If you have lost wages due to a work injury, the insurance company must pay you workers’ compensation disability benefits.
These disability benefits are intended to compensate you for your lost wages.
There are often disputes in workers’ compensation claims over whether an injured worker is entitled to disability benefits.
Even if the insurance company acknowledges your right to receive disability benefits for lost wages, disputes may arise about the amount of benefits you are owed.
What to do if I lost Wages Due to a Workplace Injury?
The injured worker has the burden of proving their entitlement to receive disability benefits.
This burden is usually met by producing medical evidence that your ability to earn wages has been reduced as a result of your work injury.
You should give your employer and their workers’ compensation insurance company any work notes you receive from your doctors.
If your employer cannot accommodate your restrictions or you earn less wages than you did prior to your injury, you are entitled to receive disability benefits for your lost wages.
Types of Wage Loss Benefits
There is a seven-day waiting period to receive disability benefits. During these first seven days, you can use PTO. However, you will receive workers’ compensation wage loss benefits for the first seven days you were out of work if your injury causes you to miss more than 21 days of work.
If you are completely out of work due to your work injury, you are entitled to receive temporary total disability benefits in the amount of 2/3 of your average weekly wage.
The North Carolina Workers’ Compensation Act permits injured workers to receive up to 500 weeks of temporary total disability benefits.
After 425 weeks have passed since the date of first disability, an injured worker may apply to extend temporary total disability benefits beyond the 500-week limit if they are still unable to earn any wages.
The Industrial Commission establishes an annual weekly compensation rate. The maximum weekly compensation rate for injuries sustained in 2021 is $1,102.00. This means high-wage earners may not receive a full 2/3 of their pre-injury average weekly wage in temporary total disability benefits.
Unfortunately, there is no cost-of-living adjustment for workers’ compensation disability benefits. An injured worker’s weekly entitlement to disability benefits is based on their wages as of the date of their injury.
Temporary partial disability benefits are paid to an injured worker who has returned to work after a work injury, but who is earning less wages as a result of their work injury.
Entitlement to temporary partial disability benefits is calculated by subtracting your post-injury average weekly wage from your pre-injury average weekly wage.
You are entitled to receive 2/3 of the difference in temporary partial disability benefits. Temporary partial disability benefits are often calculated on a weekly basis because your wages may fluctuate from week to week.
You cannot receive weekly temporary partial disability benefits for an amount greater than the annual maximum weekly amount for disability benefits set by the Industrial Commission.
You can receive temporary partial disability benefits for up to 500 weeks. Any weeks of temporary total disability benefits you receive count towards the 500-week limit. Injured workers who have sustained a catastrophic injury may be deemed to be permanently and totally disabled.
A permanently and totally disabled injured worker will be able to receive temporary total disability benefits for the remainder of their lifetime, unless their employer can prove they are able to return to suitable employment.
A permanently and totally disabled worker is also entitled to receive medical treatment for their compensable injuries for the remainder of their life regardless of whether they return to work.
Your doctor will likely assign a permanent partial disability rating to your injured body part once you heal from your injury. Regardless of whether you lost wages, you are entitled to receive permanent partial disability benefits for any rating you receive for your compensable injury.
The North Carolina Workers’ Compensation Act contains a schedule of weeks for injuries to different body parts, and it also contains provisions for damages to organs and disfigurement.
One of the most important decisions to make during the course of a workers’ compensation claim is whether to elect to receive ongoing wage loss benefits or permanent partial disability benefits after you are placed at maximum medical improvement by your doctor.
An experienced workers’ compensation attorney can help you elect the greatest amount of benefit available in your case.
Are Workers’ Compensation Disability Benefits Taxed?
Generally, any workers’ compensation wage loss benefits you receive are not subject to state or federal income taxes.
Any settlement you receive for your workers’ compensation claim is also usually not taxed. However, any wages you earn from your employer after your injury likely will be subject to income taxes. An injured worker should consider consulting a tax professional about their individual tax circumstances.
Salary Continuation for Certain State Employees
North Carolina state law allows certain state employees, such as law enforcement officers and teachers, to continue receiving their full salary for a certain period of time while they are out of work for a work injury.
Salary continuation benefits pay the injured worker 100% of their wages instead of 2/3 of their average weekly wage.
Once the statutory period of salary continuation ends, workers’ compensation disability benefits start if the injured worker remains disabled due to their injury.
Of course, these state employees are still entitled to receive reasonably necessary medical treatment during their period of salary continuation and afterward.
Other Workers’ Compensation Benefits
It is important for injured workers to remember that other workers’ compensation benefits are available in their case in addition to disability benefits.
Other benefits that may be available to you include:
- Reasonably necessary medical treatment for your work injury,
- Vocational rehabilitation, which may include education, training, and job placement services,
- Attendant care benefits for your caregivers when prescribed by your health care provider, and
- Death benefits for your beneficiaries if your injury or illness results in your death.
When Should I Hire a Workers’ Compensation Lawyer?
If the insurance company is denying your claim for wage loss benefits, you will have the burden of establishing your entitlement to disability benefits before the North Carolina Industrial Commission.
An experienced workers’ compensation attorney can help you present the evidence required to successfully prove your claim for disability benefits.
Even if you are receiving disability benefits, the insurance company may be underpaying you.
We can force your employer and the insurance company to produce the wage documentation required by the Workers’ Compensation Act.
If the insurance company is paying you disability benefits, you can be sure it will take steps to terminate or suspend your benefits.
The insurance company may file a pleading, such as a Form 24 Application, to stop your benefits.
There are strict deadlines for responding to these pleadings. Our experienced workers’ compensation attorneys will aggressively fight to preserve your claim for wage loss benefits.
Maximizing Your Recovery
As you can see, there are a variety of disability benefits available to an injured worker.
It can be confusing to determine the benefits that are available to you, especially when your focus should be on recovering from your injuries.
The two board-certified North Carolina workers’ compensation specialists at Mehta & McConnell will evaluate your claim and work to obtain all the workers’ compensation benefits you are entitled to receive.
We will help you determine which benefits will yield the largest recovery in your claim. As your claim nears a conclusion, we will help you evaluate whether it makes sense to settle your case or continue receiving weekly wage loss benefits.
Let us help you maximize your recovery in your North Carolina workers’ compensation claim. Contact us to schedule a free no-obligation consultation