To protect an injured worker from loss of income if injured at work and for payment of medical bills, the State Legislature adopted the North Carolina Worker's Compensation Act. This Act provides workers with full compensation for medical bills and partial compensation for lost wages if they have been injured on the job. While the rules and regulations governing claims under the Workers Compensation Act are complex, we believe it is important that you have a basic understanding of what the term “Worker's Compensation” means.

Worker's Compensation is a “no fault” system which means you usually don’t have to show that your employer did anything wrong to have caused your injury. You simply have to prove you were injured while working.

Frequently Asked Questions:

What is workers’ compensation?
Workers’ Compensation is a remedy that was created by the Legislature in order to provide compensation for those who were injured on the job. Prior to workers’ compensation it was necessary for an injured party to prove that the employer was negligent and it was that negligence that caused the employee’s injuries in order to obtain recovery. Many injured employees were left without compensation and unable to work thereafter. The North Carolina Workers’ Compensation Act was then formed. The North Carolina Workers’ Compensation Act offers benefits to entitled injured workers through the form of medical treatment, lost wages, and payment for permanent disability.

What is a workers’ compensation injury?
In order to have a compensable workers’ compensation injury you must have been injured by an accident that arose out of and in the course of your employment.

What should I do if I get injured on the job?
If you are injured on the job the very first step is to notify your supervisor. Make sure that an accident report is filed with the appropriate personnel of your employer. Even if your injuries are not serious you must still report your injuries as they become more problematic at a later date and failing to report them may hinder your claim. In addition if you need medical treatment then request it when you file your report with you employer.

Is workers’ compensation the same as State Disability?
No. Workers’ compensation is not disability that is provided by the State of North Carolina. It is governed by state legislation, therefore, the state has laws that govern an individual’s entitlement to workers’ compensation. The Industrial Commission is the state governmental entity that applies those laws found in the North Workers’ Compensation Act.

Can I receive unemployment compensation and workers’ comp benefits at the same time?
No. If you are receiving weekly benefits from the workers’ compensation insurance carrier then you cannot receive unemployment benefits from the Employment Security Commission.

What can I do if I’m not receiving my benefits check?
Pursuant to N.C. Gen. Stat. §97-18(g), if any payment of compensation is not paid within fourteen days of the day the payment was due then you are entitled to a 10% late payment penalties for any amounts not received. In order to receive this amount you must file a request for this penalty with the Executive Secretary’s Office of the North Carolina Industrial Commission.

If I am unable to return to the type of work I did before I was injured, what can I do?
If you are unable to return to your previous position due to your work related injuries then the North Carolina Workers’ Compensation Act allows for the injured employee to be placed in vocational rehabilitation to be provided by the workers’ compensation carrier. A vocational rehabilitation counselor will be assigned to help the injured employee find suitable employment.

Is there a period of time after which my claim is no longer open?
If you have a workers’ compensation claim and you receive only medical treatment and do not lose any time from work then your claim will close within 12 months of the last date of medical treatment paid for by the workers’ compensation carrier. If you received weekly benefits due to your injury then your claim will close two years from the last date of compensation received.

If I am injured, do I have to file a claim form?
No. There is no requirement to a file a form with the Industrial Commission, however, in order to protect your statutory rights it is highly recommended that you file Form 18. A Form 18 is a Notice of Accident which lets the Industrial Commission, your employer, and their insurance carrier know that you are claiming a work-related injury. If a Form 18 is not filed within two years then your claim may be time barred and no recovery may be had.

What are my benefits?
If you are injured on the job and you have a compensable workers’ compensation injury then you are entitled to medical treatment, lost wage benefits, and benefits for any permanent partial disability suffered as a result of those injuries.

Do all claims go to court?
No. We handle many more claims that settle without filing suit. About 2 out of 10 cases result in trial. The insurance company generally wants to avoid trial and if a law firm has a reputation for trying cases it will work harder with that law firm to settle a claim. While we make every effort to settle claims, we are also prepared to move the case quickly through the Courts system.

What if I have just been in an accident?
If you have been involved in an accident, we urge you to move quickly to document your claim. If you have not yet hired an attorney make sure you get photographs of your vehicle. Get 2 to 3 estimates of repair on your vehicle. If you are injured, see a doctor immediately and follow the doctor’s advice. If a doctor places you out of work, get a written note and keep a copy. Notify the defendant’s insurance company immediately. Be prepared to be without a vehicle until the insurance company can investigate the accident. They will not pay for your vehicle, a rental, or your injury until they are satisfied you had no fault in the accident. You should also at least consult with a lawyer to make sure you understand your rights.

What do you do if you are my lawyer?
Once you hire us, we move quickly to preserve the evidence and notify the insurance company you are represented. We routinely obtain photographs of vehicles and the accident scene. We interview the witnesses, if any. We notify your medical providers we are involved. We give the insurance company an overview of your claim and keep them updated with your progress during recovery. We document your claim with medical reports, bills and any lost wages you may incur. We will also will get a great deal of personal information from you so we can present your claim in the best possible light.

What happens when I recover?
We strongly tell our clients do not attempt to settle your case until you are pain free. Doctors will routinely release you presuming you are 100% pain free. We also suggest you wait 30 days to make sure you have no recurrence or pain. Once you are comfortable that you are fully recovered, we begin putting together your settlement package and send it off to the insurance company with a request for settlement.

What does the insurance company do? 
The adjustor takes the package and reviews it and makes a recommendation to his or her supervisor for settlement authority. The adjustor and your attorney then discuss the issues and what is a reasonable amount for your claim. Negotiations for settlement usually take four to six weeks before it is determined if a case can settle without filing suit.

What happens if my case settles without going to Court?
The insurance company issues a check for the total amount of settlement and sends it to our firm. A settlement statement is prepared that will show the deductions for our fee, the costs, and payment to medical providers. It also shows what you will receive as the net proceeds. This usually takes one to two weeks to conclude.

What happens if the claim cannot be settled?
If your claim cannot be settled, then we promptly file a Complaint for you. Once a lawsuit has been filed, the average time to get before the Court is twelve months. This is because our courts have heavy backlogs. However, we fast-track our cases so that any delay is not ours but the Courts or the other side. In North Carolina, you sue the defendant not the insurance company. In fact, you may not mention the word “insurance” in a trial. A jury hears your claim and the jury decides who was at fault and how much you are allowed to recover.

What can I expect to be paid for in my claim? As an injured person you are entitled to claim:

• Medical bills
• Prescriptions
• Other medical devices and costs
• Out-of-pocket expense related to the injury
• Lost wages if a doctor places you out of work
• Pain and Suffering during recovery

And if your injury is permanent (as defined by a medical doctor) you can also claim future damages as set out above.

Do I need a lawyer?
While not every injured person needs a lawyer, we encourage everyone to at least consult one to make sure you understand your rights. We caution everyone NEVER TO SIGN ANYTHING until you have talked to a lawyer. Many valuable rights were lost because the injured person believed what he or she was told by the insurance company. Just remember, the only person truly working in your best interests is the lawyer you hire.