Facing Insurance Pushback After a Work Injury? A Workers’ Compensation Lawyer Can Step In
Dealing with a workplace injury can be overwhelming, especially when navigating the complex workers’ compensation process. For North Carolina workers, filing a workers’ compensation claim is essential to receive benefits like medical treatment, coverage for medical bills, and temporary total disability benefits. However, disputes with an insurance company or workers’ compensation provider can make this process difficult, particularly if your claim is denied.
How a Workers’ Compensation Lawyer Strengthens Your Claim
Employers with three or more employees are required to carry workers’ compensation insurance, which provides injured workers with workers’ compensation benefits. These include temporary partial disability benefits, permanent partial disability benefits, lost wages, and even death benefits for families of workers lost to workplace accidents. Unfortunately, securing these benefits often requires a skilled workers’ compensation lawyer to handle disputes about average weekly wages, maximum medical improvement, or permanent disability benefits.
An experienced Charlotte workers’ compensation lawyer can guide you through every step of your workers’ comp case, from filing the claim to resolving disputes with your employer or insurance provider. We work on a contingency fee basis, ensuring you don’t pay unless we win your case. Whether addressing temporary disability benefits, permanent total disability benefits, or expenses, we fight for fair compensation for North Carolina workers.
Understanding North Carolina Workers’ Compensation Laws: What Injured Workers Need to Know
Workers’ Compensation is insurance held by an employer to compensate employees with work-related injuries by providing treatment-related expenses and payments for lost wages.
Under North Carolina law, only certain businesses are required to maintain workers’ compensation insurance, including those businesses that employ three or more employees.
If your employee fits into this category but fails to carry workers’ compensation insurance, you can report the situation to the state for further actions.
Hiring A Workers’ Compensation Lawyer
After a work-related injury, it’s important to take the right steps to protect your claim. Your first priority should be getting treatment. A workers’ compensation lawyer can guide you on what to do next and help ensure every requirement is met.
If you are instructed to see a particular doctor for treatment, follow that direction, as North Carolina law typically requires injured workers to begin care with the approved physician. When this doctor is unavailable, you may go to your own provider or the nearest emergency room—however, it’s wise to consult a workers’ compensation lawyer right away to avoid any issues with your claim and to properly document the situation.
North Carolina also requires that the injury be reported in writing within 30 days. This can be done through a written notice or by filing North Carolina Industrial Commission Form 18. A workers’ compensation lawyer can prepare and submit this form for you and make sure all legal deadlines are met.
Once the form is filed, make sure every injury, symptom, or condition related to the incident is included. Many injured workers assume they can update the form later, but leaving out a condition may prevent them from receiving benefits for it. A knowledgeable workers’ compensation lawyer will help you identify all relevant injuries and ensure your documentation is complete and accurate.
With a skilled lawyer involved from the beginning, you reduce the risk of avoidable mistakes and strengthen your entire workers’ compensation claim.
How do I File a Workers’ Compensation Claim?
After your claim is submitted, the insurance company will typically reach out to discuss your injuries and schedule an examination with an approved doctor. A workers’ compensation lawyer can guide you through this stage and help you understand what to expect from the adjuster and the medical evaluation process.
If you feel uncomfortable relying solely on the insurance-selected doctor, a lawyer can help you file a request with the Industrial Commission to see another physician. Avoid switching doctors without approval, as doing so may put your coverage at risk. Having a knowledgeable workers’ compensation lawyer advising you helps prevent missteps that could jeopardize your benefits.
Once the initial medical evaluation is complete, the insurance carrier will either accept your claim and outline a treatment plan or issue a denial. If they deny your claim, they must provide a detailed explanation to both you and the Industrial Commission.
If your claim is denied, you have the right to appeal — and this is where the guidance of a Charlotte workers’ compensation lawyer becomes essential. Your lawyer can gather evidence, challenge the denial, and navigate the appeals process to fight for the benefits you deserve.
What Are Common Types Of Workers’ Compensation Injuries
There are various types of work-related injuries that are typically covered under workers’ compensation coverage. These include:
- Amputations; these commonly occur in factories and industrial settings;
- Slip and fall injuries
- Hearing loss and eye injuries
- Exacerbated pulmonary conditions, like asthma
- Work induced conditions, like heart attacks, strokes or hypertension
- Work induced psychiatric and emotional problems brought on by physical injury
- Mesothelioma from asbestos exposure and other occupational-related diseases
- Burns and electrocutions
- Back, knee and shoulder injuries
- Traumatic brain injuries
- Injury from dangerous or defective tools and machines
Types of Compensation Our Attorneys Will Pursue for Your Workers’ Compensation Claim
When you’ve been injured in a workplace accident, securing the right benefits is essential to your recovery and financial stability. At our law firm, our experienced Charlotte workers’ compensation lawyers are dedicated to ensuring you receive the full range of workers’ compensation benefits you’re entitled to under North Carolina law.
We understand the complexities of the workers’ compensation process and fight tirelessly for injured workers. Below are the types of compensation we will work to secure for your workers’ comp claim:
Medical Treatment and Expenses
One of the most critical aspects of a workers’ compensation case is ensuring all medical expenses are covered. This includes hospital bills, doctor visits, surgeries, therapy sessions, medications, and other forms of care required due to your work-related injury. We’ll make sure your insurance company covers these costs without unnecessary delays or disputes.
Lost Wages
If your injury prevents you from working, our attorneys will fight to recover compensation for your lost wages. Based on your average weekly wages, you may be entitled to temporary total disability benefits while you’re unable to work or temporary partial disability benefits if your injury limits your ability to earn your full income.
Permanent Disability Benefits
For those who suffer lasting impairments, we’ll seek permanent partial disability benefits or permanent total disability benefits, depending on the severity of your condition. These benefits compensate you for long-term loss of earning capacity and quality of life due to your injuries.
Death Benefits
If a loved one tragically passes away due to a workplace accident or occupational disease, we can help secure death benefits for the surviving family members. These benefits may include financial support for funeral expenses and ongoing compensation to dependents.
Disability Benefits
In addition to workers’ compensation, we’ll explore other avenues of support, such as Social Security disability benefits, to ensure you receive the maximum possible assistance. Our team works to coordinate these benefits alongside your workers’ compensation claim to provide comprehensive financial relief.
Fair Compensation for Denied Claims
If your claim has been denied or your employer refuses to acknowledge your injury, our workers’ compensation attorneys will take immediate action. Whether presenting your case to the North Carolina Industrial Commission or negotiating with the workers’ compensation provider, we aim to overturn denied workers’ compensation claims and secure the benefits you deserve.
Monetary Compensation for Medical Bills and Expenses Related to Your Injury
We’ll ensure that you are reimbursed for all expenses related to your work injury, including out-of-pocket costs for treatment and ongoing care. Our attorneys fight to minimize your financial burden by holding the insurance provider accountable.
Personal Injury Claims
If your injury involves a third party, such as an equipment manufacturer or negligent contractor, we’ll pursue a personal injury claim in addition to your workers’ comp case. This allows you to recover further monetary compensation for pain and suffering, emotional distress, and other damages not covered by workers’ compensation insurance.
By working with an experienced workers’ compensation lawyer, you can navigate the legal process with confidence and focus on your recovery. We’ll manage every aspect of your claims process, from gathering records to proving your injury occurred on the job. Our team operates on a contingency fee basis, meaning you pay no legal fees unless we win your case.
Let our Charlotte workers’ compensation attorneys fight for your rights. Whether you’re dealing with a denied claim, an occupational disease, or ongoing disputes over maximum medical improvement, we’ll secure the fair compensation you deserve. Contact us today for a free consultation and take the first step toward receiving the workers’ compensation benefits you need.
NC’s Deadline for Filing a Workers’ Compensation Claim
There is a statute of limitations on the amount of time you have to file a workers’ compensation claim. These time limits are generally in place to preserve the availability of evidence and witnesses. Under North Carolina, a worker must file a claim within two years of the initial injury date.
You can accomplish this by submitting Form 18 to the North Carolina Industrial Commission. Your employer should send you the form upon notification of your injury, but if they don’t, you can obtain the form directly from the commission, or here.
Failure to file your claim before the statute of limitations expires will bar you from ever filing a workers’ compensation claim. Submitting the form soon after your injury is the best way to avoid a late filing.
If the relevant injury is an occupational disease, time starts on the two-year statute of limitations when the illness interferes with your ability to work.
Retaliation Deadlines and How a Workers’ Compensation Lawyer Can Help
The other statute of limitations under North Carolina law relates to retaliation lawsuits. If your employer retaliated against you after filing a workers’ compensation claim, the state gives you three years from the date of the retaliatory action to file a lawsuit with the help of our experienced Charlotte workers’ compensation lawyers.
An available alternative is to complete a complaint through the North Carolina Employee Discrimination Bureau. With this option, you are allowed 180 days from the date of retaliation to file your complaint.
The agency will determine if the discharge was lawful after investigating the circumstances of the case. If the agency sides with the employer, the Commission will issue a right to sue letter, which allows you to independently file suit in court.
Conversely, if the findings are in favor of the employee, the Commission will attempt to negotiate the matter.
Who Is Eligible For Workers’ Comp Coverage?
Workers’ compensation coverage is available to a variety of workers. Under North Carolina law, generally, all employees are eligible for coverage. Some employees excepted from this requirement include:
- Employees of certain railroads
- Casual employees, i.e., individuals who do not perform “work pertaining to the regular course of defendant’s business”
- Federal government employees
Contrary to common belief, part-time workers that do not fall under one of the exceptions listed above are eligible to file for workers’ compensation coverage as long as their employer employs 3 or more employees.
Many other factors can affect workers’ compensation eligibility. When the injury occurs, you must be performing duties that are within the scope of your employment. The scope of employment means actions completed in relation to the job.
It’s important to note that determining the scope of employment can sometimes prove challenging.
When making these determinations, the courts generally look at whether the incident occurred at the place of employment or within the time frame of employment; whether the incident occurred when the employee was performing tasks they were hired to perform; and whether the employee’s actions were motivated by the interests of the employer.
Questions over this designation can also apply when injuries occur within the employer’s physical location if issues of drug or alcohol use, reckless behavior, or the commission of a crime are involved.
Key Issues That Can Complicate Your Workers’ Compensation Claim
Navigating the workers’ compensation system is rarely straightforward. Many injured workers face additional challenges that can delay benefits, reduce payouts, or result in unfair claim denials. Understanding how these issues impact your case — and when a workers’ compensation lawyer can step in to protect your rights — is crucial. The sections below outline some of the most common complications injured workers encounter.
Pre-Existing Conditions That Make Workers’ Compensation Claims More Difficult
A pre-existing condition does not automatically disqualify you from workers’ compensation in North Carolina. If a new work-related accident aggravates your existing injury or condition, you may still qualify for benefits. The key is proving that your current limitations were made worse by a specific workplace incident or by the physical demands of your job.
Insurance companies often deny claims simply because a pre-existing condition exists, but they are not permitted to issue automatic denials on this basis alone. If your claim is rejected, you can appeal through the North Carolina Industrial Commission. Keeping detailed records of your symptoms and medical history can strengthen your case.
Working While Injured and How It Can Complicate Your Claim
You are not required to take time off of work in order to collect workers’ compensation insurance. Even if you continue working, you are still able to receive medical benefits. Your treating physician is the best party to decide about your ability to work through your job-related injury.
Upon reviewing the extent of your injuries, they will decide whether it’s appropriate for you to keep working. Your doctor may allow you to continue working with certain limitations, like only working on certain machines or only working from a seated position.
Workers who continue working on the same schedule as before their injury can receive medical expenses, but not lost time weekly benefits. Alternatively, you and your physician may determine that it is appropriate for you to only continue working on a part-time basis. In these situations, you may receive lost-time weekly benefits only for the time that you are away from work.
While it may appear more attractive to continue working and collect your regular pay instead of filing a workers’ compensation, this decision may result in some negative consequences.
- You may exceed the statute of limitations for filing even if your condition worsens
- If your employer takes retaliatory actions against you, there is no proof of your work-related injuries to demonstrate that your employer acted in bad faith.
Third-Party Involvement That Can Complicate Liability and Benefits
Any individual or entity other than the employer who may have contributed to the employee’s injuries is considered a third party. The employee seeks third party liability when they make a claim against a third party to seek compensation for work-related injuries.
Workers’ compensation coverage is in place to provide employees with financial compensation and coverage in exchange for an agreement not to file suit against the employer. It solely covers current medical expenses and income loss but does not cover long term losses of income.
To make up for these limitations, the employee may choose to file a lawsuit against the third party, which differs from the workers’ compensation claim. The process to pursue a third-party liability claim begins with the institution of a lawsuit in the appropriate court and proceeds as if there were no pending workers’ compensation claim.
Proving negligence on the part of the third party requires proof that:
- The third-party owed you a duty
- He or she breached that duty
- The breach caused your injuries and
- You suffered damages
Subrogation Issues That Can Reduce Your Third-Party Settlement
When an injured worker receives workers’ compensation benefits but also pursues a claim against a negligent third party, North Carolina law allows the workers’ compensation insurance carrier to pursue subrogation. This means the insurer can seek reimbursement for the medical bills and wage benefits it previously paid.
A knowledgeable workers’ compensation lawyer plays a crucial role in this process. Subrogation can significantly affect how much of a third-party settlement you ultimately receive, and a lawyer can help negotiate the terms so your recovery is not unfairly reduced.
Before any third-party settlement is finalized, both the injured worker and the insurance carrier must agree to the settlement terms. Once the third-party payment is issued, the insurance company is reimbursed first, and the remaining funds go to the injured worker.
Because subrogation can dramatically impact your final payout, working with an experienced Charlotte workers’ compensation lawyer ensures your rights are protected and the final agreement is fair.
When Employers Don’t Cooperate After a Workplace Injury
After you report a workplace injury, the next step should be for the company to notify its workers’ compensation insurance carrier so medical care and wage benefits can begin. Unfortunately, some workplaces fail to take action—or intentionally create obstacles—leaving injured workers without the support they are legally entitled to.
Non-cooperation may appear in several ways, including:
- Pressuring an injured worker to return before they are medically ready
- Telling the worker to use personal health insurance instead of workers’ compensation coverage
- Continuing regular wages instead of allowing proper workers’ compensation payments
- Delaying paperwork to run out the statute of limitations
- Influencing the company doctor to minimize injuries
- Threatening job loss or retaliation for filing a claim
When this happens, a workers’ compensation lawyer becomes essential. A lawyer can step in immediately to protect your rights, ensure the claim is filed properly, and prevent further interference.
In North Carolina, injured workers are not powerless. You can file the necessary claim forms directly with the North Carolina Industrial Commission or let an experienced Charlotte workers’ compensation lawyer handle the process for you.
Additionally, the Retaliatory Employment Discrimination Act (REDA) and North Carolina common law provide strong protection against workplace retaliation. If you experience punishment or unfair treatment for asserting your rights, you can file a formal complaint with the North Carolina Department of Labor’s Employment Discrimination Bureau (EDB). This must be done within 180 days of the retaliatory act.
The EDB will conduct an investigation and may either issue a right-to-sue letter or attempt mediation if they find evidence supporting your claim.
A knowledgeable workers’ compensation lawyer can guide you through each of these steps, protect you from retaliation, and ensure your case moves forward even when your workplace refuses to cooperate.
Frequently Asked Questions About Workers’ Compensation
What does workers’ compensation cover in North Carolina?
The workers’ compensation system is designed to provide comprehensive support for injured workers. It covers all treatment related to a work-related injury, including surgeries, therapy, and medication. Additionally, it provides compensation for lost wages when workers are unable to work due to their injury, along with disability benefits for temporary or permanent impairments. Families of workers who lose their lives due to workplace accidents or illnesses may also be eligible for death benefits. Working with an experienced workers’ compensation lawyer ensures that you receive the fair compensation you deserve.
What should I do if my workers’ compensation claim is denied?
If your workers’ compensation claim is denied, taking swift action is crucial. An experienced workers’ compensation lawyer can help you appeal the denied claim by presenting your case to the North Carolina Industrial Commission. They will work to gather necessary evidence such as medical records and proof that the injury occurred on the job. Additionally, they can negotiate with the workers’ comp insurance provider or your employer’s insurance company to fight for the benefits you are entitled to under North Carolina workers’ compensation law.
Can I receive lost wages through workers’ compensation?
Workers’ compensation benefits in often include compensation for lost wages. If your injury prevents you from working entirely, you may qualify for temporary total disability benefits. If you can work but at a reduced capacity, you may be eligible for temporary partial disability benefits. In cases of permanent impairments, you may be entitled to permanent partial disability benefits or permanent total disability benefits, depending on the severity of your condition. An experienced workers’ compensation lawyer can help ensure your lost wages are calculated accurately based on your average weekly wages.
Does workers’ compensation cover all medical bills?
Yes, workers’ compensation insurance typically covers all medical bills related to your work-related injury. This includes doctor visits, hospital stays, medications, surgeries, and physical therapy. However, it is essential to seek treatment immediately and document all care to support your claim. If the insurance company disputes your medical expenses, a workers’ compensation lawyer can advocate for your right to full coverage under North Carolina law.
How does North Carolina law define eligible workers?
Under North Carolina law, most workers employed by companies with three or more employees are eligible for workers’ compensation benefits. Employers are required to carry workers’ compensation insurance to cover workplace injuries and occupational diseases. Independent contractors may not be covered under the workers’ compensation system, so consulting a Charlotte workers’ compensation lawyer can help determine your eligibility and guide you in filing your workers’ comp claim.
What happens if my employer refuses to report my injury?
If your employer refuses to report your workplace injury, you should take immediate steps to protect your rights. Start by seeking treatment immediately and notifying your doctor that the injury is work-related. Provide written notice of the injury to your employer to establish a record of the incident. Then, contact an experienced Charlotte workers’ compensation lawyer who can help file your claim directly with the North Carolina Industrial Commission and ensure you receive the workers’ compensation benefits you are entitled to.
Can I file both a workers’ compensation and personal injury claim?
In certain situations, injured workers may file both a workers’ compensation claim and a personal injury claim. While workers’ comp covers injuries caused by workplace accidents, a personal injury claim may be appropriate if a third party, such as an equipment manufacturer or negligent contractor, is responsible for the injury. Filing both claims can allow you to seek additional monetary compensation for pain and suffering, emotional distress, and other damages not covered by workers’ compensation insurance.
How can a workers’ compensation lawyer help with my case?
A workers’ compensation lawyer provides invaluable support throughout the legal process. They guide you through the claims process, gather records and evidence, and fight for fair compensation. If your claim is denied, they can appeal the decision to the North Carolina Industrial Commission and negotiate with the insurance company or workers’ compensation insurance provider. They also ensure you receive the full range of benefits you are entitled to, such as temporary or permanent disability benefits, death benefits, or medical expense coverage. Working with a Charlotte workers’ compensation lawyer improves your chances of success while allowing you to focus on recovery.
Contact a 1Charlotte Workers’ Compensation Lawyers for a Free Consultation
You will often need the help of a 1Charlotte workers’ compensation lawyer to get compensation for injuries at work.
Insurance companies often deny workers’ compensation claims initially in order to make the claimant file an appeal, while also requiring them to put in more effort to obtain a settlement. You can be confident that your employer will have attorneys on their side, make sure you do as well.
If you have been injured on the job, call the 1Charlotte Workers’ Compensation Lawyers today at (704) 706-2689 and receive a risk-free consultation. Our experts are available 24/7 to answer any questions you may have about your case.
Don’t waste another minute, contact our offices today and get started on the road to recovering fair compensation for your damages.
