You get hurt on the job in NC. You can’t work. You start receiving weekly workers’ compensation checks. Then one day, those checks just stop coming.
Is it legal? What do you do? Here are some answers, from the workers’ compensation specialist attorneys at Ricci Law Firm:
Why Did My Checks Stop?
In North Carolina, when an insurer accepts your workers’ compensation claim as compensable and admits you are disabled, the insurer must pay you weekly disability benefits. Those checks must be in the correct amount (usually based on prior wages), and those checks must arrive on time. When an insurer fails to send a disability check on time or at all, you may hear one of the usual reasons:
- You returned to some work
- The doctor said you are no longer disabled / have no restrictions
- The insurance adjuster or the computer system made a mistake
No matter what reason the insurer provides, in North Carolina the workers’ compensation insurer is prohibited from cutting off your weekly benefits unless it files a Form 28, a Form 28T, or receives an Industrial Commission order allowing the checks to stop. This means the insurer, unless it files the proper forms, is not allowed to stop paying benefits simply because it discovers that you have returned to a job or that the doctor has released you to return to work without restrictions. The insurer must follow the rules and file the correct form or apply for permission to terminate benefits. It is not uncommon for the insurer to cut off benefits illegally.
What Can I do?
If your workers’ compensation check arrived late or did not arrive at all, it is important to understand your rights in North Carolina. The unilateral failure to pay benefits is improper and may even subject the insurer to sanctions. This is true even if the failure to pay the weekly checks is accidental, such as due to a “computer error” within the insurance company.
If your check did not arrive like normal, you should immediately seek the advice of a workers’ compensation attorney. Swift legal action may help get those checks back on track. The first step is usually to file a Form 23 Application to Reinstate Payment of Disability Compensation. Be careful if you submit this Application yourself! While the form appears to be straightforward, mistakes can lead to a permanent order stopping benefits, so it is always best to request legal assistance. The Application must include supporting documentation, and it must be served properly on the insurer or employer. If correctly filed and served, the employer and insurer have only 17 days to respond. If they fail to do so, the Industrial Commission may reinstate your disability payments, so make sure the Application is done correctly.
What If I lose?
Losing a Form 23 Application is bad news, because even if you are in the right, you probably will have to wait a long time for benefits. If the Industrial Commission denies your Form 23 application, your next step usually involves requesting a full hearing, which often takes several months or even a year to yield a decision. During that time, you probably will receive no weekly benefits. Also, strict deadlines apply here, so contacting an attorney immediately after receiving the order denying the Form 23 is very important.
If your checks stopped and you believe the insurer cut them off improperly, taking the proper steps up front may make all the difference. Do not let the insurer get away with breaking the rules. Contact an attorney at Ricci Law Firm for more information.
Workers’ Compensation Lawyer NOW serving Greenville, Durham, Goldsboro, and Raleigh
I’m Brian Ricci, a workers’ compensation lawyer serving Greenville and Raleigh. If you or a loved one has sustained an injury at work, please call me at (252) 777-2222 or 800-387-6406 for free, friendly advice.
I am a longtime member of the Million Dollar Advocates Forum.
Founder of the leading personal injury website: http://www.riccilawnc.com/personal-injury/