If you have been hurt on the job in Winston-Salem, you may be eligible for workers’ compensation. However, the process of filing for workers’ comp is both complicated and fraught with restrictions. It is very common for employers or their insurance carriers to deny or reduce the amount of compensation at first, and both the initial claims process and the appeals process have to be accomplished in a very short time frame. If you are filing for workers’ compensation, here are the steps you’ll need to take.
What to Do First When You’re Hurt on the Job in NC
As soon as you are aware of an injury, illness or accident that is related to your work, apply first aid, seek medical treatment and inform your employer. It is important to ensure that the illness or injury will not get any worse, and the most common reason given for denied workers’ compensation claims is that the employer or the insurance company was not informed quickly enough. If you inform your employer of the problem right away, your employer will be less able to delay informing the insurance carrier until the time limit expires. If your employer does not have on-site medical treatment facilities and you go elsewhere for treatment, you must tell your healthcare provider that your condition is work-related so that the medical costs will be billed through the appropriate channels as a workers’ compensation claim.
The Next Few Days
North Carolina workers’ compensation law requires you to provide your employer with a written notice of the accident or injury within thirty days of its occurrence; if it is an illness or condition that has built up over time, such as hearing loss or exposure to a toxic substance, then count from the date that you discovered the problem. The notice does not need to be long or complicated—it should include the date of the accident or incident and a short description of the illness, injury or condition. Make sure to keep a copy of this notice, and if possible, some kind of documentation that shows when you sent it to your employer.
Claims, Denials and Appeals
At any time after this written notice, but before two years pass, you will need to file a formal notice of your claim with the North Carolina Industrial Commission using the state’s Form 18, available at ic.nc.gov, and send a copy to your employer. You should keep a copy of this notice as well.
Unless the NCIC gives an extension, your employer must respond to this notice within 14 days of receiving it, with one of three other state forms. If you receive Form 60, your employer has acknowledged your right to compensation. Form 61 is a denial of your claim, and must include an explanation of the reasons your claim as been denied. Form 63 is also an acknowledgement, but it allows the insurance company to later reverse their decision and deny your claim.
Many claims are denied at first even though by law they should be covered, and you have the right to request a hearing and appeal the decision. From this point on, the process becomes complex enough that it is a good idea to seek legal help.
Contact Our Winston-Salem Workers’ Comp Attorneys
An experienced workers’ compensation attorney can assess your case and advise you on how to proceed. If you have been hurt on the job in Winston-Salem, and are filing for workers’ comp or considering appealing a denial, contact Lewis & Keller right away.