Workers’ Compensation Frequently Asked Questions
What is workers’ compensation?
Workers’ compensation has been brought about to create certainty in situations where there is a work-related illness or injury. There is a reliable procedure to be followed within the system that helps to resolve problems. In very vague terms, if an employee is injured while working on the job, the worker is to receive benefits, whether the employer was or was not at fault. Benefits include; lost wages compensation, medical and rehabilitation coverage, and damages for permanent disability. The employee is not allowed to sue the employer for their injuries in return for this compensation. The majority of employers must be involved with the workers’ compensation program, although some smaller employers are exempt. Federal programs that are comparable to workers’ compensation cover federal workers.
What injuries and illnesses are covered?
Usually just injuries that result from an accident at work. If you are preforming your usual job in your usual way, your claim may not be covered. However, there are some exceptions to this rule. Workers’ Compensation claims for the back do not have to be the result of a specific accident. You may also have an occupational disease claim such as carpel-tunnel that does not have to result from a specific accident, but you will need medical evidence proving the onset is work related.
What benefits are offered?
In North Carolina injured workers will be covered for lost wages, medical, and disability benefits. Wage replacement benefits are calculated by determining an injured workers average weekly wage from before the injury. An injured worker is entitled to receive medical treatment reasonably related to the injury. Other benefits include rehabilitation, mileage and attendant care services. People may be eligible for death benefits if they are surviving dependents of the worker who dies due to a work related injury or illness.
Where does the funding come from to pay for workers’ compensation benefits?
Employers may make payments based on one of three methods required by state law, or use a combination of the three. Employers can choose to participate in workers’ compensation insurance, they may self-insure by setting up their own funds, or funds may be administered by the state that employers pay into.
What steps should I take if I am injured?
First, seek medical treatment as soon as possible. Also immediately provide written notice of the injury to your employer. Keep a copy of any incident reports completed. In North Carolina there is a requirement that an injured worker must provide written notice of the injury as soon as practicable after the injury and no less than 30 days. Many times there will be a designated person who must be informed, a time frame in which it must be done, and possible deadlines. Then an injured worker must file written notice of the claim with the North Carolina Industrial omission within 2 years of the date of injury or face losing valuable benefits .You will want to consult a workers’ compensation attorney in order to get the most sound advice and guidance throughout the process.
Can I choose my doctor?
Usually in North Carolina Workers’ Compensation claims, the Doctor is chosen by the employer or their workers’ compensation insurance carrier. Emergency treatment can be given without concern or consultation in most cases. After you are treated and stable, then your medical treatment can be directed by your employer or the workers’ compensation insurance carrier. In some circumstances, you have the right to a second opinion from a physician of your choice. The right to the second opinion is just for the disability rating you may be assigned.
What if my claim is denied?
In North Carolina if your case is denied you have the right to file a Form 33, request for Hearing, with the North Carolina Industrial Commission. At this time your case will be ordered into Mediation which is a settlement conference. If the case does not resolve at mediation, a hearing is usually held. If the state agency affirms the denial, you then will have to appeal through the court system. It is very helpful to be represented by an attorney with experience in the area of workers’ compensation.
What if another party and not my actual employer caused my injury?
Regardless of who caused your injury or illness, you may are still eligible for benefits. For the workers’ comp case, you don’t have to prove fault. However, you may have a negligence claim against the third party that harmed you. You may have been harmed by faulty equipment. In this case, you have the right to sue the seller, manufacturer, or seller. If the injury was from a co-worker, you will normally not be able to sue under the laws of most states. If you are able to recover money from a third party, our employer may be able to get workers’ compensation reimbursement. The third party claim is separate than the workers’ compensation claim.
At the Whitley Law Firm, we are proud to service individuals all throughout North Carolina with their workers’ compensation claims. We have locations in Raleigh and other major cities in the state to better assist you, so contact a lawyer from our firm today for quality legal assistance!
