Work isn’t always fun, but it shouldn’t be dangerous. Unfortunately, some jobs are inherently risky and accidents happen, even in seemingly safe workplaces. Luckily, North Carolina has a system that can help you pay your medical bills and replace your wages or salary if you are injured on the job.
If you suffered an injury or illness at work, you might be able to apply for workers’ compensation benefits. This employer-paid insurance policy covers an injured employee’s medical treatment, lost wages, and additional necessary expenses.
Like all government programs, applying and getting the support you need can be difficult. At DeMayo Law Offices, we know North Carolina workers’ compensation laws and how to get our clients the benefits they deserve.
We care about our clients and will help you pursue the benefits the insurance company owes you for your injury or illness. If you’re unable to work, you need the support you’re owed to make up for the paychecks you miss, pay medical costs, and cover household expenses. When you hire us, we’ll protect your right to receive the maximum benefits you deserve while you’re out of work.
How Does Workers’ Compensation Work?
When you apply for benefits through your employer’s workers’ compensation policy, you can seek two main types of coverage: disability and medical bills.
If you can’t return to work for longer than seven days, you might qualify for disability benefits. Disability through workers’ compensation can cover the wages or salary you’re unable to earn because of your injury or illness. The insurer will pay you a percentage of your gross weekly wages, which you should start receiving after you’ve missed at least twenty-one days of work.
North Carolina doesn’t tax disability benefit payments on the state or federal level. Whether you choose to receive your benefits as a lump sum or weekly payments, you’ll qualify for the tax exemption. If you return to your job at any time, even just part-time, the wages you earn will be taxed.
You can collect benefits for a maximum of 500 weeks as long as your injury or illness keeps you out of work. If you return to work but can’t perform the same job you did before you got sick or hurt, you can continue to receive payments at a reduced amount. Your benefits will be two-thirds of the difference between your wages before and after your injury or illness.
In extreme situations, you might be able to collect payments for the rest of your life. Your doctor must conclude you’ve reached MMI (maximum medical improvement), meaning further medical intervention won’t improve your condition. Severe injuries that may qualify for extended workers’ comp benefits include:
- Severe burns
- Severe brain injury
- Paralysis of both legs or arms
- The loss of both hands, feet, eyes, legs, or arms (or a combination of any two of these body parts)
Workers’ compensation doesn’t provide benefits for any emotional pain. Even if someone’s carelessness and negligence caused your injury, you could only collect benefits for your lost wages and medical treatment from workers’ comp. Talk to your lawyer to understand if you may be able to pursue a separate personal injury claim.
Workers’ compensation can also cover the cost of necessary medical treatment. That includes hospital visits, physical therapy, surgeries, prescription drugs, and assistive medical devices, such as wheelchairs.
You’ll have to check with your employer’s WC insurer to determine what providers you can see. The policy approves specific doctors, and you’ll only receive benefit payments if you seek treatment from them. If you choose to visit your own physician, you’ll have to pay the bills yourself.
If you want to seek medical care from a doctor that isn’t on the approved list, you can do so, but you’ll have to get permission from the North Carolina Industrial Commission. Notify the insurance company or insurance representative and they will submit your request.
Qualifying Conditions for Workers’ Compensation
Most work-related injuries can be covered by workers’ comp. Contact DeMayo Law Offices if you don’t know whether yours qualifies. Any of the diseases or injuries below could entitle you to workers’ comp benefits:
- Loss of limb
- Spinal cord injury or paralysis
- Electrocution or burn
- Occupational illness, such as mesothelioma from exposure to asbestos
- Permanent disability
- Neck or back injury
- Broken bones
- Traumatic brain injury
- Repetitive motion injury or overexertion
- Physical injury from hazardous equipment or machinery
Whether you work on a construction site or sit at a desk all day, you expose yourself to various physical, emotional, and psychological risks. A construction worker could fall off a ladder. Someone working on a computer could suffer a repetitive motion injury from typing.
It’s important to protect yourself from injury at work, but when you are hurt or fall ill on the job, you can get support through workers’ compensation. Don’t leave the benefits you’re owed on the table.
How to Handle an Injury at Work
If you get hurt or sick at work, you can take these steps to secure your rights to workers’ compensation benefits:
Notify your employer.
Tell your employer about your injury or illness within 30 days of the date it occurred. Put your notification in writing and include the date, time, location, and how it happened. Keep a copy for your records.
Complete Form 18.
When you let your boss know that you got hurt on the job, they should give you a Form 18 to fill out so they can submit it to the insurance company. If they don’t provide you with one, you can print one out yourself and send it to the North Carolina Industrial Commission. You’ll also have to submit a copy of the form to your employer’s insurance company or insurance representative.
Get a copy of the workers’ compensation policy.
Ask your employer for a copy of their workers’ compensation policy. You’ll need to review it for filing deadlines, injuries and illnesses covered by the insurance company, and the list of doctors you’re allowed to visit.
Seek medical care.
Undergo a medical evaluation immediately after you get sick or notice unusual symptoms that could signify a disease. Follow your doctor’s orders and attend follow up appointments, seek treatment with anyone they refer you to, and undergo imaging, blood work, and additional testing they require. Continue to treat until they release you from care.
Keep a copy of everything related to your workers’ compensation claim. Keep your prescriptions, medical bills, physician notes, operative reports, and receipts. If you talk to a representative of the insurance company, follow up with an email or letter, so you have everything in writing.
Get a doctor’s note.
If your doctor diagnoses you with an injury or illness that inhibits your ability to work, make sure they write you a note. You must have documentation of your disability and how it affects your work-related tasks. If your doctor doesn’t explicitly state the medical condition you have, the insurer may deny your claim.
Hire a Monroe, NC Workers’ Compensation Attorney
When you pursue workers’ comp benefits, you need an experienced lawyer. Ours at DeMayo Law Offices are ready to help. It’s a complicated process, and if you miss a deadline or submit incomplete documentation, your claim could be denied.
Why Was My Workers’ Compensation Claim Denied?
There are many reasons an insurer can deny your claim. DeMayo Law Offices has years of experience appealing denied claims to help clients receive the benefits they deserve. The most common reasons for denial include:
- Failure to report the injury: You’re supposed to let your employer know about your injury within 30 days of the date it occurred. If you wait, the insurance company might not believe your injury is serious enough to justify paying your benefits.
- Lack of witnesses: People who saw what happened to you at work can help build a strong insurance claim. If no one witnessed your injury, it’s harder to prove what happened.
- Lack of medical evidence: Medical records are crucial to proving work-related injuries and illnesses. If your doctor doesn’t describe your injury explicitly and explain why it prevents you from completing your job, your claim may be denied.
- Conflicting statements from your employer: To qualify for benefits under your employer’s workers’ comp policy, your employer must support your claim that the injury or illness is work-related. If they claim it’s not, your claim could be denied.
Contact our Monroe, NC Workers’ Compensation Attorneys Today
At DeMayo Law Offices, we know the burden of being out of work and unable to support yourself and your family. If you’re missing paychecks, you’ll have trouble paying for your medical bills and household expenses. We’ll protect your right to the workers’ compensation benefits the insurance company owes you.
We offer an initial free consultation and take workers’ compensation cases on contingency. That means you won’t have to pay us unless we resolve your case successfully.
If you suffered an injury or illness while working and need help filing a workers’ compensation claim or appealing a denial, call us today at (704) 291-9200.