Filing a Workers' Comp Claim Correctly in NC
Did you get hurt at work in North Carolina? If so, you may qualify for workers’ compensation benefits from your employer. The process of claiming workers’ compensation benefits can be complicated. Knowing what you must do to file a workers’ comp claim can help protect your rights to financial assistance during a challenging time.
Filing a Workers’ Comp Claim in North Carolina: Why Doing It Right Matters
Applying for benefits under North Carolina’s workers’ comp system requires certain essential steps. You will need to complete each step to protect your right to receive financial benefits you’re entitled to under the law, including coverage for your medical expenses, partial reimbursement of lost wages from missed work, and monetary payments for permanent disabilities.
What Qualifies as a Workers’ Comp Claim?
An employee may have a workers’ compensation claim against their employer if the employee suffers an injury in the course and scope of their employment that requires them to seek medical treatment or take time off work to recover from the injury. A workers’ comp claim allows an injured employee to obtain no-fault benefits from their employer, meaning the employee does not need to prove that their employer’s negligence or fault caused their injury. Instead, an employee becomes eligible for workers’ comp solely by suffering an injury due to their employment.
Step-by-Step Guide to Filing for Workers’ Comp in North Carolina
The process of filing for workers’ compensation in North Carolina typically involves the following stages:
Step 1 – Notifying Your Employer
North Carolina regulations require employees to notify their employers of work-related injuries in writing immediately or as as soon as practicable after an accident on the job, and no later than 30 days after a workplace accident. Promptly notifying your employer of a work injury allows the company to inform its workers’ compensation insurer and begin providing you with workers’ comp benefits. Be sure to keep a copy of your written notice or a screen shot of a text to the employer where you told them that you got hurt on the job.
Step 2 – Seek Medical Attention
Following a workplace accident, you should see a doctor as soon as possible to get examined for injuries you may have suffered. It is very important that you ask your employer to direct you to the doctor they want you to see. In NC, the employer has the right to direct and control medical treatment. It is possible that they could ignore recommendations from “unauthorized” doctors and this could jeopardize your case.
When you see a doctor, remember to tell them that you had an accident at work, so the doctor knows that any injuries you may have sustained may qualify for workers’ compensation benefits. Pro Tip: Make a note detailing how the injury happened (“I tripped over a box and fell”) make a list of what is hurting and be sure to explain it all to the doctor. You can check off each note to make sure the Dr. has all of the information he or she needs.
Step 3 – Following Your Doctor’s Orders
After seeking initial medical attention, you should follow your doctor’s treatment recommendations and recovery instructions. Your doctor may impose medical restrictions on your physical activity or work duties. Remember to provide your employer with a copy of your medical restrictions (keep a copy for yourself), which can help your employer develop accommodations to help you return to work if your doctor clears you for light or modified duty.
Step 4 – Filing Form 18
A Form 18 is the initial form that an injured worker must file to notify the employer and the NCIC about a workplace injury. Filing this form within two years of the injury or the date of the last payment of compensation preserves the worker’s claim rights. It provides details of the incident, including the date, nature of the injury, and circumstances, forming the foundation of the workers’ compensation claim.
Step 5 – Keeping Records
During your recovery, you should keep complete records of your medical expenses to ensure you obtain coverage for those costs. You should also request copies of your treatment and rehabilitation medical records. You should also keep track of mileage to and from your medical appointments as you may be entitled to mileage reimbursement for travel that is over 20 miles round-trip. Furthermore, you should gather copies of your pre- and post-injury pay stubs to ensure you receive correct wage-loss benefits. Finally, keep copies of all correspondence from your employer and its insurance company regarding your workers’ compensation claim. Also, keep copies of documents from the North Carolina Industrial Commission.
Step 6 – Requesting a Hearing with the Industrial Commission
If your employer refuses to provide workers’ compensation benefits, improperly values your claim, or terminates your benefits before you have recovered, you can challenge your employer’s decision by requesting a hearing with the North Carolina Industrial Commission by filing Form 33. The Industrial Commission may order a mediation session with you and your employer to try to settle the case. However, if the mediation does not succeed, you will have a hearing before a Deputy Commissioner to present your claim. Should the Deputy Commissioner decide against your claim, you can appeal to the Full Commission and from there to the North Carolina Court of Appeals.
Common Mistakes to Avoid When Filing Your Workers’ Comp Claim
Here are some of the most common mistakes injured workers make when filing for workers’ compensation benefits.
These mistakes apply specifically to North Carolina cases:
- Not reporting the injury promptly – The North Carolina workers’ compensation system requires employees to report work-related injuries to their employer as soon as possible, and in any event, no later than 30 days after a work accident. Waiting to notify your employer of an injury could cause the employer to deny your workers’ compensation claim.
- Not seeking immediate medical attention – Employees injured at work should seek prompt medical attention to have a doctor diagnose their injuries and develop a treatment plan. That can help secure an injured employee’s claim to workers’ compensation benefits.
- Not following a treatment plan or medical restrictions – When an employee does not follow through with the treatment or rehabilitation recommended by their doctor or ignores medical restrictions on physical activity, the employer may assume that the employee has recovered and either deny or terminate the employee’s workers’ compensation benefits.
- Not filing a Form 18 – North Carolina law requires employees to file a Form 18 with the Industrial Commission within two years of a workplace accident. Failing to file the form within this deadline may result in an injured employee losing the right to pursue a formal workers’ compensation claim with the Industrial Commission should the employer or its workers’ compensation insurance carrier refuse to provide benefits.
- Talking to the Insurance Company Before Talking to a Lawyer –Many times the workers’ comp insurance adjuster will try to get you to make a recorded statement about your injury. DO NOT let them take your statement before talking to an experienced workers’ compensation lawyer and learning about your rights and your case.
When to Contact a North Carolina Workers’ Compensation Attorney
You should contact our North Carolina workers’ compensation lawyers at Kornbluth Ginsberg Law Group, P.A., as soon as possible after a workplace accident or immediately after your employer declines to provide workers’ comp benefits after you’ve reported a work-related injury. Our experienced workers’ comp attorneys can help you file your claim on time and guide you through each step of the workers’ compensation claims process. We can help you appeal your claim if the employer and its insurer deny or undervalue your benefits.
Need Help Filing for Workers’ Comp? Contact Kornbluth Ginsberg Today
Have you been hurt at work? Do not attempt to navigate North Carolina’s workers’ comp system alone. Instead, contact Kornbluth Ginsberg or call 24/7 at 919-980-9895 today for a free, no-obligation consultation with a North Carolina workers’ compensation attorney. Find out how we can make the process as simple as possible. Our office is conveniently located at 3400 Croasdaile Drive, Suite 300, Durham, NC 27705, and we are ready to help you understand your legal options.
