Call Us 919-240-4054Nobody wants to be injured at work. The pain and stress of the injury are made worse by red tape and problems with medical treatment.
Whether you need a workers’ comp injury lawyer or an occupational disease lawyer, your workers’ compensation case can’t wait: you need medical treatment and compensation. You need a Durham workers’ compensation lawyer with the experience and knowledge to help you with North Carolina workers’ compensation law.
A skilled Durham workers’ compensation lawyer with Johnson & Groninger PLLC can help when you are hurt at work and your injury is severe.
What is the purpose of workers’ compensation?
You can think of the workers’ comp program as insurance. Employers must carry it to protect their employees should they suffer a workplace-related injury or illness. The injured or sick employee will receive medical as well as financial support.
The workers’ comp program is typically the only legal recourse for employees to obtain money while they can’t perform their jobs. It’s known as the “exclusive remedy” because, in most instances, employees can’t sue their employers. This differs from a personal injury case, where an injured person can take legal action against everyone responsible.
Eligibility for workers’ compensation benefits
If you’re an employee in North Carolina, you’ll almost certainly be able to file for workers’ compensation as long as the following apply:
- You suffered an injury or an illness.
- You were hurt or became sick through something that happened in the course of your employment.
- Your injury or illness was a direct result of your employment.
- Your injury resulted from something unexpected or interrupted your regular job routine.
Employer requirements
All companies with three or more employees in North Carolina must have workers’ comp insurance. The only exceptions are certain agricultural operations with fewer than ten employees and specific kinds of logging and sawmill operations. Domestic employees are also exempt.
What is the claims process?
As important as workers’ comp is for employees, filing a claim can be complicated, so that you might need help from a Durham workers’ compensation lawyer. Here’s a quick look at what you’ll need to do.
1. Seek medical treatment
When you visit the doctor, tell them that your illness or injury is work-related and give them your employer’s name.
You should also keep track of all the expenses related to your treatment. These include your prescription receipts and the mileage to and from your medical appointments. You may be eligible for reimbursement of these and other expenses.
It will also be essential that you obtain a written note from your doctor identifying the time they’ll expect you to miss work. If you don’t have one, getting compensation could be much more difficult.
2. Notify your employer
You’ll need to tell your manager or the company owner what happened as quickly as possible. Give them all the details of how you suffered harm. This means giving them the time and date when you became hurt or sick, the location, and the names of any witnesses. You’ll also need to provide a written notice to your employer within 30 days.
3. File a claim
The North Carolina Industrial Commission (NCIC) administers our state’s workers’ comp program. You’ll need to complete Form 18 and give a copy to your employer. You’ll also need to send a copy to the NCIC. This form establishes your legal claim of injury and satisfies the applicable statute of limitations.
4. Receive a decision
Once you submit Form 18, North Carolina law mandates that your employer has 30 days to respond after notice from the Industrial Commission. This response will come in three ways: Form 60, Form 61, or Form 63. Here’s a quick look at each.
- Form 60 means the employer accepts that claim and will begin making workers’ comp payments.
- Form 61 is a denial, meaning the employer rejects the claim for the reasons provided in the notification.
- Form 63 means the employer will begin issuing payments but reserves the right to stop those payments if an investigation shows the employee is ineligible.
If you receive a Form 61 or your employer terminates your benefits, you should contact a North Carolina personal injury attorney as soon as possible to protect your rights.
Time limits for filing a workers’ comp claim
It’s important to note that notifying your employer of your injury or illness isn’t the same as starting your claim.
You have 30 days to provide notice, but you have up to two years to file a Form 18 to begin the claim. The two-year “clock,” so to speak, starts from the date of your injury. For occupational diseases, it is two years from the date a doctor diagnoses you with a work-related illness, or you start to miss work related to the condition–whichever is later. If you miss that deadline (known as the statute of limitations), you won’t be able to obtain compensation.
In most cases, it’s recommended that injured workers file their Form 18 within 30 days of the incident or the start of their illness. They must file the form within two years from that date.
Don’t wait to file.
While it might seem that you can take your time when filing a claim, you should act as soon as possible. You’ll need the money you receive to help pay your bills while you recuperate and can’t work.
If the employer denies the claim, you’ll need the help of a Durham workers’ compensation lawyer immediately so they can protect your rights and help you obtain the money you deserve.
Necessary documentation
There are several documents you’ll need to have to back up your claim. These include medical reports, the incident report, and statements from witnesses who saw how you suffered harm. Photographs of the scene and supporting evidence could also prove critical to your case.
What types of compensation are available?
First, it’s important to note that workers’ compensation is a statutory right owed to qualifying employees. Receiving compensation is not a “benefit” as in the case of short-term disability–it is an entitlement for having sustained a compensable work-related injury. There are several different kinds of compensation you may be able to obtain through a workers’ comp claim. Here’s a quick look at some of them.
Medical expenses
These could include your past medical bills and expenses for medical treatment you may need. Expenses include emergency room and hospital bills, X-rays and other diagnostic testing, surgeries, prescription drugs, related travel, and other treatments.
Lost wages and rating (indemnity)
After your injury, the amount of compensation for lost income and impairment you receive will depend on many factors. The most important one is your average weekly wage before your injury. In most cases, an injured worker will receive a little more than 66 percent of their average pay while unable to work. If they can return to work, they will receive a permanent impairment rating as compensation for the injury.
Again, though, your compensation could be calculated in many different ways. A Durham workers’ compensation lawyer can tell you how much you might expect to receive.
Vocational rehab
Your employer may have to pay to assess your ability to work (also known as “vocational rehabilitation“) by a professional. This will likely happen if you can no longer perform the same work as you did pre-injury.
Death benefits
If you lost a loved one due to a work-related injury or illness, you may be able to obtain a portion of the deceased’s pay (typically two-thirds) for 500 weeks (nearly 9 ½ years).
What is the insurance company’s role in the process?
When a company purchases workers’ comp insurance, the insurer covers injured or ill employees and pays related compensation. Insurance companies may sometimes investigate employee claims and provide legal assistance when an employer is sued after denying a claim.
Do I have a right to appeal a denied claim?
You must understand you still have rights even if the workers’ compensation carrier denies your claim. You can request an NCIC hearing by submitting Form 33. However, before the NCIC grants a hearing, it will typically require that the parties try to settle their dispute through mediation.
Whether preparing for a hearing or getting ready to go into mediation, your best chance of achieving a positive result will be getting the help of an experienced Durham workers’ compensation lawyer with Johnson & Groninger PLLC.
Resources for assistance and further information
- The NCIC FAQ page offers answers to questions employees commonly ask.
- The NC Justice and Community Development Center, Immigrants Legal Assistance Project has information on legal services for farm workers.
- The North Carolina Office of State Human Resources offers information on workers’ comp programs for state employees.
Why work with Johnson & Groninger PLLC
We have three board-certified NC workers’ compensation attorneys – Valerie Johnson, Jennifer Segnere, and Drew Culler – which means we have undergone rigorous testing and vetting to earn our workers’ compensation law expertise.
Also, Valerie Johnson’s book on NC workers’ compensation law is the one lawyers turn to, so your questions about your case are those we have answered before. Jennifer Segnere is one of only a handful of board-certified workers’ compensation specialists in North Carolina who is also fluent in Spanish.
We can push for medical treatment and help you get your weekly indemnity compensation. We can tell you when your workers’ comp settlement is reasonable and when it isn’t. Our experience in court means that we will go to bat for you – and if it takes going to court for that, we won’t hesitate.
Our Durham workers’ compensation lawyers are ready to help you
If you suffered a burn injury, construction injury, or any other kind of work injury, call a board-certified workers’ compensation lawyer at Johnson & Groninger PLLC at (919) 240-4054 or contact us online as soon as possible. We’ll fight for your rights and work to help you obtain the compensation you deserve.
