Would You Know if Your NC Workers’ Comp Injury Was Incorrectly Denied?

In North Carolina, there are three basic types of workers’ compensation claims. Each has its own nuances and special circumstances to try to prove to the workers’ comp insurance company that they owe you benefits.

  • Injury by Accident

This describes an external factor that caused your injury. Perhaps you tripped and fell or coworker dropped a computer on your foot. Were you injured while driving a company truck? North Carolina law says that you likely must be compensated for injuries that are caused by an accident. Without the help of an attorney we have seen instances where injured workers were denied compensation.

  • Specific Traumatic Incident

This occurs when you are able to determine exactly when and where your injury occurred, yet it did not result from an accident. You may have lifted something and your back locked up. Or did you reach for a tool and pull your shoulder? From a workers’ compensation standpoint, specific traumatic incidents typically only apply to spine injuries. Some things that may at first look like a specific traumatic incident can fall under the definition of injury by accident. And many times, a carrier will wrongfully deny a claim (when the injury is to a body part other than your back) based on their argument that no accident occurred. This is one of the many reasons we urge folks to consult an experienced workers’ compensation attorney. There are so many nuances as to whether an injury is or is not the result of a specific traumatic injury. How would you know these nuances? You can bet the insurance company knows them. And they know how to try to deny your claim based on what they suspect you don’t know!

  • Occupational Disease

This typically refers to a condition that develops over time as a result of your job duties and/or your work environment. Most people are familiar with carpel tunnel syndrome or exposure to mold, asbestos, or hazardous chemicals. Some workers’ compensation insurance companies will sometimes try to deny these claims and refuse to cover treatment. It is up to you to show that your job elevated your risk of injury. For someone who is not an experienced workers’ comp lawyer, this can be a tough claim to prove. We try to do this every day for our clients. That is another reason we urge injured workers to contact us. These claims can be a very tricky to prove.

Exceptions to Injury by Accident

Different rules apply for injuries to the neck and back, hernias, and repetitious motion injuries such as carpal tunnel syndrome.

In North Carolina, it is generally understood that for an injury to be deemed compensable (in other words, it was an injury by accident), it must occur by accident, and in the course and scope of employment. This definition applies to injuries that result from accidents that are unexpected or unanticipated. You can also think of an accident as an event or interruption that’s not part of the normal, everyday, performance of your job. Were you performing your normal work routine, or did you, for example, have to apply an excessive or unanticipated amount of force to open a stubborn crate?

Unfortunately, this means that not every injury that occurred at work will be considered the result of an accident. In other words, it may not be compensable. Here are some exceptions.

In order to be deemed compensable, spinal injuries must occur as the result of a “specific traumatic incident,” which is a more flexible standard and does not necessarily require an unexpected event. For example, if you sustain a herniated disc while lifting a box at work, even though you may have been performing a routine part of your job in the normal manner, you may very well have a compensable workers’ compensation claim.

Like back injuries, hernia injuries may also be compensable if they are the direct result of a specific traumatic incident of the work assigned. However, a stricter application of the rule applies to hernia injuries compared to back injuries. For a hernia injury to possibly be compensable it must appear suddenly following the injury and it must be a new hernia, and not one that had developed prior to the accident.

Finally, repetitive motion injuries, such as carpal tunnel syndrome may be (or may not be) a compensable occupational disease. Unlike an injury by accident or specific traumatic incident, an occupational disease typically develops more slowly, through prolonged workplace exposure to a particular agent or action. While certain medical conditions are expressly identified as an occupational disease in North Carolina, many are not. I have seen some insurance companies try to deny those that NC workers’ compensation laws state are compensable. These types of injuries represent a very grey area and can be difficult to prove for the uninitiated. One insurance carrier tried to blame an employee’s tendonitis on her pregnancy, claiming that tendonitis is common during pregnancy. For that reason they tried to deny her claim.

While not every work-related injury will be compensable under North Carolina workers’ compensation laws, many injuries are, and may likely entitle you to benefits. But how would you know your injury is compensable? We know. And we know how to try and prove it.

What Makes James Scott Farrin Workers’ Comp Lawyers Different?

We will often use a team approach when handling workers’ compensation cases. Any number of attorneys and paralegals may work on your case in addition to firm resources. (You, incidentally, are part of that team.)

We may consult with any one of our attorneys and paralegals that previously worked for insurance companies. They know first-hand how some insurance companies may try to delay, deny, and defend your claim because they have seen this happen from the inside.

Nearly half our workers’ comp attorneys are NC Board Certified Specialists in Workers’ Compensation law. We think this is a pretty big deal as it is the highest level of specialization available in North Carolina, and only a small percentage of NC attorneys can make that claim. Very small.

We may consult with one or both of our two former North Carolina Industrial Commissioners on your case. (The North Carolina Industrial Commission (NCIC) is the impartial agency that administers and enforces workers’ compensation laws.)

We may seek the counsel of our former North Carolina state senator who helped write some of North Carolina’s worker’s compensation laws.

Several of our attorneys have more than 10 years of experience. Some speak at seminars for other workers’ compensation attorneys. Others have written books about various areas of law, and three have received coveted awards for workers’ compensation, including:

  • Best Lawyers in America “Best Lawyer” and “Lawyer of the Year” for Raleigh (twice)3,4
  • North Carolina Super Lawyers Magazine “Rising Star” and “Super Lawyer” (three times)5,6

Get a Free Case Evaluation From NC Workers’ Comp Lawyers

When it comes to trying to get the benefits you may deserve from the workers’ comp insurance company, there is a lot at stake. That is why we urge anyone who has been injured on the job to contact us or call 1-866-900-7078. We will try to ensure that all the necessary measures are taken to try to prove your right to benefits.


3“Best Lawyer” Matt Healey from 2013–2018; Barry Jennings from 2015–2018
Since it was first published in 1983, Best Lawyers® has become universally regarded as the definitive guide to legal excellence. Best Lawyers is based on an exhaustive peer-review survey. For the 24th edition of The Best Lawyers in America (2018) more than 58,000 leading attorneys cast more than 7.4 million votes on the legal abilities of other lawyers in their practice areas. Lawyers are not required or allowed to pay a fee to be listed; therefore inclusion in Best Lawyers is considered a singular honor. Corporate Counsel Magazine has called Best Lawyers “the most respected referral list of attorneys in practice.” For more information regarding the standards for inclusion, visit www.bestlawyers.com.

4“Lawyer of the Year”: Matt Healey in 2015 and 2017.
Only a single lawyer in each practice area and designated metropolitan area is honored as the “Lawyer of the Year,” making this accolade particularly significant. Lawyers being honored as “Lawyer of the Year” are selected based on particularly impressive voting averages received during the exhaustive peer-review assessments conducted with thousands of leading lawyers each year. Receiving this designation reflects the high level of respect a lawyer has earned among other leading lawyers in the same communities and the same practice areas for their abilities, their professionalism, and their integrity. For more information on the rules of inclusion visit www.bestlawyers.com.

5“Rising Star”: Ryan Bliss in 2018; Matt Healey from 2010–2013; Barry Jennings from 2011–2013.
Published by Super Lawyers. To be eligible for inclusion in “Rising Stars,” a candidate must be either 40 years old or younger or in practice for 10 years or less. “Rising Stars” undergo a rigorous, multiphase process which combines peer nominations with third-party research. Each candidate is evaluated on 12 indicators of peer recognition and professional achievement. Selections are made annually on a state by state basis. While up to 5% of the lawyers in any state are named “Super Lawyers,” by Super Lawyers magazine, no more than 2.5% are named to the “Rising Stars” list. For more information regarding the standards for inclusion, visit www.superlawyers.com.

6“Super Lawyers”: Matt Healey from 2014–2016.
Published by Super Lawyers. “Super Lawyers” undergo a rigorous, multiphase process which combines peer nominations with third-party research. Each candidate is evaluated on 12 indicators of peer recognition and professional achievement. Selections are made annually on a state-by-state basis. For more information regarding the standards for inclusion, visit www.superlawyers.com.