North Carolina workers get hurt on the job every day. If it has happened to you recently, you probably have many questions about how to get through this stage of your life. The North Carolina workers’ compensation law spells out exactly what employers owe to their eligible workers who are injured on the job.
Unfortunately, not all employers want to follow these laws, which can be complicated. If this is the first time you’ve experienced an accident at work, you probably do not know what to expect from the North Carolina workers’ comp process.
Understanding how workers’ compensation works in North Carolina and seeking the advice of an experienced workers’ comp lawyer at Collier Law may help you if you find yourself in this type of situation.
What is Workers’ Compensation Insurance?
Workers’ compensation is an insurance policy for employers required by law.
North Carolina employers must carry workers’ compensation insurance. An insurance company helps provide benefits to employees with work-related injuries or illnesses. It can help cover employees’ medical costs and replace some of their lost income if they miss work.
The North Carolina Workers’ Compensation System
Enacted by statute in 1929, North Carolina Workers’ compensation laws require businesses with more than three employees to be covered by workers’ compensation insurance. Under North Carolina Workers’ Comp Laws, an employee may be entitled to comp benefits when injured due to a workplace accident or occupational disease. The North Carolina Industrial Commission governs this system.
It is important to note that North Carolina is a “no-fault” system, meaning that the injured employee does not have to prove it was someone else’s fault they were hurt. Therefore, it could be the employee’s fault, the employer’s fault, or no one’s fault at all, and the injured worker can still recover workers’ comp benefits.
N.C. Workers’ Compensation Act
The North Carolina Workers’ Compensation Act (NCWCA) aims to provide compensation to injured workers in the event of a workplace accident that prevents them from working. North Carolina employers should carry workers’ compensation through an insurance company or be authorized as a “self-insured” employer.
Who is Excluded From Workers’ Compensation in North Carolina?
There are exceptions to what counts as an employee in North Carolina. For example, sole proprietors, LLC members, and business partners are not considered employees. However, they can choose to be covered if they meet specific requirements.
Certain types of employees are also exempt from N.C. Workers’ Compensation Act, including:
- Casual employees or employees that do not participate in regular business or trade. These employees are only guaranteed work when needed, and there is no expectation that there will be more work in the future.
- Domestic employees include companions, babysitters, cooks, housekeepers, nannies, and nurses directly employed by a household.
- Farmworkers where there are fewer than ten employees
- Federal government employees
- Railroad employees
- Corporate officers who choose to be excluded from workers’ comp coverage. If they decide this, they’re still counted as employees to determine if a business has three or more workers.
- Employees of employers with fewer than three employees. The North Carolina Workers’ Compensation Act only requires all businesses that employ three or more employees to obtain workers’ compensation insurance.
What Qualifies as a Workers’ Compensation Claim in North Carolina?
Any workplace injury caused by an unexpected accident or incident qualifies as a compensation claim.
North Carolina citizens work in various jobs, including construction, manufacturing, shipping and receiving, distributing, health care, office work. Work-related accidents that qualify for a workers’ compensation claim may include:
- Overexertion from lifting, pushing, pulling, or carrying
- Equipment failure
- Truck accidents that happen on the job
- Construction site accidents
- Burns or scarring that occurs at work
- Injuries caused by a co-employee
- Accidents that happen at work that result in permanent injury
- Back injuries
- Wrongful death caused by accident on the job
Sometimes workplace accidents are preventable, such as when safety protocols are ignored; other times, they are unavoidable. Workplace injuries that qualify for a workers’ compensation claim include:
- Car accidents
- Wrongful death
- Medical Malpractice
- Truck accidents
- Nursing home abuse
- Motorcycle accidents
- Boat accidents
- Assault and battery
- Dog bites
- Pedestrian/bicycle injuries
Workers’ Compensation Benefits
The NC Workers’ compensation law covers what employers owe injured workers. However, most employees that have suffered a work injury do not realize that workers’ comp can cover more than their medical bills. Workers’ compensation benefits may also include:
- Medical Benefits
- Disability Benefits
- Wage Replacement Benefits
- Vocational Rehabilitation Costs
- Wrongful Death Benefits
When workers’ compensation claims are approved, medical treatment prescribed by approved medical providers is 100% covered by workers’ compensation. There are no co-pays or deductibles, and you may also get paid for travel expenses.
Medical benefits include physical therapy, surgeries, and visits to the doctor. Workers’ compensation coverage may also include:
- Travel costs to and from medical appointments (if more than 20 miles roundtrip)
- Caregivers (even if a spouse or family member is taking care of you)
- Medical equipment
- Home or vehicle modifications
- Disfigurement and scarring benefits
If you suffer a work-related injury, medical care benefits may be paid to you for products and services prescribed to help you recover from your injury – treatments focused on curing your injury and relieving your pain.
Occupational injuries that occur over time, such as repetitive trauma injuries like carpal tunnel syndrome, also can qualify for workers’ compensation benefits in North Carolina. In addition, employees diagnosed with certain diseases associated with particular occupations or types of employment may also be covered by workers’ compensation.
These benefits pertain to your inability to work or work in your previous capacity. They may be temporary or permanent.
- Temporary Disability: If your doctor determines you are unable to work at all while you’re recovering from your work-related injury, you can receive temporary total disability benefits to cover lost wages. If you return to work but cannot function at the same capacity, you may receive temporary partial disability or “wage differential.” These benefits equal two-thirds of the difference between your pre-injury AWW and your post-injury reduced weekly earnings.
- Permanent Partial Disability: These benefits are paid if you continue to experience some degree of disability after a doctor determines you have reached “maximum medical improvement,” meaning your physical condition is not expected to improve any further.
- Permanent total disability is only given for extreme injuries, such as paralysis or a double loss of limbs.
Your medical benefits might be 100% covered by your employer’s workers’ compensation insurance. Still, it’s important to note that the insurance company has the right to direct your medical care – including choosing which doctor(s) you see. The insurance company also can send you to a doctor of your choosing for a second opinion.
Wage Replacement Benefits
When you suffer a work-related injury and cannot work while you recover, N.C. workers’ compensation laws require that your employer’s insurance company pay for your approved weekly wage replacement benefits. You may receive wage replacement benefits when:
- You suffer lost wages when you take off time to rest and recover
- You can partially perform your work duties while you’re recovering
- Your injuries resulted in permanent damage, but you can still work (at least some)
In general, wage replacement benefits cover two-thirds of an employee’s average weekly wage and are distributed in the form of weekly checks during the claim and sometimes as a lump sum settlement at the end of the claim.
Vocational Rehabilitation Costs
If you can return to work but at less than 75% of your pre-injury wages, you may qualify for vocational rehabilitation to support job retention. This includes resume help, training, educational assistance, skills assessments, counseling and guidance, and job placement.
Wrongful Death Benefits
If your loved one died after a workplace accident– even if it only contributed to but was not the direct cause of death– you may be entitled to wrongful death benefits. These are payable to the decedent’s surviving spouse and dependent minors. They include funeral and burial expenses, as well as two-thirds of the descendant’s average weekly wage.
How Long Does Workers’ Comp Last in N.C.?
Workers’ comp medical benefits generally continue until the doctor has released you from treatment. In general, you have the right to additional medical treatment for an additional two years after your initial treatment ends.
For other workers’ compensation benefits, injured employees are eligible to receive them until they return to work. Compensation payments are made weekly, starting in the second week that an employee is out of work.
There is no cap for permanent and total disability for catastrophically injured workers.
Filing Workers’ Compensation Claims in North Carolina
The North Carolina Industrial Commission has a recommended set of steps you should take to file your claim.
- Tell your employer about the personal injury as soon as possible. Even if you do not miss any work due to a workplace accident, it is essential to take this initial step. If you cannot report the accident because of the severity of your injury, then have a family member, friend, or health care provider inform your employer of your work-related injury.
- Seek medical treatment immediately. Your employer should provide you with a list of approved physicians. You are required to see any doctor your employer designates.
- Inform your doctor that the injury is work-related and give them the name of your employer. Informing your physician that the injury is work-related and giving them your employer’s name ensures that any medical bills you acquire can be billed as a compensation claim.
- Notify H.R. or the closest equivalent as soon as possible after the accident. Make a simple written statement about what happened and include the date of the accident within 30 days from the date of the accident and a short description of the resulting injuries.
- Follow your doctor’s instructions for medical treatment. Failure to follow your doctor’s orders could hurt your claim and prevent you from receiving the maximum amount available to you.
- Make sure your claim is filed correctly. North Carolina workers’ compensation claims are filed with North Carolina Industrial Commission. All claims begin with the Industrial Commission’s Form 18. You can fill this form out on paper or electronically.
- Complete all paperwork. Complete and submit any form that applies to your claim from the Industrial Commission. As your claim is processed, there will be additional forms.
- Keep copies of all documents. Making copies of every document related to your case ensures that if there is a dispute regarding your claim, you will have proof that you did what you were instructed to do to recover from your injury and obtain the benefits you deserve.
To help aid you in this process, you may want to contact an experienced workers’ compensation attorney at Collier Law to discuss your case. A workers comp lawyer can help you document your accident and resulting injuries, plus guide you on seeking total compensation.
Can I Be Fired for Filing a Workers’ Compensation Claim in North Carolina?
The North Carolina Retaliatory Discharge Act (REDA) prevents all North Carolina employers from firing an employee for filing a workers’ comp claim.
Contact Collier Law for a free consultation if you are in North Carolina and worried that you would lose your job after filing your claim.
Can My Employer Force Me to Return to Work After Suffering a Workplace Injury?
The short answer is no; your employer cannot force you to return to work after a work-related accident.
Light Duty Work
If you are an injured employee in North Carolina, your employer will often attempt to make you return to work before you are ready. There are certain hoops the workers’ compensation law requires the employer to jump through, but many employers will take advantage of an unrepresented worker to get around these. For example, the statute covering return to work light duty states that before an injured employee returns to work, the employer must have a light-duty job description approved by the treating physician. In addition, the proposed work must be within the employee’s work restrictions. This is important to know, as there have been cases where an employer will make someone return to work light duty only to find a reason to terminate them at a later point.
How Collier Law Can Help You With the Workers’ Compensation Process
If you or someone you love has suffered a job-related injury or illness, call an experienced workers’ compensation lawyer at Collier Law for assistance with your workers’ comp case.
When you’re a client at Collier Law, you are so much more than a number to us: we value our attorney-client relationship and getting the justice you deserve above all else. We are advocates for injured employees. Call for a free consultation to find out how we may assist you. The initial consultation is always free.