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If you suffered an injury at work or developed a job-related medical condition, you may have questions about applying for workers’ compensation in Winston-Salem. Under the North Carolina Workers’ Compensation Act, all businesses that employ three or more employees must have workers’ compensation liability insurance.

This insurance covers all medical expenses for treatment of the injury, including doctor’s visits, medication, surgery, and physical therapy. Workers’ comp insurance also pays for a percentage of your normal wage and if you cannot return to the type of work you had before the injury or illness, you may also qualify for vocational rehabilitation and training.

A distinguished workers’ compensation lawyer can assist you in filing a claim with the North Carolina Industrial Commission, the state agency which oversees all work injury issues.

How to Apply for Workers’ Compensation

After an individual has sought medical treatment for their injury or illness, they must notify their employer of the condition. Failure to do so in a timely manner could affect their ability to receive benefits. Most companies have a procedure or protocol for notification of a work injury. Winston-Salem requires employer notification no more than 30 days following the injury. This notice must be both orally and in written form.

The next step in applying for workers’ compensation in Winston-Salem is to fill out and file a Notice of Accident to Employer and Claim of Employee (Form 18) with the Industrial Commission. Copies of the form are available either through an employer or on the commission’s website. The injured party must fill out this form within two years of the date they suffered an injury.

Potential Employee Benefits

Once the commission approves a claim, the employer must start covering the person’s medical expenses. Some employers may require the individual to receive treatment from the provider of their choice, however, a person may dispute that through the Industrial Commission.

What is Wage Replacement?

Workers compensation benefits also cover wage replacement if someone cannot work for more than seven days after an injury. The amount of this temporary benefit someone can receive is just under 67 percent of their lost wage amount, with a weekly maximum of up to $978.

As they recover, a person may be able to return to work on a partial basis, and this benefit amount may change accordingly. Once someone reaches their maximum medical improvement and can return to work full-time, the benefit stops.

In many work injury cases, the victim reaches their maximum medical improvement but still has a permanent disability or impairment. In these situations, the commission could determine the amount of financial compensation the worker may receive for the disability. Workers who are totally and permanently disabled may continue to receive the original temporary disability benefit amount for the rest of their lives.

How to Handle Claim Denials

There are situations where applying for workers’ compensation in Winston-Salem results in a denial of the claim. In these cases, a workers compensation attorney can request a hearing with the commission to appeal the decision. Typically, the parties involved may attempt mediation to negotiate a resolution. If mediation does not work, then there is a formal hearing held in front of a deputy commissioner who will decide the case.

If either party disagrees with the deputy commissioner’s decision, they have the right to request an appeal hearing in front of the full commission board. In some cases, someone could file an appeal with the North Carolina Appeals Court that can potentially go all the way to the North Carolina Supreme Court.