If you are injured on the job in North Carolina, you may be entitled to workers’ compensation benefits. After you have obtained medical treatment for your injury, schedule a consultation at once with a Raleigh workers’ compensation attorney to discuss your compensation rights.
Who is eligible for workers’ compensation benefits in North Carolina? What do you have to prove in order to receive those benefits? And what happens if your employer or your employer’s insurance company challenges your workers’ compensation claim?
If you will continue reading, these questions will be answered, and you will also learn why a Raleigh workplace injury attorney should advise and guide you through each step of the workers’ compensation application process.
What Does North Carolina Law Require?
You can be injured at any kind of job, so workplace safety is everyone’s concern. A work-related injury can damage your health, threaten your career, and eat away at your finances. What will you need to know if you are injured while you’re at work?
The North Carolina Workers’ Compensation Act (NCWCA) requires every business that has three or more employees to carry workers’ compensation insurance coverage for those employees. Business partners, LLC members, or sole proprietors are not generally considered employees.
However, if those individuals satisfy certain requirements, they may choose to be covered by workers’ compensation. If a corporate officer chooses to be excluded from coverage, he or she is still counted as an employee to determine if a business has three or more employees.
Who Is Not Covered?
The following individuals are also exempted from workers’ compensation coverage in North Carolina:
- farm workers on farms with fewer than ten employees
- domestic or “household” workers
- employees of the federal government
- railroad employees
- “casual” employees who do not work regular hours and may leave with no notice
In North Carolina, in most circumstances, you cannot sue an employer for an injury sustained in a work-related accident in a regular civil court. Employers are required only to have workers’ comp coverage for every employee.
Workers’ compensation shields employers from personal injury lawsuits that otherwise would be pursued by injured employees. In return, injured workers are compensated without having to file a lawsuit or prove that the employer was negligent.
What Does Workers’ Comp Provide?
Workers’ compensation in North Carolina pays for medical costs and partially replaces the lost wages of employees who are injured on the job or who become ill because of their work. Here are the specifics:
- Workers’ compensation pays for all reasonable medical costs to treat a work-related injury or illness. The employer or the employer’s insurance company may choose your health care provider.
- If a job-related injury or illness prevents you from working for more than seven days, you may receive temporary total disability benefits – at the rate of two-thirds of your average weekly wage – for up to 500 weeks.
- If, after receiving 425 weeks of temporary total disability benefits, you are likely to have a continuing total loss of earning capacity, you become eligible for extended temporary total disability benefits.
- Employees who have suffered catastrophic injuries such as a traumatic brain injury, a spinal cord injury, or a double amputation may receive permanent and total disability benefits for life.
- If an employee dies as the result of a job-related accident or injury, workers’ comp may cover final hospital and medical expenses, burial expenses, and provide the employee’s family with death benefits.
What Do You Have to Prove to Obtain Benefits?
If you file a workers’ compensation claim, you do not have to prove that your employer was in any way negligent. You merely have to demonstrate that you were injured by an accident or developed an occupational disease in the “course and scope” of your job duties.
You may not receive workers’ comp benefits if you were injured at work because you were intoxicated or if you were injured while engaging in “horseplay,” violence, or criminal activity.
The right North Carolina workers’ compensation lawyer can help you file for workers’ comp benefits. If you filed without an attorney’s guidance and your workers’ comp benefits were denied, have an attorney request a hearing on your behalf.
What If Your Workers’ Comp Claim is Denied?
Under the North Carolina Workers’ Compensation Act, in order to obtain benefits, you must report a work-related injury to your employer within thirty days, and you must file “Form 18” to apply for workers’ comp benefits within two years of the date of your injury or illness.
Do not wait thirty days or two years. If you are injured at work, notify your employer immediately or as soon as you have received medical treatment. Then contact a Raleigh workers’ compensation lawyer to ensure that your Form 18 is complete and accurate before you file it.
Workers’ comp claims are approved when the insurance company and the employer agree that an employee’s injury or illness is work-related. Most claims are approved, but if yours is denied, you will need to be advised and represented by a Raleigh workers’ compensation attorney.
Can the Denial of Your Workers’ Comp Claim Be Appealed?
If your workers’ compensation claim is denied, your attorney can request a hearing before a deputy commissioner of the North Carolina Industrial Commission, which governs the state’s workers’ compensation system.
At a hearing, your attorney will present medical evidence to show that your claim is compensable and how the injury has changed your life and impaired your ability to work.
If the deputy commissioner rules against you, your attorney can appeal the decision to a panel of three full Commissioners at the Industrial Commission. If that panel rejects your workers’ comp claim, your attorney can then take your case to the North Carolina Court of Appeals.
When Should You Contact a Workers’ Comp Attorney?
Seek the guidance and advice of a Raleigh workers’ compensation lawyer immediately after you’ve been injured and treated – in other words, from the very start of the workers’ comp application process. Even if you have done everything properly, complications may still arise.
If an employer’s workers’ comp insurance provider seems to be obstructing or mishandling your claim, for instance, let your attorney speak to the company on your behalf. It is better to have your attorney do the talking and negotiating for you.
Everyone’s situation is different. Every work-related injury is different. That is why, after a work-related injury, you need personalized legal advice and guidance from the right North Carolina workplace injury lawyer.