Getting hurt at work or being diagnosed with an occupational illness is stressful, overwhelming and confusing for many hardworking North Carolinians. Not only must you learn how to adjust to the new normal and focus on your recovery, but you also probably have medical bills piling up and may be unable to work. While workers’ compensation is a vital resource for injured workers, it’s one you never hope to need. But when you do, you likely have many questions about how the process works and what your legal rights are following a job-related accident, injury or illness.
Every case is different, which means that it’s in your best interest to talk with a knowledgeable workers’ compensation lawyer near you as soon as possible about your unique case and circumstances. If you were injured on the job in North Carolina, we encourage you to schedule your free consultation with one of our experienced attorneys at the Wilder Pantazis Law Group.
In the meantime, here are some answers to a few of the most commonly asked questions about workers’ compensation cases in North Carolina.
North Carolina workers’ comp faqs
- What if my company doesn’t want me to file a claim?
- Can I be fired or laid off for filing a workers’ comp claim?
- What if my employer pays me in cash?
- What if I can’t do my job after my injury?
- Does my immigration status matter?
- What if I don’t speak English?
- What injuries are covered by workers’ compensation?
- What if I was fully or partially responsible for my workplace injury?
- Can I sue my employer for my accident or injury?
- What benefits are available under workers’ compensation?
- How are my weekly benefits calculated?
- How long can I receive medical treatment?
- Am I allowed to choose my own doctor?
- Do I get reimbursed for travel to medical appointments?
- Why is North Carolina’s “accident” rule a potential problem for injured workers?
- What does a workers’ comp attorney do?
- How much does a workers’ comp lawyer cost?
- How long do I have to file my work injury claim?
What if my company doesn’t want me to file a claim?
In some cases, an employer may offer to pay for you to go to the doctor and even compensate you for a couple of days of missed work in return for you not filing a formal workers’ compensation claim. This is not a good idea because you are entitled to certain benefits under North Carolina’s Workers’ Compensation Act in addition to medical care and wage replacement.
For example, if you break your leg at work and file a work injury claim, you may get paid for your medical treatment, time out of work, AND a cash payment for the disability rating you may receive at the end of your case (sometimes called “PPD” or “permanent partial disability”).
It is a bad idea not to report your claim to the insurance company because you never know how severe your injury is until you receive proper medical treatment. Also, your employer may not know (or admit to knowing) that they are supposed to pay for PPD, mileage to and from doctor’s appointments, and prescriptions.
Can I be fired or laid off for filing a workers’ comp claim?
Your employer cannot fire you, demote you, or take any adverse employment action against you for filing a workers’ compensation claim. This is a violation of the Retaliatory Employment Discharge Act (REDA). Any attempts to do this should be reported to the North Carolina Department of Labor.
What if my employer pays me in cash?
Some employers pay their workers “under the table” and in cash. It’s important to understand that this doesn’t necessarily mean that the company is exempt from having to pay workers’ compensation benefits.
However, it will be your burden to show how much you were earning before your injury. If you are paid cash, it is a good idea to keep a weekly diary of how much you are paid, including overtime.
What if I can’t do my job after my injury?
If there is no work available at your job within your restrictions, the insurance company must help you find a job that fits within your physical limitations. An attorney can make sure that the insurance company doesn’t try to send you back to a job that is unsuitable for your age, physical limitations, education, and experience.
Does my immigration status matter?
You are entitled to workers’ compensation benefits even if you are an undocumented worker. The insurance company is not allowed to ask you about your immigration status. Although your boss can fire you if they discover that you are undocumented, the workers’ compensation carrier cannot deny your claim based on your immigration status if you get hurt at work. If you are medically unable to work, the insurance company must continue to pay your time out of work even if you are undocumented.
What if I don’t speak English?
The insurance company must provide an interpreter if the doctor’s office does not have someone on staff who speaks your language.
Si en el consultorio médico no cuenta con alguien que hable su idioma, la compañía de seguros debe proveer un intérprete.
What injuries are covered by workers’ compensation?
If your company has 3 or more employees, you may be eligible for workers’ compensation benefits. This is true regardless of your immigration status. North Carolina’s workers’ compensation laws cover injuries that result from an accident arising out of and in the course of employment. The law also covers “occupational diseases,” which include some lung conditions such as asbestosis and some repetitive-motion conditions, such as carpal tunnel syndrome.
State law is very specific and insurance carriers are skilled at applying these rules to limit or deny claims. For this reason, it’s wise to consult with a skilled work injury lawyer if you are filing a claim.
What if I was fully or partially responsible for my workplace injury?
The issue of “fault” or “negligence” does not matter in workers’ compensation. You can recover compensation even if you are at fault in the accident.
Can I sue my employer for my accident or injury?
In most cases, you cannot sue your employer outside of the workers’ compensation system for your injuries. Workers’ compensation benefits are considered an “exclusive remedy” against your employer.
What benefits are available under workers’ compensation?
Workers’ compensation benefits fall into 3 basic categories:
- Payment for your medical treatment and related medical expenses
- Compensation for lost wages (at 2/3 your average weekly earnings), including overtime and bonuses (often called “TTD”)
- Compensation for permanent disability (often called a “rating” or “PPD”)
Pain and suffering is not recoverable under workers’ compensation law. Workers’ compensation benefits are not taxed.
How are my weekly benefits calculated?
Your weekly benefits are calculated by averaging your wages in the 1 year before your injury. You receive two-thirds of this amount for any week that you miss work due to your injury. Most workers should receive time and a half for every hour worked over 40 hours per week. The insurance company must take into account overtime when calculating your weekly benefits.
Workers’ compensation benefits are not taxed, so the 2/3 wages are roughly your after-tax weekly earnings. This is called your “compensation rate” and must be paid to you for the time you miss work due to your injury. The adjuster may refer to this check as “TTD” which stands for “temporary total disability.”
The first week you miss work due to your injury is considered to be a waiting period. You do not get reimbursed for that week unless you are out of work for more than 21 days. If you are out of work for more than 21 days, then you get reimbursed for the first week. If you are only out of work for 2 weeks, then you don’t get paid for the first week, but will get paid for the second week.
How long can I receive medical treatment?
Generally, you have 2 years after the insurance company pays your rating or your last medical bill (whichever is later) to see the doctor for your injury. For example, if you see the doctor 6 months after you receive payment for your rating, the 2-year clock starts again from the date of your last medical appointment. As long as you are seeing the doctor at least once every 2 years, you should be entitled to medical benefits for as long as you need to see a doctor for your work-related injury.
Am I allowed to choose my own doctor?
If the insurance company accepts your claim, it gets to direct your medical treatment. However, if you are unhappy with the treatment you are receiving, you can request a change of physician to your own doctor.
At the end of your treatment period when you have reached “maximum medical improvement” (or MMI), the doctor may issue a permanent partial disability (PPD) rating to the part of your body that was injured. The higher the rating, the more money your injury is worth. If the insurance company’s doctor gives you a low rating, you are always entitled to a second opinion from a doctor of your choice.
Do I get reimbursed for travel to medical appointments?
If your doctor’s appointment is more than 10 miles one way (20 miles round-trip) from your home, then you are entitled to mileage reimbursement. The reimbursement rate is modified each year, but it is currently at 56¢ per mile.
If you do not have transportation or a way to get to your appointment, then the insurance company must arrange for a car to come to get you and take you to the doctor.
Why is North Carolina’s “accident” rule a potential problem for injured workers?
Most people who get hurt at work assume that it will be covered by workers’ compensation. However, no matter how much you trust and like your employer, ultimately the insurance adjusters that actually administer the claims will always look for ways to deny coverage. These adjusters will often set up recorded statements and ask questions in a way to make it seem as if there was no “accident.”
In North Carolina workers’ compensation law, an “accident” is an interruption of the normal work routine by an unexpected and untoward event. Therefore, an injury while doing normal work in a normal manner does not qualify as an accident. An accident is a deviation from the normal work routine, such as a fall, some assaults, increased volume or pace of work and literally hundreds of other events.
For example, let’s say a Charlotte airport baggage claim handler injures their shoulder while loading a bag into an airplane. Under these circumstances, the adjuster might ask: “You weren’t doing anything wrong or different than normal, were you? You were just doing your job the normal way that you have always done it, weren’t you?” Most people would answer, “No, I wasn’t doing anything different. Yes, I was doing my normal job in the way I was trained to.”
The injured airline employee wouldn’t think to mention the many things that could be unusual about why he or she was injured, such as the bag being too heavy and awkward, the bag falling backward, not having the correct number of people to help with the baggage or something in the bag that shuffled and caused it to slip. Any of these small factors could be considered an accident that caused the injury, but the claim could be denied or reduced simply because the injured worker failed to mention them in a recorded statement.
There are also exceptions to the general “accident” rule. For example, if a worker has an immediate onset of pain in their spine while performing work-related duties, this is considered an accident. This exception is called a specific traumatic incident.
These complicated rules and exceptions are exactly why injured workers in North Carolina should consult with an experienced attorney in their area before agreeing to give a recorded statement or accepting a settlement offer.
What does a workers’ comp attorney do?
While we can’t speak for other law firms, when you bring your case to the Wilder Pantazis Law Group, you can take comfort in knowing that we are aggressive advocates for injured workers from start to finish. We assist clients in the early stages of filing Form 18 all the way to a trial in front of Deputy Commissioners and appeals in front of the Full Commission.
If you decide to hire us to represent you, we will:
- Fight tooth and nail to secure all benefits owed to you
- Communicate effectively with the insurance company and the adjuster assigned to your claim
- Assist with authorization for medical treatment
- File your travel reimbursement requests
- Order your medical records
- Discuss your treatment with you and your doctor
- File the correct forms with the Industrial Commission
- Recommend physicians for second opinions
- Negotiate a full and fair settlement to your claim
- If necessary, take your case before the Industrial Commission
Our firm will also explain how other available benefits might affect your workers’ compensation claim, such as Medicare, Medicaid, Social Security disability, short-term disability, long-term disability, your health insurance policy and any third-party claims.
How much does a workers’ comp lawyer cost?
In North Carolina, the fee a workers’ compensation attorney can charge is regulated by the state and must be approved by the Industrial Commission. The standard fee is 25 percent, which typically comes out of your final settlement or award.
All of our workers’ compensation cases are taken on a “contingency fee” basis. This means that you pay no money upfront and there is no fee for the initial consultation. Instead, your lawyer will take their fee as a percentage of your final settlement. If we don’t win your case, then you owe us nothing. It’s that simple.
In addition, all initial consultations with our attorneys regarding workers’ compensation cases are free of charge. During your first meeting with our knowledgeable work injury lawyers, we will listen to your story and discuss important liability issues as well as what compensatory damages you may be entitled to.
How long do I have to file my work injury claim?
In North Carolina, the statute of limitations for workers’ compensation claims is 2 years from the date of the injury (or discovery of the condition). After this period expires, you will no longer be able to file a claim and will lose your right to compensation forever. The sooner you discuss your case with a work injury lawyer near you, the more options will be on the table to secure the best possible settlement. Don’t delay!
Meet our attorneys
Established in 2018 to serve injured workers in North and South Carolina, the Wilder Pantazis Law Group is powered by a team of tried and tested attorneys with decades of experience successfully handling cases across the region. We are dedicated to providing the highest quality of legal services in the areas of workers’ compensation, personal injury and complex civil litigation.
Client reviews and testimonials
Beau Wilder was great to work with on my Workers’ Compensation case. He was always available to answer questions and made the process seamless. He went above and beyond in the whole process! Highly recommend letting him help you.”
– Brandon Watts
Beau Wilder was amazing to work with regarding my workers’ compensation case. Mr. Wilder treated me like family and fought hard for my rights and compensation. I recommend Mr. Wilder for anyone looking for a professional, hardworking and genuine attorney! Respectfully, D. Hardin”
– Daniel Hardin
“Ms. Pantazis breaks the mold of the normal attorney. You don’t feel like you need a shower after talking to her. She is friendly, honest and truly cares about her clients. Things didn’t go as well as I wanted but would’ve been worse with anyone other than Annemarie.”
– William Gross