2024 How Does Workers Comp Work in North Carolina?

Getting injured at work is something no one expects to happen. However, if you get injured at work, you probably assume that your company has a way of seeing that you are compensated for the situation. In North Carolina, this is required by law for all employers with more than three employees. There can be a few problems that arise, though, with workers’ compensation.

One issue is that many employers aren’t sure what workers’ compensation should cover. Another issue is that the compensation is fulfilled by an insurance company whose profits are negatively impacted by every claim you make. The combination of these two issues results in employees often not getting everything that they are owed. A good workers’ comp attorney in Hickory, NC, can help with these kinds of issues.

When You Should Get Workers’ Compensation

The workers’ compensation law in North Carolina sets strict guidelines about what is and isn’t covered by workers’ compensation. This means you must be careful when speaking with an insurance agent, as they may try to get you to say something that can hurt your case. In general, there are four conditions that must be satisfied for an injury to be covered by workers’ compensation. They are:

• The injury must be to an employee.
• An accident on the job must be the cause of the injury.
• The injury must arise out of their employment.
• The employer must be covered by the North Carolina Workers’ Compensation Act.

If you accidentally make it sound like your injury doesn’t fit into one of these categories, it’s possible that the insurance company may try to reject your claim on those grounds. If you think you might be in this situation, be sure to seek legal help.

How Much Workers’ Compensation You Are Due

Employers may always choose to cover more than just what the law stipulates, but according to the law, there are a few specific areas that workers’ compensation must address. These include:

• Medical Care – Workers’ compensation should cover 100% of the medical bills associated with your injury. There is no co-pay or deductibles. For travel to medical appointments that are more than 20 miles away, you can be reimbursed for travel expenses.
• Wage Replacement – If your injury causes you to miss work, or even if you need to work less as you recover, workers’ compensation should cover a portion of your wages during this period. Generally, the plan pays out two-thirds of your average weekly wages, usually in weekly checks but sometimes as a lump sum at the end of the claim.
• Benefits – Generally, your benefits should be covered for the time you are out of work.
• Vocational Rehabilitation – It may be that your injury is so significant that it requires you to make a career change. If this is the case, worker’s compensation may cover things like education assistance, job placement services, and resume help.
• Death Benefits – If an employee were to die as a result of an injury that fits the workers’ compensation guidelines, the spouse or parent (if the employee is a minor) might be entitled to benefits that cover the expenses of a funeral and wage replacement benefits.

FAQs

Q: What Is the Workers’ Compensation “Going and Coming Rule” in North Carolina?

A: The “going and coming” rule addresses the question of whether or not an employee should be compensated for injuries that happen in the course of heading to work or returning home. The rule says that these injuries do not need to be compensated, as they do not arise out of or in the course of employment. There are, however, three exceptions to the rule:

• Premises – If the injury does happen on property owned, maintained, or controlled by the employer, it will be compensated.
• Special Errand – If the injury happens when an employee is undertaking a task of “appreciable benefit” to the employer, it will be compensated.
• Transportation – If the employer is reimbursing, furnishes, or makes other allowances for the transportation, it will be compensated.

Q: How Does Workers’ Compensation Cover in North Carolina?

A: Worker’s compensation can cover a few different categories of costs related to workplace injuries, including:

• All medical care prescribed by an approved doctor
• Travel expenses to and from a doctor if it is over 20 miles
• Wage reimbursement – Typically, two-thirds of your weekly average wage
• Benefits
• Vocational rehabilitation – If you need to change careers because of your injury, this can cover expenses like educational assistance, resume help, and job placement services.
• Death benefits – A spouse or parent (if the employee is a minor) may be entitled to funeral expenses and wage replacement benefits if the workplace accident resulted in the employee’s death.

Q: Does North Carolina Workers’ Comp Pay for Pain and Suffering?

A: An injury in the workplace carries costs that extend beyond the financial. Things like physical pain and mental suffering can weigh on a person. The financial disruptions and stress on personal relationships are further difficulties created by the workplace accident. Despite all this, North Carolina law does not require compensation for pain and suffering.

Q: What Employees Are Excluded From Workers’ Compensation in North Carolina?

A: There are a few groups of employees whose employers are not required to provide workers’ compensation:

• Employees at companies with fewer than three employees
• Corporate officers
• “Casual” employees – They don’t work regular hours and aren’t a part of regular business.
• Farm workers – if the farm has fewer than ten employees
• “Household” employees – workers like a nanny or maid
• Railroad employees
• Federal government employees

Get the Workers’ Compensation You Are Legally Entitled To

Workers’ compensation is paid out by an insurance company. It’s important to remember that insurance companies make more money by paying out less. So, if you are owed workers’ compensation, it’s important that you get a firm understanding of what you are owed and keep track of what you are paid. If you need help to understand what you should be receiving in your situation or help to ensure you are given what you are owed, a good employment lawyer can help. At Helton, Cody & Associates, PLLC, we offer our services to Burke County, Catawba County, and Caldwell County. Contact us today if this sounds like what you need.