North Carolina Workers' Compensation Guide - Stewart Law Offices
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North Carolina Workers’ Compensation Guide

The experienced North Carolina workers’ compensation attorneys at Stewart Law Offices fight for the rights of employees who are injured at work or diagnosed with a job-related disease. Call or contact us today to learn how we can build a workers’ compensation claim that demands maximum benefits for your injuries and losses.

What is Workers’ Compensation?

North Carolina Workers Comp Lawyer workers’ compensation (or “workers’ comp”) provides medical coverage, wage reimbursement and other non-monetary benefits to workers who are involved in workplace accidents or diagnosed with an occupational disease. North Carolina employers with three or more employees are required to carry workers’ compensation coverage, with certain exceptions.

Who Handles North Carolina Workers’ Compensation Claims?

The North Carolina Industrial Commission (NCIC) oversees the state’s workers compensation system. Its deputy commissioners and commissioners are in charge of resolving disputes between injured workers, employers, and employers’ insurance companies over access to appropriate workers’ compensation benefits.

Workers’ Comp Statute of Limitations in NC

  • Workplace injury: 2 years from date of injury
  • Occupational disease: 2 years from date of diagnosis
  • Death benefits: 2 years from date of death

Failure to file on time can bar a workers’ compensation claim forever.

Notification Requirements for Workers’ Compensation

  • Worker must report the injury to employer within 30 days
  • File a Form 18 —Notice of Accident to Employer and Claim of Employee with the N.C. Industrial Commission (provide copy to employer)
  • Employer has 5 days from the date of injury or allegation of injury to file a Form 19 — Employer’s Report of Injury to Employee with its insurance carrier

Filing Requirements

All forms and documents must be filed with the NCIC electronically

Employer Response to Claims

  • Employer/insurance carrier has 30 days to admit, deny or pay the claim without prejudice (by completing Form 60, 61 or 63, whichever is appropriate)
  • Employee must receive written explanation for denial of benefits within 14 days of receipt

Average Weekly Wage (AWW)

  • Calculated by totaling the amount of wages for 1 year prior to injury and dividing by 52
  • If employee worked less than one year, divide wages by the number of weeks worked
  • Any period in which employee missed more than 7 consecutive calendar days of work not included in calculation

Workers’ Comp Claim Compensation Rates

  • Calculation: 66⅔ percent of average weekly wage not exceeding the state’s maximum rate
  • Maximum rate: Adjusted annually ($1,028 for 2019)
  • Minimum rate: $30 a week
  • Mileage: Reimbursed for medical treatment more than 20 miles from home (Also adjusted annually — 58 cents per mile for 2019)
  • Other costs: Travel, hotel and food costs may also be reimbursed

Waiting Period For Payment

  • Must wait 7 days before benefits (aside from medical expenses) can be paid
  • If you are out of work for more than 21 days, you will be reimbursed for the first 7 days
  • Payments made weekly unless NCIC directs otherwise

Medical Benefits For Eligible Workers

  • Covered costs: Employer must pay for medical treatment that can cure an injury, relieve pain or help the employee get back to work. Includes payment for medical conditions that are a “direct and natural consequence” of job injury.

Handling Workers’ Comp Disputes in North Carolina

If medical treatment and wage reimbursement does not happen promptly, employee can call the insurance carrier or request a hearing with the NCIC by filing a Form 33 — Request That Claim Be Assigned for Hearing

Types of Disability Benefits

Temporary Total Disability (TTD)

  • For workers who are totally disabled (but temporarily) after a workplace accident
  • 66⅔ percent of AWW wage not exceeding the state’s maximum compensation rate
  • Limited to 500 weeks for accidents occurring after 6/24/11; no cap on claims before that date
  • Benefits still payable while employee is authorized to return to work but with restrictions

Temporary Partial Disability (TPD)

  • Paid when healing worker can return to work but will be earning lower wages
  • 66⅔ percent of difference between AWW pre-injury and AWW post-injury, not to exceed state maximum
  • Limit of 300 weeks for injuries before 6/24/11; 500 weeks for injuries after 6/24/11

Permanent Total Disability (PTD)

  • For employees who can never work again
  • Medical compensation and 66⅔ percent of AWW paid for lifetime of employee
  • Certain injuries are automatically considered PTD, including loss of both: Hands, arms, feet, legs, eyes, and any combination of two of the above.
  • May also include some traumatic brain injuries, paralysis and severe burns to 33 percent or more of the body

Permanent Partial Disability

  • Payable to workers who have reached maximum medical improvement (MMI) but continue to have impairments to “scheduled” body parts according to N.C. North Carolina Workers’ Comp Lawyer (N.C.G.S. §97-31)
  • MMI is determined by doctor and worker is assigned rating that represents percentage of loss of use
  • Scheduled body parts are entitled to benefits for a set number of weeks based on the percentage

Scheduled Members and Body Parts

Injury to Compensation (Weeks)

  • Arm – 240
  • Back-  300
    *If loss of use is more than 75 percent Total disability — 100 percent loss
  • Ears:
    One ear – 70
    Both – 150
  • Eye – 120
  • Fingers*:
    Thumb – 75
    First (index) – 45
    Second – 40
    Third – 25
    Fourth (little) – 20
    *Loss of first phalange of thumb/ finger counts loss of half of affected digit and compensation will be for one-half the weeks specified
  • Foot – 144
  • Hand – 200
  • Leg – 200
  • Toes*:
    Great – 35
    All others – 10
    *Loss of first phalange of any toe counts loss of half of affected digit and compensation will be for one-half the weeks specified
  • Serious head or facial disfigurement – Up to $20,000
    Serious bodily disfigurement – Up to $10,000
    Loss/permanent injury to any important organ – Up to $20,000

NC Workers’ Compensation Death Benefits

  • Death must be a compensable injury
  • Must occur within 6 years of date of accident or onset of disability, or within 2 years of a final determination of disability by NCIC (whichever is later)
  • Payable to dependents of employee, with burial expenses not exceeding $10,000
  • 500 weeks after death for claims after 6/24/11; some exceptions apply

Contact the N.C. Industrial Commission

Mailing Address

1240 Mail Service Center
Raleigh, NC 27699-1240

Physical Location

430 N. Salisbury St.
Raleigh, NC 27603

NCIC Main Phone Number*

(919) 807-2501
(800) 688-8349
*Press 1 to find out the status of Form 18, 19 or to learn your NCIC File Number
*Press 3 for claims or procedure questions
*Press 0 for general questions

Fax Number

(919) 715-0282
Email:infospec@ic.nc.gov

Important N.C. Workers’ Compensation Forms

Form 18 — Notice of Accident to Employer and Claim of Employee

Form 19 — Employer’s Report of Injury to Employee

Form 22 — Statement of Days Worked and Earnings of Injured Employee

Form 23 — Application to Reinstate Payment of Disability Compensation

Form 24 — Application to Terminate or Suspend Employee’s Workers’ Comp Benefits

Form 25N — Notice to NCIC of Assignment of Rehabilitation Professional

Form 25P — Itemized Statement of Charges for Drugs

Form 25PR — Request for Preauthorization of Medical Treatment

Form 25R — Evaluation of Permanent Impairment

Form 25T — Itemized Statement of Charges for Travel

Form 26A — Employer’s Admission of Employee’s Right to Permanent Partial Disability

Form 28 — Return to Work Report

Form 28B — Report of Employer or Carrier of Compensation and Medical Compensation Paid and Notice of Right to Additional Medical Compensation

Form 28C — Report of Employer or Carrier of Compensation Paid Pursuant to a Compromise Settlement Agreement

Form 28T — Notice of Termination of Compensation by Reason of Trial Return to Work

Form 28U — Employee’s Request that Compensation be Reinstated After Unsuccessful Trial Return to Work

Form 30 — Agreement for Compensation for Death

Form 33 — Request That Claim Be Assigned for Hearing

Form 33R — Response to Request for Hearing

Form 60 — Employer’s Admission to Employee’s Right to Compensation

Form 61 — Denial of Workers’ Compensation Claim

Form 62 — Notice of Reinstatement or Modification of Compensation

Form 63 — Notice to Employee of Payment of Compensation Without Prejudice or Payment of Medical Benefits Only Without Prejudice

Form 90 — Report of Earnings