasoned workers’ compensation attorney who knows your rights under the law standing up for you.
Our lawyers at Younce, Vtipil, & Baznik, P.A., have many years of experience handling North Carolina workers’ compensation appeals. Attorneys Robert C. “Chip” Younce Jr. and David E. Vtipil are board-certified specialists in North Carolina worker compensation law. Board certification by the North Carolina State Bar indicates that a lawyer has received enhanced training and passed a special examination in a particular area of law. Board certification is a designation that only a small percentage of attorneys in North Carolina have. We apply our experience and knowledge to help clients pursue the workers’ comp benefits they need. You will not owe a legal fee unless we are successful in securing benefits for you. Contact us for a free claim review and discussion of your legal options.