Workers’ Compensation laws may provide monetary compensation and non-monetary benefits as well as medical benefits to employees who experience accidents, injuries or occupational diseases on-the-job. Workers’ Compensation (also known as Workman’s Comp, Workmen’s Comp, Workers Comp, Workers’ Comp, Work Comp, Worker Comp, or even simply WC) is designed to protect workers and their dependents against hardships due to injury or death arising out of the work environment.

Workers’ Compensation laws apply to any employer with three or more employees, subject to limited exceptions. They are designed to ensure that employees who are injured or disabled on the job are provided with fair compensation.  Workers’ Compensation laws also provide benefits for dependents of those workers who are killed because of work-related accidents or illnesses.

The jurisdiction of all North Carolina Worker’s Compensation cases lies with the North Carolina Industrial Commission (NCIC), which rules on and administers the North Carolina Workers’ Compensation Act as provided for by the North Carolina General Assembly.

There are three basic ways a person can become eligible for Workers’ Compensation:

• Injury By Accident:
  The interruption of the regular work routine due to an unusual circumstance. Examples include an employee working in a warehouse and a forklift drives over his foot, or an employee working in construction who falls from a ladder. In general, the injury can not occur while the employee is performing a task the same way as always (e.g., he is bending down to lift a box when his knee pops).

• Specific Traumatic Injury:
  An exception to the doctrine of injury by accident in which a person can get compensation for performing a normal task, but sustains a neck or back injury in a specific incident that may not be an accident.

• Occupational Disease:
  A disease to which the employment was a significant factor in the disease’s development and the employment exposed the worker to a greater risk of contracting the disease than the public generally. Examples include a manufacturing worker who develops cancer from exposure to toxins in the workplace (e.g. mesothelioma resulting from asbestos exposure); or a factory worker who develops carpel tunnel syndrome from repetitive motion. Conditions specifically listed in the Workers’ Compensation Act include asbestosis, silicosis, synovitis, tenosynovitis, bursitis and chemical exposure.

Workers’ Compensation laws in North Carolina are complicated. Our experienced Workers’ Compensation attorneys can help you navigate the system to potentially maximize your Workers’ Compensation benefits – from the initial filing of a claim, to helping you obtain care or other Workers’ Compensation benefits for problems related to the initial injury that the law may provide.

How to File a Claim
In North Carolina, the first step an injured worker should take is to immediately inform their supervisor in writing.

The next step is to complete a Form 18 – Notice of Accident to Employer and Claim of Employee, Representative or Dependent for Workers’ Compensation Benefits. The employee should file the form with the North Carolina Industrial Commission and provide a copy to his employer and/or its insurance carrier – and keep a copy.

The Form 18 should be filed by the injured worker within 30 days, and must be filed within two years of the injury.  Ideally, this form is reviewed by an experienced Workers’ Compensation lawyer.

The employee is entitled to a detailed statement from the employer or insurance carrier of grounds for denying any claim within 14 days of receipt unless time is extended by the North Carolina Industrial Commission’s Executive Secretary’s Office. If a claim is denied the employee should receive a copy of Form 61 – Denial of Workers’ Compensation Claims from his or her employer, outlying the reasons for the denial.

Otherwise, the employee should receive a Form 60 – Employer’s Admission of Employee’s Right to Compensation, or a Form 63 – Notice To Employee of Payment without Prejudice.

A Form 63 is a provisional acceptance which the insurance carrier can later reverse within certain time limitations. Anyone holding a Form 63 is at risk of having needed benefits denied and should speak with an experienced Workers’ Compensation Lawyer without delay.

If a claim is denied, the employee has the right to request a hearing by filing a Form 33 - Request for Hearing with the North Carolina Industrial Commission. The Form 33 may be used to raise other disputes over Workers’ Compensation benefits with the North Carolina Industrial Commission as well.

Filing a request for hearing before the North Carolina Industrial Commission is not the same as filing a civil lawsuit. By requesting a hearing, injured workers are not “suing” their employer; they are simply requesting that the North Carolina Industrial Commission make a formal decision about whether employers and their insurance companies are responsible for providing Workers’ Compensation benefits.

The North Carolina Industrial Commission will generally order that a mediated settlement conference (“Mediation”) be held prior to the hearing, to see if the case can be resolved without court involvement. The Workers’ Compensation Team at James Scott Farrin handles numerous mediations on behalf of its clients on a regular basis.

Other forms you might want to be aware of include Form 28T – Notice of Termination of Compensation by Reason of Trial Return to Work – which means that an employee returned to work, even for a brief time. The Form 28T allows the carrier to turn off a worker’s checks. It is very important for a worker not to return to work before it is medically safe to do so. Our skilled Workers’ Compensation lawyers can help protect your rights in this regard.

A Form 24 – Application to Terminate or Suspend Payment of Compensation is what the insurance carrier must file if it wants to turn off a worker’s weekly check without him or her returning to work. Our Workers’ Compensation lawyers can help you navigate this process.