Workers’ compensation in North Carolina, sometimes called NC workman’s comp or NC workmen’s comp, provides various benefits, including medical expenses, temporary total disability, temporary partial disability and permanent disability. Unlike the tort/negligence system which allows recovery for pain, suffering and the very real aggravation associated with injuries, the NC workers’ compensation laws provide coverage primarily for economic losses. Because of this limitation injured North Carolina attorneys and employees must work carefully through each of the following benefit areas to be sure they are fairly compensated.
• Medical Expenses in NC Workers’ Comp. Expenses associated with medical treatment that are reasonably necessary to cure the injury, give relief from pain, or lessen the disability must by law be paid by the employer or their workers’ compensation insurance company. There is no deductible, no co-pay, and no requirement that you miss work to receive medical benefits. You must show a relationship between the on the job accident and the medical treatment. Injured North Carolina employees have the right to a second opinion from the doctor of their choice at the employer’s expense on any permanent disability rating. Frequently in North Carolina workers’ compensation cases there is a tug-of-war between the insurance company and the employee to control the medical care. Injured NC workers have the right to request a hearing before the North Carolina Industrial Commission to resolve medical treatment issues. Injured NC workers who go two years without receiving medical treatment paid for by the workers’ compensation insurance carrier may lose their medical benefits forever.
• Temporary Partial or Total Disability (TTD or TPD) in NC Workers’ Comp. If a doctor writes an injured North Carolina employee out of work for more than seven days then they are entitled to receive TTD benefits. If the workers’ comp disability lasts three weeks then by law the NC employer must pay that first week as well. TTD payments are calculated based on two-thirds of the injured NC employee’s average weekly wage prior to the accident (AWW). If the injured employee is unable to earn the same wages as before the accident they are entitled to two-thirds of the difference (TPD) for up to 300 weeks.
• Permanent Partial or Total Disability in NC Workers’ Comp. If a doctor determines that an injured North Carolina worker is permanently partially disabled, he will assign a disability rating. Injured workers who receive a disability rating are entitled to benefits determined by a formula which factors in the average weekly wage, the part of the body that is injured and the disability rating. Injured workers may be entitled to receive benefits for life if they are permanently and totally disabled. In some cases, the better measure of benefits is the difference in wages earned prior to the accident and after the accident.
• Clincher Settlements in NC Workers’ Comp. Injured North Carolina workers are frequently offered an additional amount on top of their entitlement in exchange for their agreement not to pursue additional benefits and not to reopen the case if the condition worsens. This is often called a clincher agreement. Workers’ compensation recipients should very carefully consider the effect of such an agreement before executing it. It is best to discuss any clincher offer with a North Carolina workers’ compensation attorney prior to signing a clincher agreement.
