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Do I Qualify For Workers’ Comp  in NC?

In a typical Workers’ Comp case, you will qualify for Workers’ Comp in NC if your case meets these requirements:

You must be employed

Your employer must carry Workers’ Comp insurance

You must have sustained a work-related injury or illness, and

You must meet North Carolina’s deadlines for reporting the injury and filing a workers’ comp claim.

After promptly notifying your supervisor about your desire to file for workers’ comp, a form 18 should be completed and filed within 30 days. The employer and/or insurance carrier should receive a copy while you keep one for yourself. This form must be filed within two years of the injury taking place. All of these components are critical for you to qualify for Worker’s Comp. You can hire a Workers’ Comp lawyer at any time during the process of your claim; however, it is best to involve an attorney earlier rather than later, to help preserve your rights under your case and to help build your case as time goes by.

Common On The Job Injuries that Qualify for Workers’ Comp

Getting hurt on the job is never a good outcome. Unfortunately, some injuries do not qualify for Worker’s Comp in NC. Generally speaking, injuries that occur in the workplace or while doing something on behalf of your employer, are qualifying injuries for Workers’ Comp in NC. Other injuries include those sustained while operating a company vehicle or traveling as a passenger in a company vehicle. For example, delivering mail, or traveling to a client destination. If you are injured during a company sponsored event, you may have the option of choosing between Workers’ Comp and Personal Injury. Your choices will depend upon the facts which led to the injuries. Your injury attorney can help you understand the factors which trigger pursuing Workers’ Comp vs. Personal Injury. Lastly, while you may have a claim for mental injuries such as anxiety or depression, you will typically need a physical connection to those injuries in order to claim them. If you claim PTSD as part of your injury, and you can tie the PTSD to a physical injury you sustained on the job, you are well on your way to making the necessary connection.

Which Employers Must Carry Workers’ Comp Insurance?

Any employer in North Carolina who employs three or more individuals must carry Workers’ Comp insurance. Often, a Workers’ Comp lawyer will devote resources to establishing that an employer actually has three or more employees. In ever-changing work structures, there are many times that an employer employs only independent contractors. While it is permissible to employ an independent contractor, an employe cannot use the status as a way to avoid Workers’ Comp insurance or paying a Workers’ Comp claim. Your attorney can help to successfully recover against the employer in these situations.

There are some allowable exceptions to the requirement to carry Worker’s Comp for an employee whether they are in independent contractor or not. Housekeepers and/or domestic servants that are directly employed by the household, certain farm laborers, and certain railroad employees are among them. Employers who fail to carry workers’ compensation insurance may face stiff financial penalties, be charged with a misdemeanor, be charged with a felony, and be imprisoned. If your employer fails to carry required workers’ compensation insurance, you should report the lack of workers’ compensation insurance or approved self-insurance to the NCIC Fraud Section and, if injured, should file a form 18 and form 33.

Coverage For Permanent Partial Disability

Permanent partial disability cases are some of the most common Workers’ Comp cases. The disability can originate from either a work related injury or an occupational disease. Permanent partial disability means that there is a permanent impairment which causes an employee to be unable to complete certain work related tasks to the best of their ability. This disability can be a physical impairment caused by a work related accident, or even a mental condition caused by the job. For example, post traumatic stress disorder. Physical examples of permanent partial disabilities include losing a limb, carpal tunnel syndrome, loss of vision in one eye (both eyes would be considered total disability), nerve damage, or a knee injury that causes walking or standing for prolonged amounts of time to be painful.

Workers’ Comp claimants routinely find themselves in a battle between their doctor and the Workers’ Comp doctor, over the percentage disability and whether it will be permanent or temporary. Good Worker’s Comp claims are won and lost over these distinctions and your lawyer will assist with building a case for the worst case scenario for your injury, to combat the insurance lawyer’s attempt to minimize your injury and the amount you should be compensated for it.

Lost Wages Claims

Lost wages are compensable in Workers’ Comp; however, even if you qualify for Worker’s Comp in NC, only a percentage of your lost wages will be paid under a Workers’ Comp claim. While this is true, when combined with a permanent partial disability, the total compensation is meant to compensate you for the injury and the financial loss you have suffered and will continue to suffer over time.

Speak With A Worker’s Comp Lawyer Today

If you would like to speak with an attorney about your Workers’ Comp or personal injury case, we’re here to help. The call is free and you will come away with a much better understanding of your options. You can reach us at 704.749.7747 or click to request a FREE CASE EVALUATION, and we will be in touch shortly.

Further Reading

If this article was helpful, you may find other helpful articles on our Personal Injury Blog. Thank you for visiting the website—we hope it has been helpful.

According to statistics, almost 2.9 million workers across the country sustained workplace injuries and illnesses in 2015.

Most of those injuries involved time off work, job restrictions or transfers. Workplace injuries in North Carolina put workers out of work every day leaving them unable to support their families. North Carolina workers’ compensation pays benefits to employees who are injured on the job. Workers may receive medical treatment, compensation for wage loss, and other financial assistance. Employers are mostly required to provide workers’ compensation to employees.

In order to preserve your rights in this regard it is important to understand what actually qualifies as a workers’ compensation claim. An injury caused by an unexpected accident or incident that occurred in the course of employment is what qualifies as a worker’s compensation claim. Other occupational injuries that occur over time such as repetitive trauma injuries like carpal tunnel syndrome also qualify for workers’ compensation benefits.

Employees diagnosed with diseases that are associated with certain occupations or employment also may be covered by worker’s compensation. All employers in North Carolina are required to carry workers’ compensation insurance for employees that are injured or develop an illness related to workplace exposures.

Necessary Steps To File a Workers’ Compensation Claim In North Carolina

  • It is important to notify your employer of a work-related injury in writing within 30 days of sustaining the injury. Make a simple written statement about what happened and include the date of the accident. Even if there is no time lost from work because of the workplace accident you should notify your employer as soon as possible. If you are unable to do so yourself because of the severity of your injury, then have a family member, friend or your health care provider inform your employer.
  • Get medical attention as soon as possible. If your place of employment has a doctor on site then you should see them. If your employer sends you to a doctor or healthcare provider somewhere else, go see the health care provider. You can also visit your own doctor but you are required to see any healthcare provider your employer designates.
  • Describe your injury or illness to the doctor in detail. The doctor should be aware of the fact that your injury happened in a workplace accident or your illness developed as a result of workplace exposures. Give your employer’s name to the doctor because it allows the doctor to record the treatment as a workers’ compensation expense.
  • Follow doctor’s orders. It is imperative that you follow any and all directions that the doctor gives you regarding your treatment. The primary aim of workers’ compensation insurance medical care is to restore the employee to the health and ability to work as before the injury occurred. Failure to follow the doctor’s instructions and appointments will jeopardize your workers’ compensation benefits.
  • It is important to make sure that your claim is filed correctly with the N.C. Industrial Commission. All claims are initiated with the Industrial Commission’s Form 18 which is available in paper and electronic form. It must be filled out completely and submitted. Additional forms should also be filled accurately as the claim is processed. Do not fail to complete and submit any form that applies to your claim.
  • It is important to make and keep copies of every letter, every medical report, every bill, and every completed form. In the event that there is a dispute regarding your workers’ compensation claim, you may need to show proof that you have acted according to the law.
  • It is imperative to follow the notification process and remain within the time limits otherwise your claim may be denied.

An injured employee is eligible to receive workers’ compensation benefits until he or she is able to return to work.  If you or someone you love has suffered a job-related injury or illness, you may need to file a North Carolina workers’ compensation claim. Call us at 704.749.7747 for a free consultation or click HERE To request a call. We hope you’ll choose to recover with us.

Author: The Law Office of Pittsburgh Injury Lawyers offers a diverse range of legal services with special focus on workers compensation, personal injury, and Social Security Claims.

 

Workers’ Comp: Claims and Benefits

To apply for a Workers’ Comp claim you will have to establish that the injury was within the scope of employment. Otherwise you may not be able to file for a Workers’ Comp claim. Generally, if your injury was sustained while within the scope of employment, your lawyer and doctor will work together to make a determination regarding the benefits you deserve.

 

Your Workers’ Comp lawyer will generally negotiate with the insurance adjuster for the employer’s insurance company regarding your missed pay or wages, as well as any percentage impairment you’re entitled to receive. Keep in mind that if you have a Workers’ Comp claim you can’t also pursue a personal injury claim against the employer for the same incident. You do not however, have to prove negligence in order to file a Workers’ Comp claim.

Workers’ Comp Denied?

There are many reasons that your Workers’ Comp claim can be denied. Perhaps your injury was not being within the scope of employment, you perhaps you failed to file within the required amount of time. Additionally, a Workers’ Comp claim or the value of the claim, can be compromised if you failed to seek proper medical treatment for your injury.

 

If your claim is denied, you can appeal the denial of your claim. The denial letter should provide a certain amount of days by which you need to appeal, otherwise your right to appeal will be lost. You will be asked to provide any medical or employment documentation of your injury in your appeal. If you do decide to appeal it is an arduous process best undertaken by an attorney who can adequately assist you in protecting your rights.

 

Returning To Work Early

Your doctor will be the voice of reason when it comes to returning to work. While youyou’re your lawyer will maintain contact with the employer or their insurance adjuster during your absence, it is not unusually to return to “light duty” work assignments as you heal from your injury.

 

Employers are allowed to replace injured workers, however, and you should be prepared that you may lose your position due to extensive time away from the job. If you return to work with another employer, keep in mind that may have ramifications on your Workers’ Comp claim—your lawyer should be consulted before you engage in employment with another employer.

 

Components of A Settlement

Workers’ Comp covers wage loss benefits and medical expenses, but to the surprise of most clients, it does not provide for pain and suffering. You also cannot sue for cause of disability or cause of injury within your Workers’ Comp claim. Future earning capacity should be addressed in your claim, and these benefits are calculated in a similar manner to your permanent or partial disability benefits.

 

What Your Attorney Can Do For You

Your attorney can help you determine the value of your Workers’ Comp claim as well as file the claim, manage it on your behalf, and negotiate your best result. Your attorney will fight to help you receive the benefits you deserve. Your Workers’ Comp attorney will also help to ensure that your claim and you are both taken care of in the most efficient and caring way.

Call A Workers’ Comp Lawyer Today

If you or someone you love has been injured on the job, please call us to find out your rights. We are more than happy to hear your story and give you a complimentary assessment of your case or claim. If we can’t take your case for some reason, we will help refer you to another trusted lawyer or law firm that can assist you. If you’d like to speak with an attorney today, call 704.749.7747 or click HERE to send us a request for a phone consultation. We hope you’ll choose to Recover With Us.

What Is Workers’ Comp?

Workers compensation or (“Workers’ Comp”) is a state mandated insurance coverage that covers employees when they are hurt on the job. The primary difference between Workers’ Compensation (“Workers’ Comp”) and Personal Injury is that in order to establish a Workers’ Comp claim, you must be employed at the time of the injury, and the injury must be a direct result of the employment.

Entitlements from Workers’ comp include benefits such as medical care, coverage for rehabilitation services, indemnity wage benefits, and in certain cases death benefits. This type of claim does not provide for mental anguish or pain and suffering the way a personal injury claim might provide for such categories of damages.

Scope Of Employment

If you seek Workers’ Comp benefits, the employer will fight to make sure that the injury was within the scope of employment. The scope of employment is a way to determine whether the injury was an  “on the job” injury. This doesn’t require the employee was physically on the employer’s property. Quite often employees perform tasks which take them off the job site, though they are still within the scope of their employment. For example, the employer would more likely be liable if an employee on a construction site was hit by a falling pipe or injured in a trench collapse.

If the same employee was in a car accident while driving to get lunch at a gas station, the employer might argue at the time of the car accident, the employee was not performing his job and was “outside the scope of employment” and therefore the employer is not responsible. Of course, the employee may have a personal injury claim against the individual who hit his vehicle.

Medical Treatment In Workers’ Compensation

The employer or its insurance company has the right to direct the medical treatment of the injured employee. The reasoning for this is that the employer or insurance company will be paying for the treatment. The employee can petition the Industrial Commission of NC to change physicians if good grounds for doing so are established.

If an employer refuses to provide medical treatment in an emergency, the employee can and should seek medical treatment. Shortly following that treatment, the employee should notify the Industrial Commission and request approval retroactively.

Receiving Compensation

No compensation is due for an employee during the first seven days of missed work. However, if the loss of work exceeds twenty-one days then the employee is entitled to be compensated for all lost wages.

Payments for lost wages in a Workers’ Comp claim are made to the employee on a weekly basis, or sometimes on a monthly basis if authorized by the Industrial Commission of NC.

How Much Will I Get Paid?

The general formula for Workers’ Comp is 66 2/3 of the average pay per week, not to exceed $978.00 per week. This maximum weekly benefit is revisited and adjusted by the Industrial Commission every year.

You will receive your agreed upon wage until you are able to return to work, at which time your salary our hourly rate will resume and your Workers’ Comp claim will close.

Lawyers Fees In Workers’ Comp

Lawyers fees in Workers’ Comp cases must be approved by the state of NC, the Industrial Commission. Typically, those fees will be approved for up to 25% of the total settlement or award.

The injured employee benefits from this compensation structure in a few ways. First, the employee doesn’t owe the attorney anything if the attorney doesn’t win the case for the employee. Second, because most attorneys will get paid the exact same amount in a Workers’ Comp case, it allows the employee to choose a Workers’ Comp lawyer they want to work with—rather than choose the cheapest attorney for the job.

Call A Workers’ Comp Lawyer Today

If you or someone you love has been injured on the job, please call us to find out your rights. We are more than happy to hear your story and give you a complimentary assessment of your case or claim. If we can’t take your case for some reason, we will help refer you to another trusted lawyer or law firm that can assist you. If you’d like to speak with an attorney today, call 704.749.7747 or click HERE to send us a request for a phone consultation. We hope you’ll choose to Recover With Us.