Every year, thousands of North Carolina workers are injured on the job. Whether you work in construction, manufacturing, healthcare, retail, or any other industry, a workplace injury can happen in an instant and change your life. North Carolina's workers' compensation system is designed to provide benefits to injured workers, but navigating the system can be complex and frustrating, especially when you are dealing with pain, medical treatment, and lost income.

What Is Workers' Compensation?

Workers' compensation is a form of insurance that provides wage replacement and medical benefits to employees who are injured in the course of their employment. In exchange for these benefits, employees give up the right to sue their employer for negligence. North Carolina law requires most employers with three or more employees to carry workers' compensation insurance.

Benefits Available Under NC Workers' Comp

Medical Benefits

Workers' compensation covers all reasonable and necessary medical treatment related to your work injury. This includes doctor visits, hospital stays, surgery, prescription medications, physical therapy, medical devices, and mileage reimbursement for travel to medical appointments. The employer or its insurance carrier has the right to direct your medical treatment, meaning they can choose your treating physician.

Disability Benefits

If your injury prevents you from working, you may be entitled to disability benefits:

  • Temporary Total Disability (TTD): Paid when you are completely unable to work while recovering. Benefits are typically two-thirds of your average weekly wage, subject to a maximum set by the state.
  • Temporary Partial Disability (TPD): Paid when you can return to work but at reduced hours or in a lower-paying position due to your injury.
  • Permanent Partial Disability (PPD): Paid when you reach maximum medical improvement but have a permanent impairment rating. The amount depends on the body part affected and the degree of impairment.
  • Permanent Total Disability (PTD): Paid when your injury is so severe that you are permanently unable to work in any capacity.

Death Benefits

If a worker dies as a result of a work-related injury or illness, the worker's dependents may be entitled to death benefits, including funeral expenses up to $10,000 and weekly benefits for qualifying dependents.

The Workers' Comp Claims Process

The workers' compensation claims process in North Carolina involves several important steps:

  • Report the injury: You must report your injury to your employer as soon as possible. North Carolina law requires written notice within 30 days of the accident, though you should report it immediately.
  • Seek medical treatment: Your employer should direct you to an approved medical provider. In an emergency, go to the nearest emergency room.
  • File a claim: If your employer or its insurer disputes your claim, you may need to file a Form 18 with the North Carolina Industrial Commission.
  • Receive benefits: If your claim is accepted, you should begin receiving medical treatment and disability benefits.

Common Reasons Workers' Comp Claims Are Denied

Unfortunately, many legitimate workers' compensation claims are initially denied. Common reasons include the employer or insurer disputing that the injury is work-related, claiming the injury was caused by a pre-existing condition, alleging that you failed to report the injury on time, arguing that you were intoxicated or engaged in horseplay at the time of the injury, or disputing the extent of your disability.

When to Hire an Attorney

While not every workers' compensation case requires an attorney, there are situations where legal representation is essential. If your claim has been denied, if the insurance company is disputing your medical treatment, if you have a pre-existing condition that the insurer is using against you, or if you have suffered a serious or permanent injury, you should consult with an experienced workers' compensation attorney.

At Dr. Ted Injury Law, Emily Thompson handles workers' compensation cases across North Carolina and South Carolina. Contact us at (800) 555-HURT for a free consultation.