Don’t Believe Everything You Hear About Workers’ Comp: What Every Injured Worker in North Carolina Should Know

If you work with a large number of people—whether you’re driving trucks or buses, working in a factory, or any other job involving hard work—it’s likely you’ve heard advice about workers’ compensation from coworkers or friends. While they may mean well, it’s crucial to remember that every workers’ compensation case is unique. Relying on general advice from others about benefits, medical treatment, or settlements can leave you vulnerable and hurt your case.

The truth is that workers’ comp claims are rarely straightforward. Many factors, such as the severity of your injury, the type of work you do, and how your body responds to treatment, can lead to vastly different outcomes. This blog post explains why it’s important to seek legal help in specific situations and avoid falling into the trap of thinking that your case will work out exactly like someone else’s. Below are three critical moments when consulting a lawyer is essential.

1. When the Injury is Catastrophic: Lifelong Medical Needs and Programs like Medicare

If your injury is severe—making you unable to return to any work, requiring repeat or complicated surgeries, or permanent and  life-altering —your medical care may extend far beyond the immediate aftermath of the accident. In these cases, workers’ compensation will need to cover much more than just short-term treatment. However, coordinating lifelong medical care involves more than simply receiving workers’ comp benefits. You may also need to factor in other programs, such as Social Security Disability Insurance (SSDI) or Medicare.

Here’s the catch: Medicare and workers’ comp often overlap, and handling the coordination between these programs requires careful planning. For example, Medicare may require the creation of a Medicare Set-Aside (MSA) account, a legal arrangement that ensures workers’ comp funds are used for future medical expenses before Medicare steps in. Without proper legal guidance, injured workers risk leaving significant benefits on the table—or worse, violating Medicare rules.

2. If the Injury is Denied: Strict Time Limits Apply

It’s not uncommon for workers’ compensation claims to be denied initially, even for legitimate injuries. Insurance companies might claim that the injury didn’t happen at work, that it wasn’t reported correctly, or that it’s a pre-existing condition. If your claim is denied, time is of the essence.

In North Carolina, you have only two years from the date of the injury to file a claim with the North Carolina Industrial Commission (NCIC) unless an exception applies. However, other deadlines may apply, such as the need to formally appeal a denial. Missing these deadlines could result in permanently losing your right to benefits. A workers’ comp attorney will know exactly how to navigate the appeals process, file the necessary paperwork, and ensure your rights are protected.

3. When Medical Treatment is Inadequate: Getting the Care You Deserve

Unfortunately, not all workers receive the medical treatment they need through workers’ comp. Even if they have the best intentions, some doctors may minimize injuries or push workers to return to work before they’re ready. If you feel that your treatment is insufficient or that your doctor isn’t taking your recovery seriously, it’s time to consult a lawyer.

In North Carolina, workers have the right to request a second opinion from a different doctor, but this process can be complicated. An experienced attorney can help you request the right kind of independent evaluation, ensuring that your injuries are fully documented and that you receive the appropriate treatment. They can also fight to ensure that workers’ comp covers necessary procedures, medication, and follow-up care.

Conclusion: Don’t Go It Alone—Get the Right Legal Help

Every workers’ compensation case is different, and no two injuries are exactly alike. What works for one worker’s case may not apply to another. Even though your coworkers may be eager to share advice, it’s critical to understand that relying on someone else’s experience could cost you valuable benefits and medical care.If you are an injured worker in North Carolina and your injury is catastrophic, denied, or if your medical care isn’t meeting your needs, seeking legal help isn’t just smart—it’s essential. The experienced workers’ comp attorneys at Johnson & Groninger will know the complexities of North Carolina law, help you navigate deadlines, and ensure that you get the benefits and care you deserve.Don’t gamble with your health or your future. If you’ve been injured at work, contact Valerie Johnson, Drew Culler, and Jennifer Segnere, who can provide the right advice for your specific situation.