1. Report your injury to your employer immediately and seek medical attention. Immediately see your employer’s on-site health care provider. If there isn’t one available, your employer may advise you to go see a designated health care office specifically for work injuries. If an off-site health care office related to your employer does not exist, seek medical care from your family doctor or the emergency room. 2. Inform your health care provider of the incident. Be clear that your injury is related to your work and provide the name of your employer. Your health care provider is then able to bill any treatment you receive as a workers’ compensation claim. 3. File a Form 18 about your claim against the employer. The Form 18 must be submitted to the North Carolina Industrial Commission. You may fill out the form electronically and submit online or complete the standard PDF version. Your employer should then submit a Form 19, which is the first report of injury (FROI) they send when an employee makes a claim. 4. Provide a written statement to your employer about the incident within 30 days. Keep track of everything, such as the date and time you were injured, what you were doing, etc. Give this notice to your employer and keep a copy for your records. If your injury prevents you from being able to write, have a friend or family member write it for you. 5. Contact an lawyer as soon as possible if your injury prevents you from working. The North Carolina Workers’ Compensation System’s goal is to ensure you receive good health care and treatment in order for you to recover from your injury and go back to work at 100% capability. But if your injury prevents you from working like you did before, it’s time to get in touch with a workers’ comp attorney. For additional information please refer to the North Carolina Industrial Commission website. We are committed to seeing your case through to the end. We do not let anything stand in our way of getting you the compensation you deserve for your injuries. We have the experience, compassion and knowledge to get you the benefits you’re entitled to. Contact us so we can get started on your unique case.
Payment of Medical Expenses This includes your current expenses and all those you expect to have in the future due to your injury. Medical care means any care necessary to repair your injury and relieve your pain. Payments for your disability and lost wages You may be classified as temporarily or permanently partially disabled or permanently totally disabled. The disability rating is based on the doctors opinion of permanent loss of use of a body part. Not all body parts are rated. Types of Settlements Temporarily disabled or partially disabled. If you are temporarily disabled and will be able to return to your former employment after a recovery period, or partially disabled and will be able to be employed but at a reduced wage, you are entitled to have your medical expenses paid and be compensated for your lost wages. Permanently disabled? This is based on a complicated procedure. If certain criteria are met, you may be eligible to collect benefits for your medical expenses and lost wages for the remainder of your life. Usually these weekly benefits are limited to a maximum of 500 weeks except for certain exceptions. A “clincher” agreement is a final settlement, and this should include compensation for all medical expenses and lost wages you ever expect to incur. The agreement has to be approved by a workers’ compensation Deputy Commissioner. Once the court approves the settlement agreement, you give up forever your right to seek additional benefits. All of these benefits need to be coordinated with other benefits like Social Security Disability, Medicare, Unemployment, and other disability policies. A good lawyer in this field can make a big difference in maximizing your recovery from all sources.
An injured worker is eligible for workers’ compensation benefits if the on-the-job injury is an aggravation of a prior injury or condition (both are called pre-existing conditions). A worker is not eligible for workers’ comp benefits if the only injury is the pre-existing one; he must have sustained a new injury. Pre-existing injuries can include herniated disks, broken bones, torn ligaments, and other relatively obvious injuries. Other conditions may be more closely related to general physical health, such as age-related spine degeneration or arthritis. It’s not uncommon for an insurance company to wrongfully deny a legitimate claim because of a pre-existing medical condition. Many times, an injured worker simply gives up on the claim; however, insurance companies cannot immediately deny an on-the-job injury claim based solely on a pre-existing condition. Workers’ compensation laws were enacted to make the employer-worker injury claim process less adversarial. Over time, insurance companies responsible for compensating injured workers became huge corporations with stockholders to answer to, profit margins to meet, and executive salaries to pay. As a result, the once non-adversarial system has become more adversarial than ever. Insurance companies look for any means to deny your injury claim. The insurance adjuster assigned to your claim will thoroughly investigate your medical background and look for any evidence of falsehoods concerning pre-existing conditions. Trying to be greedy in a claim ultimately backfires. It’s better to tell the truth. If questions on the doctor’s admitting form ask if you have any pre-existing medical conditions, you must answer truthfully. If the medical staff or doctors ask you, you must be honest with them. Failing to disclose a pre-existing condition can be grounds for denial of your claim. Be clear when discussing your current pain and discomfort with the doctors that it’s very different from any residual pain and discomfort you may have from a pre-existing injury. Let them know you did not have symptoms before your current injury. If you tell the doctors your current symptoms are no different than those you’ve been experiencing since your previous injury, your claim will likely be denied. Giving detailed information during your medical exams is very important. Clearly explain that you weren’t having pain or discomfort from a prior injury when your new injury occurred. Describe any changes in the type of pain you’re feeling, including its frequency, intensity and duration. Tell the doctor how the new injury is affecting your daily activities in a way it hasn’t since your prior injury. Most important don’t give up. Get a workers’ compensation lawyer with experience to help you.
When liability for payment of compensation is denied, the Commission, claimant, his or her attorney (if any), and all known providers of health care shall be promptly notified of the reason for such denial. The denial Form 61 shall not be worded in general terms, but must detail the exact reason for the denial of liability. If a claim is denied by the insurance company or self-insurer, the employee may request a hearing before the Industrial Commission by submitting a Form 33, Request for Hearing. Medical providers may bill the employee only after it has finally been determined that it is not a compensable workers’ compensation claim. The case will then be ordered into a Mediation before hearing is held to see if the case or issue can be settled. If settlement can not be reached then a full hearing or trial is held to make decisions for the parties. If any part of the case is denied the parties need legal representation to help them through this process. Evidence issues and hearing rules make this process very difficult without a lawyer to help navigate the case.
The rise of the Industrial Revolution meant extreme working conditions in early factories. Hazards were plenty, and injury rates were colossal. Though hurt workers rarely received compensation, they could turn to the courts for help. However, the legal framework for compensating injuries was exceptionally restrictive – so restrictive that the following principles became known as the “unholy trinity of defenses.” If the employer could prove these to be true about the injury, the worker couldn’t claim a farthing: Contributory negligence. The employer wouldn’t be held liable if the worker was responsible for his own injury, regardless of how hazardous the machinery or work environment was. So if a worker slipped and lost a hand, they wouldn’t receive compensation. The “fellow servant” rule. If a fellow employee caused the worker’s injuries, employers were not held liable. Assumption of risk. This doctrine held that employees accepted the hazards of their work when they signed their contracts. To make matters worse, many industries had employees sign contracts that relinquished their right to sue for injuries. That’s why these unfair documents earned the grim moniker “death contracts.” Luckily, the rise of Realpolitik in Prussia would usher in the end of these dark times for workers. Chancellor Otto von Bismarck implemented a system of social insurance, known as the Employers’ Liability Law of 1871. This provided some social protection for workers in certain factories, quarries, railroads, and mines. In 1884, Bismarck championed Workers’ Accident Insurance, which laid the groundwork for today’s Workers’ Compensation Insurance. Workers’ Compensation in America The trend toward compensating workers for their occupational injuries was a little slower to hit the United States. It took Upton Sinclair’s shocking 1906 novel The Jungle, which details the horrors workers experienced in Chicago slaughterhouses, to stir the public’s outrage. Eventually, Congress passed the Employers’ Liability Acts of 1906 and 1908, which made contributory negligence doctrines less restrictive. Between 1898 and 1909, New York, Maryland, Massachusetts, and Montana attempted and failed to pass workers’ compensation acts. Wisconsin passed the first comprehensive workers’ compensation law in 1911, while Mississippi was the last state to jump onboard in 1948. These early laws required employers to provide medical and wage replacement benefits for injured workers. If the injured employee accepted these benefits, they forfeit their right to sue the employer. Today, this basic structure for Workers’ Comp is essentially the same. Most states require employers to carry Workers’ Compensation Insurance for their full- or part-time employees. Each states’ laws vary and we will happily answer any questions you have regarding your North Carolina or South Carolina claim. Contact us or call us for a free consultation.
Make sure your employer has workers’ comp. It may be awkward, but ask. Don’t let the business call you a “contractor” if you’re an actual employee. Some do that to avoid the law. That way, it looks like they don’t have the three workers required for them to have to carry workers’ comp. It’s a tactic called “misclassification.” How do you know which you are? Contractor vs. Employee: Contractor: You set your own schedule, have your own tools, get paid by the project or can work for other employers. Employee: You have a set schedule, need permission for days off, use company equipment or get paid hourly or have a set salary. Call 888-891-4895 to report employers breaking the law, or email FraudComplaints@ic.nc.gov. Who is policing this? According to a recent state audit, as many as 52,000 employers in North Carolina should have had workers’ comp insurance and did not. Stoogenke asked the commission’s director of compliance and fraud investigations, Bryan Strickland, why they aren’t catching more of the employers. Strickland said that he joined the agency in 2013 and has made sweeping changes, the biggest being a new database that flags employers who may be skirting the law. He said that the numbers show it’s working. Before Strickland arrived, the commission charged about 10 employers with breaking the law and collected $374,000 in fines. Last year, it charged about 150 employers and collected almost $1.5 million. Since July, the commission has already charged more than 210 employers.
Injuries from falls frequently happen at home, in business establishments, restaurants, sidewalks, parking lots, and, of course, in the workplace. In fact, trips, slips, and falls accounted for 238,610 nonfatal workplace injuries across the U.S. in 2015, according to the Bureau of Labor Statistics BLS. Common injuries from workplace falls include: Traumatic brain injury (TBI); Spinal cord damage and paralysis Damaged spinal column Chronic back pain Broken bones Sprains; Lacerations Contusions Accidental Workplace Death and Falls From Height After traffic collisions, falls account for the largest segment of on-the-job fatalities. While most jobs have become safer over the years, as machinery has become less hands-on, safety measures are more strictly enforced, and fewer jobs require manual labor, falls still kill around 800 American workers every year. Workplace falls made up 15.6 percent of all workplace fatalities in 2015, according to the BLS. If you work on scaffolding, on rooftops, or other high scenarios, the risk of falling becomes much greater than other types of jobs, and your employer should take reasonable measures to ensure safety for all. Many employers fail to use safety harness equipment, provide equipment, or provide training, Death Benefits in Tragic, Fatal Workplace Falls If a family member has died in a fatal fall accident while on the job, you may file for workers compensation death benefits. Dependents of the deceased workers may be eligible for death benefits, depending on the extent of their dependency, among other factors. Contact a lawyer as soon as possible is a serious fall occurs at work.
Tendonitis, an inflammation of the tendons, is the most common repetitive use injury we treat. Tendons connect muscle to bones, and they can be inflamed or injured along their course by repetitive movements. “Trigger finger” and “tennis elbow” are two common maladies that are actually tendonitis. Uncommonly, tendonitis is caused by a disease. What are the symptoms of repetitive use injury? In addition to pain, other common symptoms can include swelling, tingling, numbness, stiffness, weakness and sensitivity to cold or heat. How soon should I seek treatment if I suspect a repetitive strain injury? Don’t wait until the pain and functional loss is severe. In other words, if pain and loss of function are limiting your activities, seek medical help immediately. Even if you are experiencing mild discomfort and dysfunction, you may want to look at modifying your activities or work techniques to reduce further injury. Carpal Tunnel and Tendonitis are common repetitive use injuries workers compensation may cover. The key is to get treatment and diagnosis as soon as possible.