Workers’ Compensation
Workers’ Compensation Lawyers
Who Fight for Injured Workers
Insurance companies have lawyers from the day you’re injured. You should too. Lennon, Camak & Bertics has spent decades representing North Carolina workers with serious and catastrophic injuries — and getting the medical care and wage replacement they’re owed under the North Carolina Workers’ Compensation Act.
- Board-Certified
- 50 Plus Years of Combined Experience
- No Fees Unless You Win
- Board-Certified
- 50 Years of Combined Experience
- No Fees Unless You Win
Why You Need An Attorney
Workers’ compensation in North Carolina is a no-fault system. That sounds simple — and the system is supposed to be simple. In reality, insurance companies have entire legal departments dedicated to limiting what they pay injured workers. They delay accepted claims.
They deny compensable claims. They send nurse case managers to your appointments. They demand recorded statements. They schedule independent medical examinations with doctors they regularly hire. They quietly cut off benefits using Form 24 motions before you’ve even spoken to a lawyer.
None of this is illegal. All of it is leverage. The only way to neutralize it is to have an experienced workers’ compensation attorney who knows every form, every deadline, every tactic, and every case law citation that controls your situation. That’s what we do — and only what we do.
How North Carolina Workers’ Compensation Works
- Full medical care for the work-related injury or disease
- Weekly wage replacement (indemnity) benefits while you’re unable to work
- Permanent partial disability benefits if your injury results in a permanent impairment
- Vocational rehabilitation if you can’t return to your prior job
- Death benefits to surviving family members in fatal injury cases
- Reimbursement for travel to authorized medical appointments more than 20 miles round-trip
- Home health care, adaptive housing, and handicapped accessible transportaion
The Benefits You Are Entitled To
Many injured workers don’t realize the full range of benefits available under the Act. Here’s what every injured worker in North Carolina should know about.
Medical Benefits
Workers’ compensation covers all reasonably necessary medical treatment for your work-related injury — emergency care, surgery, physical therapy, prescription medications, durable medical equipment, mental health treatment when related to the injury, and ongoing care. The insurance company has the right to direct your initial medical care if the claim is accepted, but you have rights here too: the right to a second opinion before surgery, the right to a second opinion on disability ratings, and the right to petition the Industrial Commission for a different physician. The definition of medical benefits is broad – home health care, adaptive, housing and handicapped accessible transportation.
Temporary Total Disability (TTD)
If your doctor takes you out of work entirely while you recover, you’re entitled to weekly indemnity benefits at two-thirds of your pre-injury average weekly wage, up to an annually adjusted state maximum. These benefits are tax-free and continue until you’re released to return to work, reach maximum medical improvement, or hit the 500-week statutory cap (with certain exceptions for total and permanent disability).
Temporary Partial Disability (TPD)
If you can return to work but only at reduced hours, lighter duty, or lower wages because of your injury, TPD pays two-thirds of the difference between your pre-injury average weekly wage and your reduced earnings.
Permanent Partial Disability (PPD)
Once you reach maximum medical improvement, your treating physician will assign a permanent impairment rating to the affected body part. North Carolina law assigns a specific number of weeks of compensation to each scheduled body part — for example, 300 weeks for the back, 200 weeks for the leg, 240 weeks for the arm. You can also be paid for scarring or damage to internal organs, up to $20,000. Your PPD award is the rating percentage multiplied by the scheduled weeks, paid at your compensation rate.
Lifetime Medical Care (Form 18M)
Without action, your medical benefits end two years after your last authorized treatment. To preserve lifetime medical care for your injury, you must file a Form 18M with the North Carolina Industrial Commission within strict time limits, supported by your authorized treating physician. This is one of the most overlooked rights in workers’ compensation — and one of the most valuable. We routinely secure lifetime medical for clients with serious back, neck, knee, and shoulder injuries.
Vocational Rehabilitation
If your injury prevents you from returning to your prior job, you may be entitled to vocational rehabilitation services to retrain for new work. The insurance carrier is also entitled to assign a vocational counselor to your case, and that counselor’s job is to find you any suitable job. We make sure vocational rehab is used to help you, not pressure you back into work you can’t do. We may also be able to get the insurance company to pay for your education, if necessary, to get you back to work.
Death Benefits
If a worker is killed, or contracts a fatal disease, on the job, surviving spouses and dependent children are entitled to death benefits at two-thirds of the worker’s average weekly wage for up to 500 weeks (or more), plus burial expenses. Our firm represents surviving family members in fatal injury cases with the same care and rigor we apply to any other claim.
Common North Carolina Workplace Injuries
Workers’ compensation covers virtually any injury that arises out of and in the course of employment. The cases we handle most often include:
Back, Neck, and Spine Injuries
Herniated discs, ruptured discs, spinal stenosis aggravated by work, compression fractures, and post-laminectomy syndrome are some of the most expensive injuries in workers’ compensation — both in medical care and in lost earning capacity. We have decades of experience proving the work-relatedness of these injuries, even when the insurance company points to pre-existing degeneration on imaging.
Shoulder, Knee, and Joint Injuries
Rotator cuff tears, labral tears, ACL and meniscus injuries, and joint replacements are common in construction, healthcare, manufacturing, and warehousing. Insurance companies routinely accept the immediate injury but try to deny later surgery as ‘unrelated.’ We push back.
Traumatic Brain Injury and Concussion
Falls and motor vehicle accidents at work cause TBIs that can permanently affect cognition, mood, the ability to work, and can lead to intractable headaches. These cases require careful neuropsychological evaluation and aggressive treatment.
Repetitive Trauma and Occupational Disease
Carpal tunnel syndrome, cubital tunnel syndrome, hearing loss, asbestos-related disease, occupational asthma, and other diseases caused by long-term workplace exposure are all potentially compensable. We have extensive experience proving all varieties of accident claims and require proof that the work was a ‘characteristic and peculiar’ source of risk.
Catastrophic and Permanent Total Disability
Spinal cord injuries, severe burns, amputations, multiple-system trauma, and second injury cases that combine with prior conditions to render a worker totally and permanently disabled are our most complex cases. We routinely secure lifetime benefits for clients with permanent total disability. This can include home health care, adaptive housing, and handicap accessible transportation.
Motor Vehicle Accidents on the Job
If you were driving for work — making deliveries, traveling between job sites, transporting clients — and were injured in a crash, you may have both a workers’ compensation claim and a third-party claim against the at-fault driver. Coordinating these two claims is critical so the workers’ comp carrier doesn’t take all of your third-party recovery.
Workplace Violence and Assault
Injuries from workplace assaults are compensable when the assault arose from the work itself — common in healthcare, retail, security, and education. We’ve represented nurses, social workers, teachers, law enforcement officers, and convenience store clerks injured in workplace violence.
Professional Athletes
Professional athletes injured during the course of their sport are often eligible for workers’ compensation in North Carolina, including coverage for acute injuries, chronic conditions, rehabilitation, and permanent impairment. We represent athletes whose careers have been cut short or permanently affected by sports-related injury.
Five Steps to Take Right Now if You’ve Been Hurt on the Job
- Report the injury to your employer in writing as soon as possible. Verbal notice is allowed but a paper trail protects you. Note the names of any witnesses.
- Get medical treatment immediately. Tell the treating provider how the injury happened and that it’s work-related — make sure that’s in the medical record.
- File Form 18 with the North Carolina Industrial Commission. The employer’s Form 19 is not your claim. You generally have 30 days to give written notice and up to 2 years to file your Form 18 — but the sooner the better.
- Cooperate with the claim investigation, but be careful. Sign Form 25C only after reading it. If the insurance company asks for a recorded statement, contact an attorney first.
- Call an experienced workers’ compensation attorney. If treatment is delayed, if the carrier wants you back at work too soon, if benefits haven’t started, or if the claim is being investigated as denied, you need legal help.
Workers’ Compensation Claim Denied? You Have Options.
North Carolina workers’ compensation insurers deny valid claims every day. Common reasons for denial include disputes about whether the injury was ‘work-related,’ allegations of pre-existing conditions, missed deadlines, late reporting, alleged horseplay or intoxication, and ‘idiopathic fall’ defenses. None of these denials is the end of the road.
Time is critical. Hire an attorney immediately if your claim has been denied, so that you can full y explore your legal options.
Should You Settle Your Workers’ Compensation Case?
Most accepted workers’ compensation cases eventually resolve through some form of settlement. There are two ways cases settle in North Carolina:
Form Agreements
Form 21, Form 26A, and similar agreements settle a particular issue — for instance, the percentage of permanent partial disability — but leave the case open for further benefits. Useful in some situations, especially when significant medical care is still ahead.
Compromise Settlement Agreements (Clinchers)
A clincher is a final, lump-sum settlement that closes the entire case. After approval by the Industrial Commission, the worker can never seek additional indemnity or medical benefits for that injury again. Clinchers usually pay more than form agreements but the trade-off is permanent — and irreversible. Whether to settle, when to settle, and how much to settle for depend on your specific medical situation, your earning capacity, your Medicare eligibility, and the carrier’s exposure on your case.
We don’t push clients into clinchers. We tell you honestly what your case is worth, what the carrier is likely to pay, and what you’d give up. The decision is always yours — but it should be informed.
What ‘MMI’ and a ‘Rating’ Mean for Your Case
‘Maximum medical improvement’ (MMI) is the point at which your treating physician determines that further treatment is unlikely to substantially improve your condition. It does not mean you’re ‘all better’ — it means you’ve stabilized. At MMI, your physician often issues a permanent partial impairment rating to the affected body part and permanent work restrictions.
A rating is not a settlement. Accepting payment of your rating, however, often closes out your indemnity benefits — and sometimes triggers credits the insurance company will use against later compensation. Before accepting any rating, consult with any attorney about how this will impact your case.
Get a second opinion if you doubt the rating’s accuracy, and have an attorney evaluate the long-term cost of accepting versus pursuing wage loss benefits, vocational rehabilitation, or further medical care.
Was Someone Other Than Your Employer Responsible?
North Carolina’s workers’ compensation system bars most lawsuits against the employer, but it does not bar lawsuits against negligent third parties — for example, a driver who hit you in a work-related crash, a contractor at your job site, a manufacturer of defective equipment, or a property owner who failed to keep their premises safe.
Coordinating a workers’ compensation claim with a third-party personal injury claim is technical and high-stakes. The workers’ comp carrier has a statutory lien on third-party recoveries, and that lien must be negotiated, reduced, or extinguished. Done right, a coordinated claim maximizes the worker’s net recovery. Done wrong, the worker can win a third-party verdict and end up with very little of it. We work alongside trusted personal injury counsel where appropriate to coordinate these claims.
What It Costs to Hire a Workers’ Compensation Lawyer
Workers’ compensation cases are handled on a contingency fee basis. There is no hourly billing, no retainer, and up-front retainer Our fee is a percentage of what we recover for you — and only what we recover. If we don’t get you a recovery, you pay no attorney’s fee. The fee percentage is regulated by the North Carolina Industrial Commission and is approved as part of any settlement order.
The initial consultation is always free. We’ll evaluate your case, explain the law, and tell you honestly whether you have a claim worth pursuing — at no cost and with no obligation.
Why Choose Our Firm for Your Workers’ Compensation Case
Board-Certified Specialists
All eligible attorneys are board certified by the North Carolina State Bar in workers’ compensation law — a credential held by fewer than 1% of North Carolina attorneys. It signals deep, tested expertise in this specific body of law.
Trial-Ready
We try cases. Many firms talk a tough game and then push clients to settle the moment a hearing is scheduled. We don’t. Our attorneys regularly try cases before North Carolina Industrial Commission Deputy Commissioners and in the Full Commission. Insurance carriers know us, and they know we’ll go to a hearing if the offer isn’t right.
Hands-On, No Settlement Mill
Our attorneys give clients direct phone lines. We meet face-to-face. We respond to calls and emails. We don’t run the kind of high-volume settlement mill that processes hundreds of cases at once and offers clients whatever the insurer puts on the table to clear the file.
Both Workers’ Compensation and Social Security Disability
Many catastrophic injury cases involve both workers’ compensation and SSDI. We handle both — under one roof, with one team, and with proper offset coordination so you maximize your total recovery.
North Carolina Workers’ Compensation FAQs
General Questions
Workers’ compensation is a benefit paid to workers who have suffered compensable work-related injuries or occupational diseases. The insurance is a required purchase for most employers by the North Carolina Workers’ Compensation Act, N.C. Gen. Stat. §§97-1 et seq., unless they are self-funded or not covered under the Act at all.
How Much Does A Workers' Compensation Lawyer Cost
All workers’ compensation cases are unique. Our Raleigh workers’ compensation lawyers prioritize your best interests. We will not collect any fees from you unless you win, in which case we charge a percentage of your total awarded compensation. Attorney costs depend entirely on the amount of your monetary award.
Do I need a workers’ compensation attorney?
Any person with an injury requiring surgery which prevents a return to pre-injury work should consult an attorney right away. The seriousness of the injury or disease, whether the insurance company is delivering appropriate benefits, whether the insurance company has accepted or denied the claim, are other factors to consider.
What should I do if I am injured on the job?
There are a few general things you can do in almost every case to give your claim the best chance of proceeding smoothly in the workers’ compensation system:
- Report the injury to your employer in writing ASAP; Note the names of any eye witnesses.
- Obtain medical treatment ASAP. Make sure the doctor addresses your ability to safely return to work.
- File your claim with the NC Industrial Commission on a Form 18 ASAP. Beware, there are time limits to file your claim and the employer’s Form 19 Report is not a claim.
- Cooperate with the claim investigation.
- Sign Form 25C so they can get your medical records, and be clear and honest when giving a recorded statement.Remember to explain your answer.
- Cooperate with medical treatment. Failing to appear at appointments or obtain recommended treatment may result in loss of benefits. If you need transportation, ask the carrier to provide it.
- Call an experienced attorney if you have any questions.
Where can I find more information about how workers’ compensation cases work generally?
The North Carolina Industrial Commission publishes a Bulletin that can be obtained by going to their website (as well as all forms and other helpful information), or by calling the North Carolina Industrial Commission at 919-807-2500.
Qualifying for Workers' Compensation
Workers’ compensation is a “no fault” insurance program. This means your own contributory negligence in causing the injury is irrelevant. At most, your benefits may be reduced by 10% for failing to observe recognized safety laws.
What if my work-related condition only contributes to my overall disability, considering other non-work-related medical conditions?
The defense takes you as they find you when you get hurt, including all pre-existing medical conditions. So long as the work-related injury or disease is a substantial contributing factor in your disability, it is compensable.
Does it matter if I have had previous medical problems in the same area as my work related injury?
If a non-work related condition is materially aggravated or accelerated by a work related, compensable event, the insurance company is responsible for the injury regardless of the fact that you had a pre-existing condition.
What happens if I return to work, but am forced to stop working again due to my work related injuries?
If you are released by your physician with no medical restrictions, the law provides a 45 day window for you to attempt to return to work. If you are released to return to work with medical restrictions, the law allows you a nine month period during which you may attempt to return to work. If you are unsuccessful in returning to work due to your work related injuries during either one of the periods noted above, you and your doctor should complete an N.C.I.C. Form 28U/Form 23 and file it with the North Carolina Industrial Commission for an immediate resumption of weekly disability benefits.
Workers' Compensation Coverage
The primary benefits are weekly indemnity wage loss benefits and full medical care for the work related injury and/or disease. The indemnity benefits are capped at an annually adjusted maximum, but are tax free.
Can I get lifetime medical care for my injuries or occupational disease?
Unless you settle your case on a final settlement agreement, medical benefits will end two years after the date last provided unless you file an N.C.I.C. Form 18M with the North Carolina Industrial Commission seeking lifetime medical care for your injuries and/or occupational disease. Time limitations do apply, and the cooperation of your authorized treating physician is recommended.
My doctor told me that I have reached “MMI,” was going to be “rated” and “released.” What does this mean?
The term “MMI” means maximum medical improvement. In the eyes of the law, you have now reached the end of the “healing period,” and may receive a permanent partial impairment rating to the affected body part from your treating physician. If you believe the rating is too low, you have the right to a second medical opinion on the issue (as well as prior to any proposed surgical intervention). You may also be issued permanent work restrictions at this medical appointment, and released from the care of your treating physician on a “return as needed” basis.
Depending on whether or not you have suitable employment to return to by this time, you may elect to continue to receive temporary total disability benefits (if you are unable to return to any competitive work), receive temporary partial disability benefits (a wage loss claim if you return to work at reduced wages), or permanent partial disability benefits (based on the disability rating assigned by your doctors). You may not receive more than one benefit at a time.
Workers' Compensation Claims
Generally, you must file an N.C.I.C. Form 18 with the North Carolina Industrial Commission within thirty days (maximum up to two (2) years if excused) of your date of injury. Different rules apply for occupational disease claims.
How are workers’ compensation claims settled?
Generally, there are two ways workers’ compensation claims are settled. The first way is by way of a form agreement. These kinds of settlements are usually not as high, but they leave open the possibility of reopening the claim for additional indemnity and/or medical benefits. The second way to settle a claim is by way of a final settlement agreement, or “clincher.” This type of settlement usually results in a higher settlement amount, but is riskier in that all rights to future payment of medical or lost wage benefits are permanently waived.
If the insurance company denies my claim, or denies a benefit in an otherwise accepted claim, how should I respond?
The North Carolina Industrial Commission is the quasi-judicial agency set up to determine disputes that arise under the North Carolina Workers’ Compensation Act. File an N.C.I.C. Form 33, Request that Claim be Assigned for Hearing, and wait for your claim to appear on a hearing docket within several months.
Can I be reimbursed for mileage incurred in connection with my claim?
You are entitled to be reimbursed for mileage incurred in connection with medical treatment of your work-related injury and/or disease as long as the required travel for said medical treatment is in excess of 20 miles round trip. Use Form 25T.
Insurance Company Involvement
Generally, if the claim has been accepted by the carrier as compensable, the insurance company is allowed the right to initially direct medical treatment. However, N.C. Gen. Stat. § 97-25 does allow an injured worker to select a physician of his own choosing, subject to approval by the Industrial Commission. You may also have the right to a second medical opinion regarding surgery or a disability rating.
Does the insurance company have the right to send a nurse to go with me to my medical appointments?
The insurance company, assuming the claim has been accepted as compensable, does have the right to assign a nurse case manager to your claim. However, the nurse case manager (as well as any vocational rehabilitation provider), is required to operate under specific rules set forth by the North Carolina Industrial Commission. For example, the nurse case manager must allow you the right to have a private examination by your doctor outside of his or her presence before the nurse is allowed to meet with you and the doctor.
How can I be sure the insurance company has calculated my compensation rate correctly?
Demand the insurance company obtain an appropriately executed N.C.I.C. Form 22, Report of Earnings, from your employer.
Can the insurance company cut off my benefits without permission?
There are typically only two ways for your temporary total disability benefits to be cut off. One way is for you to return to work, wherein the insurance company should file a Form 28 or 28T as soon as possible. Otherwise, the insurance company must file an N.C.I.C. Form 24, Application to Terminate or Suspend the Payment of Benefits, with the North Carolina Industrial Commission. You will be afforded an opportunity to send in a written response supported by medical and other documentation if you object to the termination of suspension of your benefits, and an informal telephone hearing will be scheduled.
Am I entitled to receive copies of my medical records?
The insurance company is receiving copies of all of your medical records. You are entitled to copies of these records from the carrier without charge, as well as a copy of any recorded statement that may have been taken, rehabilitation records, employment records, and any written communications with your treating physicians. You must request these in writing.
Professional Athletes
Eligibility and Coverage:
- Who Qualifies: Professional athletes are eligible for workers’ compensation benefits if they sustain an injury while performing duties related to their sport. This includes injuries sustained during games, practices, and even while traveling for team activities.
- Types of Injuries Covered: Both acute injuries (such as a broken bone from a fall) and chronic conditions (like repetitive strain injuries) are covered under workers’ compensation.
Key Benefits of Workers’ Compensation for Athletes
1. Medical Expenses: Workers’ compensation covers all necessary medical treatments related to the athlete’s injury. This includes emergency room visits, surgeries, physical therapy, medication, and ongoing medical care.
2. Lost Wages: Injuries can sideline athletes for weeks, months, or even longer, leading to significant income loss. Workers’ compensation provides wage replacement benefits to help offset this loss.
3. Rehabilitation Services: Professional athletes often require extensive rehabilitation to regain their strength, flexibility, and performance levels. Workers’ compensation covers rehabilitation services, including physical and occupational therapy.
4. Permanent Disability Benefits: In cases where an injury results in permanent impairment, disfigurement or bodily scarring, workers’ compensation provides benefits based on the severity of the disability.
Our experienced team specializes in representing athletes, ensuring they receive the full benefits they are entitled to. We offer:
- Personalized Support: From filing the initial claim to navigating appeals, our team provides tailored assistance to meet the specific needs of professional athletes.
- Expert Guidance: We understand the intricacies of sports-related injuries and the specialized care required. Our expertise ensures that every aspect of the athlete’s recovery and compensation is thoroughly addressed.
- Advocacy: We are committed to advocating for the rights of injured athletes, ensuring they receive fair and just compensation for their injuries.
Let us help you focus on your recovery and return to the sport you love with confidence and ease.