A workplace injury can create immediate questions about your health, income, and ability to return to work. Fortunately, North Carolina’s workers’ compensation system provides benefits to many employees injured on the job.
However, receiving benefits requires more than simply reporting the accident. Workers must meet important deadlines, follow medical treatment requirements, and comply with specific procedures throughout the claims process.
Understanding how the process works can help protect your right to compensation. If benefits are delayed, denied, or disputed, an experienced workers’ compensation lawyer can help you navigate the system and protect your interests. Contact us to schedule a free consultation.
Which Employers Are Required to Carry Workers’ Compensation Insurance?
Under state law, businesses with three or more employees must provide workers’ compensation coverage. This requirement applies to many full-time, part-time, and seasonal workers. While there are some exceptions, including certain agricultural and casual workers, most North Carolina employees are covered.
Employers can either purchase workers’ compensation insurance from an approved carrier or receive authorization from the North Carolina Industrial Commission (NCIC) to self-insure.
If you are unsure whether your employer carries workers’ compensation insurance, an attorney can help you understand your coverage options.
What Types of Injuries Are Covered?
Many workers are surprised to learn that workers’ compensation covers more than isolated workplace accidents. Depending on the circumstances, employees may be eligible for benefits for traumatic injuries, repetitive stress conditions, and certain occupational illnesses.
In North Carolina, benefits may be available for:
- Injuries caused by slips, trips, and falls
- Construction accidents
- Vehicle accidents that occur while performing job duties
- Machinery and equipment injuries
- Repetitive stress injuries, such as carpal tunnel syndrome
- Occupational illnesses caused by workplace exposure to harmful substances
- Hearing loss and other job-related medical conditions
The injury or illness must arise out of and occur during the course of your employment. For example, if you are injured while performing assigned work duties, traveling for work, or exposed to hazards related to your job, you may qualify for benefits.
What to Do After a Workplace Injury
One of the biggest mistakes injured workers make is waiting too long to report an accident.
To protect your claim, you should do the following:
| Step | What You Should Do |
| Report the injury immediately. | Notify your employer as soon as possible. Although North Carolina allows up to 30 days to provide written notice, prompt reporting can help avoid disputes. |
| File Form 18. | File NCIC Form 18 with the North Carolina Industrial Commission. While workers have up to two years to file, waiting can create unnecessary complications and make it more difficult to secure evidence. |
| Seek medical treatment. | In most workers’ compensation cases, your employer or its insurance carrier has the right to direct your medical treatment and select the authorized treating physician. Following the approved treatment process can help avoid claim complications. |
| Follow your doctor’s instructions. | Attend appointments, follow treatment recommendations, and comply with any work restrictions. Gaps in treatment can create challenges during the claims process. |
| Keep records. | Save medical records, work restrictions, receipts, correspondence, and other documents related to your injury and claim. |
Taking these steps can protect your right to benefits and reduce the risk of delays or disputes.
What Benefits Are Available?
Workers’ compensation benefits help injured employees recover physically and financially.
Depending on the circumstances, benefits may include:
- Payment for reasonable and necessary medical treatment related to the injury
- Temporary disability benefits that replace a portion of lost wages while you are unable to work
- Permanent disability benefits for lasting impairments
- Vocational rehabilitation services for workers who cannot return to their previous jobs
- Death benefits and funeral expense assistance for eligible surviving family members
For workers who are unable to work during recovery, temporary total disability (TTD) benefits equal two-thirds of the employee’s weekly wage, subject to North Carolina’s maximum compensation rate. In most cases, benefits begin accruing after more than seven days of missed work. However, compensation for the seven day waiting period may still be available if the disability lasts longer than 21 days.
What Must Your Employer Do?
Once an injury is reported, employers must notify their workers’ compensation insurance carrier, file Form 19 with the North Carolina Industrial Commission within five days, provide information about the claims process, and cooperate with the claim investigation.
Employers are prohibited from discouraging workers from filing legitimate claims. Failing to report a workplace injury properly can create additional legal issues for both the employer and its insurance carrier.
After receiving notice of the injury, the insurance carrier must investigate the claim and either accept or deny benefits within the time allowed by North Carolina law.
How Long Does the Process Take?
Simple claims that are accepted quickly may begin paying benefits within a matter of weeks and resolve within several months.
However, more complicated cases can take longer. Disputes involving medical treatment, permanent disabilities, denied claims, or disagreements over the cause of the injury may take a year or more to resolve fully.
Cases that proceed to hearings before the North Carolina Industrial Commission require additional time.
What Happens If Your Workers’ Compensation Claim Is Denied?
Workers’ compensation claims can be denied for many reasons, including:
- Missed filing deadlines
- Insufficient medical evidence
- Disputes about whether the injury was work-related
- Employer or insurance carrier challenges
If your claim is denied, you still have the right to appeal.
Before an appeal, depending on the circumstances, most matters are prompted to a Mediation to determine if the matter can be resolved between both parties. If the issue, remains unresolved, then the next step is hearing before a Deputy Commissioner of the North Carolina Industrial Commission. If either party disagrees with the decision, the case may be appealed to the Full Commission. In some cases, additional review may be available through the North Carolina Court of Appeals.
While some workers successfully handle straightforward claims on their own, the appeal stage is often where legal representation becomes especially important. Insurance companies have experienced professionals working to protect their interests, and injured workers deserve someone protecting theirs.
Get Help Navigating the Workers’ Compensation Process
The North Carolina workers’ compensation system can provide valuable benefits, but the process is rarely as simple as filling out a few forms. Mistakes during the claims process can jeopardize your right to compensation. Do not let a missed deadline, denied claim, or insurance dispute put your benefits at risk.
Our team includes a Board-Certified Workers’ Compensation Specialist who has spent decades helping injured workers navigate complex claims, resolve disputes, and pursue the benefits available to them under North Carolina law.
If you have been injured at work, the experienced workers’ compensation attorneys at Lewis & Keller Injury Lawyers can guide you through every stage of the process.
Contact us today for a free case review.
