When Should You Talk With a Lawyer About Your North Carolina Workers’ Compensation Benefits?

Work Injury Claim Denied Letter

Under North Carolina law, most individuals who work for an employer with three or more employees receive workers’ compensation benefits for a work-related injury or occupational disease. While it is not always necessary to consult with a lawyer to receive those benefits, sometimes issues can arise that require assistance from an attorney knowledgeable in the law.

You should understand what benefits are available under the workers’ compensation law. It is also important to know when you should talk with a North Carolina workers’ compensation attorney to ensure that you receive all the benefits you deserve.

Workers’ Compensation in North Carolina

A specific statute governs workers’ compensation benefits. The law requires most employers with three or more employees to provide the coverage for employees. The North Carolina Industrial Commission (NCIC) administers the workers’ compensation law.

What Is Covered?

Under the law, coverage includes benefits for injuries received in a work-related accident or from an occupational disease. Benefits do not cover non-work related accidents that occur during the workday, such as an accident that occurs during the commute to or from work or while on a lunch break.

Coverage for occupational diseases may include conditions caused by repetitive motion required by a job, such as carpel tunnel syndrome. Generally, to recover for this type of condition, the worker must prove two facts:

  • The work environment put the worker at greater risk of developing the condition than exists for members of the public in general.
  • The work environment was a significant contributing factor to contracting the condition.

For approved claims, workers’ compensation provides specific benefits for injured workers, as follows:

Medical Benefits

Workers’ compensation benefits cover all medical care and expenses related to your claim. However, your employer can require you to receive care from a specific doctor or clinic.

You have the right to petition the Industrial Commission for approval to have a different physician provide treatment. However, filing a petition and receiving a ruling can be time-consuming. Delaying your treatment may not be advisable.

Temporary Disability

If you cannot work for more than seven (7) days because of an injury from a work-related accident or occupational disease, you receive temporary total disability benefits. If your disability lasts more than 21 days, you receive benefits for the first seven days of absence.

Your benefits are equal to 66-2/3% of your lost wages, up to a weekly maximum amount that is set annually. For 2019, the maximum weekly benefit is $1,028.

The benefits end when you can return to work or reach maximum medical improvement. If you can perform modified or alternate work during a temporary disability, you receive partial benefits.

Permanent Disability

When your condition reaches maximum medical improvement, your physician gives you a permanent impairment rating. If you have a permanent total disability that makes you unable to work, you receive payments at the temporary disability rate for the rest of your life.

If your disability is partial rather than total, the Industrial Commission uses the doctor’s permanent impairment rating to determine the amount of a monetary award for your permanent partial disability. A state schedule sets the amount of monetary awards based on the type and severity of injuries.

Workers’ Compensation Claim Process

When you have a work-related accident or suffer from an occupational disease, you must notify your employer within 30 days. You also must file an official claim, using a Form 18, Notice of Accident to Employer and Claim of Employee.

You complete Form 18 and give it to your employer, who then completes a separate form (Form 19). The employer sends both forms to the employer’s insurance carrier and the Industrial Commission.

If your employer does not file the forms, you can submit the Form 18 directly to the Industrial Commission. You have two years from the date of your injury to submit the form.

If the insurance company approves your claim, you are eligible to begin receiving benefits.

When Should You Talk With a North Carolina Workers’ Compensation Lawyer?

If you file a claim and receive the workers’ compensation benefits provided by the law, it usually is not necessary to talk with a lawyer. Generally, you do not need to consult legal counsel if:

  • Your injury or illness is not severe and not long-term;
  • You can return to work within a short amount of time;
  • You do not have a permanent or extended disability, injury, or illness; and
  • Workers’ compensation paid all your medical expenses.

However, talking with an attorney knowledgeable about worker’s compensation law benefits you in any of these circumstances:

  • Your claim is denied,
  • Your medical expenses are not paid in full,
  • Your injury or illness requires significant recovery and treatment,
  • You suffer any type of permanent loss or disability,
  • You encounter other obstacles to receiving your full benefits, or
  • You lost a loved one who died because of a work-related accident or disease.

When you need to appeal denial of a workers’ compensation claim, representation by legal counsel gives you the best chance at succeeding in your appeal. There are time limitations on filing an appeal, so you should contact a lawyer as soon as possible after you receive the notice of denial.

Before the Industrial Commission schedules a formal hearing on your appeal, your case will be scheduled for a mediation conference. Almost three-quarters of all workers’ compensation cases reach resolution through settlement during the mediation process.

Representing yourself in the mediation process is not a good idea. Your lawyer will explain how mediation works and represent you during throughout mediation process.

An experienced workers’ compensation attorney knows how to leverage the evidence in your case. When your lawyer represents you in mediation or a formal hearing, he or she works hard to get the best possible result for you.

Talk With An Experienced North Carolina Workers’ Compensation Attorney

Our civil litigation attorneys at The Twiford Law Firm have the experience and knowledge to help with your workers’ compensation claim, regardless of what issue you encounter in obtaining your benefits. With offices in Elizabeth City and Moyock, we serve clients throughout northeastern North Carolina. Call us at 252-338-4151 (Elizabeth City) or 252-435-2811 (Moyock) or complete our online form to schedule an initial consultation.