If you’ve suffered a work-related injury or illness in North Carolina, it’s important to understand your rights in a workers’ compensation case. The state’s workers’ compensation system provides medical treatment, wage replacement, and other benefits to injured workers, but the process can be difficult to manage without the right information.
In this blog, we explain your rights in a workers’ compensation case, outline the steps for filing a claim, and show how working with an experienced Charlotte workers’ compensation attorney can help protect your health, income, and legal benefits.
Who Is Covered Under North Carolina’s Workers’ Compensation Laws?
Understanding who qualifies for workers’ compensation coverage in North Carolina is essential before filing a workers’ compensation claim.
Employees Covered by North Carolina Law
Most employees in North Carolina are covered under the workers’ compensation system. This includes full-time, part-time, and seasonal employees. State law requires any business with three or more employees to carry workers’ compensation insurance. This rule applies regardless of the type of work or position.
According to N.C. Gen. Stat. § 97-2(1), an “employee” includes anyone engaged in employment under a contract of hire. This includes minors and undocumented workers. If you receive wages and work under the control of an employer, you likely qualify for benefits under North Carolina’s workers’ compensation laws.
Exceptions to Coverage
Certain groups of workers are not covered. Independent contractors, federal employees, and some domestic workers or agricultural laborers may not be eligible for benefits. The distinction between an employee and an independent contractor is important. It affects whether the injured worker can file a workers’ compensation claim.
If a worker is classified as an independent contractor, they do not have the same workers’ comp rights as employees. However, misclassification is common. If there is a question about your employment status, a workers’ compensation attorney can help you determine your rights.
Special Rules for Specific Jobs
Some jobs have different rules under North Carolina law. Public officials, railroad workers, and federal employees follow different workers’ compensation systems. For example, federal employees are covered under the Federal Employees’ Compensation Act, not state law.
Workers Covered by Out-of-State Employers
If you work in North Carolina for a company based in another state, you may still qualify under North Carolina’s workers’ compensation laws. If your injury occurred while performing work in North Carolina, the law may apply to your case.
Employers doing business in the state must comply with local rules and carry workers’ compensation insurance as required by N.C. Gen. Stat. § 97-93.
What Qualifies as a Work-Related Injury or Illness?
To receive workers’ compensation benefits, the injury or illness must be directly related to your job duties or work environment.
Definition of a Work-Related Injury
A work-related injury happens while performing tasks related to your job. This includes accidents that occur during your regular work hours and at your job site. Common examples are falls, machinery accidents, lifting injuries, and vehicle collisions while on the job.
According to N.C. Gen. Stat. § 97-2(6), the injury must occur “by accident arising out of and in the course of the employment.” This means it must be unexpected and happen during work activities. A workers’ compensation claim may be denied if the injury occurs during a personal activity or outside work hours.
Repetitive Motion and Strain Injuries
Not all work injuries are caused by a single event. Repetitive motion injuries, like carpal tunnel syndrome or back strain, can also qualify. These injuries develop over time from repeated tasks or poor ergonomics.
Workers’ compensation laws in North Carolina recognize these as valid claims when the condition is caused by the nature of the job. Medical documentation is often necessary to link the condition to your work duties.
Occupational Illnesses
An occupational illness is a disease caused by workplace exposure. This can include chemical exposure, respiratory conditions, or hearing loss from loud machinery. To qualify, the illness must be a direct result of conditions specific to your job.
Under N.C. Gen. Stat. § 97-53, certain diseases are listed as compensable when linked to the job. These include asbestosis, silicosis, lead poisoning, and others. If your job exposed you to harmful substances and you became ill, you may be entitled to benefits.
Mental Health Conditions
Mental health conditions may qualify if they result from a specific traumatic event on the job. For example, a first responder who develops PTSD after a workplace incident could file a workers’ compensation claim. However, general workplace stress or anxiety unrelated to a specific event does not usually qualify under North Carolina law.
Injuries During Breaks or Off-Site
Injuries that happen during scheduled breaks or off-site duties may still count if they occur while performing job-related tasks. For example, if you are injured during a business errand or at a company-sponsored event, you may have a valid workers’ compensation claim.
Your Key Rights in a Workers’ Compensation Case
Injured workers in North Carolina have specific legal rights under the state’s workers’ compensation laws.
Right to File a Workers’ Compensation Claim
If you suffer a work-related injury or illness, you have the right to file a workers’ compensation claim. You must notify your employer and complete Form 18, which is submitted to the North Carolina Industrial Commission. According to N.C. Gen. Stat. § 97-22, you must give written notice within 30 days of the accident or diagnosis. Filing this form preserves your right to seek benefits.
Right to Medical Treatment
You have the right to receive medical care for your injury. This includes doctor visits, surgery, prescriptions, and physical therapy. The employer or their insurance carrier must pay for treatment that is necessary and authorized. Under N.C. Gen. Stat. § 97-25, they choose the initial treating physician, but you may request a change through the Industrial Commission if needed.
Right to Wage Replacement Benefits
If your injury prevents you from working, you may receive wage replacement benefits. These benefits are called Temporary Total Disability (TTD) or Temporary Partial Disability (TPD), depending on your condition. N.C. Gen. Stat. § 97-29 covers TTD benefits, which pay two-thirds of your average weekly wage up to the maximum allowed by law.
Right to Compensation for Permanent Impairment
If your injury results in a permanent loss of use of a body part, you may be entitled to compensation. N.C. Gen. Stat. § 97-31 provides a schedule of payments based on the body part and percentage of disability. A doctor must assign an impairment rating, which determines the amount of benefits.
Right to Appeal a Denied Claim
If your claim is denied, you have the right to request a hearing before the North Carolina Industrial Commission. N.C. Gen. Stat. § 97-84 allows you to present evidence, call witnesses, and receive a formal decision. If the ruling is not in your favor, you can appeal to a higher level within the commission or the North Carolina Court of Appeals.
Right to Legal Representation
You have the right to consult a workers’ compensation lawyer at any point in the process. A lawyer can help you understand your workers’ comp rights, deal with the insurance company, and fight for the benefits you deserve. Legal fees are regulated by the commission and are usually paid as a percentage of any settlement or award.
When to Contact a Workers’ Compensation Lawyer
Some workers’ compensation cases can be handled without legal help, but many situations require guidance from an experienced workers’ compensation attorney.
Your Claim Was Denied or Delayed
If your workers’ compensation claim is denied or payments are delayed, you should contact a lawyer. Insurance companies often deny claims due to lack of evidence, missed deadlines, or disputes over whether the injury is work-related. We can review your case, collect the necessary documentation, and fight for your right to compensation.
You Are Not Receiving Full Benefits
Sometimes injured workers receive less than they are owed. This can include unpaid medical expenses, underpaid wage loss benefits, or incorrect disability ratings. Our team will review your benefits and identify errors. We can file the necessary forms and represent you in disputes with the insurance carrier.
You Were Forced to Return to Work Too Soon
If your employer or the insurance company pressures you to return to work before you are medically ready, speak with a lawyer. Returning too early can worsen your condition and affect your right to future benefits. We will review your medical records and protect your rights in a workers’ compensation case.
You Have a Permanent Injury
Permanent injuries often involve complex legal and medical issues. These cases require an accurate impairment rating, proper calculation of benefits, and often a settlement offer. We help injured employees understand the value of their claim and negotiate a fair result.
Your Employer Does Not Carry Workers’ Compensation Insurance
North Carolina law requires most businesses with three or more employees to carry workers’ compensation insurance. If your employer does not have coverage or refuses to cooperate, legal action may be needed. We can help file a claim with the North Carolina Industrial Commission and take steps to hold the employer accountable.
You Were Misclassified as an Independent Contractor
If you were injured but classified as an independent contractor, you might still qualify for benefits. Misclassification is common and can prevent workers from getting the compensation they deserve. Our lawyers can help prove that you meet the legal definition of an employee under North Carolina law.
You Received a Settlement Offer
Before accepting any settlement, consult a workers’ compensation attorney. Insurance companies often offer less than what a case is worth. We can evaluate the offer, explain your options, and negotiate for the full benefits you are owed.
Contact an Experienced Charlotte Workers’ Comp Lawyer Today!
If you’ve suffered a work-related injury or illness and need help understanding your rights in a workers’ compensation case, our team at 1Charlotte Injury Lawyers is here to support you. Whether your claim was denied, your benefits are delayed, or you’re being pressured to return to work too soon, we can step in to protect your legal rights and help you pursue the compensation you are owed.
Contact us at (704) 706-2689 for a free case review today!
