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. The first workers’ compensation law in the state was passed in 1929.
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.
Both Employer and Employee Benefit From Workers’ Compensation
The North Carolina workers’ compensation system introduces the tradeoff that employees must make to obtain coverage for a work-related injury. Businesses with three or more employees must purchase workers’ compensation coverage.
However, in exchange for the premiums they pay, businesses get an important protection of their own — they cannot be sued by their employees in a personal injury case under nearly all circumstances. If the employer does not have workers’ compensation insurance in violation of the law, they may be sued in a personal injury case. Even though it costs money, an employer has every incentive to follow the law and purchase workers’ compensation coverage.
Reporting Requirements for Work-Related Injuries
Under North Carolina law, you have 30 days to report your injury to the employer, either verbally or in writing. To be safe, you should report the injury as soon as possible and do it in writing, so nobody can dispute whether you actually made the report. If you made a verbal report, you should follow it up in writing to ensure that there is a written record.
North Carolina’s Workers Compensation Act of 1929 created the North Carolina Industrial Commission, which is the state agency that oversees the workers’ compensation system. Instead of filing your claim as a lawsuit with the court, you will file it with the NCIC.
If your claim is denied, you may file an appeal with the NCIC, where an objective administrative law judge will hear your case. You have multiple levels of appeals if you are unsuccessful at first. If your claim is denied, you should always contact an experienced attorney to help you with an appeal.
Eligibility for Workers’ Compensation Benefits
When a company has workers’ compensation insurance, the following are the requirements for coverage:
- You are in an employment relationship with an employer (importantly, this will exclude independent contractors from filing a workers’ compensation claim or those who are not strictly employees of a business).
- You suffered a work-related injury or occupational illness.
- You suffered a loss or an inability to work.
- You have followed the procedural requirements to file a claim (which we will discuss in more detail below).
When Employers Might Challenge a Workers’ Compensation Claim
Coverage under the law is often in dispute. Employers and insurance companies will often challenge a workers’ compensation claim under the following grounds:
- They will claim that you have not suffered an injury.
- They will challenge that your injury was work-related (for example, they may argue that you were not injured on the job or that your injury was a pre-existing condition — a common exclusion is when you suffered an injury on your way to or from the office for the day).
- They will dispute the connection between your injury and their workplace (for example, if you suffered from an occupational illness, the employer may claim that you were sickened at a previous or later job).
Although you can still receive workers’ compensation benefits if you were at fault for the accident, you may be unable to get benefits if you were drunk or impaired. You may also be disqualified if you were found to have acted intentionally. In practically all other cases, you will be entitled to benefits if you suffered a work-related 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 at 910-405-7751 to get our lawyers’ help.
