At 1Charlotte Injury Lawyers, we focus on helping injured workers across North Carolina. Our team has extensive experience handling workers’ compensation claims, personal injury cases, and car accident disputes. We are dedicated to using our knowledge and training to guide you through every step of the process. Whether you are dealing with injuries from a car accident, personal injury case, or a workers’ compensation claim, our team is here to assist individuals from all walks of life.
Workers’ compensation in North Carolina provides essential protection for employees who suffer work-related injuries or illnesses. This system offers medical care, wage replacement, and other benefits without requiring the worker to prove fault. Understanding how the process works is key to getting the support you need.
In this blog, we explain how workers’ compensation works in North Carolina, outline the steps to file a claim, review available benefits, and highlight how working with an experienced Charlotte workers’ compensation attorney can help you protect your rights and secure the support you need.
What Is Workers’ Compensation in North Carolina?
Workers’ compensation in North Carolina is a legal system that provides benefits to employees who suffer job-related injuries or illnesses. It ensures access to medical care and wage replacement without needing to prove employer fault.
Purpose of Workers’ Compensation
The workers’ compensation program protects both employers and employees. Injured workers receive necessary benefits, while employers are shielded from most lawsuits. The system covers medical expenses, lost wages, and disability related to work-related injuries or occupational diseases.
Legal Basis and Oversight
North Carolina’s workers’ compensation laws are defined under the North Carolina Workers’ Compensation Act (N.C. Gen. Stat. § 97-1 et seq.). The North Carolina Industrial Commission manages all claims, disputes, and appeals. Employers with three or more employees are required to carry workers’ compensation insurance under N.C. Gen. Stat. § 97-93.
Who the Law Covers
Most employees are covered by the workers’ compensation system, including part-time, full-time, and temporary workers. Independent contractors may not be eligible unless misclassified. Federal employees are covered under a separate federal workers’ compensation program. Specific groups, such as agricultural workers or domestic workers, may be exempt based on the nature of employment.
What Injuries and Illnesses Are Covered
The program applies to injuries incurred during work or caused by work conditions. This includes accidents like falls, machinery injuries, or exposure to harmful substances. Repetitive stress injuries and certain occupational diseases are also covered. To qualify, the injury must arise out of and occur during the course of employment.
Workers’ Compensation Benefits Available
Covered workers may receive several types of workers’ compensation benefits. These include full medical care, wage replacement for lost time, compensation for permanent disability, and support for dependents in fatal cases. The amount and type of benefits depend on the injury, the employee’s average weekly wage, and how long the disability lasts.
Who Is Eligible for Workers’ Compensation Benefits in NC?
Eligibility for workers’ compensation benefits in North Carolina depends on employment status, employer requirements, and the nature of the injury or illness.
Employee Status Requirements
Most employees in North Carolina are eligible for workers’ compensation. This includes full-time, part-time, and temporary workers. Workers do not need to prove fault to qualify. Independent contractors are generally not eligible, but misclassified workers may still qualify depending on the level of control the employer has over the job.
Employer Coverage Rules
Employers with three or more employees are required to carry workers’ compensation insurance under North Carolina law. Businesses that fail to carry coverage can face civil penalties. Certain small businesses, farms, and domestic employers may be exempt, but most companies must comply with insurance laws to support injured workers.
Types of Injuries Covered
Eligible claims include any injury or illness that happens during the course of employment. This includes sudden accidents like slips, falls, or equipment injuries, as well as long-term exposure to harmful conditions that cause occupational disease. Injuries incurred during lunch breaks or commuting may not be covered unless specific job duties are involved.
Special Groups and Exceptions
Some workers in specific groups may have different rules. Agricultural laborers, domestic workers, and federal employees follow other workers’ compensation programs or laws. Volunteers and unpaid interns are usually excluded unless otherwise specified by the employer’s insurance policy.
Requirements for Filing a Claim
To be eligible, workers must report the job-related injury to their employer within 30 days, as required by N.C. Gen. Stat. § 97-22. They must also file a formal claim with the North Carolina Industrial Commission. Failing to meet these deadlines can result in a denied claim and loss of access to workers’ compensation benefits.
Step-by-Step Guide to Filing a Workers’ Compensation Claim in North Carolina
Filing a workers’ compensation claim in North Carolina involves several steps that injured workers must complete to receive benefits.
Report the Injury to Your Employer
Report the workplace injury to your supervisor or employer immediately. North Carolina law requires written notice within 30 days. Verbal notice is not enough. Include the date, time, and cause of the injury. Delay in reporting may lead to a denied claim.
Seek Medical Care
Get medical treatment right away. In most cases, the employer selects the initial doctor under N.C. Gen. Stat. § 97-25. If emergency care is needed, go to the nearest facility, then notify your employer. Keep all medical records and follow the treatment plan closely.
File Form 18 with the North Carolina Industrial Commission
Submit Form 18 to the North Carolina Industrial Commission to start your official claim. This form documents the injury and requests benefits. You must file it within two years of the work-related accident or diagnosis of an occupational disease, as required by N.C. Gen. Stat. § 97-24. A copy should also be sent to your employer or their insurance carrier.
Confirm Employer Files Form 19
Employers are required to file Form 19, which reports the injury to the Industrial Commission. This form does not replace Form 18. Both forms must be submitted for the claim to proceed. The employer’s insurance company may then begin evaluating the claim.
Cooperate With the Investigation
The insurance company will review the claim by collecting statements, medical reports, and job details. Respond to requests quickly. If more information is needed, be honest and direct. Delays or inconsistencies may affect your access to workers’ compensation benefits.
Monitor the Status of Your Claim
After reviewing your claim, the insurer will approve or deny benefits. If approved, you may begin receiving medical care coverage and wage replacement for lost time. If denied, you will receive a notice explaining the reason. You have the right to appeal.
Types of Workers’ Compensation Benefits Available
Workers’ compensation benefits in North Carolina provide support for medical treatment, lost wages, and long-term disability for eligible injured workers.
Medical Care Benefits
Workers are entitled to full medical care for any job-related injury or illness. This includes hospital visits, surgeries, prescriptions, rehabilitation, and necessary medical equipment. The employer or its insurance company chooses the healthcare provider. Workers may request a change in provider with approval from the North Carolina Industrial Commission.
Temporary Total Disability Benefits
If an employee cannot work at all during recovery, they may receive Temporary Total Disability (TTD) benefits. Payments are two-thirds of the employee’s average weekly wage, up to a state-set maximum. These benefits begin after a seven-day waiting period and are retroactive if the disability lasts more than 21 days.
Temporary Partial Disability Benefits
Workers who can return to work in a reduced role or with fewer hours may receive Temporary Partial Disability (TPD) benefits. These benefits help cover part of the lost wages when the new income is lower than before the injury. The payment is based on two-thirds of the wage difference.
Permanent Partial Disability Benefits
If the worker suffers a permanent injury but can still work, they may qualify for Permanent Partial Disability (PPD) benefits. Compensation is based on the percentage of loss to a specific body part, as listed in N.C. Gen. Stat. § 97-31. This schedule determines the amount and duration of payment.
Permanent Total Disability Benefits
Workers who can no longer return to any job may be eligible for Permanent Total Disability (PTD) benefits. These are lifetime benefits, usually provided in cases involving severe injuries such as paralysis, loss of both hands or feet, or brain damage.
Vocational Rehabilitation
If a worker cannot return to their original job, vocational rehabilitation services may be available. These services include job retraining, education, and job placement assistance. The goal is to help the injured worker re-enter the workforce in a suitable role.
Death Benefits for Dependents
If a workplace injury leads to death, the worker’s dependents may receive death benefits. This includes two-thirds of the deceased worker’s average weekly wage and coverage for burial expenses, up to a set limit under N.C. Gen. Stat. § 97-38.
Contact an Experienced Charlotte Workers’ Comp Lawyer ASAP!
If you’ve suffered a job-related injury or illness, don’t wait to get the support you need. The workers’ compensation process can be strict and confusing, and one mistake could delay or reduce your benefits. Our team at 1Charlotte Injury Lawyers is here to guide you through every step. We help injured workers across Charlotte and throughout North Carolina file claims, appeal denials, and fight for full benefits.
Contact us at (704) 706-2689 for a free claim review today!
