The lawyers and staff at Wallace Law Firm, PLLC help injured employees throughout North Carolina and South Carolina obtain workers’ compensation benefits after being involved in an accident at their job site or while performing job-related duties. We thoroughly investigate each case to determine if the claim is compensable and help you explore the benefits to which you may be entitled. Contact our workers’ comp attorneys today to learn more about how we can assist you with your case.
North Carolina Workers’ Compensation Laws
What Is Workers’ Compensation?
Workers’ compensation is a form of insurance that is intended to protect both employers and employees in the event of an accident at a job site or if a worker develops an occupational disease. It provides victims with compensation for medical costs and lost earnings due to time spent unable to work while recuperating.
What Types of Injuries Are Covered Under Workers’ Comp Laws?
Workers who sustain serious injuries while performing job-related tasks may be eligible for workers’ compensation benefits. A range of injuries and diseases are covered under workers’ compensation laws, including but not limited to:
- Neck Injuries
- Brain and Spinal Cord Injuries
- Joint Conditions
- Hearing Loss
- Vision Loss
- Limb Loss
- Occupational Diseases
Generally, in order for your claim to be accepted as compensable, the injury or illness must occur during the course and scope of the employee’s employment and must be caused by an injury by accident or an occupational disease.
Injuries that occur outside the workplace, but while an employee is performing work-related tasks, are typically covered under workers’ compensation laws. For example, an employee who is involved in a car crash while transporting materials from one job site to another would be entitled to benefits because they were acting within the “course and scope” of their employment. However, an employee who was injured in a motor vehicle accident while commuting to work would ordinarily not be eligible for workers’ compensation benefits.
If you have questions regarding the extent of your injuries and whether you are eligible to file a claim, seek legal counsel with an experienced workers’ compensation law firm who has full understanding of the types of injuries that are covered under North Carolina and South Carolina workers’ compensation laws and can determine if you qualify for benefits.
Workplace accidents are quite common and throughout the Carolinas. Unfortunately, the majority of accidents at a job site or during the course of employment are related to employer negligence. Employers often fail to protect workers from the dangers that can occur at a job site. They may fail to provide sufficient safety gear, may fail to inform employees of dangers at a job site, may employ inexperienced workers, may fail to keep machinery in proper and safe working condition, and may also fail to keep premises free from obstacles that can lead to injuries.
Statistics show that some of the most commonly experienced workplace accidents include:
- Injuries caused by overexertion
- Falls from heights
- Slips and trips
- Injuries from falling objects
- Vehicular accidents
- Machinery accidents
- Workplace violence
- Inhalation of toxic substances
- Chemical burns
Sadly, many of these accidents led to fatalities. According to a report by the Bureau of Labor Statistics, in 2016, there were 174 workplace accident fatalities in North Carolina – the highest recorded workplace fatality rate in the state in the past 10 years. The Bureau also reported that in 2016, a total of 96 fatal workplace accidents occurred in South Carolina. In both states, transportation accidents accounted for the highest number of workplace fatalities. Falls and slips also accounted for a significant number of job-related fatalities.
Workplace Disease and Exposure
One of the worst repercussions imaginable for a worker is being exposed to toxins at their place of employment. Unfortunately, workers are frequently exposed to health risks that can ultimately lead to life-threatening or fatal conditions. Chemicals and hazardous substances at a job site can lead to innumerable diseases, including mesothelioma, an incurable form of cancer that develops following exposure to asbestos.
When North Carolina workers sustain personal injuries while performing job-related duties that cause temporary or permanent physical impairment, they may be eligible for disability benefits under their employer’s workers’ compensation policy. Disability benefits can vary depending on the extent of the injuries, such as whether the workplace accident caused short-term or permanent damage. Unfortunately, despite suffering a work-related injury or illness, it is up to the employee to prove their disability. In the world of workers’ compensation, disability simply means the inability to earn the same wages that you were earning pre-injury.
Depending on your medical condition and your work restrictions, an employee may be entitled to one of the following types of disability benefits following a job-related injury:
Temporary Partial Disability Benefits (TPD). If a worker in suffered a job-related injury but can perform modified work duties or alternate work, they may be given partial disability benefits. Temporary partial disability benefits are paid to workers who can return to work, but who are still recuperating from their injury or illness and, therefore, are paid lower wages than they would normally expect. TPD benefits may extend for up to 500 weeks after the injury or illness in North Carolina and up to 350 weeks in South Carolina.
Temporary Total Disability Benefits (TTD).If you sustained a job-related injury or a workplace-related disease that renders you unable to work for more than seven days, you may be entitled to temporary total disability benefits. Temporary total disability benefits compensate victims the equivalent of 66 2/3% of your average weekly wages due to the injury or disease. In 2018, the weekly total maximum that workers can receive for this type of disability benefit in North Carolina is $992 (often called “the maximum comp rate”). For South Carolina, the maximum comp rate for the year 2018 is $838.21. These types of disability benefits are just as the name suggests: temporary. Under ordinary circumstances, TTD benefits ordinarily cease once the employee can return to work full duty or when the employee has reached the maximum possible recovery for their injury or illness.
Permanent Partial Disability Benefits (PPD). Once a worker’s condition has reached Maximum Medical Improvement (MMI), but continues to suffer impairment, they may be eligible to receive Permanent Partial Disability Benefits. The amount paid for PPD benefits depends on the actual body part that suffered impairment, as listed in Section 97-31 of North Carolina’s Workers’ Compensation Act and Section 42-9-30 of the South Carolina Workers’ Compensation Law, which provides for a schedule of benefits for various types of physical impairments. The exact amount of PPD benefits depends on the impairment rating assigned by a treating physician.
Permanent Total Disability Benefits (PTD). If a worker suffers an injury or illness while performing job-related duties that renders them incapable of working in any position in the future, they may be eligible for Permanent Total Disability Benefits. PTD benefits are paid to the injured worker for life. Compensation will depend on the type and severity of the injury or illness and is determined by the North Carolina Industrial Commission. PTD benefits are more difficult to obtain now since North Carolina has undergone substantial tort reform which resulted in changes to the workers’ compensation statute that are less favorable to employees.
Injured workers must wait seven days before receiving benefits. These first seven days are not paid unless the disability exceeds 21 total days for North Carolina claims or 14 total days for South Carolina claims. Once workers’ comp is approved, victims will receive wage reimbursement weekly, in most instances. However, there are times when payments are made monthly.
Wages are paid at 66 2/3% of the worker’s weekly average wage and allotted until the employee can return to work. If the victim is unable to resume work, disability benefits will be paid according to the severity and type of injury.
Burden of Proof
In North Carolina and South Carolina (as in many other states), employees are responsible for providing evidence that substantiates their workers’ compensation claim. Many people who are injured on the job may think that as long as they tell their employer about their accident and injury, they will be taken care of and will begin receiving workers’ compensation benefits. That is not always the case, however, as your employer and its insurance company will likely try to limit your benefits as much as possible or deny your claim altogether.
Employers and insurers can attempt to limit or deny a claim in a number of ways by asserting defenses to a claim, such as untimely or improper reporting of the injury, employee fault (i.e. intoxication), lack of adequate causation, or credibility issues. In the end, companies want to protect their bottom lines and, unfortunately, this often results in the injured employee having to fight for benefits that are rightfully theirs.
Sometimes, however, even with extensive medical evidence, employees are still denied their benefits. Additionally, if the victim developed an occupational disease, symptoms may not manifest for several years after initial exposure to a toxin. When this happens, it is imperative that victims seek legal assistance with a workers’ compensation attorney.
Frequently Asked Questions (FAQ’s)
Who is entitled to benefits under the North Carolina Workers’ Compensation Act?
The general criteria for receiving workers’ compensation benefits is that you must be an employee of a business that regularly employs at least three people at the time of your injury. This law also applies to workers who are illegally employed, such as undocumented immigrants or underage employees, and non-permanent/seasonal employees. Of course, there are some exceptions to this general rule, so consulting with an attorney who knows the ins and outs of the workers’ compensation process can be very helpful when determining whether your injury is compensable.
What should I do if I am injured on the job?
If you are injured on the job, it is very important for you to immediately report the accident to your employer. You should also seek medical treatment from an employer-approved medical provider as soon as possible. Hold onto any medical bills or records you receive and keep copies of receipts for any out-of-pocket expenses you incur as a direct result of your injury, including receipts for insurance co-pays, prescription drugs, and/or medical accessories like ice or heat packs. Additionally, you should consider contacting an attorney who will help educate you about your rights and how to proceed in filing a workers’ compensation claim.
When will I receive my first workers’ compensation check?
You should begin receiving benefit checks after you have missed seven days of work. Unless you are out of work for more than 21 days in North Carolina or 14 days in South Carolina, you will not be paid for those first seven missed days. You should receive a check each week, although there can be exceptions to this. If your check has not been sent to you or your payments are cut off before you have received notice that you can return to work, you may want to consult an attorney to go over your options.
How is my weekly workers’ compensation check calculated?
Your weekly check is equal to two-thirds of your average weekly wage (up to $992 per week for the year 2018 in North Carolina or $883.21 in South Carolina). Your average weekly wage is calculated by assessing your wages for the 52 weeks preceding your injury. In cases where the injured employee has not been with the company for 52 weeks, other methods are used to calculate the average weekly wage.
Am I entitled to damages for pain and suffering in a workers’ compensation case?
Unlike a personal injury case, there is no award for pain and suffering in a workers’ compensation case. Workers’ compensation is primarily designed to provide medical treatment and indemnity benefits.
What types of medical expenses are covered?
Any medical expenses directly related to your workplace injury should be paid for by your employer or their insurance provider. This includes expenses such as prescriptions; physical therapy; medical equipment, such as crutches, braces, or splints; and, in some cases, travel expenses to and from medical treatment. However, because they are protecting their own interests, the employer or insurance provider can often make it difficult for the employee to obtain the treatment he or she needs by refusing to provide authorization or payment for medical treatment. An experienced attorney will advocate on your behalf to ensure you are receiving all the treatment you are entitled to and to navigate the complexities of the Workers’ Compensation Act so that you have time to rest and heal.
Can I choose my own doctor?
If your workers’ compensation claim is accepted, your employer or their insurance company directs your medical treatment, which means they determine which doctor you will see. However, in certain situations, you may be able to petition the Commission for additional or alternative doctors.
What happens if a third-party was responsible for causing my workplace injury?
If a third-party is responsible for your workplace injury, you are not restricted from filing a claim against that individual while also receiving workers’ compensation benefits. If, for example, you are driving a work vehicle and are rear-ended by another driver, you may have grounds to seek damages against that individual in civil court to recoup personal injury damages, including, but not limited to, medical expenses, lost wages, and/or compensation for pain and suffering. Your employer will also have an interest in that claim and will have the ability to pursue the claim under certain circumstances.
Am I Entitled to Workers’ Compensation Benefits if I Am Injured on My Way to Work?
Generally speaking, an accident that occurs on your way to or from work does not qualify as a compensable workers’ compensation claim. This is commonly referred to as the “coming and going rule.” There are exceptions to this rule, however, including situations in which the accident took place in your employer’s parking lot or premises (premises exception); transportation is part of your contract of employment; you are required to use your own personal vehicle for work; you are a traveling salesperson, or you are on a special errand for your employer. All of these situations are fact-intensive and case-specific.
I Have Been Receiving Weekly Compensation Checks, but They Have Stopped Coming. What Can I Do?
If you know you should be receiving weekly benefit checks, and did not receive one of your scheduled payments, you should get in touch with your employer’s workers’ compensation carrier or administrator to let them know of the lapse. In certain situations, you may be entitled to a late payment penalty.
What Should I Do if My Workers’ Compensation Claim is Denied?
If your claim is denied, you should receive a copy of Form 61 from your employer. This form should include a detailed statement of why your claim was denied. The form will also contain information about your right to request a hearing with the Commission. You may want to consider seeking legal advice upon receiving notice of your claim’s denial.
We help victims of workplace injuries throughout the Charlotte Metro Area, North Carolina, and South Carolina. Contact our workers’ comp attorneys today to learn more about how we can assist you with your case.