Archives for December 2010

Choosing your Workers Comp Doctor in NC

Anyone who is injured on the job in North Carolina must be careful when researching their rights on the internet.  As Mike Helfand points out in this post on his Illinois Workers’ Compensation Law Blog, workers in Illinois are able to choose their own doctor and medical facility for treatment.

Unfortunately, workers in North Carolina are not afforded such luxuries, except for in rare circumstances.  In North Carolina, once the insurance company accepts liability for your claim, they are able to direct your medical care.  That means that they can pick the doctors who treat you, and tell you where to go for your appointments.

In some cases, you are able to object and ask for a second opinion, but for the most part your adjuster can tell you where to go and who to see for treatment.

Based on Mr. Helfand’s post, it appears that in Illinois workers are given the right to pick their own doctors and hospitals for treatment.  Is this a better system that North Carolina?  It’s hard to say without more information.  It would appear to be more fair to the injured worker, and lead to less incidents of fraud on the part of the insurance company.

However, some of the other rights that residents of Illinois receive, such as being able to visit providers without having to pay a co-pay or other out of pocket expenses are similar to the policies in North Carolina.  Here, if you claim is accepted, you need not worry about paying your medical bills, they will be paid for by the insurance company.

Mr. Helfand also states that in Illinois, the worker may “speak to your doctors freely without fear that your privacy is lost”.  In North Carolina, you must be careful when you talk to your doctor, because anything you tell them is likely to become part of the record in your case.  Therefore, you must be very careful about how you talk to your doctors and what you tell them about your injury.  Seemingly inconsequential statements can have disastrous effects when taken out of context.

Bottom line – if you have been injured in North Carolina and are researching Workers Comp laws online, make sure that the website you are reading deals with North Carolina laws – not the law of other jurisdictions!

Why do I need a lawyer for my Workers Comp case?

Lot’s of people believe that they have no need for a Workers Comp lawyer.  This could be for a number of reasons, including:  they don’t think they have a claim or don’t wish to file a claim, they believe that the system is “fair” and they they can handle their case on their own, or perhaps they just don’t like attorneys and don’t want to hire one.  Still others are scared of some sort of retaliation by their employer (which is illegal, by the way).

Obviously, I am a bit biased here, but if you have been injured at work, and there is any chance at all that you might miss a prolonged period of work, I strongly recommend that you contact a lawyer.  Here are a couple of reasons why:

  1. Worker’s Comp lawyers generally will not charge you for the initial consultation
  2. There are a lot of “issues” or “disputes” that might arise that would most people won’t fully comprehend
  3. A lawyer can help you the most when they have been involved from the very beginning – i.e. they can coach you through the recorded statement and other communications with the insurance company
  4. They can answer your questions so that even if you decide to proceed without a lawyer, you will have information you need

Although workers comp may appear to be fairly straight-forward and simple, there are a number of “disputes” that can arise during the course of your case.  One dispute might be as to the amount of your weekly average wage, another might be as to your right to be compensated at all.

When the employer has workers comp claims made against it, the insurance company will increase the insurance premiums it collects to cover the increased risk of future claims or payouts.  Accordingly, the employer has a substantial incentive to decrease the number of claims filed against it, and assist in getting them settled for as little as possible – leading to conflict between the worker and the employer when there is a potential claim.

On the flip side, the insurance company makes money by paying out as little money as possible.  They have lots of very smart attorneys working for them to interpret the rules and statutes in a way that most favors the insurance company – which leads to lots of “disputes”.

Many people feel that they don’t need an attorney if the insurance company accepts their claim.  However, even in those cases where liability is undisputed, the lawyers working for the insurance company will make sure that you are paid the least amount possible – sometimes much less than you would receive with competent counsel.

If you have been injured at work and aren’t sure about your rights, give us a call at (919) 460-5422 for a free consultation.