If you are injured on the job, or become ill as a result of your job, you may be entitled to benefits from the North Carolina workers’ compensation system. In theory, applying for benefits and being approved for those benefits should be simple. However, in reality, navigating the workers’ compensation system can a challenge. Although you are not required to have an attorney to guide you through the workers’ compensation system, there are a number of reasons why you may need one. Consider the following six reasons why:
1. The application process is complicated. Despite the fact that the workers’ compensation system is a no-fault system, navigating the application process can be confusing. A wrong step can cost you time and money. Specific forms must be filed in a timely fashion to be considered for benefits. Claims are frequently denied for something as simple as the claimant failing to file a Form 18 (the official claim form required by the North Carolina Industrial Commission, or NCIC) even though the claim was properly reported to the employer. Moreover, the reporting requirements don’t stop after a claim is approved. To receive benefits, a claimant must stay on top of all administrative reporting requirements for the life of the claim. Hiring an experienced North Carolina workers’ compensation attorney ensures that all the requirements for filing and maintaining a claim are satisfied.
2. Your application may be denied. Although you may be certain that your injury or illness qualifies for benefits, the claim could still be denied. A denial is not the end of the road for your claim. You have a right to appeal. However, getting a claim approved becomes less likely with each step up the appeals ladder, making it even more important to have an experienced attorney on your side early in the process. Common reasons for a denial include:
- Technicality. Failing to file the proper forms and/or supporting documents is a leading cause of denials.
- Pre-existing condition. Your employer (or the employer’s workers’ compensation carrier) may claim that the injury/illness was pre-existing and, therefore, the employer has no liability.
- Injury/illness not job related. Your employer may claim that the injury or illness occurred outside the scope of employment.
- Not a covered employee. If there is a question as to whether you are an employee or a sub-contractor, for example, your employer may deny coverage by claiming you are not a covered employee.
3. The impairment or disability rating may be disputed. Unless your injury or illness causes you to be permanently totally disabled, an impairment and/or disability rating will need to be determined at some point (often at various points) during the life of your claim. The higher the impairment rating the more valuable your claim is, making it important to dispute a rating that you believe to be inaccurate. The assistance of an experienced workers’ compensation attorney can be invaluable at this point.
4. You may have return to work issues. Again, unless you are permanently totally disabled you will reach a point at which your doctor considers you able to return to some type of work. Contrary to the doctor’s opinion, you may not agree that you are ready to return to work or may believe you are ready for some type of work, but not the type you did before the injury/illness. You have a right to dispute “return to work” issues. However, doing so without the assistance of an attorney decreases the odds of being successful.
5. You may lose out on “hidden” benefits. Neither your employer nor the NCIC is likely to voluntarily inform you of additional benefits you may be entitled to. For example, did you know that your employer is supposed to help you find a job and/or provide vocational rehabilitation services if you cannot return to your old job? Your workers’ compensation attorney will make sure you do not miss out on any benefits.
6. You could settle your claim for less than it is worth. At some point you may enter into settlement negotiations for your workers’ compensation case. The insurance carrier will be represented by an attorney who is skilled at negotiating settlements and who knows what your case is worth. Shouldn’t you level the playing field by having an attorney on your side to ensure that you don’t settle for less than what your case is worth?
If you have been injured in a North Carolina workplace accident, or are suffering a work-related illness, contact an experienced North Carolina workers’ compensation attorney as soon as possible to ensure that your rights are protected throughout the life of your claim.