Workers’ Compensation – The Basics and What You Need to Know

Getting hurt while working can lead to a mountain of hospital and medical bills, rehabilitation costs, and extended time out of work. The financial and mental anguish during this time makes it difficult to get your life back and provide a stable income for yourself and your family.

That’s why DeVore Acton & Stafford can assist you when you’ve experienced a workplace injury. Here’s what you need to know about workers’ compensation benefits and how you can use them.

What is workers’ compensation?

Workers’ compensation is a state-mandated insurance program employers purchase to provide compensation to employees covering work-related injury or illness. Employees can receive benefits regardless of who’s at fault for the job-related injury in most situations. Often called workers’ comp, each state has its own laws and programs. North Carolina is no exception. The goal of workers’ comp is to provide immediate medical treatment and disability to people who are injured on the job and disabled from performing their job.

What does workers’ compensation cover?

Workers’ comp covers most but not all on-the-job injuries. In compensable cases workers’ compensation medical benefits include 100% payment for medical and hospital bills needed to diagnose and treat your job-related injury. This assistance may also include disability payments when you are disabled from work by your injury. Other covered expenses may also include rehabilitation and sometimes even retraining.

On-the-job injuries are covered under workers’ comp if they are caused either by an accident at work or by special exposures to work conditions that cause injuries or illnesses. These can include injuries from falls on the job and gradual illness or diseases from work exposures such as chemical exposures or repetitive work (assembly line jobs) that make the body more susceptible to injuries. Working in certain industries, such as assembly line work, can put a worker at an increased risk of repetitive stress injuries, such as carpal tunnel syndrome. Other jobs that can lead to repetitive stress injuries include regularly using computers and keyboards, using barcode scanning, and fixed position activities like prolonged standing or sitting.

Not all job injuries are covered under workers’ comp. These would include injuries that are not caused by an accident at work, such as injuries suffered while traveling to work while still off the company premises, or injuries suffered while the worker is on a personal errand.

How do you know if you’re eligible for workers’ compensation?

This question can be complicated, and different situations can lead to different answers. Questions that must be answered include whether you suffered a work-related illness or injury while on the job site itself, whether the injury occurred while you were performing employer-related business off the employer’s premises, whether your injury was caused by exposures to dangerous chemicals at work, whether your injury occurred while you were attending a mandatory business outing, etc.

There are many uncertain areas in workers’ comp coverage, and each case must be assessed separately. For example, for an injury that occurred during a lunch break, the attorney will need to know if you were injured on the job site, or on the employer’s premises, or crossing a street to get to the employer’s parking lot. Another example is if you slip and break your arm while dancing at a company event, the attorney will need to know if you were required to attend that event or whether attendance was optional. If you’re traveling off the worksite or on a sales trip and are injured, you may be entitled to receive benefits. You may not be able to collect workers’ comp on your work commute in your own car, but you may be covered if you drive the company vehicle.

Workers’ comp benefits may also be uncertain in relation to certain injuries. If you have a pre-existing condition like carpal tunnel syndrome that your job aggravates or exacerbates, you may be entitled to workers’ compensation benefits if your job put you at a higher risk of developing the disease.

How do you apply for workers’ comp?

In North Carolina, injured workers are supposed to file written notice of a workers’ compensation claim with the Industrial Commission and with the worker’s employer. We can help you with this requirement. The Form 18 should be filed within 30 days of the accident, and certainly not more than 2 years from the accident.

Do you need to sue your employer for your work-related injuries?

Filing a Form 18 with the Industrial Commission and copying your employer effectively starts the claim. In general, workers’ compensation injuries fall under the jurisdiction of the North Carolina Industrial Commission, and with few exceptions, one cannot file a lawsuit against one’s employer unless the employer’s actions were substantially certain to cause serious injury or death.

To learn more about your legal options after you’ve experienced a work-related injury, contact Bill Acton at DeVore Acton & Stafford, P.A.


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