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How Does a Worker File for Workers’ Comp After an On-the-Job Injury in Winston-Salem?

Winston-Salem is a great place to live and work in North Carolina, but, like anywhere else, workplace accidents happen every day. If you’ve been injured on the job, it’s essential that you take the right steps to get any compensation you may be owed under the North Carolina workers’ comp system.

But how does a worker file for workers’ comp in Winston-Salem? Our lawyers at Lewis & Keller have broken down the process step-by-step to help you get started and know what to expect.

Notify Your Employer

worker notifying employer of workplace injury

The first step after being injured at work is to let your employer know. There’s no special form that’s required for this. All you have to do is give them notice of your injury or illness that occurred while you were at work. This can be done through virtually any form of communication, though it’s generally best to have some kind of written evidence that you’ve done so, such as an email.

File Form 18

The next step is filing Form 18 with the North Carolina Industrial Commission. This form is known as the Notice of Accident to Employer and Claim of Employee, Representative, or Dependent for NC Workers’ Compensation Benefits. Despite the long title, this form is relatively simple. Within it, you’ll specifically state the details of your accident, as well as provide additional personal information about yourself and your employment. You should file this form within 30 days of the accident that caused your injury. The Industrial Commission will then notify your employer’s workers’ comp insurance carrier of your accident.

Receive Notice of Approval or Denial

This step is easy, as all you have to do is wait. After filing Form 18, your claim will be reviewed by your employer’s workers’ comp insurance carrier and you should receive notice of whether your claim has been approved or denied within 14 days of the insurer receiving your claim.

Ideally, you will receive Form 60, the Employer’s Admission of Employee’s Right to Compensation. This means the insurer has fully approved your claim and you will begin receiving workers’ comp benefits. However, if your employer or its insurer is uncertain whether or not you’re entitled to benefits, you may receive Form 63, the Notice to Employee of Payment without Prejudice. While you may begin to get payments, keep in mind that, by issuing Form 63, the insurance company reserves the right to deny your benefits within a 90-day period.

Should your claim get denied for any reason, you’ll receive Form 61, or Denial of NC Workers’ Compensation Claims. This form will detail the reason why you were denied compensation. However, rest assured that Form 61 doesn’t have to be the end of the road. You can still pursue benefits through the appeals process.

Request an Appeal

man filing a workers’ compensation appeal

If your claim is denied, you’ll have to take extra steps to fight for the compensation you deserve. An appeal begins with filing Form 33, which is a Request for Hearing with the North Carolina Industrial Commission. This is the same kind of form used for all disputes with the state Industrial Commission.

It’s important to remember that filing this form is different from filing a lawsuit. The purpose of this form is to request that the Industrial Commission, the state’s authority on the matter, make an official ruling on your specific workers’ compensation issue. Typically, to prevent time in court, the Industrial Commission will send the case to mediation to see if the issues or the case might be able to be resolved without a full evidentiary hearing.

Request a Hearing

If you didn’t get the answer you were looking for from the mediator, you can request a hearing. This hearing is similar in structure to a trial, as testimony and evidence from both sides will be presented before a Deputy Commissioner. After all the evidence is presented, which may include post-hearing medical testimony, the Deputy Commissioner will make a ruling in favor of or against your claim.

Should the Deputy Commissioner deny your claim, you can request an appeal of the decision to the Full Commission, a panel of three members who will review the evidence, hear oral arguments, and make their own decision as to the compensability of your claim. Should you still not get the answer you want, you can move on to a hearing with the North Carolina Court of Appeals and eventually to the state Supreme Court. However, appeals past the initial hearing stage aren’t as common.

Hire an Experienced Workers’ Comp Attorney

Navigating the workers’ comp system in North Carolina isn’t easy. If you’re wondering how a worker files for workers’ comp, it’s in your best interest to consult a knowledgeable workers’ comp attorney.

That’s where our team at Lewis & Keller comes in. We strive to be a champion for every client and that includes helping you understand your rights as a North Carolina worker.
If you’ve been hurt on the job in Winston-Salem or anywhere in the Piedmont Triad, don’t wait to give our office a call today at 877-674-5047 or fill out our online form to schedule a free case review. Our goal is to help you handle the hassles of your claim so you can focus on your recovery!