If you’ve been injured in a workplace accident, you’ll want to take advantage of the North Carolina Workers Compensation Act and the benefits provided by that act. This act provides worker’s compensation benefits, which means that if you are injured on the job, you can be compensated for medical expenses and paid a portion of the wages you lost while unable to work. However, to receive those benefits, there are certain steps you need to take.
Does my injury qualify as a worker’s compensation claim?
The first step in filing a worker’s compensation claim in North Carolina is to ensure that your injury is eligible. Any injury that occurs in the course of your employment generally qualifies as a worker’s compensation claim. Some of the most common injuries seen in worker’s compensation claims include:
- Slip and falls
- Motor vehicle collisions or crashes
- Machinery accidents
How do I file a worker’s compensation claim in North Carolina?
Notification
To be eligible for worker’s compensation benefits, you must notify your employer of the work-related injury. If you’re able, immediately notify your employer orally, even if you’re not sure you will miss work as a result of the injury. If your injury is severe and you cannot notify your employer immediately, have a relative, friend, or coworker contact your employer on your behalf.
Despite the fact that you’ve orally notified your employer, you also need to report the injury in writing within 30 days of receiving the injury. This notification should be a simple written statement that details the facts of what happened and a timeline. If you cannot write the letter, have a relative write it for you. Keep a copy for your records to show that you properly notified your employer.
Physician Visit
Any time you experience a workplace injury, you should see a physician, even if it seems minor. Some injuries may start small but can escalate over time or have side effects that show up later on, so it’s key to have everything documented.
You are always free to see your own physician. However, you will be required under the worker’s compensation benefits to see a physician designated by your employer or their insurance. When you see the physician, be sure to tell them that your injury occurred at work. The physician will need to record the treatment as an expense related to worker’s compensation.
Physician Follow-Up
In addition to going to the physician for an initial visit, it’s critical that you follow any directions the physician provides and attend any follow-up appointments or specialist visits. The point of medical care benefits under worker’s compensation is to help the injured employee fully recover. To do that, you need to follow the treatment plan provided by the doctor. Failure to do so may cause you to lose your worker’s compensation benefits.
Form 18
In North Carolina, your worker’s compensation claim will be filed with the North Carolina Industrial Commission. The first step in starting the official claims process is to file Form 18. You must fill out the form in its entirety and submit it to the North Carolina Industrial Commission to be eligible to receive benefits. Form 18 is normally filed within 30 days of your injury.
Depending on your situation, you may need to file additional forms. An experienced workers’ compensation attorney can guide you through the process to ensure that your forms are filled out correctly and that you’ve filled out every document applicable to your injury and benefits claim.
Employers Response
You will receive a response from your employer within 14 days after the employer receives notice of your claim. The employer can and generally will ask for an extension to the 14-day deadline.
When you do get a response from your employer, it will come in one of the following forms:
- Employer’s Admission of Employee’s Right to Compensation (Form 60) – This form represents confirmation that your employer has accepted the claim and will begin paying benefits such as wage loss and medical care costs.
- Notice to Employee of Payment Without Prejudice (Form 63) – When you receive this form, it means that your employer will begin provisionally paying benefits. However, the employer is reserving the right to terminate your benefits within a specific time if, after investigation, the employer makes the determination that you are not eligible for the benefits.
- Denial of North Carolina Workers’ Compensation Claims (Form 61) – Receiving the denial means your employer has rejected your claim. The employer will include reasons for the denial on the form.
If your claim is denied, you have the right to appeal and request a hearing. You may also seek a hearing for any other worker’s compensation disputes that arise with your employer. Before going to a hearing, you will typically have an opportunity to try and reach a settlement.
[LEARN MORE]: North Carolina Industrial Commission
Should I hire a worker’s compensation attorney to help with my claim?
You do not need an attorney to file a worker’s compensation claim. However, these claims are often complex and require negotiation with insurance companies and their attorneys. You’ll have an advantage and be more likely to obtain the maximum benefits available if you have an attorney on your side.
Even if you have a strong positive relationship with your employer, when claims and insurance companies get involved, it can quickly get complicated. Your employer may not even have a lot of say in the matter.
At Horton & Mendez, our attorneys have been on the insurance company’s side, so they know what to expect and how to negotiate your benefits most effectively.
Contact Us today
Don’t go through the worker’s compensation claim process alone. Let us guide you through the process and help strengthen your claim so you can get the maximum benefits available to you. Contact our attorneys at Horton & Mendez today to schedule a free, no-obligation case evaluation. We do not charge a fee unless you receive compensation.
