3 Red Flags That You May Need A North Carolina Workers' Comp Lawyer

One of the most commonly asked questions we receive about North Carolina Workers Compensation claims is how to know when you need to contact a lawyer. There three main red flags that we’ve seen in our time which indicate injured workers may need to reach out to an attorney to get more information.

🚩 Red Flag #1: Lack of Communication from the Insurance Company

If you have filed a Workers Compensation claim and have not heard anything from the insurance company after a significant amount of time, this is a red flag. Despite your employer reporting the claim and the Industrial Commission having your information, the lack of communication from the insurance company is concerning.

It is not uncommon for insurance companies to delay the claims process, as it benefits them to put up walls and defenses against your claim. The longer they can delay your claim, the more advantageous it is for them. If you find yourself in this situation, it is important to reach out to an attorney.

🚩 Red Flag #2: Delayed Authorization of Medical Treatment

Another red flag to watch out for is the insurance company’s delayed authorization of necessary medical treatment. After filing your claim, the insurance company may authorize initial treatment, such as a visit to urgent care or physical therapy.

However, if they fail to authorize further diagnostic tests like an MRI or a referral to an orthopedic specialist in a timely manner, it is a red flag. These diagnostic tools are essential for determining the nature and extent of your injury. Delaying or denying access to these tests inhibits your medical treatment and recovery.

🚩 Red Flag #3: Conflict Between Parties Due To Permanent Restrictions

A significant red flag arises when an injured employee has reached Maximum Medical Improvement, but still has permanent restrictions preventing them from returning to their previous job. At this point, a conflict of interest arises between the insurance company and the injured employee.

Prior to this point, both the insurance company and the injured employee share the goal of returning the employee to work. The insurance company provides benefits and medical treatment to facilitate this goal. However, when the employee’s injury is severe enough to prevent them from returning to their previous job, a divergence occurs.

According to NC Workers Compensation laws, the insurance company must continue providing benefits until the employee can return to work. However, there is no specified timeframe for this, and the insurance company may seek ways to terminate or suspend benefits. This conflict of interest is a red flag that the injured worker may need to contact an attorney and learn what steps can be taken to maximize their best interests in this conflict.