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North Carolina Workers' Comp Lawyers
North Carolina
Workers' Comp Lawyers
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Your Path to Clarity and Peace of Mind About Your Work Injury
Dealing with a workplace injury in North Carolina can leave you with more questions than answers. We understand your need for clarity and peace of mind during this challenging time. Our team is dedicated to providing you with the answers you need.
You might be wondering about your rights, the compensation you’re entitled to, or how to deal with the insurance company. These are the questions we answer every day, providing clear, understandable guidance to ease your mind.
Whether it’s securing medical benefits, navigating through the complexities of claims, or ensuring you’re treated fairly by the insurance company, our goal is to lift the weight of uncertainty from your shoulders. We deal with the legalities and the insurance company, so you can focus on what’s important – your health and recovery.
Our Workers' Comp Attorneys
Ben Cochran
Board-Certified NC Workers Compensation Law
Jack Hardison
Board-Certified NC Workers Compensation Law
Adam Bridwell
Board-Certified NC Workers Compensation Law
Carter Whittington
Board-Certified NC Workers Compensation Law
Joey DeMartin
NC Workers Compensation Lawyer
Ben Cochran
Board-Certified NC Workers Compensation Law
Jack Hardison
Board-Certified NC Workers Compensation Law
Adam Bridwell
Board-Certified NC Workers Compensation Law
Carter Whittington
Board-Certified NC Workers Compensation Law
Joey DeMartin
NC Workers Compensation Lawyer
Ben Cochran *
Jack Hardison *
Adam Bridwell *
Carter Whittington *
Joey DeMartin
* Board-Certified in North Carolina Workers' Compensation Law.
Board-Certification in Workers' Compensation Law in North Carolina is a significant professional credential that a lawyer can earn. It is granted by the North Carolina State Bar, the legal licensing organization in the state, and signifies a high level of expertise and competence in the field of workers' compensation law.
We Want To Make This As Easy As Possible For You
We’re committed to supporting injured workers across North Carolina through every step of their claim process. We want to make sure getting started with our firm is stress-free as possible:
100% Free and Confidential Consultations: Available for injured workers across North Carolina.
No Upfront Costs: Our representation starts at no cost to you.
Contingency-Based Representation: Attorney Fees are only collected if we secure compensation for you.
Easy Sign-Up Process: Choose between e-sign options or a personal home visit for your convenience.
We Handle Workers' Comp Claims Across North Carolina
No matter your location or where your injury occurred in North Carolina, our experienced team is ready to assist you.
We understand the unique challenges faced by workers across our state. You deserve the right answers and effective representation, regardless of your zip code. With us, distance is no barrier to justice. No matter where in North Carolina, we come to you. Let’s connect and start your journey towards recovery and peace of mind.
NC Workers' Comp Results
$6.75
Million
Worker who was paralyzed while unloading a delivery at his final destination when the load fell on him.
$3.5
Million
Worker who was paralyzed from the waist down after trees fell on him while on-the-job in Mebane, North Carolina.
$1.5
Million
Worker from Fuquay-Varina, North Carolina who fell from a roof while on the job.
The above results should not set an expectation as to the success of yours or a loved one's claim. Each case is unique and the above results involved very serious and life changing injuries to our clients.
Honored to Help People Who Have Been Injured At Work in North Carolina
"From the very first contact I had with Hardison & Cochran I could tell that my best interest was a priority. My Case Manager was always ready to help me and get answers to any questions that I had. Ben Cochran handled my case and I can say that he kept me informed of how it was progressing as well as making sure I saw the doctors I needed to see . When it came time to settle my case Ben went the extra mile for me!"
Greg W.
Workers' Comp Client
"I had not been in a Worker’s Compensation situation and I had no experience or knowledge of the process. Attorney Jack Hardison and his staff not only provided me with personal attention, I honestly felt that they cared about my injury and my health. This law firm has my future business for whatever reason I may need. I highly recommend them."
L. Poole
Workers' Comp Client
35 North Carolina Workers' Comp Questions Answered
First, notify your employer. Second, contact an attorney who will provide helpful guidance and make sure your rights are protected from the beginning.
You can report your injury to your boss, manager, a supervisor or directly to a human resources office. Make sure that an accident report is filed with the proper person or office.
Keep in mind, under North Carolina workers’ compensation law, your injury must be reported to your employer within 30 days of the accident unless it can be shown that the employer had knowledge of the injury. The N.C. Industrial Commission also may, within its discretion, allow the claim to be filed as long as the employer was not prejudiced by the delay.
However, even if you are not sure whether your injury is serious, the best practice is to notify your employer right away in order to avoid any questions about your injury and the date it occurred.
If you contact an attorney after notifying your employer, the attorney can help to make sure that all forms are properly filed and work with your company’s workers’ compensation insurer to secure any benefits that you are entitled to receive.
North Carolina workers who are injured as a result of a workplace accident or who contract an occupational illness qualify for workers’ compensation benefits. The N.C. Industrial Commission administers the state’s workers’ compensation program.
These benefits can help injured workers pay medical bills, replace lost wages and cover income lost when disabled workers are unable to return to work on a temporary or permanent basis. Family members of a worker who has died because of an injury or illness may qualify for a workers’ compensation death benefit.
The specific amounts of the various workers’ compensation benefits paid to injured and disabled workers are calculated with formulas set by state law. The following is a general outline of the types of North Carolina workers’ comp benefits:
Medical Benefits
Benefits may be paid for specific medical procedures from the emergency room through recovery, diagnostic tests and medications and the services of medical professionals (surgeon, assistant surgeon, physician, physician assistant, registered nurse, nurse practitioner, etc.).
Vocational Rehabilitation Benefits
If a worker’s injuries mean they cannot return to the job they had and must accept a different kind of work or a job that pays less, they may qualify for vocational rehabilitation benefits.
Disability Benefits
An injured worker may apply for disability benefits if doctors determine that he or she will not be able to return to their job. “Total disability” means a worker cannot earn a living. “Partial disability” means the worker can’t return to the line of work pursued prior to the injury and will not earn the rate of pay earned prior to his or her injury.
Payments are capped but should amount to 66.66 percent of the difference between the worker’s post- and pre-injury weekly income.
Disfigurement Benefits
Compensation for scarring or damage to internal organs not specifically covered under PPD rules (above) may be up to $10,000.
Death Benefits
If a worker dies from an injury suffered in a workplace accident, his or her survivors may receive a death benefit from workers’ compensation. The amount of the benefit will be based on 66.66 percent of the deceased worker’s weekly salary plus an annual cost-of-living allowance (COLA) and be paid for up to 500 weeks.
A workers’ compensation death benefit also includes up to $10,000 for burial expenses and reimbursement for medical expenses.
Here are 4 myths or misconceptions we commonly see when it comes to Workers’ Compensation claims in North Carolina:
Myth #1: My employer will file all necessary forms to protect my claim.
The employer is required to file a Form 19 report of injury to the Industrial Commission. This form does not protect your claim. You must file notice to the employer and a Form 18 with the Industrial Commission.
Myth #2: Workers’ compensation claims require that I sue my employer.
This is not true. You file a claim (not a suit) with the North Carolina Industrial Commission which is a state government agency that oversees workers’ compensation claims in North Carolina. Workers’ compensation is an administrative hearing process and is not civil litigation. An injured worker is really filing the claim against the employer’s insurance company most of the time unless the employer is uninsured or self insured.
The Industrial Commission is the judicial body that hears motions and hearing requests through appointed judges called Deputy Commissioners. There is no right to a jury trial in a workers’ compensation claim.
Myth #3: I can collect for pain and suffering.
This is not true. The purpose of the Act is to compensate the employee for lost wages, medical treatment and diminished future earning capacity. The Act does not allow for compensation for pain and suffering.
Myth #4: My employer states that since the accident was my fault I can’t pursue a workers’ compensation claim.
This is not true. North Carolina Workers’ compensation is a no fault system. The accident can be 100% your fault and you still are entitled to full benefits under the North Carolina Workers’ Compensation Act.
The top 3 reasons we have seen NC Workers’ Comp Claims denied in our years of experience include:
1. Missing Deadline to Report Injury
North Carolina law requires that you provide your employer with written notification of your job-related injury or illness within thirty days. If you miss the deadline, you might not receive the necessary benefits to cover your accident-related expenses.
The North Carolina Industrial Commission (NCIC), which oversees the state’s workers’ comp system, will only enforce the 30-day requirement if your employer can show it was prejudiced by your failure to submit the notification. Failing to report your injury within 30 days of the accident doesn’t necessarily mean you’re prohibited from receiving benefits. However, you shouldn’t take any chances. Notifying your employer of your injury promptly is always best.
Sometimes, your employer or the workers’ compensation insurer will claim your work-related injuries were never reported to your doctors. That means your initial medical records don’t mention the accident. Even if that’s the case, it shouldn’t disqualify you from seeking benefits.
2.Injury Isn’t Work-Related
Another common reason that insurers deny workers’ comp claims is if there is an issue about whether the injury is work-related. Only ailments that occur in the course of your employment are covered by workers’ comp. Injuries while off the clock or on a lunch break don’t qualify. However, sometimes unusual circumstances mean that an injury that would normally lead to a denied claim should be covered.
For example, suppose an employee takes out the trash at the end of their night shift. They’re not on the clock, technically, but doing so is part of their normal job duties. One night, they hurt their shoulder while bringing the garbage to the dumpster. Typically, the employee’s claim would be denied since it was not technically an injury at work.
However, the NCIC has previously ruled that unusual circumstances can trip the “injury by accident” standard. For example, if the dumpster was in a different location that night and the worker consequently had to change the way they disposed of the trash, their subsequent injury could be a covered event.
3.Pre-Existing Condition
A pre-existing condition is another common reason for denied workers’ comp claims. It refers to the worsening of an old injury or medical condition that predates an injury for which an employee is pursuing benefits.
Let’s say you hurt your back in a car accident five years ago. You fully recovered and were given no medical restrictions by your doctor. Then, a month ago, you injured your back trying to lift a heavy box at work. Now, the insurance company determines the car accident led to a pre-existing condition that was exacerbated by the back injury suffered last month. It might try to deny your claim on this basis.
However, if it is determined that your new injury was an aggravation of your previous one, the injury should still be compensable under North Carolina law.
The North Carolina Industrial Commission is the authoritative body tasked with administering Workers’ Compensation in North Carolina. This commission plays a pivotal role in the oversight and adjudication of work-related injury claims across the state of North Carolina.
Structure and Function
Comprised of Deputy Commissioners and Full Commissioners, who effectively act as judges, the NC Industrial Commission, among other duties, is responsible for overseeing North Carolina workers’ injury claims.
Filing a NC Workers’ Compensation Claim
If you suffer a workplace injury in North Carolina, initiating a Workers’ Compensation claim involves filing with the North Carolina Industrial Commission.
The Commission’s Role in Your NC Workers’ Comp Claim
Their responsibilities encompass a broad range when it comes to NC Work Injury claims, these include, but are not limited to:
Determining the compensability of a claim.
Overseeing medical treatment and approvals for second opinions.
Resolving disputes between involved parties, often through mediation.
Settlement Approval
In cases where you and your legal representative opt for a settlement with your employer’s Workers’ Compensation Insurance Provider, it’s important to note that such settlements require the approval of the NC Industrial Commission.
No Jury Proceedings
It’s essential to understand that Workers’ Compensation claims in North Carolina do not involve jury decisions. Instead, all proceedings and determinations are conducted through the Industrial Commission.
Even though you can pursue workers’ compensation benefits without the help of an attorney, we strongly suggest at least contacting an experienced North Carolina Workers’ Compensation attorney to discuss your situation.
An attorney can help you to overcome several problems that may arise in your case, including:
You are not receiving the proper medical treatment
Your benefits checks are not coming properly
The insurance adjuster will not call you back
You are not capable of returning back to work and you are concerned about your future.
Every Workers’ Compensation claim in North Carolina is unique and has its own specific details. When
assessing the value of a workers’ compensation case in North Carolina, these unique factors are taken into consideration.
In North Carolina, the value of a workers’ compensation claim is primarily based on how much money the employee was earning at the time of the injury. Many aspects of Workers’ Compensation revolve around the employee’s compensation rate.
The compensation rate in North Carolina is calculated as two-thirds of the injured employee’s weekly wage. The average weekly wage is determined by considering the earnings over a 52-week period prior to the injury.
Once the compensation rate is determined, the settlement amount in part is then based upon how the case will resolve. Below are the three main factors in addition to the compensation rate calculation.
Loss in wage earning capacity: This depends on whether the injured employee can return to their job and how long it will take for them to recover. Several factors affect the duration of time someone may be out of work, such as age, employer, training, skills, vocational background, and education. In this type of scenario the settlement will be based upon how long the injured employee will continue to receive the weekly benefits. This time period is speculative in nature and where the fight comes in.
Loss of function to a body part: Workers’ Compensation laws have specific provisions that assign different monetary values based on the percentage of loss of function to a particular body part.
Future Medical Treatment: The cost of future medical care needed for the worker’s recovery is a key factor in calculating the claim’s value. This includes anticipated treatments, medications, and therapies.
If you’ve suffered a workplace injury in North Carolina, it’s crucial to understand your rights and the steps to take if your employer is reluctant or slow to file a workers’ compensation claim.
Step 1: Identifying Your Employer’s Insurance Provider
The initial step in this process is to determine who your employer’s workers’ compensation insurance provider is. If your employer is not forthcoming with this information, don’t worry, there are ways to find it yourself:
Online Search: Visit the North Carolina Industrial Commission’s website (https://www.ic.nc.gov/). They provide a tool where you can enter your employer’s name and the date of your injury to retrieve the relevant workers’ compensation information. This allows you to contact the insurance provider directly.
Direct Contact: If online resources don’t yield results, consider calling the Industrial Commission to inquire about your employer’s workers’ compensation carrier.
Understanding Potential Employer Resistance
It’s unfortunate, but sometimes an employer’s hesitation in filing a claim can signal deeper issues, such as not having proper workers’ compensation insurance. This can complicate matters significantly.
The Impact of Delays in Reporting
A delay in reporting your claim can also create challenges. The longer the gap between your injury and the notification to the insurance company, the more complicated it may become to communicate with the insurer. They will likely investigate why the claim wasn’t reported promptly by your employer.
In such cases, employers might provide misleading information to the insurance company, potentially claiming that the injury was never reported. This creates a dispute that can be difficult to navigate without assistance.
Taking Action: Your Rights and Next Steps
When faced with an uncooperative employer, it’s essential to involve the Industrial Commission or consult with an experienced North Carolina Workers’ Compensation attorney.
Remember, filing a workers’ compensation claim is your right as an employee. Don’t let your employer’s reluctance deter you from seeking the compensation and support you may be entitled to. Being proactive and informed is key to protecting your rights and wellbeing.
After an on-the-job injury in North Carolina, the first step of the injured employee should be to notify their employer.
While that is commonly known, many wonder what happens after they notify their employer.
Additionally, they want to know who will be making the final decision on their claim for Workers’ Compensation Benefits in North Carolina.
After being notified of the injury by the employee, the employer or the employer’s Human Resources Department will then inform their Workers’ Compensation Insurance Company and let them know an injury has occurred at the workplace.
That process is when the Workers’ Compensation claim is officially filed.
Once the claim is filed, the insurance company will then assign a Workers’ Compensation Insurance Adjuster to the claim.
More likely than not, the adjuster will contact the claimant (the injured worker) to discuss the claim.
They’ll try to figure out how the injury happened, medical treatment information, and any other information they need to investigate the claim.
Ultimately, the insurance adjuster will decide if the claim is accepted or denied once they have reviewed all the information. The claimant (injured employee) will then be notified of the decision.
It’s important to remember that a denied claim is not always the end of the road when seeking Workers’ Compensation Benefits in North Carolina.
Denied North Carolina Workers’ Compensation Claims can be appealed.
At Hardison & Cochran, we frequently help individuals whose initial claims for Workers’ Compensation Benefits has been denied.
If you get injured at work in North Carolina, there are specific steps you need to follow. First, it’s important to report the injury to your employer. After that, you should fill out a form called Form 18, also known as a “Notice of Accident.” This form needs to be submitted to the North Carolina Industrial Commission. You should also send copies of the form to your employer and the company’s Workers’ Compensation insurance carrier.
Once you file the claim, the Workers’ Compensation insurance company representing your employer will create a file for your case. They will then start investigating the claim to determine if it qualifies for compensation. A compensable claim means that your accident and injury are covered by the Workers’ Compensation Insurance.
After investigating all the details of the accident and injury, the insurance company will ultimately decide whether to accept or deny your Workers’ Compensation claim. If they choose to deny the claim, they will submit a Form 61 to the North Carolina Industrial Commission. This form will explain the reasons for their denial.
In a situation where your claim is denied and you still want to pursue benefits, you will need to request a hearing with the North Carolina Industrial Commission.
Once the hearing is requested by either you or your legal representative, a mediation will be scheduled. In North Carolina, mediations are mandatory before appearing in front of an Industrial Commission Deputy Commissioner.
If the denied claim doesn’t reach a resolution during mediation, within 2-3 months, the claim will likely proceed to a hearing in the county where the injury occurred.
During the hearing, a Deputy Commissioner will listen to testimony from you, the injured employee, as well as any witnesses you provide. It’s also likely that they will hear testimony from the medical professionals who treated your injury.
Once all the testimony is heard, the Deputy Commissioner will make a final decision, either deeming the claim compensable or not compensable.
The next steps in the claim process depend on whether either party decides to appeal the decision. If an appeal is made, the claim will continue in the legal process.
While it is customary for employers or workers’ compensation insurers to ask for a recorded statement, you may want to consult with an attorney before you do so.
It is usually permissible for an injured employee to give a recorded statement. However, if for any reason you have reason to believe that the insurance carrier questions the circumstances surrounding the events of your case, an attorney can give you proper advice and representation.
Keep in mind: Insurance companies typically want to avoid paying any benefits or as little as possible. It protects the companies’ profits. Your lawyer’s primary goal will be to protect you.
Your employer has the right to direct you to a doctor for treatment. However, you have a right to get a second opinion if you are dissatisfied with your treatment.
You must find out from either your employer or your employer’s workers’ compensation insurance carrier where you need to go to seek treatment. If they will not provide you with treatment, then you can seek treatment on your own and request that the N.C. Industrial Commission name this physician as your treating physician.
If you become dissatisfied with your treatment, and that medical provider releases you, then you may be entitled to a second opinion. If, after that second opinion, there are other treatments recommended, you can ask the Industrial Commission to order your employer’s workers’ compensation carrier to provide the recommended treatment.
These matters can often lead to disputes between injured employees, employers and insurance companies. It is important to get help from a lawyer who will help you to be covered for the medical care and treatment that you need to address your injury or illness.
North Carolina employees who have been injured at work and are receiving Workers’ Compensation will ultimately be placed at “maximum medical improvement” by the treating physician.
Maximum medical improvement is essentially the conclusion of your medical care. It’s when the medical professionals have deemed your injuries are “as good as they’re going to get.
However, this doesn’t always mean that the injured employee is physically 100% whole again and can perform at the same capacity as they were able to before the on-the-job injury.
A medical professional can determine if an individual has arrived at maximum medical improvement and assign a permanent partial disability rating. They may also question whether or not the injured worker has permanent restrictions.
The most common form of test used in North Carolina workers’ compensation claims to determine if an injured employee has permanent restrictions and precisely what those restrictions are is the Functional Capacity Evaluation or (FCE).
Generally, a functional capacity evaluation is a one-day test that will take several hours for the injured employee to complete.
After completing the functional capacity evaluation, the results will be sent to their treating physician. At this point, the treating physician will either place permanent restrictions on the injured employee or determine that the functional capacity evaluation results didn’t provide enough information for a permanent restriction assignment.
Have you ever wondered why the Workers’ Compensation insurance company assigns a nurse case manager to accompany you to your doctor’s appointments after a work injury in North Carolina?
You might be curious if this is a normal practice or if there is any particular reason behind it.
It is indeed normal for Workers’ Compensation insurance companies to hire nurses as case managers to accompany patients to their North Carolina Workers’ Compensation doctor’s appointments.
The primary purpose of these nurses is to facilitate the treatment recommendations made by the doctors, ensuring that you receive the necessary treatment promptly and appropriately.
By having a nurse case manager present during your appointments, the insurance company aims to streamline the communication and coordination between you, the doctor, and the insurer.
While it is common for a nurse case manager to be present during your NC Workers’ Compensation doctor’s appointments, it is important to note that you are entitled to a private examination with your treating physician. This private examination allows you to have one-on-one time with the doctor, away from the nurse.
During this private examination, you can freely discuss your symptoms, concerns, and ask any questions you may have without feeling rushed or inhibited. It provides you with an opportunity to build a rapport with your doctor and establish a trusting relationship, which is crucial for effective healthcare delivery.
Moreover, a private examination allows the doctor to fully focus on your case, thoroughly evaluate your condition, and make personalized treatment recommendations tailored to your specific needs. It ensures that your doctor has a comprehensive understanding of your medical history, symptoms, and any previous treatments, enabling them to provide you with the most accurate and appropriate care.
Once you have had your private examination, the nurse case manager will then join the conversation and discuss the treatment recommendations with you and the doctor.
It can be frustrating and potentially devastating if you do not receive workers’ compensation benefits that you are entitled to receive. It is important to contact an attorney right away.
North Carolina workers’ compensation law provides that, if any payment of compensation is not paid within 14 days of the date the payment was due, you are entitled to a 10 percent late payment penalty for any amount you have not received.
In order to receive this amount, you must file a request for this penalty with the N.C. Industrial Commission. An attorney can help you file all required paperwork, seek these penalty payments and get your workers’ compensation benefits checks back on track.
When you’re unable to work due to an injury sustained at work, North Carolina workers compensation benefits, especially temporary total disability benefits by way of a weekly check, are crucial for covering your daily expenses. If you find yourself in a situation where these benefits checks are missing and showing up late, here’s what you can do:
Contact the Insurance Adjuster: Reach out to the adjuster overseeing your claim. Ask when the last check was mailed and check if there was a delivery issue. If the adjuster is unreachable, speak with the adjuster’s supervisor. They can check the electronic system to verify the status of your payment.
File a Motion with the Industrial Commission: Persistent check delays may warrant filing a motion with the North Carolina Industrial Commission to ensure timely payments. If represented by a North Carolina Workers’ Compensation Lawyer, inform them immediately so they can assist you with the process.
At Hardison & Cochran, we generally ask our clients to give us a call if their check shows up three or more days after their customary receipt day. After three days, we usually find that it’s not a postal issue and unfortunately many times the check simply hasn’t been sent in a timely fashion.
Should the delay exceed 14 days, you’re entitled to request a 10% penalty for late payment.
It’s imperative to stay proactive to ensure your North Carolina Workers’ Comp benefits are delivered without unnecessary delays.
If you get hurt at work, it’s important to report the injury and seek medical assistance promptly. Inform your boss about the incident, and they will initiate a workers’ compensation claim and refer you to a doctor whom the Workers’ Compensation Insurance Company selects.
Urgent care centers are typically used for the initial visit after an injury, except when the injury is severe enough to require an emergency room visit. When you visit the medical provider for your North Carolina work injury, make sure to immediately tell the doctor about all your injuries and any pain you’re experiencing. Detail the affected body parts and the extent of your discomfort to enable the doctor to diagnose your condition accurately and prescribe the appropriate treatment.
Work restrictions, such as not lifting more than a specified weight, avoiding bending or crawling, or not using ladders, are implemented to ensure your safety and aid in your recovery.
In North Carolina, present these work restrictions to your employer. If they can accommodate them, they must provide a job description and submit it to the treating physician to verify that the job is suitable.
If you earn less in this light duty role than you did before your injury, you are entitled to temporary partial disability benefits. This means the insurance will compensate for the difference between your pre-injury wage and your current light duty earnings.
Should your employer be unable to provide work that adheres to the doctor’s restrictions, they are obligated to offer you temporary total disability benefits to cover the wages you lose as a result of being unable to perform your regular job duties.
It is crucial to understand your rights and ensure you receive the proper benefits while you recover from your work injury in North Carolina.
In North Carolina, understanding your rights and entitlements under Workers’ Compensation claims is vital, especially when it comes to work restrictions after a work injury. A frequent question we encounter is whether employers can insist on employees performing their regular job roles despite these restrictions.
Once you have work restrictions prescribed by your healthcare provider, your employer is legally required to accommodate these limitations. If your regular job duties are beyond your current capabilities due to the restrictions, your employer must adjust your tasks to align with your abilities.
If accommodating your work restrictions is not feasible for your employer, then the insurance company must step in to provide lost time benefits. These are referred to as temporary total disability benefits, calculated at two-thirds of your average weekly wage. You’re entitled to these benefits when your work-related injury prevents you from working.
To safeguard your rights and ensure compliance from your employer and the insurance company, always carry a copy of your light duty restrictions. This document is proof of your medically advised work limitations. If you’re asked to perform tasks beyond these restrictions, you can present this document and politely decline, citing your medical advice.
This approach helps ensure clarity and protects your rights in the workplace following an injury.
Navigating the intricacies of North Carolina Workers’ Compensation Benefits is crucial for injured employees in North Carolina. A key aspect of these benefits is the 500-week entitlement period.
In North Carolina, workers who sustain injuries on the job and are unable to return to work are entitled to receive Workers’ Compensation Benefits. A pivotal aspect of these benefits is the 500-week entitlement period. This duration, equating to approximately 9.5 years, is the standard timeframe set by the court for injured workers to receive these benefits.
If you’re an injured worker, it’s important to understand that these benefits are designed to support you for up to 500 weeks. This duration is significant as it ensures continued support for a substantial period, aiding in your recovery and financial stability following a work-related injury.
There may be situations where you need support beyond the standard 500 weeks. In such cases, it’s possible to request an extension of these benefits. The application for this extension can be submitted to the North Carolina Industrial Commission 425 weeks after you start receiving the Workers’ Compensation Benefits.
Understanding the 500-week rule and the possibility of extending these benefits is crucial for any worker facing a long-term recovery from a workplace injury in North Carolina. While the process might seem daunting, knowing your rights and the available support can make a significant difference.
When you suffer a job-related injury in North Carolina that leads to total disability as determined by a physician, or if you’re given restrictions that prevent you from resuming your usual employment, you become eligible for what are known as temporary total disability benefits.
In North Carolina, the method for calculating these benefits is outlined in the state’s statutes. Typically, the calculation is based on your earnings from the 52 weeks prior.
Here’s how it works: The insurance company will review your wage records for the year before your injury and determine your average weekly wage by dividing the total amount you earned by 52. This average is pivotal because it sets the stage for your compensation rate.
The compensation rate—the key number in your workers’ compensation claim—is generally two-thirds of your average weekly wage. This is the amount you’ll receive as your temporary total disability benefits. Essentially, these benefits are a financial safety net, compensating for lost wages while you’re unable to work due to your injury.
But the compensation rate’s role extends beyond just the temporary total disability benefits. It’s also integral when calculating potential settlements for permanent partial disability that may result from your injury. The accuracy of this rate is vital to ensure you’re fairly compensated.
Understanding the compensation rate and the calculation of temporary total disability benefits is critical when navigating workers’ compensation claims in North Carolina. Knowing how these figures are derived can provide clarity and assurance that you’re receiving the full financial support you’re entitled to during your recovery.
The short answer: No. It is against the law for an employer to terminate or demote an employee for filing a workers’ compensation claim. This is covered by both state and federal laws. However, these cases require careful handling.
For example, the N.C. Retaliatory Employment Discrimination Act prohibits employers from firing or discriminating against employees for filing a worker’s compensation claim or exercising other rights such as filing a complaint about workplace safety violations.
You may have the right to pursue legal action if this occurs to you.
However, you must first file a written complaint with the N.C. Department of Labor’s Employment Discrimination Bureau within 180 days of your employer’s retaliatory act. Only after you get a response from this agency can you pursue other relief, including the filing of a lawsuit.
Throughout the progression of a North Carolina Workers’ Compensation Case, numerous conflicts may surface, ranging from outright claim rejections to disputes over the medical care prescribed.
Frequent issues that emerge are:
Rejection of claims
Disputes regarding the need for certain medical interventions
Discrepancies over specialist referrals
The North Carolina Industrial Commission is responsible for adjudicating these matters.
In the event that a hearing is requested, each matter is routed to mediation. Mediation is simply a meeting of the two parties. This meeting is designed to iron out the contentious points between the injured party and the employer.
Key mediation steps include:
Choosing a mutually agreeable mediator.
Arranging a schedule for the settlement conference.
Conducting the mediation typically within three months of the hearing request.
Both parties engaging, in person or online, to address pending issues before the Commission.
The mediation, which might span three to five hours depending on the case’s intricacies, often includes settlement discussions, aiming to conclusively address the workers’ compensation claim.
The Mediator’s Function
Acting as a neutral facilitator, the mediator does not issue a binding decision but encourages a mutually acceptable settlement.
What Happens After Mediation?
Successful mediation can lead to the full or partial resolution of the claim. Should mediation not yield an agreement, the case advances to the Industrial Commission for a more formal resolution.
Here, a deputy commissioner evaluates the conflicts to determine the merits of each party’s stance.
In Summary
North Carolina’s workers’ compensation system is characterized by its administrative nature and the inherent opposition between employee and employer. Mediation is a key step in this process, serving as a vehicle for negotiation and potential resolution of the disputes that arise during the life of a North Carolina Workers Compensation Claim.
If your injury prevents you from working – but only for what is expected to be a short period of time – you may be entitled to receive temporary total disability benefits.
You should be eligible to start receiving these benefits after a seven-day waiting period. Temporary total disability (TTD) benefits usually come in a weekly check and represent two-thirds of your average weekly wage. Your average weekly wage is the average wage you earned over the 52 weeks prior to your injury.
Ultimately, a doctor will determine when you are able to return to work. If you disagree with the doctor’s conclusion, it may be time to get a second opinion and / or to consult with an attorney.
This situation often arises among workers whose injuries prevent them from returning to a previous job that requires extensive physical activity. Fortunately, there are benefits available to help the transition to a new career.
If you are unable to return to your previous position due to your work-related injuries, then the N.C. Workers’ Compensation Act allows for you to be placed in vocational rehabilitation to be provided by your employer or its workers’ compensation carrier. These benefits should cover the costs of:
Getting on-the-job-training or education
Receiving an analysis of your transferable skills
Searching for a job
Getting assistance with your resume, applications and interviews.
A vocational rehabilitation counselor should be assigned to help you find suitable employment.
Once an injured employee in North Carolina reaches Maximum Medical Improvement they are medically evaluated. This evaluation is utilized to determine if the employee has permanent restrictions.
If this evaluation discovers that the injured employee suffered a permanent disability and that disability doesn’t allow them to return to work with the employer then they will be entitled to Vocational Rehabilitation.
Vocational Rehabilitation is a process that is utilized to assist the injured employee to get back to work within the restrictions discovered by the medical evaluation.
As an example, let’s say John was working at full duty and suffered an injury at work. After his medical evaluation, the medical professional determines a permanent restriction of “no lifting over 50 pounds.” Due to this restriction, John is not able to return to his position with the company he worked for when he was injured.
At this point, the Vocational Rehabilitation process may begin to see if they can find suitable employment for John.
Suitable employment is available employment within the general marketplace that is within the injured employee’s education, training, experience, and most importantly within their permanent restrictions that have been medically assigned.
Does the Vocational Rehabilitation have to find a job that is equal in pay to the position held at time of injury?
Unfortunately in North Carolina, finding employment at equal salary before injury is not required.
Using John as example again, prior to his injury, he was making $75,000 a year. After his injury and being assigned permanent restrictions and going through the Vocational Rehab process, suitable employment was found for him that had a yearly salary of $50,000 a year. The North Carolina Industrial Commission may determine this is suitable employment.
Even though John is making $25,000 less a year, he would be entitled to 66% of the difference between to two yearly salaries. The insurance company would have to pay John 66% of $25,000.
Who will the injured employee have to meet with during Vocational Rehab?
During the Vocational Rehabilitation process, the insurance company will hire a Vocational Rehabilitation Counselor.
This individual has to have certain qualifications, experience, credentials, and has to be registered with the North Carolina Industrial Commission to be able to perform this service for injured employees.
What does the Vocational Rehabilitation Counselor do for the injured employer?
Normally, after a Vocational Rehabilitation Counselor is assigned, they will perform an initial assessment with the injured employee.
The initial assessment will normally include obtaining the injured worker’s work history, receiving updates on their Maximum Medical Improvement status, and they discuss the disability sustained as the result of the work injury.
During this assessment, they may also discuss disabilities that were not the result of the work injury. The Vocational Rehabilitation Counselor is getting a “full picture” of everything about the person, so items like this will have to be discussed to accomplish the task they were hired to perform.
Once all this information is gathered, the Vocational Rehabilitation Counselor may perform a Job Market Survey. A Job Market Survey attempts to discover available opportunities in the general job market within 50 miles of the injured employees residence.
If they determine there is job viability, they may begin Vocational Rehabilitation services.
During this process, they will meet with the injured employee approximately once or twice every other week to assess how the injured employee is doing in terms of trying to find a job.
Does The Injured Employee just wait for the Vocational Rehabilitation Counselor to find them a job?
While the North Carolina Industrial Commission requires the Vocational Rehabilitation Counselor to provide job access in terms of applications and other avenues to seek employment, it is also required that the injured employee participates in this process.
It is not a situation where the injured employee waits around for the Vocational Rehabilitation Counselor to simply find them employment.
Active participation by the injured employee is required to continue receiving Temporary Total Disability benefits.
It is possible for the insurance company to seek to terminate or suspend the injured employees benefits for lack of cooperation through the vocational rehabilitation process.
Insurance firms and adjusters in North Carolina must adhere to specific guidelines set by the Industrial and Insurance Commissions, governing claim processing and claimant communication. These are stipulated by statutes and regulations, especially for North Carolina Workers’ Compensation cases.
Regarding recording conversations, insurers are obligated to inform North Carolina injured workers before recording any discussions related to the claim investigation. To answer the question, they cannot legally wiretap or eavesdrop on personal communications such as your home phone or cell phone.
For surveillance, insurers can and often times do, employ private investigators to observe injured workers, often initiating when the subject appears in public places like a doctor’s office. These investigators may track individuals to collect evidence, typically over two to three days, to establish consistency, as single instances lack credibility.
In the realm of North Carolina workplace injuries, it’s not uncommon for employers to request drug testing from employees who have been injured. This practice is frequently observed as part of the standard protocol in workers’ compensation processes.
It’s pivotal to recognize that, in the context of North Carolina Workers’ Compensation, there is no universal legal mandate necessitating a drug test. Nevertheless, comprehending the implications of opting out of such a test is of utmost importance.
Declining to participate in a drug test could potentially lead to your North Carolina Workers’ Compensation Claim being contested or denied by the insurance company. This is based on legal principles stating that if an injury occurs under the influence, the claim may be invalidated.
While taking the drug test isn’t mandated by law, it’s vital to consider how refusing it might affect your situation. The decision should be informed by your confidence in the test’s outcome, as it could play a pivotal role in your case.
If you’re facing uncertainty about undergoing a drug test in a workers’ compensation scenario, seeking guidance from experienced North Carolina Workers’ Compensation Lawyer can be invaluable. A professional with experience in workers’ compensation law can offer tailored advice that suits your unique situation.
To summarize, while drug testing isn’t a legal requirement for North Carolina Workers’ Compensation Claimants, choosing not to participate can have significant repercussions. It’s essential to fully understand how this decision might impact your claim and to consult with a experienced North Carolina Workers’ Compensation Attorney when necessary.
No. You do not have to use up your vacation time or sick leave when you get hurt.
In fact, if your case is accepted and you do use your vacation time or sick leave, you may still be entitled to temporary total disability benefits for those days.
In other words, you can collect temporary total disability on top of your vacation time or sick leave. This is because that time is earned and, unlike workers’ compensation benefits, “vacation . . . [or sick leave] can be taken to renew physical and mental capabilities, for personal reasons, for absences due to adverse weather conditions, and for personal illness or illness in the immediate family.” Estes v. N. Carolina State Univ., 102 N.C. App. 52, 58, 401 S.E.2d 384, 387 (1991) (citing N.C.Admin.Code tit. 25, r. 01E.0201 (1984)).
“Workers’ compensation, however, is available only for a work-related injury.” Id.
In other words, vacation time and sick leave are separate and distinct from workers’ compensation benefits.
At Hardison & Cochran, we often receive phone calls and web submissions from injured workers who are unsure if their daily repetitive job tasks, which led to an injury, are covered by North Carolina Workers Compensation Claims.
In some cases, these injuries are indeed covered. They fall under what is called Occupational Disease Claims. To determine if an Occupational Disease Claim is compensable, we consider a few factors:
1. We compare the injured employee’s duties to what the general public typically does in their work environment.
2. We calculate the level of risk associated with the nature of the employee’s job.
3. We consider the medical diagnosis given by a healthcare professional.
4. Finally, we determine if there is a clear cause-and-effect relationship between the employee’s duties and their injuries.
There are other types of Occupational Disease Claims, however repetitive motion stress injury claims are the most common within this classification of injuries. These occur when someone repeatedly performs a specific task that requires significant force, resulting in cumulative stress and injury to a body part.
An example of a repetitive motion stress injury claim could involve an assembly line worker who primarily uses their hands in their job. As they continuously handle and process products for their employer over the course of several years, they may develop various hand injuries due to the repetitive nature of their work. These injuries can accumulate gradually over time.
Carpal tunnel syndrome is a common diagnosis in these cases, along with tenosynovitis, tendonitis, and bursitis.
It is possible to have a compensable North Carolina Workers’ Compensation Claim for a repetitive motion stress injury. However, proving that the injury falls under the category of an Occupational Disease Claim and is compensable may require the assistance of a trained legal professional for a thorough analysis of the situation.
When it comes to Workers Compensation in North Carolina, it’s important to understand that ordinary diseases of life are generally not covered. This means that if you get sick while at work, such as coming down with the flu or contracting tuberculosis, you may not be eligible for North Carolina Workers Compensation Benefits.
Why is this the case? Since these diseases can be found in the general population and can be contracted just as easily at a grocery store or any other public place, they are not considered to be work-related illnesses.
However, there are certain circumstances where diseases can be considered compensable under North Carolina Workers Compensation. In order for a disease to be compensable, you must be able to show that your employment puts you at a greater risk of contracting that particular disease. Additionally, you must also demonstrate that you contracted the disease through a risk incident to your employment.
Occupational Hazards
One example of a compensable disease is when individuals who work as nurses or in a similar healthcare profession contract a transmittable disease, such as hepatitis, through an accidental prick or stick with a contaminated needle. In these cases, the disease would be considered compensable because it was the performance of their job duties that exposed them to the risk of contracting the disease.
Proximity to Risk
Another situation where a disease may be deemed compensable is when an employee can show that their job requires them to be in close proximity to a known risk factor. For instance, if you work in an industry where you are regularly exposed to hazardous chemicals or substances that are known to cause specific diseases, and you subsequently develop one of those diseases, it may be considered compensable.
Proving a Compensable Disease
If you believe you have contracted a compensable disease due to your employment in North Carolina, it is crucial to gather the necessary evidence to support your claim. This may include medical records, witness statements, and any documentation that demonstrates the link between your job and the disease you have contracted. It is highly recommended to consult with an experienced North Carolina Workers Compensation attorney who can guide you through the process and help you build a strong case because these types of claims can be very complex.
It depends. The North Carolina Workers’ Compensation Act states that an employee’s injury is compensable only when it arises out of and in the course of’ the employment. Whether or not a heart attack is compensable will typically depend on whether or not it was an “injury by accident” and whether or not it “arose out of” the employment.
In Dillingham v. Yeargin Construction Company, the North Carolina Court of Appeals wrote that when the employee suffers a heart attack, he or she must show that it was caused by some unusual or extraordinary exertion. Dillingham v. Yeargin Constr. Co., 82 N.C. App. 684, 348 S.E.2d 143 (1986), rev’d on other grounds, 320 N.C. 499, 258 S.E.2d 380 (1987). For example, in King v. Forsyth County, the North Carolina Court of Appeals held that when a sheriff suffered a heart attack immediately after he engaged in a vigorous foot chase of a fleeing suspect caused by the overexertion experienced during the foot chase was an “injury by accident.”
Whether or not a heart attack arises out of the employment is a question of what caused the heart attack. For example, were you pre-disposed to having a heart attack and this just happened to be when you had it or was something at work the reason for it? Take the previous police chase example. The Court would probably consider the chase to have caused the heart attack since it involved overexertion and it occurred immediately after the chase. If so, then the heart attack arose out of the employment.
This question of what caused the heart attack is always up to the medical experts. Therefore, even if you think work caused the heart attack, if the medical experts say otherwise, the court is likely to agree with them.
An employee may be entitled to benefits under the Workers’ Compensation Act if he or she sustains (1) an injury by accident (2) arising out of and (3) in the course of employment. N.C. Gen. Stat. § 97–2(6).
The phrase, “arising out of” refers to the origin of the injury while the phrase “in the course of” refers to the time, place and circumstances under which the injury occurred. Freeman v. Triangle Grading & Paving, Inc., 160 N.C. App. 415, 587 S.E.2d 100 (2003) (internal citations omitted).
The North Carolina Supreme Court has held that if the employee’s injury is “fairly traceable to the employment … or any reasonable relationship to employment exists,” it arises out of the employment. Id. (internal citations omitted). For an injury to be “in the course of his employment” it must be “‘under circumstances in which the employee is engaged in an activity which he is authorized to undertake and which is calculated to further, directly or indirectly, the employer’s business.’” Id. (quoting Powers v. Lady’s Funeral Home, 306 N.C. 728, 730, 295 S.E.2d 473, 475 (1982). Activities undertaken for the employee’s personal comfort are considered part of the aforementioned “circumstances” element of the course of employment. Id.
North Carolina Supreme Court has thus recognized the “personal comfort doctrine.” Freeman, 160 N.C. App. 415, 587 S.E.2d 100 (internal citations omitted). The court stated “‘[a]n employee, while about his employer’s business, may do those things which are necessary to his own health and comfort, even though personal to himself, and such acts are regarded as incidental to the employment.’” Id. (quoting Rewis v. Insurance Co., 226 N.C. 325, 328, 38 S.E.2d 97, 99 (1946). The North Carolina Court of Appeals has added “[T]he fact that the employee is not engaged in the actual performance of the duties of his job does not preclude an accident from being one within the course of employment….” Id.
The North Carolina Court of Appeals further wrote that “‘[I]n tending to his personal physical needs, an employee is indirectly [benefitting] his employer.’” Id. As a result, the course of employment continues when the employee goes to the washroom, takes a smoke break, [or] takes a break to partake of refreshment….” Id. (citing Harless v. Flynn, 1 N.C.App. 448, 456–57, 162 S.E.2d 47, 53 (1968) (citations omitted)).
Because off-premises breaks have increasingly become a regular part of many employees’ daily routine, the Court has addressed them as well. In order for injuries sustained during an off-premises break to be compensable, there are a number of factors to consider. These factors revolve around the underlying notion of whether the employer, considering all the circumstances, is deemed to have retained authority over the employee. Freeman, 160 N.C. App. 415, 587 S.E.2d 100 (internal citations omitted). The factors are:
(1)the duration of the break period;
(2) whether the employee is paid during the break period;
(3) whether the employer provides a place for employees to take breaks, including vending facilities;
(4) whether the employer permits off-premises breaks, or has acquiesced in such despite policies against such breaks; and,
(5) the proximity of the off-premises location where the employee was injured to the employment site.
Shaw v. Smith & Jennings, Inc., 130 N.C. App. 442, 447, 503 S.E.2d 113, 117 (1998) (internal citations omitted).
Therefore, whether or not an employee is entitled to benefits for an off premises break will depend on the circumstances of that employee’s individual case. Some things to note, however, are that injuries by accident sustained during on-premises breaks for your personal benefit are typically compensable so long as the remainder of the workers’ compensation act is satisfied. The factors laid out by the North Carolina Court of Appeals in Shaw and subsequent cases provide the framework for determining the compensability of an injury by accident sustained by an employee during an off-premises break.
Even though you cannot sue your employer if suffer an injury that entitles you to workers’ compensation benefits, you may be able to sue any “third party” who caused the harm.
For example, if your injury was caused by a defect in the forklift, you may have a product liability claim against the manufacturer, distributor and seller of the equipment.
Other common “third-party claims” involve automobile accidents or accidents at construction sites that are caused by negligent site owners and supervisors or negligent subcontractors. In some cases, you may be injured at work because of the negligence of a vendor hired by your employer such as a security service or cleaning company.
Keep in mind: Your employer’s workers’ compensation carrier may also have a lien in this matter. The amount of the carrier’s lien is limited to medical treatment and disability benefits that they have provided for you by way of your workers’ compensation claim. In order to resolve the third-party action, you will need to address this lien. It may be possible to have the lien waived by the carrier or extinguished by a court.
An attorney can help you to pursue a “third-party claim” and carefully handle all lien issues.
Yes, under some circumstances, you can be compensated for disfigurement. North Carolina workers’ compensation law allows for compensation for disfigurement if there is no other compensation payable under the statute for that injury.
If the disfigurement is to the face or head, then the law allows up to a maximum amount of $20,000 for the disfigurement.
If the disfigurement is to any other body part, then compensation may be payable up to $10,000.
The North Carolina Workers’ Compensation Act is a state program that is designed to compensate employees for work-related injuries and families who lose a loved one in a workplace accident. The program is set up as insurance that’s meant to cover a worker’s total medical costs and a portion of any lost income.
