Workers Comp Process Explained

In North Carolina, the Workers Comp process can be prolonged and confusing to anyone who is not familiar with how the system works.  There are a three key points you must understand as you begin to navigate this system:

  • If you get injured on the job, Workers Comp is your exclusive remedy.  You can’t sue your employer for negligence, you can’t recover pain and suffering, and you are not entitled to a trial by jury.  The trade-off for this is that the employee does not have to prove that anyone was negligent in causing your injury.  Even if you are at fault, you may still recover under North Carolina’s Workers Comp laws.
  • The North Carolina Industrial Commission is the state agency that will administer your Workers Comp claim.  The Industrial Commission is efficient at disposing of cases relatively quickly, but at the same time is extremely overloaded in their work.
  • The Insurance company is not your friend, and will do anything it can to cut off your benefits.

Here is a brief overview of how the Workers Compensation system works in North Carolina:

  1. You are hurt in an accident at work, which may or may not result in a compensable injury (without speaking with an attorney, you probably don’t know if it is compensable yet or not).  Either way, you should immediately report the accident to your employer and seek medical treatment for your injuries.  Your employer may have a doctor on-site, or they may direct you to a designated health care provider.
  2. Tell the medical services provider that your injury occurred at work, and give them the name of your employer so that the treatment can be billed as a Workers Comp claim.  Make sure to give the doctor as much detail as possible about how the accident occurred, what it did to your body, what you felt/experienced at the time of and immediately after the accident, and any other details that are necessary for the doctor to adequately understand what happened to you and how it has affected your body.
  3. Give written notice to your employer of the accident.  The law requires that this notice be given within 30 days of the accident.  It would be prudent to copy the notice and give it to several people, in addition to keeping a copy for your files and to give to your attorney (should you require one).  You can use Form 18 to provide this Notice to your employer.  Form 18 must also be filed with the Industrial Commission within two years of the accident.
  4. Follow the instructions and restrictions provided by your doctor.
  5. Return to work – hopefully without being out for too long.

Most people are cleared to return to work after only being out a couple of weeks.  However, if you have sustained a more serious injury that involves a complete or partial disability, then you may be out of work much longer than that.  Since Workers Comp benefits can go on indefinitely, the insurance company will do everything they can to cut off or limit the amount of those checks.