+ What is workers' compensation?
Workers' compensation is a form of state-mandated insurance that provides medical benefits and lost wages (indemnity benefits) to workers who are injured in the course and scope of their employment. Workers' compensation is a no fault system therefore, even if the injured worker is at fault for his or her accident, he or she may still recover benefits and/or wages. General damages for pain and suffering, as well as punitive damages for employer negligence, are not recoverable.
+ How do I find out whether my employer has workers' compensation insurance?
If you are injured on the job, and your employer has three or more employees, they are required to carry workers' compensation insurance. If you are unsure whether your employer has workers' compensation coverage, contact Collier Law or you can search the North Carolina Industrial Commission database at: https://ccms.ic.nc.gov/insurancecoverage/inscov/insCoverageSearch
+ What is the North Carolina Industrial Commission?
The North Carolina Industrial Commission administers workers' compensation laws. It is comprised of the executive secretary's office, which handles administrative matters, and twenty deputy commissioners who are judges that hear and decide workers' compensation matters in dispute. After a claim has been heard before a deputy commissioner, either party has the right to appeal to a panel of the full commission, which will be heard before three commissioners.
+ What injuries are covered?
Workers' compensation insurance provides coverage for illnesses and injuries that occur by accident in the course and scope of an individual’s employment. This can include orthopedic injuries, such as back, rotator cuff, and knee injuries, as well as occupational diseases, which are conditions that are particular to the hazards of a certain employment (such as carpal tunnel syndrome, asbestos exposure, etc.). Most injuries require an accident, i.e., something unexpected that is not in the routine of normal work. However, there are exceptions to this rule, specifically for injuries to the back, hernias, and overuse injuries due to repetitive motion.
+ What should I do if I am injured on the job?
The first thing you should do is report your injury immediately to your supervisor, human resources, or designated personnel. Ask to fill out an incident report. If the employer has a preferred doctor, such as Concentra, Fast Med, or another urgent care, ask to be sent there as soon as possible
+ Do I get to see my own doctor?
Under North Carolina workers' compensation laws, the employer or its insurance company has the right to direct medical treatment, meaning they can send you to a doctor of their choosing. However, you may be entitled to a second opinion. Feel free to contact us to discuss this further.
+ Do I get reimbursed for medical travel?
If you travel more than 20 miles round-trip for medical services, such as doctor appointments or physical therapy, you are entitled to mileage reimbursement. The mileage rates are .56 cents per mile for travel incurred between January 1 and December 31, 2014, .575 cents per mile for January 1 to December 31, 2015, and .54 cents per mile for January 1, 2016 to December 31, 2016.
+ What is a Form 18?
A Form 18 is a Notice of Accident to your employer. The Form 18 is one of the most important forms to complete once you have suffered an injury or illness. We highly recommend that you contact us to properly complete the Form 18, as incorrect completion can result in an insurance company denying part of your claim in the future.
+ How are my weekly benefits calculated?
Injured workers who are out of work due to their injury are entitled to receive 2/3 of their average weekly wage from the insurance company. The insurance company will normally contact your employer to determine your wages and then make the appropriate calculation. For example, if you make $300 a week in gross wages, you would be entitled to receive a check in the amount of $200 per week from workers’ compensation. Workers' compensation benefits are considered after-tax income, and therefore are not subject to taxation.
+ What if they are paying me incorrectly?
If you feel the insurance company is not paying you correctly, it is important that you contact us immediately to rectify the situation. We have tools that can force the employer and insurance company to turn over your actual wages in order to make a determination if you are not being paid properly. Often times, insurance companies may take a guess at what you were making and issue you a weekly check based on that figure. If the number is incorrect, you may be entitled to additional wages.
+ How will I know whether my claim is accepted or denied?
The employer and its insurance company have the right to investigate the claim to make a determination whether it is accepted or denied. If the claim is accepted, then the insurance company will usually file a Form 60 or Form 63. It is very important if the insurance company accepts your claim that they file one of those forms. If an insurance company denies your claim, they will file a Form 61.
+ Is my claim over if they deny it?
Absolutely not. You should contact Collier Law immediately if the insurance adjuster indicates they are denying the claim or if they file a Form 61. If the claim is denied, your attorney will file a hearing request that will let the Industrial Commission know there is a dispute between the parties.
+ What happens if the claim is denied?
If your claim is denied, contact us immediately. We will file a Form 33 Request for Hearing, which places the Industrial Commission on notice of the dispute. The Industrial Commission will require the parties to attend mediation in an attempt to resolve the claim; if the case cannot resolve at mediation, the parties will proceed to a hearing before a deputy commissioner
+ How much does it cost to hire an attorney?
Absolutely nothing. We work solely on a contingency fee basis where we only get paid if you win or we resolve your case. The standard fee for workers' compensation attorneys in North Carolina is 25%. We provide a free consultation and you will not pay us anything out of pocket.
+ Should I give the insurance company a recorded statement?
Many times insurance companies will ask the injured worker to submit to a recorded statement, where an insurance adjuster will ask you questions and record the conversation. We highly suggest that you contact an attorney prior to giving a recorded statement.
+ If I hire Collier Law, will I be able to talk to an attorney?
Absolutely. Collier Law prides itself on its personal approach to handling claims, and while you will have a paralegal dedicated solely to your case, you will always be able to speak with an attorney.
+ The insurance company is trying to cut off my check. What should I do?
Many times, if a doctor releases you to go back to work, the insurance company will file an application with the Industrial Commission to stop your weekly check. It is imperative that you contact an attorney immediately when you receive this application in order to preserve your right to continue receiving weekly payment.
+ After I get hurt, do I have to go back to work?
It depends. Frequently an employer will offer an injured worker a light duty job that may or may not be within the restrictions assigned by your doctor. The law requires, in an accepted claim, that the employer submit a job description to the doctor for his approval prior to you returning to work. If you feel your employer is trying to make you come back to work before you are capable, you should contact Collier Law immediately.
+ What is vocational rehabilitation?
Vocational rehabilitation is a job placement tool that insurance companies use to try to find an injured worker a job. It is a process that the insurance company can put in place or the injured worker can request. Please contact us to discuss vocational rehabilitation further
+ The company has assigned me a nurse case manager. What are my rights?
If your claim is accepted and you are receiving medical treatment, an insurance company may assign a nurse case manager to attend medical appointments with you. It is extremely important to know that you are entitled to a private examination with the doctor and the nurse can only speak to the doctor in your presence.
+ When do I get to settle my case?
This depends. If your claim is denied, then we will proceed to mediation prior to going to a hearing before a deputy commissioner. If your claim is accepted, then we will strategically put your case in the best possible posture for settlement. This will include making sure that you have received the medical treatment you require, are receiving the correct weekly compensation, and are cared for financially in the future if you cannot return to work.
+ What is MMI?
MMI refers to maximum medical improvement. Basically, this is the doctor saying your condition is as good as it is going to get. A doctor will inform an injured worker they are at MMI when the condition cannot be further improved
+ What is TTD?
TTD, also referred to as temporary total disability, is payment of a weekly check to an injured worker in lieu of wages. As noted above, it is calculated as 2/3 of the injured worker's average weekly wage. Please contact us if you feel your TTD payments are incorrect.
+ What is TPD?
TPD, also referred to as temporary partial disability, is payment of the difference in wages if you have returned to a job at a lower wage due to your injury than what you were making before you were hurt.
+ What is a rating?
A rating, also referred to as permanent partial disability, is a percentage assigned to the loss of use for a specific body part. The significance of a rating is judged on a case-by-case basis. In many cases, it is more beneficial for an injured worker to continue receiving temporary total disability (TTD) than payment of the rating
+ What is mediation?
Mediation is either court ordered or voluntary. If there is a dispute between the parties and a hearing request has been filed, the Industrial Commission will order the parties to mediate the claim and try to resolve the issues. Many times mediation may be voluntary for example, an injured worker may be at maximum medical improvement, receiving a weekly check, and wish to resolve their claim. Mediation is a low-stress environment designed to bring the parties together to attempt to resolve all issues with a lump-sum payment. You will not be asked questions, interrogated, cross-examined, or forced to speak.
+ How long does it take to receive my settlement funds once a case is resolved?
This depends on each case. If the parties settle at mediation, they sign a mediated settlement agreement that makes the settlement binding. After that paperwork is signed, the defense attorney will send the parties a clincher, which is a more formal document that describes the history of the injured worker's claim, the medical treatment, and the terms of settlement. Once all parties sign that document, the employer or insurance company’s attorney sends the clincher to the Industrial Commission for review and approval. Once the Industrial Commission approves the settlement, the insurance company has 24 days to issue the settlement funds before a penalty is imposed. It is important to note that if you are receiving a weekly check at the time of settlement, your weekly check will continue until the settlement is approved so you don’t have a gap in payment.