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.
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