Workers' Compensation FAQs
Workers' Compensation Frequently Asked Questions
- What do I do if I get hurt on the job?
- What kinds of monetary benefits are available to injured workers?
- Do I have to go to the doctor that the insurance company provides? What if I want a second opinion?
- How long do I have to report my injury?
- Under what circumstances is a person eligible for Workers' Compensation in North Carolina?
- What kinds of employers are covered by Workers' Compensation law?
- How will I know if my employer has accepted my claim?
- Can the insurance company cut off my checks, stop paying me, or stop my TTD benefits?
- I’ve been denied workers’ comp benefits. How can I appeal my WC claim?
- Can I get fired from my job if I file a workers’ comp claim?
- Are non-U.S. citizens eligible for workers’ compensation in North Carolina?
- What if I get hurt working in another state?
- What does it mean when an attorney is a "North Carolina Board Certified Specialist in Workers' Compensation Law"?
- Are your attorneys paid by the hour? What is your fee structure?
1. What do I do if I get hurt on the job?
The first thing you want to do is report the injury immediately and in writing to your employer as required. The next thing is to get medical treatment right away. Once you’ve done that, you may want to consider whether you want to attempt to handle your case on your own or hire a North Carolina workers’ compensation attorney to advocate for you.
Certain minor injuries that involve minimal time from work and straightforward medical treatment may be able to be handled on your own. For these types of cases, our workers’ comp team developed a booklet to help guide you through the process.
For many types of cases — those with serious or long-term injuries, longer periods of time away from work, and dealing with less-than-sympathetic employers — a workers’ compensation lawyer may be the way to go. Worker’s compensation laws can be complex and confusing. There are literally thousands and thousands of pages of laws and statutes dealing with North Carolina workers’ compensation law. The system is fraught with strict timelines, filing deadlines, meticulous protocol, and highly complex mathematical calculations. One misstep could cost you. If you have questions or are unsure whether you need an attorney, just call us for a free case evaluation. Several of our workers’ compensation attorneys are board certified in workers’ compensation law. We’ll let you know, based on our experience if we think your specific situation warrants legal help.
2. What kinds of monetary benefits are available to injured workers?
Temporary Total Disability (TTD) benefits may be payable when employees becomes totally disabled (unable to work in any capacity) as a result of workplace activities, and the disability is not expected to be permanent.
After a seven day waiting period, employees are entitled to obtain weekly benefits equal to two-thirds (2/3) of their average weekly wage up to the maximum compensation rate set by the North Carolina Industrial Commission (NCIC). If the disability continues for more than 21 days, the employee is entitled to receive these Workers' Compensation benefits for the first seven days as well.
Temporary Partial Disability (TPD) is a form of Workers' Compensation benefits that employees may be entitled to receive after they have returned to work, but are earning less than they were prior to the injury because they are working fewer hours or earning less per hour than before their injury.
Employees are entitled to compensation equal to two-thirds (2/3) of the difference between the post-injury and pre-injury weekly wages for a maximum period of 500 weeks.
Permanent Partial Disability (PPD) Workers' Compensation benefits are those which employees may be entitled to if they have sustained a permanent disability to certain body parts (e.g., arms, legs, back, hands). Benefits for less than the total loss of a body part are calculated by the treating physician on a percentage basis. This calculation is referred to as a "PPD rating."
Employees are entitled to compensation equal to two-thirds (2/3) of their average weekly wage for a period calculated by the North Carolina Industrial Commission (NCIC) for each body part and percentage of disability (PPD rating). As an example, if a worker loses complete use of a leg, that worker can receive benefits up to 200 weeks. If the worker loses 5% of the use of a leg, the worker is entitled to 10 weeks of disability benefits.
Total and Permanent Disability benefits may be potentially paid to the employee for a lifetime when the employee's injury renders him or her unable to return to any form of suitable employment.
In such a case, a worker may be able to receive weekly benefits and medical compensation for the remainder of his or her lifetime.
3. Do I have to go to the doctor that the insurance company provides? What if I want a second opinion?
The employer's insurance carrier has the right to direct your medical care. This means that the insurance company can send you to a doctor and/or facility of their choice for your medical treatment. If you are not satisfied with your treatment or you would like a second opinion, you have the right to obtain one from another doctor you and the insurance company agree on. The North Carolina Industrial Commission (NCIC) can approve your request to change direction, or seek treatment from a provider of your choice. To learn more about the medical treatment you are entitled to under North Carolina’s workers’ compensation laws, click here.
4. How long do I have to report my injury?
You have 30 days to report a workers’ compensation claim to your employer in North Carolina. For an injury by accident, the requirement is written notice within 30 days (unless the employer has actual notice of the injury) unless the North Carolina Industrial Commission believes there is a reasonable excuse and the employer is not prejudiced by the delay. For occupational diseases, the notice requirement is 30 days from the date you were informed by a competent medical authority of the nature and work-related cause of your disease.
We recommend you file your claim in writing immediately or as soon as possible. You must also file a Form 18, Notice of Accident to Employer and Claim of Employee, Representative or Dependent for N.C. Workers' Compensation Benefits with the North Carolina Industrial Commission court and provide a copy to your employer and/or its insurance carrier. Ensuring you meet these timelines is important. Click here to learn more about next steps.
5. Under what circumstances is a person eligible for Workers' Compensation in North Carolina?
There are three basic circumstances in which a person can become eligible for North Carolina 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.
- 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).
6. What kinds of employers are covered by Workers' Compensation law?
North Carolina Workers' Compensation laws apply to any employer with three or more employees, subject to limited exceptions.
7. How will I know if my employer has accepted my claim?
An injured worker is entitled to a detailed statement from the employer or insurance carrier stating whether the claim has been accepted, or grounds for denying the claim, within 14 days of receipt of the claim unless time is extended by the North Carolina Industrial Commission's (NCIC) Executive Secretary's Office. If a claim is denied, the employee should receive a copy of Form 61 — Denial of NC Workers' Compensation Claims from his or her employer, outlying the reasons for the denial. Otherwise, the employee should receive a Form 60 — Employer' Admission of Employee's Right to Compensation, or a Form 63 — Notice To Employee of Payment without Prejudice.
A Form 63 is a conditional 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 North Carolina Workers' Compensation Lawyer without delay.
8. Can the insurance company cut off my checks, stop paying me, or stop my TTD benefits?
In North Carolina, the insurance company is not allowed to stop paying your weekly checks except under only two circumstances:
- You return to work. If you return to work, even just for a day, the insurance company can cut off your checks without even having to appear before a judge. Getting your checks re-started after returning to work is extremely difficult.
- The insurance company gets permission from the North Carolina Industrial Commission to stop paying. If the insurance company chooses to go before the Industrial Commission to attempt to get you to return to work before you are ready or before you have reached “maximum medical improvement,” you and your lawyer will have the opportunity to argue against this and explain why you are not ready.
9. I’ve been denied workers’ comp benefits. How can I appeal my WC claim?
If you’ve been denied benefits, you have the right to appeal that decision. But it can often be a long and potentially stressful experience. The first thing you should do is file Form 33 to request a hearing before the North Carolina Industrial Commission. This means you will need to appear before the Commission to present your case. Can you do this without an attorney? Yes, but we wouldn’t recommend it. Your employer and the insurance company are very likely to have their own legal counsel to make a strong case against paying you benefits. That is why we strongly urge anyone who appeals their case to have an experienced workers’ comp attorney advocate for them to try to even the playing field.
10. Can I get fired from my job if I file a workers’ comp claim?
Legally? No. But we see it happen all the time. An employer cannot legally fire you simply because you filed a workers’ comp claim. If they do, they could be violating North Carolina’s Retaliatory Employment Discrimination Act, (REDA). REDA is one of several laws enacted to protect employees who have been hurt on the job and are entitled to workers’ comp benefits. It also protects them from being mistreated at work for filing a claim. Don’t let termination stop you from filing a workers’ comp claim. An experienced N.C. workers’ compensation lawyer may be able help protect your job, your workers’ comp benefits, and if needed, file a discrimination claim.
11. Are non-U.S. citizens eligible for workers’ compensation in North Carolina?
Whether documented or undocumented, non-U.S. citizens are entitled to workers’ compensation under North Carolina workers’ compensation laws. Workers’ compensation was established to encourage employers to keep their working conditions safe for every employee – no matter where they’re from. Sadly, we’ve seen some employers and insurance companies try to convince non-U.S. workers to settle for much less than they may be entitled to – or deny them benefits just because they come from another country. We deal with this issue quite a bit. If you need someone to advocate for you, contact one of our N.C. workers’ compensation attorneys.
12. What if I get hurt working in another state?
If you are injured on the job while working outside the state of North Carolina, the protections of the N.C. workers’ compensation system generally travel with you if your employment contract was made in N.C. The protections also generally travel with you if the employer’s principal place of business is in N.C. or the employee’s principal place of employment is in N.C. The analysis that goes into making these determinations can be extremely complicated (and often requires a hearing). For this reason this question is best addressed by an experienced workers comp attorney. We are available 24/7 and offer free case evaluations. Contact us at 1-866-900-7078 to learn more about your options.
13. What does it mean when an attorney is a "North Carolina Board Certified Specialist in Workers' Compensation Law"?
Nearly half our workers’ comp attorneys are N.C. Board Certified Specialists in Workers' Compensation law. This N.C. State Bar certification denotes a high level of proficiency in a particular practice area, and less than 4% of attorneys licensed in N.C. can make that claim*. To become a board certified specialist in workers’ compensation law, a lawyer must have been in practice for at least five years, devote a significant part of their practice to workers’ comp, be favorably evaluated by other lawyers and/or judges, and pass a lengthy written exam in the area of workers’ compensation law.
14. Are your attorneys paid by the hour? What is your fee structure?
Like most personal injury attorneys, the Law Offices of James Scott Farrin operates under a contingency fee arrangement. This means that there is no attorney’s fee unless we recover compensation on your behalf. The attorney's fee is based on a percentage of the gross recovery. This arrangement allows many individuals to obtain legal representation even if they do not have funds to retain a lawyer at the outset of a case. (In the case of Social Security Disability clients, the federal government caps contingency fees to a certain amount.)
* Percentage from North Carolina State Bar as of December 2016.
About the Law Offices of James Scott Farrin
The experienced Workers' Compensation Department at James Scott Farrin has helped thousands of North Carolinians with their Workers' Compensation claims over the years.
Several of our attorneys are Board Certified Specialists in Workers' Compensation law by the North Carolina State Bar.
Several of our Workers' Compensation attorneys have worked as defense lawyers for the insurance industry. These attorneys have seen Workers' Compensation cases from both sides.
Several of our Workers' Compensation attorneys have more than 10 years of Workers' Compensation and/or civil litigation experience. Numerous members of our staff are bilingual.