These are Seven Crucial Things every working person in NC should know about workers' compensation law.
Are all on-the-job injuries covered by North Carolina Workers' Compensation?
NO. In order to be covered, you must you hurt in a certain way. You must be "injured by accident" in the "course and scope of your employment." An "accident" is something unusual or unexpected that occurs that causes you to be injured. If you hurt your back or neck, or develop some kind of rupture or hernia, then you can be injured in an "accident" or in a lesser event known as a "specific traumatic incident." But, for example, if you are walking down the hall at work and your knee gives out, that is probably not an accident and you would not be covered. However, if you stepped on an object on the floor, your foot slipped, and that caused your knee injury, then you would have suffered an "injury by accident." An accident can be a very subtle change in your normal work routine--for instance , getting hurt in your first day on a new job is an "accident." Doing a co-worker's job when he is out can also be an "accident." These questions cause a lot of litigation in workers' compensation claims.
You can also be covered for an "occupational disease" which has different criteria for coverage. Call Mr. Bollinger for more information if you believe you have contracted an occupational disease such as a repetitive motion injury.
If I am injured at work, how long do I have to report it?
Under the law, you have up to thirty days (30 days) to report it to your employer in writing, and you have two years to file a claim with the North Carolina Industrial Commission. An oral report to your employer does not count. Failure to file the proper paperwork with the Commission within two years means that your claim is barred by the passage of time.
What do I do if my North Carolina workers' compensation claim is denied by the insurance company?
Well, if your claim is denied, you will need a lawyer to help you. Contact us---we can help you. Many of the cases we handle are denied claims that we have to litigate before the Industrial Commission. The North Carolina Workers' Compensation Act encompasses hundreds of pages of law, and it is really not something that a non-lawyer can learn effectively. Call an experienced North Carolina workers' compensation lawyer for help.
If I am out of work due to my injury, does the insurance company have to pay my regular salary?
NO. If you are out of work due to your injury, and your case is "accepted" by the insurance company, then you will receive 2/3 of your "Average Weekly Wage" as your "Temporary Total Disability" weekly benefit. The average weekly wage is based on your gross earnings in the job of injury during the 52 weeks immediately preceding the date of your injury. There are a number of other rules pertaining to this calculation. As an example, if you earned on average $600 per week during the 52 weeks before your injury, then your "compensation rate" for your temporary total disability would be $400 per week. This money is not subject to income taxes. If you think your AWW has been calculated incorrectly, call us for free information and advice about how to get it fixed.
My Doctor Rated Me at 3% to My Injured Body Part. Is That All I Can Get?
NO. You are entitled to a second opinion, from a doctor you and your lawyer choose, on the rating. And if you are unable to return to work making your pre-injury AWW, then the rating may not be important anyway. You get to choose the most remunerative (lucrative) settlement option from three options, if you qualify for each of them. Often, the rating money is the least money and you would get a better outcome by ignoring it. Contact us for more free information about these options.
After I Am Healed Up, Do I Have to Cooperate With the Vocational Rehabilitation Provider?
YES, you should cooperate. If you fail to cooperate, the insurance company can file a "Form 24" petition to suspend or terminate your weekly Temporary Total Disability benefits. If that happens it may take two years to get them restored, if at all. If you have questions about the actions of the Vocational Rehabilitation Professional assigned to your case, contact a competent North Carolina workers' compensation lawyer for legal advice.
When Do I Need a Lawyer on My Case?
Not everyone needs a lawyer on his or her North Carolina Workers' Compensation case. But based on my 20 years of experience, I think that a person needs a lawyer when one or more of these factors are present:
(1) Your claim has been DENIED by the insurance company. Usually, you will get a letter and a "Form 61" telling you the case has been denied. You will get no benefits without fighting the denial. You need a competent NC workers' compensation lawyer for that.
(2) Your case has been accepted but you are not getting a weekly check even though you are out of work due to the injury.
(3) Your "Average Weekly Wage" has not been calculated correctly and you are being underpaid.
(4) You cannot get the medical treatment that you need.
(5) The insurance company has offered you a settlement but you do not know if it is fair or not.
(6) You want an experienced professional to help you get through it.