Who is required to provide Workers’ Compensation coverage? Any employer who regularly employs three or more employees.
What do I do if I am hurt at work? Report your injury to your supervisor or boss or the employer immediately by telling them and also in writing. The law requires you to submit it in writing within 30 days. If you do not file your claim within two years of your injury, you may lose your right to any benefits under this law. Seek medical treatment immediately.
Are all injuries at work covered by Workers’ Compensation? No. The law in NC requires that you have an accident while doing your job and is caused by your job. Any resulting disability has to be proved to be from your specific injury. You might also suffer from an occupational disease, such as carpal tunnel syndrome or tendonitis, but a doctor needs to link your job to the disease. Back injuries do not require an “accident” however, they do require a specific moment in time on a specific date that the pain or symptoms began. It is important to seek medical care as soon as possible after getting hurt at work and as important to report any pain or symptoms to your boss as soon as you notice them, even if you think the injury is not serious at the time.
What if my employer fails or refuses to report my injury? Even if your employer does not file a report, any injured Employee must file a claim (Form 18 or 18B) within thirty days (but no later than two years) of the accident with your employer and the Industrial Commission. Please e-mail completed forms to forms@ic.nc.gov or mail it. If you write out your own statement of what happened and give to your employer, keep a copy for yourself and put the date on it. But please know that until you have filed a Form 18 or 18B with the N.C. Industrial Commission, you have not fully filed your claim and you could have your case dismissed if not filed in time.
Who provides and directs medical treatment? The employer or its insurance company, subject to any Commission orders, provides and directs medical treatment. The employee may petition the Commission to change physicians or approve a physician of employee’s selection when good grounds are shown. However, payment by the employer or carrier is not guaranteed unless written permission to change physicians is obtained from the employer, carrier, or Commission before the treatment is rendered. If you are having a medical emergency you should go to the nearest hospital emergency room or urgent care and make sure you report it as an on-the-job injury.
Do I get paid mileage going to/from my medical treatment? If an employee travels 20 miles or more round trip for medical treatment in workers’ compensation cases, they are entitled to be paid mileage. The amount per mile changes from time to time with the most current amount on the N.C. Industrial Commission website.
When do I get paid for being out of work? No benefits are paid for the first seven (7) days of lost time unless the disability later exceeds 21 days.
How often are compensation payments made? Weekly, but the Commission can authorize payments on a monthly basis in some circumstances.
What is the WC benefit if my case is accepted? In N.C., an injured worker is due weekly compensation equal to 66 2/3% of your average weekly wage for the one year prior to your accident, not to exceed $978* (2017 maximum) per week. * The maximum weekly benefit is adjusted annually and is listed at http://www.ic.nc.gov/ncic/pages/maxrates.htm
How long can I receive lost-time weekly benefits? Until a doctor has released you to return to your job or another job that is available within your restrictions. If your doctor releases you and you disagree, you have other rights available. However since 2011, the maximum weekly benefits is 500 weeks with a few exceptions.
What is permanent partial disability? Total loss or partial loss of use of a part of your body (leg, arm, back) or inability to earn the same wages in any employment as earned at the time of injury.
Who determines permanent partial disability? The Industrial Commission, based on the impairment ratings of a physician or evidence of consideration of wage earning capacity. Or the parties can agree on a rating assigned by a doctor.
What happens when the employer refuses to acknowledge my claim? When liability for payment of compensation is denied, the Commission, claimant, his or her attorney (if any), and all known providers of health care shall be promptly notified of the reason for such denial. The denial Form 61 shall not be worded in general terms, but must detail the exact reason for the denial of liability.
If a claim is denied by the insurance company or self-insurer, the employee may request a hearing before the Industrial Commission by submitting a Form 33, Request for Hearing. There is a two year deadline after receiving a denial of your claim to file a Form 33.
Can medical providers bill directly and seek to collect from the injured worker for treatment given for the Workers’ Compensation injury? No. If the worker files a claim, medical providers may not bill the employee during the life of the claim. It is a criminal misdemeanor for them to do so. Only after it is determined by the the Industrial Commission that it is not a compensable Workers’ Compensation claim, can they begin billing the injured worker.
