Accidents happen every day on work sites, even to the most careful workers. You might trip over equipment, lift something incorrectly, or make a mistake while using a machine. But if the accident was your fault, can you still get workers’ compensation benefits in North Carolina?
In most cases, yes, you can. North Carolina’s workers’ compensation system protects employees regardless of who caused the accident. However, there are a few exceptions that can affect your eligibility.
Our Winston-Salem workers’ comp lawyers explain what can disqualify you from benefits and how legal help can push back when the system denies your claim unfairly.
North Carolina’s No-Fault Workers’ Compensation System
North Carolina law operates under a “no-fault” workers’ compensation system. You don’t have to prove your employer did anything wrong to get benefits. You’re usually covered if your injury occurred while performing your job duties, even if your actions caused the accident.
For example:
- A warehouse worker who slips while carrying a box and sprains their ankle can still receive benefits.
- A nurse who strains their back while lifting a patient incorrectly can qualify for coverage.
- A machinist who injures their hand after mishandling equipment can typically claim workers’ comp.
The goal of the system isn’t to assign blame; it’s to ensure injured employees receive medical care and wage replacement while they recover.
When Fault Does Matter for Workers’ Compensation Claims
While most on-the-job injuries are covered regardless of fault, there are exceptions where workers’ compensation may reject your claim. Under § 97-12 in North Carolina, these include:
- Intoxication or Drug Use: If your injury happened because you were under the influence of alcohol or illegal drugs, your claim can be denied. Employers often require post-accident drug and alcohol tests for this reason.
- Willful Misconduct or Horseplay: Roughhousing, fighting, or breaking safety rules on purpose can also make you ineligible for benefits. For instance, if two coworkers start wrestling in the warehouse and one gets hurt, that injury likely won’t be covered.
- Intentional Self-Harm: Workers’ compensation doesn’t apply to injuries you deliberately cause yourself.
- Criminal or Reckless Acts: Injuries sustained while committing a crime or deliberately engaging in dangerous, non-work-related behavior generally aren’t covered.
Outside of these exceptions, fault rarely prevents a worker from receiving benefits. Even if you made a mistake, acted carelessly, or didn’t follow every procedure perfectly, you may still qualify.
Why You Should Still File a Claim
Many employees hesitate to report an injury because they think the accident was their fault or they worry that they’ll get in trouble. But delaying your claim can make things worse.
Filing a workers’ comp claim in North Carolina right away ensures that:
- Your medical bills, including emergency treatment, follow-up care, and physical therapy, are covered.
- You begin receiving wage-replacement benefits if you cannot work for more than seven days.
- There’s a clear, documented record of the incident, which helps prevent disputes or denials later.
Even if your employer suggests that you may not be eligible, it is still important to file a claim and speak with an attorney.
The Role of a Workers’ Comp Lawyer
While the North Carolina Industrial Commission oversees workers’ compensation claims, getting approved isn’t always straightforward. Insurance companies may argue that your injury was caused by misconduct, or they might delay your payments.
A qualified Winston-Salem workers’ comp lawyer can help by:
- Gathering evidence to show your injury was job-related.
- Ensuring all paperwork is filed correctly and on time.
- Representing you in hearings if your claim is denied.
- Negotiating for full benefits, including ongoing medical care or disability payments if needed.
Employers and insurance companies sometimes deny valid claims, hoping workers will give up. If your injury is being questioned or your employer pressures you to return to work too soon, get legal help.
Our experienced team at Lewis & Keller Injury Lawyers will help you receive the full benefits you’re entitled to under North Carolina law.
Get Legal Help for Your Workers’ Compensation Case
If you’ve been injured at work, even if you think it was your fault, don’t assume you’re out of options. North Carolina workers’ comp benefits protect employees like you, regardless of how the accident happened.
At Lewis & Keller Injury Lawyers, our Winston-Salem workers’ comp lawyers have helped countless injured workers secure the benefits they deserve. We understand how confusing and stressful the process can be, especially when you’re already dealing with pain and lost wages.
With five decades of experience and a record of successful case results for those hurt on the job, our team knows what it takes to win claims against tough insurers and get clients the care and compensation they need.
Don’t wait to see if your employer or insurer does the right thing; get an experienced workers’ comp lawyer on your side today. Contact Lewis & Keller Injury Lawyers for a free consultation.
