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Workers’ compensation is a complex system involving lots of paperwork that must be completed perfectly within strict time frames to qualify for benefits from industrial accidents.

However, when work crews on factory floors and in other industrial settings get hurt on the job and apply for North Carolina’s workers’ compensation program, they sometimes receive disappointing results.

If you are trying to secure benefit through a workers’ claim, a New Bern industrial injury lawyer could help. To learn your rights before filing a workers’ comp claim or to appeal a denial of benefits, contact a distinguished workers’ compensation attorney right away.

Understanding Workers’ Compensation Programs

The federally mandated workers’ compensation program is an insurance program administered by the individual states. The North Carolina Industrial Commission is the agency that handles claims in New Bern, helping employees to get the health coverage they need and reducing employee negligence lawsuits against companies.

Workers’ comp insurance provides wage replacement and medical care for workers who are injured or disabled on the job. Unless they are impaired at the time of the accident, workers are eligible for workers’ comp even if the injury or disability is their own fault. Mental illness is also covered in New Bern, North Carolina if it can be proven that the employee’s work contributed to the condition.

What is Wage Replacement Benefit?

Through workers’ compensation, injured employees may receive two-thirds of their average weekly wages earned in the year prior to the injury as a weekly salary during their recovery. Workers with permanent injuries who cannot return to the job they held before becoming injured may—as part of their compensation—request training to enter into another type of work.

Role of Industrial Companies

The law in New Bern does not require all companies to provide workers’ compensation insurance for employees. Companies with three or fewer employees, farm laborers, domestic workers, and federal staffs are all exempt from workers’ comp requirements.

Disabilities and diseases caused by occupational hazardous diseases are covered, but only if the disease is on the list of covered diseases. An employee with a disease that is not on the list needs to prove the job significantly increased the risk of that disease in order to be covered, which may require outside help from a New Bern industrial injury lawyer. For hearing loss, asbestosis and silicosis-related illnesses, a set of complex and distinct rules apply.

What Happens if a Claim is Refused?

Employees in New Bern have the right to a hearing before a deputy commissioner of the North Carolina Industrial Commission if their workers’ compensation claim is denied. However, the case will first be placed in mediation and presided over by a neutral third party, which is mandatory. This process is complex and requires the worker to present documentary and witness evidence showing why their claim should be approved. If mediation does not result in an agreement, the appeal moves to an industrial commissioner, then—failing that—finally to the full commission of three judges.

How a New Bern Industrial Injury Attorney Could Help

It is not required by law in New Bern to have an attorney help you file a workers’ compensation claim or advocate on your behalf in the appeal process. However, it is almost always to the advantage of the claimant to have competent legal counsel. Otherwise, a worker could be at a severe disadvantage navigating the complicated rules and procedures against professionals who know the system well.

Many claims are denied because the paperwork is insufficient or has errors. Avoiding those pitfalls can help the claim move smoothly through the system with a better chance of acceptance. A New Bern industrial injury lawyer with extensive experience preparing and defending workers’ compensation claims on appeal could help you prepare and defend your claim.