What Is Not Covered by Workers’ Compensation Insurance in NC?

Workers’ compensation insurance provides coverage for employees if they suffer injuries in the line of work. This insurance provides for injuries or illnesses that occur within the “course and scope of your employment.” In other words, workers’ compensation covers employees if they get injuries while working.

The injuries that workers’ compensation covers include slips and falls, back injuries, knee injuries, fractures, etc. All these injuries commonly occur in the workplace, and employees receive compensation for them.

However, workers’ compensation insurance does not cover all workplace injuries. If you have injuries from your place of work, you might need to contact a Charlotte workers’ compensation lawyer.  We will be discussing those injuries not covered by workers’ comp.

North Carolina Workers’ Compensation Laws

The State of North Carolina insists that businesses with three or more employees must insure their employees. These also include businesses that are sole proprietorships, limited liability companies, corporations, etc. Employees can receive benefits in different forms.

One of such is medical benefits which cover doctors’ visits, drugs, hospital stays, etc. In addition, employees can also receive disability benefits, which are divided into temporary disability benefits and permanent disability benefits. Finally, the government can fine, imprison, and charge employers who do not insure their employees with a felony.

Injuries Not Covered by Workers’ Compensation Insurance

Workplace injuries occur during work hours, within the work environment, or while carrying out work duties. Workers’ compensation insurance might not cover injuries that occur outside an employee’s course of employment. These include wounds that happen during/because of the following:

  • Intoxication 

Injuries might happen when an employee is intoxicated. For instance, an employee could suffer from a slip and fall injury due to drug or alcohol intoxication. Unfortunately, injuries like these do not fall under workers’ compensation. Therefore, the employee will not receive any payment for the harm they have from this intoxication.

  • Injuries that Occur During Lunch Break 

An employee could encounter an injury while on their lunch break, such as a car accident. Sometimes, workers’ compensation does not cover this injury type. However, if the employee is injured while having lunch in the lunchroom, they might receive payments for their injury.

  • Fights

Often, injuries that result from fights within the workplace do not fall under workers’ compensation. However, an employee may request compensation for their injuries if the conflict is due to a disagreement on work duties. But the employee will not receive any payment if the fight was due to issues not relevant to work.

  • The Drive to Work

The commute to work, especially on the road, can be hazardous. Workers’ compensation insurance will not pay for an employee’s injuries if they suffer an injury while going to work. The employee can only receive benefits if they were on official business during the accident.

  • Minor Injuries

Minor injuries only require first aid attention and do not require you to see a doctor. Therefore, you might not receive workers’ compensation for minor injuries. Examples of such minor injuries are scratches and bruises.

  • Horseplay

Sometimes, horseplay happens among employees. Horseplay is a rowdy play that can end in accidental injuries. Such injuries do not fall under workers’ compensation coverage.

Jobs Not Covered Under Workers’ Compensation Insurance

The North Carolina Workers’ Compensation Act states that most businesses need to insure their employees. However, there are some jobs which workers’ compensation does not cover. Employees not covered by work comp include:

  • Independent Contractors: Employers do not have to get insurance for their independent contractors. This is because the law does not recognize them as “employees.”
  • Volunteers: Volunteers are often unpaid workers and so do not need workers’ compensation. However, volunteer police officers and firefighters have coverage under workers’ compensation.
  • Business Owners: The law does not push business owners to cover themselves under workers’ compensation insurance. Partners and sole proprietors also do not require coverage.

Additionally, the North Carolina Workers’ Compensation Act does not include household employees, federal government employees in North Carolina, etc. It also does not cover some specific railroad workers and farm laborers.

We Are Ready to Help You!

Another type of injury that does not fall under workers’ compensation is an unreported injury. The first step to take when you have a workplace injury is to inform your employer immediately. You might not receive payments if you fail to make the report.

The next step is to contact your North Carolina workers’ compensation lawyer. Your lawyer would lead you through the entire process and would legally represent you in court. We are available 24/7 to provide you with the best legal advice you need in your workers’ compensation case. We offer free consultation, and we do not request upfront fees. Contact us today!