North Carolina workers injured in workplace accidents are usually qualified to receive workers’ compensation benefits. For help with the application process, or if your claim for benefits is denied, you will need the advice and services of a Raleigh workers’ compensation attorney.
In North Carolina, workers’ compensation is an insurance system established and managed by the state. Employers buy workers’ comp insurance for their employees. If an employee is injured on-the-job, the employee may file a claim and receive benefits as compensation for the injury.
Who is eligible to receive workers’ compensation payments in North Carolina? If you are eligible, for how long can you continue to receive the payments? And what happens if, for any reason, your workers’ compensation claim is denied?
If you’ll continue reading, these questions will be answered, and you will also find out how a North Carolina workers comp lawyer will help you with the application process – and if necessary, the appeals process – for workers’ comp benefits.
Who Is Eligible to Receive Workers’ Comp Benefits?
An on-the-job injury can damage your health and disrupt your family, your career, your finances, and your future. If you sustain an on-the-job injury, are you eligible to receive workers’ compensation benefits?
The law in North Carolina requires any business with three or more employees to offer workers’ compensation coverage to their workers. Criminal penalties (explained below) may be imposed on employers who fail to provide coverage.
Sole proprietors, business partners, and LLC members are not usually considered employees. Others who may not be covered by workers’ compensation include federal employees, domestic help, railroad workers, and farm workers employed at farms with fewer than ten employees.
What Benefits Do Injured Workers Receive, and for How Long?
Workers’ compensation in North Carolina pays for medical expenses and reimburses injured workers for a percentage of their lost wages, as detailed here:
- Workers’ compensation pays for reasonable medical costs for job-related illnesses and injuries.
- If a job-related injury or illness prevents you from working for seven or more work days, you become eligible to receive temporary total disability benefits – which total two-thirds of your average weekly wages in the previous year – for as long as 500 weeks.
- You may also become eligible for extended total disability benefits after receiving temporary total disability benefits for 425 weeks.
- Employees who suffer a catastrophic or permanently disabling injury at work – a severe brain injury or spinal cord injury, for instance – may qualify to receive workers’ compensation benefits for life.
- Should a job-related injury, accident, or illness result in a fatality, workers’ compensation pays the final healthcare costs and burial expenses and pays death benefits to that worker’s immediate family members.
When Should You Contact a Workers’ Comp Lawyer?
While the law places a 500-week limit on temporary total disability benefits, if your attorney can prove that you have entirely lost the capacity to earn an income, it is possible that you could receive workers’ comp payments for the rest of your life.
Do not procrastinate. If you’re unable to work, you need workers’ compensation benefits now, so you need to schedule a meeting at once with a North Carolina workers’ comp lawyer.
You will receive a free case evaluation – with no obligation – so you’ll understand how the law applies to your case, and you will be able to make an informed decision about moving forward with a workers’ comp claim or appeal.
What Else Should You Know About Eligibility?
To obtain workers’ compensation benefits, you do not have to prove that your employer was in any way negligent. You only need to prove that the injury occurred (or the illness developed) within the “course and scope” of your duties as an employee.
You won’t be eligible for workers’ comp payments if you were injured as the result of “horseplay,” intoxication, or your own violent or criminal behavior.
What If Your Claim Is Denied?
If you are injured at work, report the injury to your employer immediately or as soon as you’ve received medical treatment. Then contact a North Carolina workers’ compensation lawyer to help you complete the benefit application form or to review it for accuracy and completeness.
Your workers’ compensation claim will be approved when your employer and your employer’s insurance company both agree that your injury or illness is work-related. Should your workers’ comp claim be denied, speak to a workers’ comp attorney at once about handling your appeal.
When a claim is rejected, a first appeal will be considered by a deputy commissioner of the North Carolina Industrial Commission (which administers workers’ compensation in this state). At your appeal hearing, your attorney will present evidence that your job-related injury prevents you from returning to work.
Should your first appeal fail, a panel of commissioners will hear a second appeal, and should that fail, your Raleigh workers’ compensation attorney can take your claim to a North Carolina civil court.
What If The Employer Has No Coverage?
As mentioned previously, criminal penalties may be imposed on employers who do not provide workers’ comp coverage.
A North Carolina employer who is required to provide workers’ compensation coverage and “willfully fails” to secure the coverage may be charged with a Class H felony and may be fined from $50 to $100 for each day that employees are not covered.
However, an employer who merely “neglects” to provide workers’ compensation coverage may be charged with a Class One misdemeanor.
Can An Employer Be Sued?
The North Carolina Workers Compensation act is an exclusive remedy, which means that the employer cannot be sued outside of the workers compensation act, even if they do not have workers compensation insurance coverage. The only exceptions to this exclusivity provision is if the employer intentionally injures the employee, or if the work practice is so dangerous that it constitutes willful and wanton behavior likely to cause serious injury. This exception is also known as a Woodson case. Proving Woodson cases in North Carolina is extremely difficult, and they are very rare.
Why Is a Lawyer’s Help So Important?
If you are entitled to workers’ compensation benefits, a North Carolina workers’ comp lawyer will know how to prove it. Put your case in the hands of a lawyer who can provide the help you need to acquire the benefits you deserve.
In fact, if you’re injured on the job anywhere in North Carolina, contact a workers’ comp lawyer as soon as possible. Your attorney can help you file your claim and ensure that no mistakes or misunderstandings – on your end – delay your benefits.
