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Workers’ Compensation

The following descriptions are meant to be only a brief summary of the law in this area. You should never rely upon these descriptions in lieu of legal advice by a licensed attorney

In order for your case to be considered a workers’ compensation claim, certain requirements must be met under North Carolina General Statutes, Chapter 97, Workers’ Compensation Act. The employer must employ three full-time regular employees in order to be an employer under the act. If an injured individual is working as an independent contractor, as opposed to a W-2 employee, the act may or may not apply. The injury by accident or occupational disease must occur in the regular course and scope of employment.

There are two situations in which a worker can be compensated under the act:

• Injury by accident –this is a legal term of art that is defined in the act. Generally a person must be doing something out of the ordinary when the injury occurs, like a fall or a machinery malfunction. However, in the case of back injuries, all a claimant has to show is that he had a specific traumatic incident. This exception only applies to back injuries and means that an injured worker may be compensated, even if he was not doing something out of the ordinary.
• Occupational Disease – A person may be compensated for an Occupational Disease, if he can show that he was exposed to environmental factors at the job that caused the occupational disease. The Claimant must show that people that work within the employer’s industry are at an increased risk of contracting the disease than members of the general public

Once a person’s claim is accepted by the employer or worker’s compensation carrier, or when a denied claim as been found compensable by the North Carolina Industrial Commission, an injured worker’s benefits can be summarized as follows:

• Temporary Total Disability – If an injured worker has been out of work for more than seven days consecutively, he is entitled to Temporary Total Disability Benefits (TTD). TTD is to be paid weekly and is two-thirds of the worker’s average weekly wage, also known as the compensation rate.
• Medical Treatment – An injured with an accepted workers’ compensation claim is entitled to any and all medical treatment necessary to effect a cure and/or lessen his period of disability. However, the insurance company generally has a right to direct the medical treatment and choose the primary treating physician. An injured worker has some other limited rights as to his choice of physician or treatment.
• Permanent Partial Disability – When an injured worker has reached Maximum Medical Improvement (MMI), the treating physician will usually assign a permanent partial disability (PPD) rating to the affected part of the body. The Worker’s Compensation act lists specific numerical formulae to calculate the amount of compensation an injured worker is due for his PPD based on the PPD rating and the injured body part. The act does not afford any compensation for pain and suffering, and this is the only aspect of the system that addresses permanent disability.