While many programs that are considered part of the social safety net began at the time of the New Deal, the North Carolina workers’ compensation program actually pre-dated the Great Depression.
Workplace injuries increased exponentially in the 1800s as an unfortunate byproduct of the Industrial Revolution. As workplaces used more technology and became more complex, workers were more at risk. At the same time, increasingly powerful companies were not investing in what they needed for workplace safety. In the early 1900s, there were very few workplace safety rules to help workers.
Workers’ compensation is exactly that — compensation that you will receive as a worker for the direct costs of your injury. Direct costs are defined as the following:
- The medical care that is necessary to help you recover from your injury to the fullest extent possible
- The lost wages that you would have earned had you not suffered an injury
The system intends for you to be partially supported until you can return to work. Once you can, you may still receive partial benefits, depending on your disability rating and the amount that you can work. The workers’ compensation system is there to support you as a worker, regardless of who was at fault for the accident, although there are some exclusions that will be described below.
North Carolina Workers’ Compensation Laws
Here are some important laws regarding how workers’ compensation works in North Carolina. You should be aware of these when you are going through the process.
Note that you are not expected to be an expert on every workers’ comp law in NC, especially when you have hired an experienced Wilmington workers’ compensation attorney. Ultimately, the laws and the procedures that they contain will be what is applied when your eligibility for benefits is in question.
North Carolina Law Requiring Purchase of Workers’ Compensation Insurance
The North Carolina Workers’ Compensation Act specifies that all employers in the state that employ three or more people have an obligation to either purchase workers’ compensation insurance or qualify as a self-insuring employer.
Under NCGS § 97-94, employers are required to give proof that they have complied with this law. They can face fines for failing to purchase workers’ compensation insurance. Moreover, if an employer does not have a workers’ compensation policy in place, they can be directly sued by their employees in a negligence action.
Creation and the Role of the North Carolina Industrial Commission
The North Carolina Industrial Commission was created in 1929, and it plays a major role in administering the North Carolina Workers’ Compensation Act.
The Industrial Commission does the following:
- Processes workers’ compensation claims that are filed
- Provides a forum to resolve disputes under the Workers’ Compensation Act
- Helps facilitate high-quality, effective medical care and rehabilitation for injured workers in complex medical/legal situations
- Reviews medical bills in accordance with the published schedule
- Investigates potential criminal violations of the NC Workers’ Compensation Act
The roles of the NCIC are covered under NCGS § 97-77.
NCGS § 97-22 — North Carolina Workers’ Compensation Reporting Requirements
Under NCGS § 97-22, you have 30 days to report your injury to your employer in order to be eligible for benefits. This time period is equivalent to your own statute of limitations for your workers’ compensation claim. The law requires you to give this notice in writing. You should keep a copy of the notice for your own records, so you have proof in case you are challenged. It is always better to give this notice as soon as you realize that you are injured, so you do not place yourself in legal jeopardy.
NCGS § 97-24 — Time Limit to File Your Case
Once you have notified your employer of the injury, you have a certain amount of time to file a claim. The law gives you two years from the date of your injuries to file a workers’ compensation claim with the Industrial Commission. In reality, there is little reason why you would wait that long to file a claim, especially since the two years is since your accident. Presumably, you would need the compensation far before two years.
NCGS § 97-12 — Use of Intoxicant or Willful Neglect
While workers’ compensation is generally a no-fault regime, there are times when an insurance company may deny your claim that are based on your own alleged behavior.
You could still receive benefits when you were negligent yourself in the events surrounding an accident. However, an employer may challenge your claim if they believe that you were intoxicated or under the influence of a controlled substance at the time of the accident. They may also dispute a workers’ compensation claim when there was willful neglect or failure to comply with a statutory duty.
Employees may not always qualify for workers’ compensation if they intentionally disregard a safety regulation. You may need an experienced attorney to defend your own actions if your employer questions the basis for your claim.
There are other instances in which an employer or insurance company may challenge your claim. They could claim that your injury was not even work-related at all. You may need to file an appeal if your claim was denied in the first place. Then, the Industrial Commission would hear your case and render their own impartial decision on your case.
NCGS § 97-25 — Medical Treatment
North Carolina workers’ comp law states that medical treatment is to be paid for by the employer. As an employee, you have a legal right to request in writing that your employer authorize and pay for a second opinion. This would either be on agreement of the two parties or as ordered by the Industrial Commission.
North Carolina workers’ comp rules allow your employer to choose your physician and direct you to a place of their choosing for your medical care. There are limited exceptions that allow you to seek your own medical treatment. You can assume that you may need to battle your employer to get the medical care that you need to get better. An experienced workers’ compensation lawyer can advocate for your interests during the process so that you can get all the medical treatment that you require for your injuries.
Your workers’ compensation settlement depends on the extent of your injuries and whether you have a chance at recovering. There are several definitions that come into play under North Carolina law.
NCGS § 97-29 — Total Incapacity
NCGS 97-29 lays out the circumstances in which you could qualify for payments based on total incapacity. If you are deemed to be totally incapacitated, you would receive 2/3 of your pre-injury wages up to a certain statutory limit. Generally, there is a 500-week limit of total incapacity benefits.
NCGS § 97-30 — Partial Incapacity
Under NCGS 97-30, your benefits for partial incapacity are capped at 2/3 of the difference between your earnings before your disability and what you are able to earn in the wake of your injury. Under this law, you are limited to 500 weeks of payments.
NCGS § 97-31 — Schedule of injuries; rate and period of compensation
The workers’ comp system of North Carolina has a table that assigns a certain number of weeks of benefits for each injury. For example, the loss of an index finger would equate to 45 weeks of benefits. For the loss of a third finger, the amount would be 25 weeks of benefits.
The amount of wages to which you are entitled is 2/3 of your average weekly wage prior to your injury.
Contact a Wilmington Workers’ Compensation Attorney Today
If you have a complex workers’ compensation case, or your claim has already been denied, the lawyers at Horton & Mendez are in your corner. We know how to fight the good fight on behalf of our clients who are getting pushed around by an insurance company.
You can send us a message online or call us today to get our lawyers’ help.
