If you sustain an injury on-the-job in North Carolina, you will probably qualify to obtain workers’ comp benefits. However, even before you apply for benefits, you should seek legal advice and guidance from a Raleigh workers’ compensation attorney.
Every working person in this state has the right to a safe workplace, but serious work-related injuries are going to happen – and they’re going to happen not only to workers in high-risk jobs like truck drivers and construction workers.
Anyone, at any job, could slip on a damp floor, trip on a curled-up rug or carpet, suffer an electrical shock, and sustain a head, back, or neck injury or a serious burn injury.
What Does It Take to Obtain Workers’ Compensation Benefits?
If you’ve been catastrophically injured or permanently disabled because of an on-the-job injury, what benefits will workers’ compensation provide for long-term care, and what does it take to qualify for and receive long-term care benefits?
If you’ll keep reading this brief discussion, those questions will be answered, and you’ll learn how a North Carolina workers’ compensation lawyer will assist you with obtaining the long-term workers’ compensation benefits you may need.
Who Qualifies for Workers’ Comp Benefits?
North Carolina law requires almost every business that has at least three employees to provide workers’ comp coverage. The courts may impose fines on North Carolina employers who do not provide workers’ compensation coverage.
However, federal employees, railroad workers, domestic help, and farm workers at farms with ten or fewer employees may not have workers’ comp coverage in North Carolina. Additionally, sole proprietors, partners, and LLC members usually are not covered or considered employees.
North Carolina employers purchase workers’ compensation insurance to cover their employees. If someone is injured while working, that employee may submit a workers’ comp claim and – if the claim is approved – receive benefits to cover medical bills and replace lost wages.
To receive workers’ comp payments, you have to prove you were injured (or developed an illness) within the “course and scope” and “arose out of” your employment duties. You can’t receive benefits if your injury was the result of intoxication, horseplay, or your own illegal or violent behavior.
What Benefits May Be Paid?
Workers’ comp in this state pays for an injured employee’s medical costs and compensates injured employees for a portion of their lost earnings:
- Workers’ comp pays reasonable medical expenses for work-related injuries and illnesses.
- If such an illness or injury keeps you away from work for at least seven work days, you’re eligible for temporary total disability payments – at a rate of two-thirds of your average weekly pay the previous year – for up to 500 weeks (more than nine years).
- You also may be eligible to file for extended total disability payments after 425 weeks if you have no capacity to earn wages.
- If you sustain a catastrophic injury on-the-job, you may be eligible for workers’ compensation payments for life.
- If a work-related illness, accident, or injury results in death, workers’ comp pays the employee’s final medical expenses and burial costs and also pays death benefits to the worker’s immediate family.
While temporary total disability payments are limited to 500 weeks, if you and your Raleigh workers’ compensation attorney can prove you have fully and permanently lost your capacity to earn income, you could qualify to receive workers’ compensation benefits for life.
How Can You Receive “Permanent” Partial Disability Benefits?
When you reach the point of “maximum medical improvement” (which means you’ve recovered your health as much as you’re going to recover it), you will be examined to determine if your job-related illness or injury has caused any permanent impairment.
The amount and type of workers’ comp permanent disability payments you may receive will hinge on the exact nature of the disability and on your “permanent partial disability rating” (expressed as a percentage).
How Are Permanent Partial Disability Benefits Calculated?
If you permanently lose your hearing, vision, or use of your hands, arms, fingers, feet, legs, toes, or back, your benefit is two-thirds of your average weekly wages the previous year multiplied by the applicable number of weeks in proportion to your impairment rating percentage.
Confused? A Raleigh workers’ compensation lawyer can explain how your own disability benefit will be calculated, but here’s an example: If you’ve lost 50 percent of the use of your hand as the result of a work-related injury, you would qualify for 100 weeks’ worth of payments at two-thirds of your average weekly wages the year before you were injured.
For back injuries, a PPD rating at 75 percent or higher will be considered a total back disability. North Carolina worker’s comp also allows these payments for permanent partial disability:
- for serious face or head disfigurement, as much as $20,000
- for permanent injury to or loss of an organ, as much as $20,000
- for serious disfigurement to any other part of the body, as much as $10,000
How Are Permanent Total Disability Benefits Determined?
You may qualify for workers’ compensation permanent total disability benefits for life – at a rate of two-thirds of your average weekly pay for the last year you worked – if you’ve sustained at least one of these injuries:
- a loss of both hands, arms, eyes, legs, or feet
- a severe traumatic brain injury
- a spinal injury causing permanent paralysis of both arms, legs, or the trunk of your body
- second- or third-degree burns to one-third or more of your body
Will You Need Help to Receive Your Benefits?
Has your employer’s workers’ comp insurance company rejected your injury claim, refused to approve your benefits, or failed to authorize necessary medical treatment? Ask a North Carolina workers’ compensation lawyer to review your case and help you obtain the benefits you deserve.
If an insurance company mishandles your claim, let your lawyer contact the company for you. If you’re entitled to benefits, your lawyer will be able to prove it. The best strategy is contacting a Raleigh workers’ comp lawyer as soon as you’ve been injured at work.
Your lawyer will complete or review your application for benefits and ensure that there are no mistakes or misunderstandings on your part. If a dispute emerges regarding your claim, your attorney will already be familiar with your case and ready to fight for the benefits you deserve.