Workers’ Compensation- How Does it Work?

Just because you are hurt at work does not mean you have a workers’ compensation claim. North Carolina requires an injury by accident arising out of the course and scope or employment in order to be a compensable claim. The term “injury by accident” has been defined by our courts as a slip, trip or fall. Alternatively, it can be an untoward event that does not fall within the parameters of the worker’s normal job duties.

North Carolina law requires that an employee give notice of his injury at work to the employer. North Carolina General Statute § 97-22, provides that “every injured employee or his representative shall immediately on the occurrence of an accident, or as soon thereafter as practicable, give or cause to be given to the employer a written notice of the accident…” G.S § 97-23 provides that the notice “state in ordinary language the name and address of the employee, the time, place, nature, and cause of the accident, and of the resulting injury or death…”

Beyond giving notice to the employer, the employee should also be sure to file a workers’ compensation claim with the North Carolina Industrial Commission by submitting a Form 18. G.S. § 97-24 provides that “the right to compensation under this Article shall be forever barred unless (i) a claim or memorandum of agreement as provided in G.S. § 97-82 is filed with the Commission or the employee is paid compensation as provided under this Article within two years after the accident or (ii) a claim or memorandum of agreement as provided in G.S. § 97-82 is filed with the Commission within two years after the last payment of medical compensation when no other compensation has been paid and when the employer’s liability has not otherwise been established under this Article.” It is not enough if the employer says they will take care of filing the claim.

Temporary Total Disability Benefits (TTD) in NC Workers’ Comp are paid during the healing period after an accident when the injured worker is written out of work by his treating physician or given work restrictions that his employer cannot accommodate.

There is a waiting period to receive TTD in workers’ comp in NC meaning the worker must be out for a total of seven days before wage loss benefits are initiated. The seven days do not have to be consecutive and if an employee misses any part of a day that counts towards the seven days. If the worker’s disability lasts for twenty one days then the insurance company must go back and pay the injured worker for the first seven days. For cases that arise under workers’ comp in NC after June 24, 2011, TTD benefits can continue for up to 500 weeks, with the possibility of an extension in certain circumstances.

The amount of the TTD payment in workers’ comp in NC is 2/3rds of the employee’s average weekly wage. The average weekly wage is determined by the 52 weeks of wages immediately preceding the injury date.

When an injured worker is being paid TTD in NC the employer may only stop benefits in one of two ways. First, if the employee returns to work his TTD benefits may be stopped. Alternatively, the employer may file a Form 24 Application to Terminate Benefits with the Industrial Commission in order to try and prove the worker is no longer disabled. The Industrial Commission will usually decide a Form 24 application in a telephonic hearing. An injured worker who receives a Form 24 should immediately contact an attorney.

Published by Maggie S. Bennington on April 26, 2018.