How Does Workers’ Compensation Work?

A lawyer can explain how workers’ compensation works, which begins with reporting your workplace injury to your employer and filing a claim with their insurance company. Workers’ compensation provides benefits to cover medical expenses, lost wages, and rehabilitation for employees injured on the job, regardless of who was at fault. 

Understanding the process is important, as missing deadlines or providing incomplete documentation can delay or jeopardize your claim. A Raleigh workers’ compensation lawyer can help injured workers by providing guidance on filing, appealing denied claims, and pursuing the full benefits they are entitled to under North Carolina law. 

If you’ve been hurt at work, learning how workers’ compensation works can help you take the first steps toward financial recovery.

Who Qualifies for Workers’ Compensation?

In North Carolina, most employees are covered under workers’ compensation laws, which require employers with three or more employees to provide this type of insurance. 

Workers’ compensation benefits are available to employees who suffer injuries or illnesses during their work, regardless of fault. This includes full-time, part-time, and seasonal employees, as long as their injury or illness is work-related.

Exceptions to Workers’ Compensation

There are exceptions. Independent contractors, domestic workers, agricultural workers at small farms with fewer than ten employees, and certain employees of small businesses may not be covered. 

If you are unsure whether you qualify, a Raleigh personal injury lawyer can help determine your eligibility and explain your rights under North Carolina law. They can provide more information about how workers’ compensation works, as well.

What Does Workers’ Compensation Cover?

Workers’ compensation in North Carolina provides a range of benefits to employees injured on the job, as outlined by the North Carolina Workers’ Compensation Act (N.C. Gen. Stat. § 97-1 et seq.). These benefits include:

• Medical expenses: Covers all necessary medical treatments related to the work injury, including doctor visits, surgeries, hospital stays, medications, physical therapy, and mileage reimbursement for travel to medical appointments.
• Temporary disability benefits: Provides compensation for lost wages if the injured employee is unable to work during recovery. Temporary Total Disability (TTD) benefits equal two-thirds of the worker’s average weekly wage, subject to a weekly maximum set by the state.
• Permanent disability benefits: If the injury results in a permanent impairment, benefits may be awarded based on the severity of the disability and the body part affected, as determined by a physician.
• Vocational rehabilitation: Covers support for retraining or education if the injured worker can no longer perform their previous job and needs new skills to re-enter the workforce.
• Death benefits: Provides financial support to surviving family members of an employee who dies from a work-related injury. This includes up to two-thirds of the deceased worker’s average weekly wage for a specified period, as well as coverage for funeral and burial expenses (up to $10,000).

The North Carolina Industrial Commission (NCIC) is the state agency responsible for administering the workers’ compensation system in North Carolina. 

This department resolves disputes between employees and employers or insurers and ensures injured workers receive the benefits they are entitled to under the law. The NCIC also oversees the filing of claims, hearings, and appeals related to workplace injuries.

Steps to File a Workers’ Compensation Claim

Filing a workers’ compensation claim in North Carolina involves several important steps to ensure you receive the benefits you are entitled to after a workplace injury, such as:

• Report the injury to your employer: Notify your employer of your injury as soon as possible, but no later than 30 days after the incident. Provide written notice detailing what happened, when it occurred, and the nature of your injury.
• Seek medical treatment: Get medical attention immediately, even if the injury seems minor. Your employer or their insurance carrier may direct you to a specific approved healthcare provider. Be sure to follow all medical advice and attend follow-up appointments, as medical records are critical for your claim.
• File the claim with the employer’s insurance carrier: Your employer is required to report the injury to their workers’ compensation insurance carrier, who will then file a claim with the North Carolina Industrial Commission (NCIC). To protect your rights, you should also file a Form 18 (Notice of Accident to Employer) with the NCIC within two years of the injury.

Understanding how workers’ compensation works can help you make a strong claim for benefits. If you encounter challenges during the process, consulting a knowledgeable attorney can help protect your rights.

Filing a Lawsuit Against a Liable Third Party

In some workplace injury cases, a third party—someone other than your employer—may be responsible for your injuries. For example, if you were hurt by defective equipment, the manufacturer could be held liable. While workers’ compensation generally prevents you from suing your employer, it does not bar you from filing a lawsuit against a negligent third party.

To pursue a third-party claim in North Carolina, you must demonstrate that the third party’s negligence caused or contributed to your injury. Compensation in these cases can include damages not covered by workers’ compensation.

The statute of limitations for filing a personal injury lawsuit in North Carolina is generally three years from the date of the injury, as outlined in N.C. Gen. Stat. § 1-52. Missing this deadline could prevent you from pursuing compensation, so it’s important to act promptly.

We Can Explain How Workers’ Compensation Works

Understanding how workers’ compensation works can be overwhelming, especially when you’re trying to recover from a workplace injury. From filing your claim to exploring additional options like third-party lawsuits, having the right guidance is crucial to protecting your rights and securing the benefits you deserve. 

At Whitley Law Firm, our team of dedicated attorneys brings over 120 years of combined experience to help injured workers file workers’ compensation claims and personal injury lawsuits. 

If you are wondering how workers’ compensation works or need help pursuing a claim, contact us today for a free consultation. Let us put our experience to work for you.