Workers’ Compensation Benefits
Generally speaking an injured worker with an accepted or compensable claim is entitled to the following benefits:
- Medical Care: The injured party has the right to all reasonable necessary treatment to cure or relieve the effects of the injury. Included under medical treatment compensation are all medical bills, prescriptions, and even mileage, if the roundtrip from your home to the medical provider is more than 20 miles. Generally, a patient has to use the company doctor. In some limited circumstances, a patient may choose a different doctor, but a motion to the Industrial Commission is often required to make the change.
- Temporary Disability: If the injured party must take time away from work due to medical reasons related to the injury, he or she might be entitled to temporary total disability payments (TTD) that would provide him or her with partial compensation for lost wages. There is a specific maximum pay rate, but this compensation rate normally equals about two-thirds of one’s average weekly gross pay, and is paid out every week. After the doctor verifies an inability to work and the injured worker has missed more than 7 days consecutively, the first temporary total disability check should arrive within a few weeks.
- Permanent Disability: If a worker can’t completely recover from the effects of an injury, he or she could be entitled to a monetary award for his or her permanent disability. Permanent disability means that the injured party has lost some ability to compete in the open labor market of uninjured workers. The amount and rate at which permanent disability is paid depends on how great a limitation the injury places on one’s earning capacity, the part of the body injured and earnings at the time of injury. Under North Carolina Workers’ Compensation Act, permanent partial disability compensation is calculated in two ways. One way is by a permanent partial disability (PPD) rating to a particular part of the body. A second way is by the loss of a person’s earning capacity over 300 weeks. These benefits are generally payable based on a percentage difference between the employee’s pre and post-injury earnings. If a person is unable to return to any suitable employment for the rest of his or her life, that person is permanently and totally disabled and will receive weekly payments for the rest of his or her life or until the case is settled.
- Vocational Rehabilitation: If an injury prevents a return to one’s former job, assistance in getting another job, vocational rehabilitation, might be included in workers’ compensation benefits. During vocational rehabilitation, the injured worker continues to receive temporary disability. The vocational rehabilitation process is designed to help the injured worker regain suitable employment, but in practice it often merely serves as a harassment.
Remember, if there is any change in an employee’s work status while he or she is receiving workers’ compensation benefits, the employer or the insurer should be notified immediately, as well as the workers compensation attorney. Failure to do so may have adverse effects on the employee’s right to receive benefits. You have two years after you receive your last payment to request additional medical treatment or other benefits if your condition worsens. Workers are frequently offered an additional amount on top of their entitlement in exchange for their agreement not to pursue additional benefits and not to reopen the case if the condition worsens. This is called a clincher agreement. Carefully consider the effect of such an agreement before executing it.