Workers’ compensation is a type of insurance that provides medical and wage replacement benefits to employees who suffer injuries on the job.
In North Carolina, the law requires most employers to carry workers’ compensation insurance to cover the costs of these benefits.
Understandably, injured employees want to know who is eligible for workers’ comp.
To be eligible for workers’ compensation in Northern Carolina, you must meet specific requirements, and the company must offer benefits.
Workers’ compensation in North Carolina doesn’t cover all workplace injuries. To be covered, you must show the following:
- You suffered an injury,
- By accident,
- During the course and scope of employment, and
- You were employed at the time of injury by a business that has coverage through the North Carolina Workers’ Compensation Act.
The lawyers at Mehta & McConnell can help you determine what North Carolina workers’ compensation benefits you’re entitled to receive.
What Companies Must Offer North Carolina Workers Compensation?
In North Carolina, most employers must carry workers’ compensation insurance or qualify as self-insured employers.
This requirement extends to businesses with three or more employees, including companies operating as LLPs, LLCs, sole proprietorships, and corporations.
Exceptions to the requirements include:
- Casual employees,
- Employees of certain railroads,
- A domestic employee directly employed by the household,
- Farm laborers where the employer regularly employs fewer than 10 non-seasonal, full-time laborers,
- Federal government workers based in North Carolina, and
- Certain types of sellers of agricultural products.
People who are LLC members, partners, or sole proprietors do not automatically count as employees, and corporate officers can elect to exclude themselves from coverage.
Companies cannot get around the NC workers’ comp requirement by declaring employees independent contractors. Companies that violate these laws could face criminal charges and hefty financial penalties.
What Medical Benefits Does North Carolina Workers’ Compensation Provide?
Workers’ compensation insurance should cover the necessary medical treatment for your injury.
That includes all reasonable and necessary medical, surgical, and hospital treatment, as well as any other required medical supplies and services.
If your claim is approved, you don’t pay co-pays or deductibles if you see an approved doctor. Your company might also cover mileage should your doctor be more than 20 miles roundtrip.
What Wage Replacement Benefits Does North Carolina Workers’ Compensation Provide?
Workers’ compensation insurance will provide you with wage replacement benefits if you cannot work due to a job-related injury or illness.
These benefits are two-thirds of your average weekly wage, up to a maximum amount.
The insurance will pay you wage replacement benefits until you can return to work or until your injury or illness has reached maximum medical improvement.
Maximum medical improvement (MMI) is when doctors don’t expect your condition to improve any further, even with additional treatment. At that point, you might still be eligible to receive wage replacement benefits.
You may also be eligible for other benefits, such as permanent disability benefits or vocational rehabilitation benefits.
Does North Carolina Workers’ Compensation Pay Pain and Suffering?
In North Carolina, workers’ compensation benefits are designed to cover the costs of medical treatment and wage replacement for job-related injuries and illnesses.
It is no-fault coverage. Pain and suffering is not covered because those damages are part of the tort law system.
However, suppose you believe that the intentional actions of your employer or a co-worker caused your injury or illness.
In that case, you may be able to file a personal injury lawsuit to seek damages for pain and suffering.
Why You Should Hire a North Carolina Workers’ Compensation Lawyer
A North Carolina workers’ compensation lawyer can help you navigate the system and ensure that you receive the benefits to which you are entitled.
A workers’ compensation lawyer at Mehta & McConnell, PLLC can also help if your employer or the workers’ compensation insurance company disputes your claim or refuses to pay benefits.
We can also represent you in an appeal or other legal proceedings.
Can You Sue an Employer for a Workplace Injury?
In North Carolina, you cannot sue your employer for a workplace injury if workers’ compensation benefits apply.
That’s because the law considers the workers’ compensation system a “no-fault” system. You’re entitled to benefits regardless of who was at fault for your injury.
However, there are some exceptions to this rule. If your injury was caused by the intentional actions of your employer or a co-worker, you could file a personal injury lawsuit to seek damages, such as pain and suffering.
Proving intent is challenging, which is just one more reason why you should have a lawyer representing you.
You could file a third-party personal injury lawsuit if a defective product caused your injuries. In this situation, you would be suing the product manufacturer rather than your employer.
If you think you have a valid liability claim related to your workplace injury, please immediately contact Mehta & McConnell, PLLC.
The Importance of Reporting Your Injury Right Away
Immediately reporting your injury or illness is crucial. You could have as long as 30 days post-accident to report it, or you might lose your benefits.
However, you shouldn’t wait long to notify your employer. If you cannot report your injury due to a severe medical condition, you must report it as soon as reasonably possible.
You must complete a Claim for Workers’ Compensation Benefits form to file a claim. This form is available from your employer or the North Carolina Industrial Commission.
Complete the form and return it to the Industrial Commission within two years of the date of your injury.
Once you have filed your claim, the Industrial Commission will review your claim to determine workers’ comp eligibility.
If they approve your claim, you will begin receiving benefits, including medical treatment and wage replacement benefits.
Should your benefits be denied, you can request a hearing before the North Carolina Industrial Commission.
Contact a North Carolina Workers’ Compensation Lawyer
If you have questions on who is eligible for workers’ comp in North Carolina, contact Mehta & McConnell, PLLC.
We have over 30 years of combined legal experience, including with workers’ compensation claims. We can help guide you through the process and help you understand your options and rights.
Should your employer dispute your injuries, we can help you gather evidence and prepare an appeal.
We started our careers as defense attorneys. That means that we are accustomed to going to court. It might surprise you to know that many attorneys do not have much courtroom experience, but we do!
This experience gives us advantages that many other lawyers simply don’t have when going up against insurance companies and employers in court.
When you can’t work due to a job-related injury or illness, it is essential to remember that you are not alone.
The workers’ compensation system is in place to provide you with the benefits you need to cover your medical costs and lost wages.
With the help of a qualified workers’ compensation lawyer at Mehta & McConnell, PLLC, you can get the benefits you deserve and move forward with your life.