With Huntersville Workers’ Compensation disputes, the disagreement is often about medical care and income benefits. The injured worker will be requesting what’s rightly owed, but the employer and their insurer will be pressing hard to discredit the claim or limit the settlement.
If your employer or the insurance provider denied your workers’ compensation claim, we at 1Charlotte can help. Our Huntersville workers’ compensation lawyers can evaluate the matter and determine if you can appeal the denial and receive your benefits. Call our law offices today at 704.706.2689 to schedule a free case review and learn more about how we can help.
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Some Of The Common Causes Of Workers’ Compensation Disputes
Workers’ compensation disputes in North Carolina are associated with the following causes:
The Employee’s Employment Status
Businesses and employees in North Carolina have more than three people as employees are legally obligated to have workers’ compensation coverage and the relevant benefits. But some employers will carry the coverage but dispute the compensation claim, challenging the claimant’s employment status on the basis that the person was working under independent contractor terms.
In some situations, the claimant might have valid documentation that proves their employment status and conditions as stipulated by North Carolina laws. Our lawyers will evaluate the evidence and use it to invalidate the denial to ensure you receive your benefits.
Outside Scope of Employment
Suppose the workplace accident is linked to intoxication or intentional misconduct resulting in self-inflicted injuries. In that case, the incident and subsequent damages will likely be considered outside the employment scope. As such, the insurance adjusters will dispute and reject the claim. If an employer and their insurance try to unfairly blame you for your injury and deny your claim, you’ll want a skilled attorney to represent you.
Lack of Causation
In a situation where an insurance adjuster cannot find any valid connections between the claimant’s injuries and the accident that took place at the workplace, the adjuster might deny the claim. Submitting additional medical evidence and obtaining a second medical opinion that highlights the injuries’ extent might prove useful in countering any disputes or appealing the denial.
Missed Deadline
When employees in North Carolina are injured when at work, they have thirty days to inform their employer of the incident. A workers’ compensation claim could be denied if the claimant does not comply with the set procedures of reporting the accident, which entails submitting a written notification that also details the nature of the injuries.
It is not uncommon for insurance adjusters to dispute a workers’ compensation claim made months after the incident happened, even when some reasons might validate the lateness.
Inadequate Information
The insurance adjuster might refute and deny the requested workers’ compensation benefits if the details in the file claim are incomplete, such as the lack of information that proves the claimant’s injuries and medical processes.
What To Do When Your Workers’ Compensation Claim Is Denied In North Carolina
The North Carolina Industrial Commission is mandated to hear workers’ compensation claim cases. You are expected to file your claim and schedule a hearing before this commission within two years from the day your employer or their insurance provider denied your claim. You must file a Form 33 requesting for the hearing. Our lawyer can help you if you do not know where to start with the process. The commission will expect you to prove why you believe the denial was unethical.
If your claim is still denied after the hearing, you can dispute that outcome, appealing the Industrial Commission’s ruling by submitting a Form 44 to the North Carolina Court of Appeals. You must do this within 15 days from the day of your hearing.
The appeal process can be complicated, hence the reason for working with an experienced attorney that understands what the process entails. Call our workers’ compensation lawyers in Huntersville to schedule a free consultation and get the best legal counsel fighting for you.
Typical Huntersville Workers’ Compensation Disputes
Our attorneys can assist you in these common types of workers’ compensation disputes in Huntersville, NC.
Medical Disputes
The process entails facts concerning medical opinions and treatment administered to the injured employee. The outcomes governing medical disputes are pegged on the doctor’s inclination to fight for the patient’s (the worker) treatment. Some of the conflicts in this situation include denied treatment services such as surgery, physical therapy, and assisted living arrangements.
Claim Disputes
Working with a lawyer is highly advisable when it comes to workers’ comp claim disputes. Such disputes include:
- Disability Disputes – which involves proving the work lost his or her wages because of the injuries sustained in the workplace accident.
- Compensability Disputes – that entails determining the employee’s injuries or health status after the accident meets Coverage Eligibility requirements in North Carolina.
- Average Weekly Wage Disputes – addresses discrepancies related to how much the claimant is entitled to get when on workers’ compensation.
Workers’ Compensation Dispute And Appeals Process In North Carolina
If the dispute resolution with your employer or their insurance provider is not feasible, you can opt to escalate the issues. North Carolina dispute resolution options vary based on the insurer, jurisdiction, and circumstances surrounding the case. Some of the dispute resolution measures that might be worth considering include:
Mediation
During mediation, a neutral third party helps in resolving the workers’ compensation dispute. The goal is to prevent the need for litigation by helping the employer, insurers, and employee reach an amicable agreement. However, mediation can be expensive and time-consuming.
Hearings
It is the option that many people consider when it is hard to find a consensus via the mediation process. The hearing is similar to court trials, though not presided over by a judge but a workers’ compensation hearing board appointed by the State.
Appeals
If the hearing does not result in a satisfactory verdict, the claimant is eligible to appeal that ruling.
Contact a Huntersville Workers’ Compensation Attorney Today
If fighting for your workers’ compensation benefits is becoming a daunting task, you should consider working closely with an experienced lawyer. At 1Charlotte, we will offer you the best legal counsel and guidance for your Huntersville worker’s comp case. We guarantee to fight for your rights and do everything possible to ensure your claim is honored.
Get in touch with our personal injury law firm today at 704.706.2689 to schedule a non-obligatory case evaluation and learn how we can handle the claim dispute.
