New Bern Workers Compensation Lawyers
Injuries and illnesses caused by work accidents can be painful and distressing. Given that you are unable to work and support your family, it is possible that you have no idea how you will pay for your medical care. You may be eligible for workers’ compensation benefits to cover these costs and other expenditures if you sustained a work-related injury.
It can be challenging to understand workers’ compensation law on your own, and you might be unsure of what to ask an attorney or whether to file a lawsuit. You are entitled to certain benefits under no-fault insurance regardless of whether you or your employer were at fault for the accident that wounded you.
Consult with an experienced workers’ compensation lawyer to understand the full benefits and process of a workers’ compensation claim in North Carolina. The New Bern Workers’ Compensation lawyers at Ricci Law Firm are here to navigate you through the workers’ compensation process.
What Does a Workers’ Compensation Attorney Do?
You should always conduct some research before choosing any workers’ compensation lawyer to handle your claim if you are looking for legal representation. Not all attorneys are created equal.
A reputable workers’ compensation attorney will have a record of cases they have handled or be able to give you information about their prior experience and pertinent years of practice. Make sure the lawyer you hire specializes in workers’ compensation law if you need legal representation for a claim.
Victims of workplace injuries can seek the maximum payments they are entitled to with the assistance of an experienced workers’ compensation attorney. If the insurance adjuster tries to underpay the employee, a workers’ compensation attorney is committed to giving the worker the support they need to get a satisfactory conclusion to their workers’ compensation claims.
A committed workers’ compensation attorney will protect the employee’s rights and legal interests, in contrast to employers who might not always have their employees’ best interests in mind. While you concentrate on recovering from your injury, workers’ compensation attorneys can make obtaining your benefits easier.
How Can Workers’ Compensation Help You?
Dealing with employers and the claim process after an employment-related injury can be intimidating. A workers’ compensation attorney can assist as soon as possible. To prevent a claim that has lapsed or is barred, a knowledgeable workers’ comp attorney can assist with giving notice to your employer and making sure they submit the required report on time.
After a work-related injury, many employees are unaware of their rights or do not completely understand them. Employers must make sure they have access to all relevant paperwork and disclose information concerning workers’ compensation claims. This isn’t always the case, and an employee seeking workers’ comp may not know they have not been provided all necessary information. This is where a workers’ compensation lawyer can help.
Additionally, if a claim has already been rejected, a workers’ compensation attorney can assist with the hearing and appeal procedure. Many people might not be aware that they have three years after their claim is dismissed to reopen it.
What is Workers’ Compensation?
Employees who have an injury at work in North Carolina are eligible to get compensation. An employee’s rights after injury are protected under the North Carolina Workers’ Compensation Act, which describes the administrative and appeals procedures as well as the benefits an employee may be eligible for when hurt at work.
A workers’ compensation claim can typically be made by an employee who sustains an injury or illness while doing their duties in order to be compensated for missed income and any medical expenses incurred as a result of the injury, including those for emergency care, surgery, therapy, prescription medications, and other medical procedures and treatments.
Starting on day one, all workers will be protected by workers’ compensation insurance for the duration of their employment. A worker will not be disqualified from receiving workers’ compensation benefits because they were hurt at prior employment or because they had a preexisting medical condition. An employee will be protected if they sustain an injury at work.
The only criteria for any workers’ compensation claims are that the employee has to be actively working at the time of the injury in order to be eligible for payments.
Who is Eligible for Workers’ Compensation?
Employees who sustain an illness or accident at work may get benefits thanks to workers’ compensation insurance. If an employee misses work, it may be able to help defray some of their lost income and cover some of their medical expenses.
Employers provide no-fault insurance for their employees in the form of workers’ compensation and employers’ liability. The protection from work-related injuries is exchanged for the employee giving up some of their legal recourse.
Under the North Carolina Workers’ Compensation system, only accident-related injuries are compensable. This implies that the damage must have some definite outside of usual work-related causes. The North Carolina Industrial Commission (NCIC) has made decisions on this question in hundreds of different factual scenarios. Whether an injury was caused by an accident or not is a frequent topic in contested cases, and if the injury was found to incur through a non-accident, then a worker will not be eligible for workers’ comp insurance.
Filing for Workers’ Compensation
There are many steps to filing and claiming workers’ compensation in North Carolina. The initial claim should always be filed by completing Form 18 and filing it with the North Carolina Industrial Commission.
Step One: Report
After any workplace injury or illness, an employee must immediately report the injury to the employer. Often, an employer will have a provider or list of providers that are covered under workers’ compensation insurance that an employee will need to consult. If there is no provider on-site or a list of healthcare providers, then one should seek medical care that is appropriate for their injuries as soon as possible after reporting the injury.
Generally, an employer will have a form or point of contact to report an injury. If unable to report an accident due to the condition or injuries sustained, then another employee or family member should report the injury to the employer.
Step Two: Notice
Along with reporting the injury, notice must also be given to the employer. There is a thirty-day period after an accident where an employee must give an employer notice. If the notice is not given within this time frame, then an employee may be barred from obtaining workers’ comp insurance.
The notice should include a precise written statement that includes the date of the accident, the time of the accident, a description of all injuries sustained, and an overview of where/how the accident occurred.
Step Three: Obtain Healthcare
After the injury, always obtain healthcare. Even if you feel the injuries are not extensive enough medical care, it is important to seek medical attention. This will give an overview of all injuries sustained and will help when seeking workers’ compensation insurance through the employer.
It is also important to listen to a physician’s instructions and follow the medical treatment and care they provide. Following medical care instructions is important because the goal of North Carolina Workers’ Comp is to restore employees to their original health and allow them to return to work.
Workers’ Compensation Requirements in North Carolina
According to the North Carolina Workers’ Compensation Act, all businesses with three or more employees must either obtain workers’ compensation insurance or meet the requirements of self-insured employers in order to be eligible to pay workers’ compensation benefits to their employees. This requirement applies to corporations, sole proprietorships, limited liability companies, and partnerships.
Workers’ compensation insurance is a legal requirement for businesses when one or more employees are engaged in radiation-related tasks.
There are a few exceptions for employers in North Carolina that may not be required to hold workers’ compensation insurance. Those exempt from always acquiring workers’ comp insurance in North Carolina include:
- Domestic servants (those directly employed by a household)
- Railroad employees (only of certain railroads)
- Farm laborers (when fewer than 10)
- Federal government employees
- Casual employees (non-traditional and not in the course of trade/regular business practice)
Many times, independent contractors can be exempt, but that is not always an exception. The designation of employees as “independent contractors” by an employer does not absolve it of its obligations under the Act. In North Carolina, the Industrial Commission may still determine that the workers were actually employees based on a number of factors, including but not limited to the degree of control exercised by the employer and the tasks assigned to the contractor.
Even if the employer refers to its employees as independent contractors and issues a Form 1099 for tax purposes, that does not solely bar them from obtaining workers’ comp insurance.
Workers’ Compensation Benefits
Workers’ compensation will be qualified based on the employee’s current salary at the time of the injury and the extent and costs of the injury. Benefits will be given to an employee until they are provided notice of suspension or a final statement with full receipt.
While a claim is pending, an employee may be given notice of temporary remuneration. This gives the claim review process an additional 90 days. Once they’ve decided, the employee will be informed whether their pay will stop or whether they’ll be receiving the entire amount of workers’ compensation benefits for their injury.
The maximum amount of workers’ compensation benefits or pay that an employee may get is determined by the average weekly wage as determined by the North Carolina Industrial Commission.
Depending on the worker’s current salary and the year the claim was made, the compensation will change. Workers should typically be compensated with benefits equivalent to two-thirds of their weekly wages. The Workers’ Compensation Act specifies a state minimum and maximum wage.
The current maximum weekly wage for the most recent year in North Carolina after a work-related injury is $1,184.00.
How Long Does Workers’ Compensation Last?
If an employee is unable to work for longer than seven days, lost wage compensation is due. Until you return to work, temporary complete and partial disability benefits are paid for up to 500 weeks.
The main components of workers’ compensation benefits are disability benefits to make up for lost wages and payment for medical costs associated with an injury sustained on the job. The workers’ compensation insurance carried by your employer will cover any incident-related medical costs.
Some industrial accidents are referred to as “scheduled injuries.” Permanent partial disability compensation is available to workers who sustain certain injuries, both during their recovery period and for some time following. You are entitled to lifetime permanent complete disability compensation if you get an accident that renders you permanently unable to work.
Statute of Limitations for Workers’ Comp Claims in North Carolina
In North Carolina, a workers’ compensation claim has a two-year statute of limitations from the date of the job injury. The 2-year statute of limitations usually starts when you first encounter symptoms of a persistent work-related injury or occupational disease, such as carpal tunnel syndrome or similar ailment linked to repetitive stress.
This is less time than a typical personal injury claim. However, it does not require proof of negligence, only proof of an accident. For a regular personal injury claim that is not a work claim, the statute of limitations is three years.
Denied Workers’ Compensation Claims
If the North Carolina Industrial Commission (NCIC) denies your workers’ compensation claim, you must file the necessary paperwork indicating your intention to appeal. If you disagree with the decision, you may appeal the refusal regardless of the grounds given.
You must submit Form 18—Notice of Accident to Employer—within 30 days of the accident if you suffer an on-the-job injury. According to North Carolina statutes, your employer has just 14 days to inform you that your claim has been rejected after receiving written notification of the injury. The employer will do this by sending Form 61, which is the Denial of Workers’ Compensation Claim form.
There is a possibility that the claim will not be outright denied, and if that is the case, then an employee will receive Form 63, which gives the employer an extension of 90 days to complete the investigation. This can result in a denial of claims or affirm that they will receive coverage.
What to Do After a Denied Claim?
Once an employee receives notice of denial, they should cease communicating with their employer and any insurer. Stop communication and promptly file an appeal with the aid of a workers’ comp lawyer. In North Carolina, an employee has a series of steps to complete when seeking an appeal of a denied claim:
- Provide notice to the Industrial Commission by completing Form 18.
- Request a hearing through the Industrial Commission by filing Form 33.
- Complete the required mediation process under the Commission’s Office to potentially come to a resolution with the employer.
- If an agreement cannot be reached, then the hearing process will commence, and one should prepare for the hearing with the assistance of a North Carolina workers’ compensation attorney.
- A date will be provided, and the employee should attend the hearing and present all evidence before the Deputy Commissioner.
- A decision will be given, and one has 15 days after the decision to request an appeal.
If an employee is still unhappy with the commission’s decision, then they can appear to the North Carolina Court of Appeals. If a satisfactory decision is still not rendered, then the employee can appeal the ruling to the North Carolina Supreme Court.
Employer Duties for Workers’ Compensation
To make sure they contribute promptly to the claims investigation, an employer may need to frequently communicate with other employees who saw the incident or have information about it as an employer. The claims procedure might move more quickly if accountability is encouraged, allowing everyone to start working again sooner.
The insurance adjuster, the injured worker, and the medical professionals may get in touch with the employer after an employee files a workers’ compensation claim with questions or requests for information. Employers should answer these questions as soon as they can because the claims process has a deadline.
After a decision is rendered and the investigation is complete, the employer must not require the employee to return to work any sooner than the medical provider has stated. Additionally, they cannot reprimand the worker for any missed time while receiving workers’ compensation benefits.
Hiring a Workers’ Compensation Attorney
Consulting our lawyers at the Ricci Law Firm as soon as possible after sustaining an injury or becoming ill might significantly increase your chances of receiving all of the benefits to which you are legally entitled under the no-fault work injury insurance.
We provide thorough guidance on each step of the claims filing or appeals process to help you maximize your benefits and hasten your recovery. We even recommend the right experts and medical providers for you to contact for treatment in order to help you get the best possible care.
Contact the workers’ compensation attorneys at the Ricci Law Firm’s New Bern office and schedule a free consultation today.