You don’t need to show negligence in order to file a workers’ compensation claim for an injury at work in the Tarheel State
Every employer in North Carolina is responsible for maintaining a safe and hazard-free workplace.
An injury at work is handled differently from any other type of injury in the tort law system. That’s because the tort law system (which includes personal injury law) is based on negligence. In order to recover costs associated with an injury, the plaintiff (injured person) must prove that their injury was caused by some intentional or unintentional action by a person or entity that owed them a duty of care.
The law is different when it comes to a work-related injury.
The primary difference between a workers’ compensation claim and a person injury lawsuit is that you’re not required to prove negligence after a workplace accident, injury or illness.
You only need to prove 3 things:
- You were injured.
- The injury happened while you were at work or performing a work-related task.
- Your injury cost money, either for medical treatment or lost wages.
It’s not necessary for a workers’ compensation claim to assign fault. Regardless of whether or not there was negligence on the part of the employer, a coworker, or even yourself, it won’t affect your ability to receive workers’ compensation benefits.
What types of injuries are covered under North Carolina workers’ compensation?
There are 3 main categories of work-related injuries:
- Traumatic injuries are caused by a specific event or accident (this includes injuries like back and neck injuries, broken bones, head injuries, electrocutions, and others that occur at a specific time).
- Stress injuries can include repetitive strain injuries like carpal tunnel syndrome, tendinitis, back or neck strain, and other injuries that are related to body positioning and movements related to your job. Stress injuries don’t develop overnight. They’re the result of a person’s position while sitting, standing, lifting, reaching, stretching, driving, or doing other repetitive motions (slicing food, opening boxes, even using the phone) that cause injuries to occur over time.
- Occupational injuries are caused by exposure to toxins or harmful conditions in the workplace. These include illnesses caused by toxins like asbestos, chemical burns or poisoning, hearing loss, industrial asthma, neurological disorders, and others.
Most of these examples are directly related to performing your job, either because of the physical demands of your occupation or the environment where you work. But there are work-related injuries that happen that are unrelated to your actual job function.
For example, you might be injured from a trip-and-fall over a phone cord, a box left on the floor, or a folded carpet edge. Slipping on a wet floor after coworkers or visitors have tracked snow inside on a wintry day, being hit by books or boxes falling from a shelf, or other injuries also happen in the workplace, even under the best of conditions.
What benefits does North Carolina provide injured workers?
Medical benefits
Workers’ compensation should cover all medical care and treatment related to your work injury. Claim processing is handled by the North Carolina Industrial Commission, and your employer may require you to receive treatment from an approved physician or clinic. Medical treatment would include surgeries, doctor’s visits, prescription medications, assistive devices, and any other costs associated with your physical recovery.
Temporary disability benefits
If your injury or illness prevents you from working for more than 7 days, you can receive benefits for two-thirds of your lost wages, up to a weekly maximum that changes each year.
Your temporary disability benefits continue until you’re able to return to work or have reached maximum medical improvement (MMI), which means you’ve improved as much as your doctor believes you’re going to with treatment.
Permanent disability benefits
When you reach MMI, your doctor provides a permanent impairment rating. This is an assessment for your level of disability. The Industrial Commission uses this rating to determine how much your benefits should be for a permanent disability that has left you unable to work.
If you have a partial disability, you will receive some benefits to compensate you if you’re able to work but you’re unable to receive the salary you earned prior to your injury.
Death benefits
If you lost a family member as a result of a fatal work-related injury or illness, you might be eligible to receive survivor benefits.
A qualified survivor would receive either the full weekly benefit amount if they were fully dependent on the deceased worker, or a partial amount if they were partially dependent, based on the proportion that they received from the deceased worker on an annual basis.
A surviving family member, including a child, parent, or sibling of the deceased worker is entitled to receive a lump sum payment of the benefit amount. Each survivor would receive an equal share of the benefits.
If there are no dependents or surviving family members, the only benefit would be up to $10,000 for burial expenses.
North Carolina workers’ compensation death benefit includes:
- Two-thirds of the worker’s average weekly wage at the time of the accident or illness (minimum of $30 and maximum changes each year)
- Burial expenses up to $10,000
Should I file a workers’ compensation claim or a personal injury lawsuit?
You might not have a choice.
The workers’ compensation system is designed to benefit both the employee and the employer. The injured employee benefits by receiving no-fault compensation for medical expenses and lost wages so they have the money to cover costs right away.
This system also protects the employer from litigation. Generally, you may not sue the employer for an injury that is covered under a workers’ compensation claim. This allows the employer protection from a time-consuming legal process and expensive attorney and court fees.
As a trade-off for receiving benefits without proving fault or participating in a lengthy legal procedure, the employee is limited to receiving costs only for medical treatment and lost wages. In other words,you can’t recover for non-economic damages such as pain and suffering, mental anguish, loss of consortium, and loss of enjoyment of activities.
BUT…
Some work-related injuries are caused by a third party’s negligence. A third-party lawsuit might be the correct way to handle a claim if the injury was caused by a person or company that’s not your employer.
Here are examples of when a third-party lawsuit might be an option:
If you’re in an accident while in the scope of your employment (i.e. on a work-related trip, errand, or task), you might be able to file a personal injury claim against the driver who caused the accident in addition to filing a workers’ compensation claim.
If you were on someone else’s property to do your job and were injured by a hazard on that property, you might be able to file a lawsuit against the property owner. For example, if your job involves home visits to clients and you’re bitten by the homeowner’s dog, it might qualify as a third-party lawsuit.
Many injuries happen as a result of defective machinery that malfunctioned or had a manufacturing defect. This could also include personal protective equipment (PPE) like safety harnesses or belts used on construction sites, for example. You might have a lawsuit against the equipment manufacturer if the company’s negligence caused your injury.
There are many times when you’re working alongside people who are employed by another company. For instance, if you’re employed in the construction industry, the building contractor might work with engineers, architects, and others. Though you have different employers, you are working together on a project.
How to file a workers’ compensation claim in North Carolina
- Seek medical treatment. If your employer has an on-site health care provider, you may visit that provider to get an evaluation of your injuries. If not, ask your employer for an approved health care provider who can diagnose your injury or illness. If the injury requires immediate or emergency attention, seek the appropriate treatment like a hospital or your own medical provider.
- Tell the doctor that it’s a work-related injury. Be sure this becomes part of your medical record. Not only is it important for filing your claim, but it also allows the health care provider to bill the treatment as a workers’ compensation claim.
- Notify your employer of the injury. You must notify your manager, supervisor, HR representative, or other appropriate person in your company that you’ve suffered a work-related accident. If your injury prevents you from providing notification, have a family member, health care provider, or someone else notify your employer. You must follow up with written notice within 30 days of the injury.
- File a Form 18 with the Industrial Commission to begin your claim.
You must file a North Carolina workers’ compensation claim with the Industrial Commission within 2 years from the date of the injury, and you must report the injury to your employer within 30 days of the injury (as soon as possible).
It’s best to report to your employer AND file with the Industrial Commission as soon as possible. The process can take a long time, and there are frequent delays. Also, the sooner you file your claim, the sooner you can begin to receive your benefits.
Do you need a workers’ compensation lawyer?
The answer to this question depends on the seriousness of your injury and amount of your claim. If your medical treatment has concluded and you’ve returned to work, and if your claim was approved, you might not need additional assistance.
But if you’re going to require future medical treatment related to the injury or you’re not able to return to work quickly, you might want to consult a workers’ compensation lawyer about your claim and legal options. It’s important to ensure that the amount of your claim will cover all of your future medical treatment and lost wages.
There are 2 primary ways your workers’ compensation lawyer will help you through the claim process:
- Your lawyer can make an accurate determination of how much you should claim in benefits. Part of your lawyer’s job is to understand costs associated with medical procedures, accounting, and actuarial tables so they can figure out how much your future expenses will cost.
- Your lawyer is an experienced negotiator. If your claim is denied, your lawyer will produce the necessary evidence to make your claim and work through the appeals process.
Were you hurt on the job?
Let the Enjuris law firm directory be your source to find a qualified, experienced, and compassionate North Carolina workers’ compensation lawyer who’s ready to handle your claim.
- North Carolina Workers’ Compensation: A Guide for Injured Workers
- FAQ: Questions & Answers On North Carolina Workers’ Compensation
- How to File a Claim for a Workers’ Compensation in North Carolina
- North Carolina Construction Injuries: Your Legal Options & Benefits
- North Carolina Social Security Disability (SSDI and SSI) Benefits
- What Workers’ Compensation Benefits Are Available in North Carolina?
Did you know that workers' compensation law varies by state?
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What does an injury lawyer do?
A personal injury lawyer helps individuals who have sustained injuries in accidents to recover financial compensation. These funds are often needed to pay for medical treatment, make up for lost wages and provide compensation for injuries suffered. Sometimes a case that seems simple at first may become more complicated. In these cases, consider hiring an experienced personal injury lawyer. Read more