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Will Workers’ Comp Pay for Additional Injuries From Overcompensation?

Oftentimes, when you injure one part of your body and overcompensate for that injury it can result in another injured body part. And, sometimes, it can be difficult to get your workers’ comp insurance company to pay for the other injury.

Our workers’ compensation attorneys deal with this issue frequently and it is an area where we strongly urge you to enlist the help of an experienced North Carolina workers’ comp lawyer.

Here are some questions I hear frequently on this subject which I believe warrants sharing.

Will I Be Compensated for Injuring Another Part of My Body as a Result of Overcompensating for My Original Work Injury?

If you're on workers' comp and a new injury happens from overcompensation, you may have a right to compensation.

The answer to this question is probably, yes.

If the workers’ compensation claim you filed was accepted, and a new injury or condition to another body part came about by overcompensating for the original injury, every “natural and probable consequence” that comes from that original injury “arises out of employment,” and you would likely have a right to compensation. So, for example, if your authorized doctor (the one the workers’ comp carrier sent you to) says your overcompensation comes from your original injury, then you likely would have a claim to compensation for that new injury.

What Does This Mean for Me?

If an insurance adjuster tells you they can’t provide your medical care for your new condition, we strongly urge you to contact an experienced workers’ compensation attorney. There have been laws passed that state that if a new body part was not listed on the initial acceptance form then you have to prove that the new injury is related to your original injury. Proving this can be very challenging.

It has been my experience that some workers’ comp insurance companies will sometimes do everything in their power to try to deny or at the very least minimize the initial claim, much less an additional claim. One common example is that after a serious knee injury, some patients develop pain in the opposite knee or back due to an altered gait. Some insurance companies will sometimes deny the opposite knee or back conditions as unrelated or claim they are degenerative conditions related to age.

How Do I Show That My Injury for Overcompensating Is Related?

Medical documentation for a secondary injury while on workers' compensation is important.

It may be necessary to hire an attorney to help you explain to the insurance company how your new medical condition is related to your original injury.

We can speak with authority on how these issues have been handled in other cases. If the adjuster doesn’t understand or simply disagrees, it may be necessary to request relief with the NC Industrial Commission by filing a Medical Motion with the Executive Secretary’s office, which involves presenting evidence to a judge about how the new medical condition is related to your original medical condition. Sometimes, we will even have to request a full evidentiary hearing on these disputes about medical care. The most important thing you can do is get medical evidence that your new injury is related. It is key to let your doctor know about any condition that arises from overcompensation.

A doctor who treats you would need to promptly document your new condition and provide their opinion about whether the new condition is being caused by the original injury. This medical documentation is extremely important, as this is in large part what the insurance company will rely on when deciding whether to pay for your new injury. Even with a doctor’s documentation, we have seen some insurance companies fight back in an effort to deny the new claim.

That can be frustrating, having an insurance company adding insult to injury by saying your new injury is not related when your doctor even says that it’s related! Having an experienced workers’ compensation attorney can help you try to overcome these obstacles that injured workers sometimes face.

9 NC State Bar Board Certified Specialists in Workers’ Comp Law

More than half of our workers’ comp attorneys are NC State Bar Board Certified Specialists in workers’ compensation law. Of the approximately 30,500 North Carolina licensed attorneys, fewer than 160 are North Carolina State Bar Board Certified Specialists in workers’ compensation law.* Nine of them practice at the Law Offices of James Scott Farrin.

What does it mean to be Board Certified in North Carolina? It means you have an attorney who shows special knowledge and proficiency in their specific area of law, having undergone additional training (and other intense analysis) to become certified as a specialist.

Our firm has been recognized by U.S. News – Best Lawyers® as one of the “Best Law Firms” for workers’ compensation for the greater Raleigh area3 in 2021.

Get a FREE Case Evaluation from NC Workers’ Comp Lawyers

Workers’ compensation law is highly complex and the system is extremely difficult to navigate successfully on your own. That is why we urge anyone who has been injured on the job to contact us or call 1-866-900-7078 immediately after their injury. Whether it’s for the original injury or one that stemmed from overcompensation, we will try to ensure that all the necessary measures are taken to preserve your right to workers’ compensation benefits.

*Figures provided by the N.C. State Bar as of February 2021.

3 For standards of inclusion, visit www.bestlawyers.com and www.usnews.com.