How Does Workers’ Comp Work in NC?

North Carolina workers’ compensation can raise a lot of questions. Whether you’re sidelined by a work-related injury or just want to be well-informed, you need answers. From how it can help combat medical bills to alleviate job uncertainties, here’s what you need to know about the North Carolina workers’ compensation experience. 

What Is Workers’ Compensation in North Carolina?

North Carolina workers’ compensation provides coverage after a worker experiences an on-the-job injury that inhibits their life and/or ability to work. As a no-fault system, benefits are allocated regardless of who caused the accident. Additionally, outside of a few exceptions, workers’ comp is required by law in NC for businesses with three or more employees. Most employers will have workers’ compensation coverage in the form of insurance, though employees can also potentially opt to be self-insured. 

What Can North Carolina Workers’ Compensation Cover?

There’s mainly a financial focus for workers’ compensation benefits. To know the fullest extent of what you’re entitled to in your specific scenario, it’s best to partner with an experienced workers’ compensation lawyer

100% of Medical Treatment for Related Injuries

This includes everything and anything needed for recovery—doctor appointments, physical therapy, surgeries and more—done by insurance-approved medical professionals. Missing work is not required for this to apply, though not every workplace injury is covered either (e.g., hard-to-prove injuries like back pain can be an uphill battle). Primary medical benefits can continue until the doctor(s) say so, and from there, additional medical treatments are typically covered for two more years. 

Wage Replacement Payments 

If due to injuries a worker can’t work or has to reduce the amount of time they work, they’re also eligible to receive wage replacement payments. The amount of payment is often correlated to two-thirds of their average weekly wage. Additionally, there are also options for vocational rehabilitation if a career change is needed (coverage can include payments towards professional resume help, additional educational opportunities and working with job placement professionals). 

Additional Benefits

  • Travel costs for medical appointments that exceed a 20-mile drive roundtrip 
  • Care expenses for anyone who’s assisting in the recovery (even if they’re family)
  • Money towards medical equipment
  • Funding towards any necessary home or vehicle modifications
  • Coverage of funeral expenses (in the case of death that affects a spouse, or the death of a minor that affects parents)

While the preceding benefits can seem reasonable, please note that the workers’ comp insurers can essentially guide the medical care given (e.g., choose what doctor(s) can be seen). This can result in getting stuck with medical professionals that aren’t your first choice. Insurers may even be slow to approve treatment or even outright refuse to authorize it. At moments like these, it’s crucial that you have a law firm that’s willing to fight in your corner

What Is the Process for Workers’ Comp Benefits?

Here’s a general overview of how you can get set up with workers’ compensation benefits. For even more information, you can always check the North Carolina Industrial Commission’s site or speak with someone at the HR department of your workplace. 

  • Seek care in the form of an on-site healthcare provider, a specific health office your employer utilizes or an option of your choice if these aren’t available—like your personal physician or even the ER if it’s called for. 
  • Inform your healthcare provider that your injury is work-related and who your employer is. This ensures that your treatment can be billed as part of their compensation claim system.
  • Notify your manager(s) if they’re not already aware (someone else, or even your healthcare provider, can do this if the severity of your injuries doesn’t make it feasible for you to do so). 
  • Provide a written notice that presents the date and description of the injury (someone else can also do this on your behalf). 
  • Complete the claim form that relates to your scenario. Your employer will either provide this to you, or you can locate it here. Once your employer or their insurance administration has approved the claim, payments usually start in fourteen days (unless payment is being done as a lump sum when the claim concludes). 

Can You Sue Your Employer Even if You’re Getting Workers’ Compensation?

As part of workers’ compensation, workers generally can’t sue their employer under traditional negligence claims (unless the employer directly caused the accident). In turn, employers cannot deny a workers’ compensation claim (even if it was due to negligence on their part). This said, that doesn’t mean employers are always forthcoming about getting workers set up on workers’ compensation. If you’re having trouble, consider seeking out a workers’ compensation attorney that can help. 

Clear Up Workers’ Compensation Confusion With Lennon, Camak & Bertics, PLLC

Even with everything stated above, there are a number of exceptions and gray areas with North Carolina workers’ compensation. If or when an accident happens to you, the need for workers’ compensation can become tremendous. As such, an experienced workers’ comp attorney will always be your best advocate. At Lennon, Camak & Bertics, PLLC, we pride ourselves on delivering workers’ compensation expertise so our clients can stay focused on their recovery. Please request a free consultation if or when you need it.