How Long Do You Have to File a Workers’ Compensation Injury Claim?
- A person must report their injury to their employer within 30 days.
- The statute of limitations for a workers’ comp case is two years. Form 18 must be submitted within two years of the date of an injury, or the worker will lose their right to workers’ compensation.
Am I Eligible for Workers’ Compensation After a Workplace Accident in Charlotte, NC?
Not all workers necessarily qualify for workers’ compensation in North Carolina. To determine your eligibility, several factors must be considered, including the circumstances surrounding your injury and whether your employer carries workers’ compensation insurance.
You likely qualify for workers’ compensation if:
- You are classified as an employee. Independent contractors are not eligible for workers’ compensation, but some employers will misclassify employees as independent contractors to avoid issuing benefits, including workers’ comp. Discuss your situation with a lawyer if you think your employer may be misclassifying you, as you are still entitled to workers’ compensation if your duties legally make you an employee.
- Your private employer has at least three employees. While there are some limited exceptions, if your employer has at least three employees, investing in a workers’ compensation insurance policy is not optional.
- Your injury was work-related. Your injury must have arisen “out of and in the course of your employment,” which is another way of saying you must have sustained your injury while you were on the job. This includes injuries stemming from workplace accidents as well as occupational illnesses.
- You were not intoxicated or trying to hurt someone (including yourself) when the injury occurred. You can still get workers’ compensation even if an injury-causing accident was your fault, but you may be barred from receiving benefits if the incident was caused by your being intoxicated or attempting to harm yourself or another party.
Fault does not matter when determining workers’ compensation eligibility. You do not need to prove a workplace accident was the result of your employer’s or anyone else’s negligence, and you still may be able to get benefits even if the accident was partially or completely your fault.
Still not sure whether you qualify for benefits? Our Charlotte workplace accident attorneys are happy to review your situation and ascertain your eligibility.
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How to File Workers’ Compensation in Charlotte
Filing a workers’ compensation claim is similar to filing any other insurance claim. It is not a lawsuit against an employer, but rather a request for benefits.
The first step in filing a claim is to notify your employer. No matter how the employer learns of the incident, they must offer you a claim form immediately. Until this claim form is completed, the employer has no obligation to provide benefits. Your employer should be able to supply you with the forms needed to file a claim. In fact, most states require the employer, doctors’ offices, and hospital emergency rooms to have the forms that start the process. If they cannot, immediately contact your state Workers’ Compensation Office, which can be located on our site’s state government agencies page. When filling out the form complete only the “Employee” section. Be sure to SIGN and DATE the claim form. It is important that you keep a copy of the claim form for your records. Return the claim form to your employer. You may hand-deliver or mail it to your employer. If you choose to mail the claim form, we recommend you use the certified mail return receipt requested. It is important to file quickly because otherwise, you could be subject to delays in receiving your benefits.
Your employer should then complete the “Employer” section and forward the completed claim form to his workers’ compensation insurance company. Your employer should give you a copy of the completed claim form. You should request a copy from your employer in the event you do not receive one. Keep a copy for your records. Generally, the insurance company has fourteen (14) days to mail you a status letter about your claim. If you don’t receive this letter, you should call the insurance company.
What Benefits Can I Receive for Workplace Accident Injuries?
Workers’ compensation insurance covers all expenses related to your medical treatment, though you will not get to choose your doctor. You will also receive compensation for a portion of your lost income (2/3rds of your average weekly wages) as well as permanent disability, if applicable. Non-economic damages, such as pain and suffering, are not covered by workers’ compensation.
Keep in mind that your employer’s insurer is not on your side and will likely make every effort to minimize what you recover. Whenever possible, speak to a legal professional before you make any written or recorded statements to an insurance agent. Do not accept a proposed settlement without first discussing your case with an attorney. Our Charlotte workplace accident lawyers are familiar with the tactics some insurers use to unfairly deny or reduce benefits, and we will aggressively fight to get you the money you need and deserve.
Tips for Obtaining Workers’ Compensation Benefits Successfully
When you are injured in an accident on the job, your first step should be to get medical care and report the injury to your employer. If any co-workers or other people saw the accident, make sure that you know their names and phone numbers. Our Charlotte worker’s compensation lawyers strongly advise you to take the following additional steps. By doing so, you can ensure that you receive the maximum compensation that you are entitled to.
- Do not speak to anybody about your accident other than your attorney.
- Do not write about the accident or post social media status updates discussing the accident or your injuries.
- Hire an experienced workers’ comp lawyer before speaking to any of your employer’s insurance representatives.
- Do not talk to any insurance company without legal representation. You should refuse to provide a recorded statement without the advice of your attorney.
- You should prepare for possibly being requested to submit to an independent medical examination (IME), which is an evaluation performed by a company’s selected health professional. Make sure you contact a lawyer before agreeing to any IME, as these exams are usually intended to find reasons to deny or minimize workers’ compensation benefits.
- Be mindful of the fact that your activities could also be watched by private investigators working for your employer’s insurance carrier. The investigators will see if the activities you engage in outside the workplace indicate that your injuries are not as severe as you claimed.
What to Do If My Claim Is Denied
Workers’ compensation claims are frequently denied for multiple reasons. Some of the most common reasons that claims are denied include failure to follow a doctor’s instructions, disputes about whether an injury was work-related, and lack of medical records. Your employer may assert that you were actually an independent contractor, not an employee, and reject your claim. Although fault is generally not an issue in workers’ comp, an employer may claim that the injured worker was intoxicated by alcohol or drugs or intentionally caused the injury.
The good news is that an initial denial of a workers’ compensation claim does not mean that a worker will be unable to obtain benefits. Injured workers often have several appeal options.
The North Carolina Industrial Commission (NCIC) will notify you within 14 days of your claim being denied, and you have 14 days from the date you receive your denial to file an appeal. The NCIC will typically schedule a mediation conference, at which an independent mediator will discuss your case with you and your employer’s insurance representative.
The mediator’s recommendation is forwarded to the NCIC, and an employee who disagrees with a mediator’s recommendation can request a hearing before an administrative law judge (ALJ). That hearing operates much like a trial, and an employee can then request a hearing before a panel of three ALJs if they disagree with the single ALJ decision.
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