Following a work-related injury, it is common for injured employees and their families to be concerned about how they are going to make ends meet, especially when no paycheck is coming in.
Knowing the waiting period for North Carolina workers’ compensation claims can help give you reasonable expectations of what you are entitled to receive and when.
North Carolina Workers’ Compensation Program
Most workers in North Carolina are covered by workers’ compensation.
Under this system, all businesses that employ a minimum of three employees are required to carry insurance in case a worker is injured in the course of doing their job.
Workers’ compensation is a no-fault system, which allows workers to receive compensation quickly and to avoid costly and lengthy litigation between employers and employees.
Types of Workers’ Compensation
There are different categories of North Carolina workers’ compensation benefits. You may be eligible to receive one or more, depending on the nature of your injury.
Medical treatment can be expensive; without insurance coverage, they can be devastating.
North Carolina workers’ compensation helps employees pay for healthcare costs due to work-related injury or illness.
Applicable costs may include emergency care, diagnostics, surgery, therapy, medication, equipment, and in-home care.
In accepted workers’ compensation claims, the employer has the right to choose the doctor seen by the injured party.
This is usually because they pay less for in-network providers. The employee can petition the North Carolina Industrial Commission to allow the use of a specific doctor.
Failing to go through the proper channels for approval may result in expenses that are not covered by the program.
Is there a waiting period for workers’ comp? This question is most relevant to receiving indemnity benefits. These benefits are also referred to as “lost wages” or “disability” benefits.
If you were injured so severely that you are unable to work, either temporarily or permanently, you might be eligible for a portion of your lost income.
Disability benefits are calculated using your average weekly wage. How much you receive and for how long depends on the severity of your injuries.
Not all injured employees will be able to return to their original position because of the nature of their injuries.
These workers’ may be entitled to vocational rehabilitation benefits that could cover the cost of re-training or additional education.
The employer can pay for a one-time assessment of the employee’s vocational potential.
From there, a counselor is appointed to determine the best course of action to help the employee succeed in a new position.
When a North Carolina employee is killed due to a workplace accident, their surviving dependents may be eligible for compensation, known as “death benefits.”
No amount of monetary compensation can come close to making up for the loss of a loved one, but death benefits can help ease the financial burden.
Death benefits are generally paid weekly, at a rate of two-thirds of the deceased’s average weekly wage, for 500 weeks.
In some situations, a lump sum payment may be made. Dependants may also receive up to $10,000 for funeral and burial expenses.
Is There a Waiting Period for Workers’ Comp?
The workers’ comp waiting period applies primarily to indemnity benefits. Again, these are benefits related to lost wages.
North Carolina workers’ compensation does not cover the first seven days an employee is out of work for their illness or injury unless they remain disabled for at least 21 days.
For example, if an employee was unable to work for 14 days, they would be compensated for seven days of work. If an employee could not work for 22 days, they would be compensated for 22 days of work.
How Long Does a Worker’s Compensation Claim Take in North Carolina?
The exact timeline is a little different for each worker. The first step is to notify your employer in writing within 30 days of when the injury or illness occurred or was made known.
In some cases, the employer having actual knowledge may be enough, but it is best to have it in writing.
Within five days of notifying your employer, they should file the necessary forms with their workers’ compensation insurer or the North Carolina Industrial Commission.
The insurance company will then notify you whether your claim has been accepted or denied. This information could also come from your employer.
If the claim is accepted, you can receive payments for medical treatment. It is important to note that the insurance company can begin paying benefits while reserving the right to ultimately deny your workers’ comp claim.
Wage replacement benefits are subject to the seven-day waiting period for North Carolina workers’ compensation claims.
Can Your Workers’ Compensation Claim Be Disputed?
In North Carolina, you have two years from the date your injury occurs to file a claim with the Industrial Commission.
You may start the dispute process if your claim is denied or is less than what you are rightfully owed.
It is best to have an attorney present to ensure you are properly represented and advise you on your rights and the best strategies to receive compensation.
The first step in the dispute resolution process is to attend mediation to resolve the issue. If you cannot agree, you may be entitled to dispute the denial of your claim before the Deputy Commissioner.
If this does not go as well as hoped, you still have 15 days after the Deputy Commissioner renders a decision to appeal to the full Industrial Commission.
The next step after that is to appeal to the North Carolina Court of Appeals.
The attorneys at Mehta & McConnell understand how frustrating this process can be. We have over 30 years of combined experience representing injury victims.
Contact us to schedule your free case consultation.