Workers’ compensation claims are often not as straightforward as you may think. If you are able to prove that you suffered a work-related injury, theoretically, you should be entitled to benefits as part of your claim. In practice, your employer and the insurance company may make things far more difficult for you.
Hire an experienced workers’ compensation attorney in Gastonia to protect your interests and fight for you during the process. Horton & Mendez Injury Attorneys stand up for the rights of the injured during the workers’ compensation claims process.
Who Qualifies for Workers’ Compensation Benefits in North Carolina?
North Carolina law requires companies that employ three or more workers to purchase workers’ compensation insurance. If you have been injured on the job, you would be entitled to benefits under this policy.
A work-related injury could be many things related to your job. Theoretically, all you need to show is that:
- You have been injured in some way.
- The injury occurred at or arose from your job.
In theory, this should not be difficult. However, your employer and the insurance company are motivated to keep you from getting benefits because it costs them money. You may need someone to fight for you during the process and look out for your interests in full.
What Injuries Qualify for Workers’ Compensation Benefits?
You can qualify for workers’ compensation benefits after any type of job-related injury. Of importance, the word “injury” is defined very broadly. An injury could be physical harm as a result of an accident on the job. You could also suffer an injury over time because of the effects of your job. For example, continuous heavy lifting on the job could result in an overuse injury, such as bursitis or tendonitis.
You may also be entitled to workers’ compensation benefits for a job-related illness if you have been exposed to toxic substances at work. You could even be eligible for payments if you have been overcome by the stress of your job.
What Workers’ Compensation Benefits Are Available?
Workers’ compensation benefits are not the same exact thing that you would receive if you win a personal injury lawsuit, but they can go a long way towards sustaining you financially and paying your medical expenses while you are recovering from your injury. They can even pay you for an extended amount of time when you have suffered a permanent injury.
Under North Carolina law, you may be eligible for the following in a workers’ compensation claim:
- 2/3 of your average weekly wage that you were earnings prior to your injury, subject to a statutory cap
- Reasonable medical expenses to treat your work-related injury
- Vocational training costs to retrain you to perform a different job or to do your job in light of your current condition
You could be entitled to benefits for an extended period of time if you have suffered a permanent injury. North Carolina publishes a chart that assigns a certain number of weeks of benefits to particular injuries based on their severity. It is not straightforward to interpret. You need a legal guide to help you understand all that you may be owed under the workers’ comp system.
Why You Need a Workers’ Compensation Lawyer
Remember that filing a workers’ compensation claim is never as simple as it seems. Your employer will end up paying higher premiums if your benefits are granted, so they may have the incentive to make your life more difficult. At the same time, the insurance company that is responsible for paying your benefits may also put barriers in your way.
You may need a workers’ comp attorney to help prepare your claim and give you advice on the process. There are some injuries that may make the insurance company more likely to deny your claim entirely. For example, they may claim that you still have the ability to work when your injury is “subjective” in nature.
You would certainly then need a skilled personal injury attorney to appeal any denial of your claim and make the most effective case to the North Carolina Industrial Commission. An attorney could also help you negotiate a settlement when you decide to receive a one-time lump sum payment of your benefits.
Finally, you may have issues when you are already receiving benefits, such as when you are being told to return to work when you are not yet physically able. The insurance company may refuse to pay for certain medical treatments that you need, and you may have to fight them. At Horton & Mendez Injury Attorneys, we can step in at any stage.
Appealing a Workers’ Compensation Claim Denial
The insurance company does not get the last word with regard to your benefits. Since they have a financial motivation in your case, they are not the judge or the jury. If your claim has been denied, you have the legal right to file an appeal with the North Carolina Industrial Commission.
Here, you would get to present your own evidence that shows that you suffered a work-related injury.
If the insurance company has denied your claim because they argue that you acted wrongfully, you would be able to present evidence that shows otherwise. Under North Carolina law, you have a limited amount of time to file an appeal. You should hire an attorney as soon as your claim has been denied if you do not already have one retained.
Believe it or not, there is a reasonable chance of either overturning a workers’ comp claim denial or reaching a settlement agreement. Whether you win your appeal or settle your case, it is in your interest to fight back, especially considering that you do not have to pay a workers’ compensation attorney up front.
Our lawyers will review your case, the insurance company’s reasons for denial, and help you determine whether you have an opening to fight through an appeal.
Contact Our Gastonia Workers’ Compensation Lawyers for a Consultation
As intimidating as the workers’ compensation process may seem, you do not have to go through it alone. Horton & Mendez Injury Attorneys help injured workers like you navigate the system and get the entire scope of the benefits that you deserve. We know and understand what you are going through, and we strive to make the legal process as transparent as possible for our clients through customer service and relentless advocacy.
You can schedule a free initial consultation to speak to one of our attorneys, where we will review your case and explain possible steps forward. Message us online or call us today at 910-405-7751 to speak to one of our attorneys.
