The North Carolina Workers’ Compensation program is an insurance program that covers a worker’s medical expenses and a portion of any income they have lost by being unable to work.
Many injured workers receive benefits that are due to them with little or no problem. But there are also many workers who find themselves overwhelmed by a complex process that does not provide the benefits they need and deserve as they work to recover from their injury.
If you or someone you love has suffered a workplace injury or occupational disease that keeps them from working in North Carolina, call the experienced workers’ compensation lawyers at Hardison & Cochran toll-free at (800) 434-8399 or fill out our online contact form. We can help cut though the red tape and obtain the benefits you need and deserve. You’ll get a response within 24 hours, and your initial consultation is always free.
Claiming Workers’ Compensation Benefits in North Carolina
The North Carolina workers’ compensation program is a “no fault” insurance program. An injured or ill employee does not have to show that the employer was at fault for an on-the-job injury or a work-related illness to claim benefits. However, the employee must report the accident that caused their injury to their employer.
The state’s workers’ compensation program provides money to help injured workers pay medical and rehabilitation expenses and to replace lost wages during their recovery. Workers’ compensation also provides disability payments for workers who will not be able to resume employment and death benefits to families of workers who have died in workplace accidents.
The North Carolina Industrial Commission (NCIC) adjudicates claims. The various benefits are paid according to formulas set by state law.
The employee must file for benefits by completing and submitting Form 18 to the Industrial Commission. Form 18 notifies the NCIC, your employer and your employer’s workers’ compensation insurance carrier that you are seeking workers’ comp benefits. An injured employee has two years from the date of the accident or injury to file Form 18.
When the NCIC processes the claim applicant’s Form 18, it sends out an acknowledgement letter that contains information about the insurance carrier.
The injured worker will be directed to medical treatment by a provider chosen by their employer or the employer’s workers’ compensation insurance carrier. You must see this doctor and, to make sure you do not damage your claim, follow his or her medical instructions. You may still see your own doctor / medical provider.
Depending on the circumstances of the case, once a claim is approved a workers’ compensation beneficiary may receive:
- Medical benefits to pay for medical procedures (including chiropractic and psychological care), diagnostic tests, medications, and the services of medical professionals.
- Disability benefits, which may be for partial or total disability that is temporary or permanent. These benefits are generally based on two-thirds (66.66 percent) of the worker’s weekly pay prior to their injury, plus payments for specific injuries, such as loss of a leg or an eye.
- Disfigurement benefits for scarring or damage to internal organs.
- Vocational rehabilitation benefits for training and education as well as job search and placement assistance for workers who cannot return to their previous job because of their injury or illness.
Medical expenses are paid as reimbursements for filed expenses. Any additional benefits are paid weekly.
North Carolina workers’ compensation also pays a death benefit to surviving family members of a worker who dies in a workplace accident or later succumbs to injuries suffered on the job.
Appealing an N.C. Workers’ Compensation Decision
Unfortunately, obtaining workers’ compensation benefits is not as straightforward a process as it might seem to be. If an insurer contests a claim, a process of appeals and hearings can ensue.
First, the NCIC will order mediation. If an impartial arbiter cannot settle the dispute to the satisfaction of all parties, a hearing before a deputy commissioner may be set, typically within 30 to 60 days of the failed mediation.
If arbitration ordered by the NCIC fails to resolve disputes between the insurer and the injured worker, a workers’ compensation claim is sent before a deputy commissioner of the Industrial Commission. Deputy commissioners act as judges. They conduct hearings in contested cases at the trial level and issue written decisions in those cases. All formal hearings are held before a deputy commissioner, and they are usually in a live courtroom setting.
An appeal before a deputy commissioner is the first level of formal appeals available. This hearing will include formal testimony and other presentations of evidence. Should the injured worker who is applying for benefits or the insurer who would have to pay for those benefits remain unsatisfied, they can appeal to a full panel of deputy commissioners and then to the North Carolina Court of Appeals.
It isn’t difficult to see how disputes arise if the benefits a worker is counting on are denied or if approved benefits do not meet the worker’s needs as they recover from an on-the-job injury.
It also isn’t difficult to see how a worker struggling to recover from a job-related injury could become overwhelmed by a state bureaucracy that is about to determine his financial fate.
Contact a North Carolina Workers’ Compensation Lawyer Today
The North Carolina Workers’ Compensation Act was designed to protect employees who have been hurt on the job. But the process of making a claim can do just the opposite. The North Carolina workers’ compensation attorneys at Hardison & Cochran work to assist deserving benefits applicants through the entire workers’ comp claims process to ensure that they obtain the benefits they deserve.
We serve injured workers across Eastern and Central North Carolina, including those in Raleigh, Cary, Durham, Wake County, Fayetteville, Dunn, Greensboro, Research Triangle Park, Wilmington, the Triangle, the Triad, Person County and Southern Pines.
If you or someone you love has suffered a workplace injury or illness, contact the experienced North Carolina workers’ compensation lawyers at Hardison & Cochran toll free at (800) 434-8399 or through our online contact form. We’ll respond within 24 hours. We take every workers’ compensation claim seriously. Let us help you today.