Job related accidents often lead to medical expenses, loss of income due to recovery, and life-long injuries. Workers compensation was designed to reimburse employees for these expenses. To qualify for workers compensation, an employee must have sustained an accidental injury while performing duties within the scope of their job requirements. The employer must also carry workers compensation insurance, or by law be required to carry it, in order to file a claim with them. Independent contractors usually are not covered by a company’s insurance and don’t count as “employees” of the company. Certain types of subcontractors and truck drivers are covered, however, so there are some exceptions. A basic overview of how North Carolina Workers Compensation Law works is outlined below.
Qualifying Injuries and Illnesses
Some jobs are inherently more dangerous than others, and therefore have more opportunity for injury. Some injuries may occur due to faulty machinery, wet floors, or even during an unexpected driving accident while out for delivery. No matter the cause, employees are covered as long as it meets the requirement for an accident occurring within the normal scope of duties. Therefore, an employee who purposefully injures themselves while on the job would not qualify for benefits.
Illnesses that arose from workplace environments can also be covered under workers compensation. Examples of workplace illnesses include skin diseases, respiratory conditions, poisoning, radiation exposure, hearing loss, burns, blood borne pathogens, and even heat stroke. A direct correlation from the workplace to the disease needs to be proven in order to qualify. Employees have the right to work in a safe environment, and any workplace that causes a life-long disease would be considered unsafe. Most back injuries and repetitive motion injuries are not covered under workers compensation because those don’t count as a sudden, unexpected, or accidental.
Filing the Claim
Whether the severity of the injury is emergent or relatively minor, the first step is to obtain medical treatment. Then, you must alert your employer orally and by written statement within 30 days of the injury. If your employer fails to alert their insurance company and the Industrial Commission, you have up to two years to file a claim yourself. Sometimes employers will wait seven days before filing to see if the employee will recover first without medical treatment. Even if you alert your employer about the injury, you don’t have to rely on them to make the claim. You can file a claim at any time with or without their help.
Your employer and its insurance company are required to pay for any and all medical expenses directly related to the injury you sustained while on the job. You are also entitled to seek medical treatment for the injury up to two years after the last injury related appointment. So, if it takes longer than two years to recover and you are still seeing a doctor about it, you have two more years from the last appointment to have your medical expenses covered. Also, if you have to drive more than 20 miles round trip for medical treatment, the Industrial Commission may cover your mileage costs.
You may qualify for disability if you sustain substantial or permanent injuries that affect your ability to work. Total disability means you are no longer able to work at the job you were skilled at, such as a construction worker who became paralyzed from the waist down. Partial disability is defined as being able to return to work, but not in the same capacity or at a lower wage. A doctor will determine how limited you will be in your current role and the Industrial Commission will resolve any disputes between employer and employee. You are no longer eligible for disability when you are no longer disabled, you return to work in full capacity, or your wage returns to what it was before.
When a Claim is Denied
In the event that your employer or their insurance company decides there is no claim for your injury, it doesn’t mean that you lack a case. You are entitled to request a hearing with the Industrial Commission to determine if you qualify for workers compensation. It is always wise to consult an attorney in these situations who can help you argue your case.
If you ever have any questions about whether you qualify for workers compensation or not, contact a lawyer who is specialized in these cases. They will be able to investigate the incident and help you along with the process.