In the simplest terms, workers’ compensation is an exchange: employees give up their right to sue their employers for injuries and illnesses that happen because of their work, and in exchange have the right to recompense for their medical bills and lost wages due to a long- or short-term inability to continue working. Unfortunately, the process of claiming workers’ compensation can be complex, and it is not at all uncommon for employers or their insurance companies to try to deny or reduce the amounts of compensation to which an employee is entitled. Here’s what you need to know about pursuing workers’ compensation in North Carolina.
Are You Eligible for Workers’ Comp in North Carolina?
Not every worker can claim workers’ compensation benefits. In order to be eligible, your employer has to either have workers’ compensation insurance, be self-insured or be required by law to have this insurance, whether they have complied or not. Many employers do opt in to workers’ compensation insurance programs even if they are technically exempt from the legal requirement, however. In addition, you must be an employee of the employer in question, not an independent contractor or another type of excepted worker.
Most critically, your injury or illness must be work-related. Work-related injuries and illnesses range from the obvious, such as injuries sustained during hazardous work like construction or exposure to hazardous substances in the workplace, to the less obvious and often disputed.
If you were engaged in a task that benefited your employer and were injured because of that task, you are probably covered. If you were doing a work-related activity or on company property, you may be covered; in the past, cases that occurred during company social events, work-related travel or breaks have been judged to be covered by workers’ compensation.
Exceptions and Restrictions
While workers’ compensation covers a wide range of situations, it does have exceptions. Some types of workers are not covered by workers’ compensation laws and policies. If you work in your employer’s home, as a farm or agricultural worker, as a seasonal worker, or as part of a temp agency or another employee leasing or loaning agreement, you may not be eligible. Furthermore, if your injury or illness is a pre-existing condition, you may not be eligible for compensation, but if you can show that your work or an accident at work has exacerbated it in some way, it is possibly that you may be covered.
The restrictions that are most commonly exploited by employers and insurance companies are the extremely short time restrictions. Like many states, North Carolina requires injured workers to report their injuries to the employer immediately, either directly after the accident or as soon as you know that your illness or injury is work-related. You must also provide a written notice of the accident within thirty days. From there, your employer must inform the insurance company almost as quickly. If any of these time restrictions are not met, the claim may be disputed or denied.
What to Do
If you are filing or considering filing for workers’ compensation in North Carolina, it is important to move as quickly as possible. Because of the speed and complexity of claiming workers’ compensation, especially if your employer or insurance company is likely to dispute or reduce your compensation, it is a good idea to seek legal advice. Even if your claim is denied, an experienced workers’ compensation lawyer can guide you through appealing the claim denial. Contact us at Lewis & Keller in Winston-Salem and Greensboro, North Carolina right away for advice on how to proceed.