How to File a Workers’ Compensation Claim in North Carolina
Many of these injuries require extended medical care and may result in an employee’s temporary or permanent disability. In North Carolina, most businesses with more than three employees are required to carry workers’ compensation insurance. Workers’ compensation provides “no-fault” benefits to injured employees in the event of a workplace-related accident.
What Qualifies Me for Workers’ Compensation?
Under North Carolina law, a person is entitled to workers’ compensation benefits if he or she (1) is injured in an accident, (2) the injury occurred in the course of the person’s employment, and (3) the injury arose from the employment.
Do I Need to Report My Accident?
Your employer must be notified as soon as possible of your injury following a workplace accident. As part of the workers’ compensation process, the employer may provide on-site medical care or refer you to a designated health care provider. If for some reason your employer does not direct you to a provider, you should still seek immediate medical attention from your own physician or the local emergency department.
Dealing With Health Care Providers
Once you seek treatment, you should inform your health care provider you were injured at work or while performing duties related to your employment. For example, if you were in a car accident while making a sales call for your employer, this may still constitute a workplace-related injury. It is essential to inform your health care provider upfront, as it will enable him or her to bill any treatment to your employer’s workers’ compensation insurance carrier. You should also follow any treatment prescribed by your doctor or other health care provider.
Do I Need to Give Notice in Writing?
It is not enough to verbally inform your employer about a workplace accident. As soon as possible, and no more than 30 days after the accident, you must give written notice to your employer. This need not be a detailed statement of your claim. A brief description of the accident and your injuries will suffice at this stage.
What is a Form 18?
The North Carolina Industrial Commission is the state agency that oversees the workers’ compensation system. Any employee who needs to bring a workers’ compensation claim must file a document known as Form 18 with the Commission. This form can also be used to provide the required written notice to the employer. Form 18 is not complicated, but it is necessary. It basically informs the Commission about the date of the accident, how it occurred, and the specific injuries that you suffered.
Form 18 must be filed within two years of your accident. Failure to meet this deadline may prevent you from receiving any workers’ compensation benefits. Of course, you should try to file Form 18 as soon as possible and not wait until the two-year deadline is about to expire. Learn also about the failure to file a form 18 for your workers comp claim.
What Are My Employer’s Reporting Obligations?
Your employer is required to file an accident report with the Commission whenever an employee misses more than one day of work or incurs more than $2,000 in medical bills. This report is known as Form 19. It is important to note that an employer’s filing of Form 19 does not relieve the employee, in any way, of his or her duty to file Form 18.
What Happens After I File for Workers’ Compensation?
The Industrial Commission will notify you it has received Form 18. A copy will also be provided to your employer. At that point, your employer (or its insurance carrier) must decide whether or not to voluntarily pay you workers’ compensation benefits.
What If My Employer Refuses to Pay?
If your employer denies a workers’ compensation claim, you may ask the Industrial Commission to review your case. A Commission official will conduct a hearing where you and your employer can present evidence about the accident. The official will then render a decision, which either you or your employer can appeal to the full Industrial Commission, and beyond that to the North Carolina Supreme Court.
What If My Employer Does Not Have Workers’ Compensation Insurance?
Most North Carolina employers are legally required to carry workers’ compensation insurance. If for some reason your employer does not, you should report them to the Industrial Commission. You must still file Form 18 in order to preserve your workers’ compensation claim.
Please note that some employers may offer “occupational accident insurance,” which covers certain types of workplace injuries. These policies are not required by North Carolina law. More importantly, they are not an acceptable substitute for workers’ compensation insurance.
Do I Need a Workers’ Compensation Attorney?
You do not need an attorney to file Form 18. But while the Industrial Commission can provide limited technical assistance, they will not give legal advice to injured employees. It is therefore in your own best interest to work with an experienced workers’ compensation attorney, who can assist you not only with filing your claim, but also with any appeal should it be necessary.
It is especially important to have a workers’ compensation attorney if your employer denies your claim or your case involves any complex legal or medical issues, such as the following:
- Your injury requires surgery and/or long-term care and you are not able to return to work for an extended period of time;
- You have problems with the medical treatment provided by your employer and would like to change health care providers;
- Your employer has offered you a “clincher agreement,” which is an offer to settle all outstanding workers’ compensation claims; or
- Your injury was caused by the negligence of a third party, which may require additional personal injury litigation.
Even if you are simply unsure whether your injury qualifies you for workers’ compensation, it is still a good idea to speak with an experienced Raleigh workers’ compensation attorney who can help guide you through the process. If you have been injured at work in North Carolina and need advice on how to proceed, contact Hardison & Cochran, Attorneys at Law, to speak with someone right away.