North Carolina boasts a robust employment sector, being the third-largest financial center and the 10th-largest automotive employment sector in the country. It is also home to the biggest research park and the fifth-largest chemical industry workforce in the country. The town of High Point is regarded as the furniture capital of the world.
But even with such a large labor force, the Tar Heel State statistically has a lower incidence of non-fatal workplace injuries in the private sector. In a 2021 news release from the Bureau of Labor Statistics, North Carolina registered a rate of 2.2 cases per 100 full-time employees, compared to the national rate of 2.7. Around 70% of these incidents came from three sectors: manufacturing, education and health services, and transportation, trade, and utilities.
In a similar report from the same year, however, the incidence of fatal workplace injuries due to hazard exposure was higher in the state at 21.2, compared to the nation’s at 15.4. Most of the cases came from the waste management and remediation and private administrative services industries.
Workers, especially those from the aforementioned industries, are advised to arm themselves with pertinent information regarding North Carolina’s workers’ compensation laws. This enables them to exercise their rights and take the appropriate steps following an injury in the workplace. Just like any legal system, workers’ compensation can be a maze of paperwork, professional jargon, and complicated provisions that may take some time to get used to.
North Carolina Workers’ Compensation Insurance Requirements
Businesses with three or more employees are required to carry workers’ compensation insurance, according to the North Carolina Workers’ Compensation Act. This rule applies to various types of businesses, including sole proprietorships, corporations, and limited liability companies.
In general, however, the following worker categories are exempt:
Certain railroad workers.
Federal government employees.
Farm workers of businesses with fewer than 10 full-time workers.
Commission-based salespersons of agricultural products.
Penalties for Non-Compliance
The North Carolina Industrial Commission imposes a fine of $1 a day per employee, or up to $100 per day maximum. This goes to say that if the employer does not carry the insurance for a year, they could pay up to $36,500 in fines.
Non-compliant employers will also have to make restitution if any employee gets injured. They are required to shoulder the costs of medical bills and the replacement of lost wages, among others.
If found to be neglectful, employers can face misdemeanor charges. But if found to be willfully non-compliant, they can be charged with a felony.
Employee Misclassification: Independent Contractor vs. Employee
Some employers deliberately misclassify employees to save on costs, such as worker’s compensation insurance. A common example of this is classifying an employee as an independent contractor. Some employers may inadvertently have done so because of a lack of knowledge of the law.
Either way, annual payroll audits can expose non-compliance. If found to have misclassified employees, the employer can be held liable for workers' compensation claims plus regulatory penalties. Therefore, it is important for employers to properly classify their employees. It can even help them save on insurance costs and, most importantly, avoid penalties in the long run.
The North Carolina Office of State Human Resources offers employers classification specifications as a guide. Generally, employees can be temporary or part-time staff, minors, or seasonal workers. They can be hired on a contractual basis, through an apprenticeship, or by implied arrangement.
How Can Employers Get Workers’ Compensation Insurance?
Private insurance companies in North Carolina offer workers’ compensation insurance. Employers can also opt to self-insure themselves. On the other hand, high-risk employers who are unable to secure insurance from insurers can apply to the state fund or the North Carolina Rate Bureau.
In addition to employee benefits, workers’ compensation insurance also includes employer liability coverage. The coverage can be useful in various injury-related lawsuits not initiated by the employee, such as those involving third-party-over action or consequential injury suits. Insurance from state funds does not include this coverage. In most cases, though, if the employee obtains workers’ compensation benefits, the law stipulates they can no longer sue their employers, except in a few cases.
North Carolina Workers’ Compensation Benefits
Employees suffering from work-related illnesses and injuries can secure financial benefits from workers’ compensation insurance. The process follows a “no-fault” system, which means benefit eligibility applies regardless of who is at fault for the injury or illness. However, there are certain cases where an employee cannot be eligible. These include incidents involving alcohol or drugs and failure to wear safety equipment.
The benefits are further categorized as medical, disability, rehabilitation, and death benefits. These include, but are not limited to, travel costs for medical care, the replacement of lost wages, and expenses needed for workforce reintegration. In general, these are considered non-taxable unless the employee is concurrently receiving other benefits, such as those from Social Security.
Employees can quickly learn more information about the insurance their employer carries by using the North Carolina Industrial Commission Insurance Coverage Search System. They can also contact the Industrial Commission’s Claims Administration Section at 800-688-8349 (press 3 after the prompt).
As already mentioned, because of the workers’ compensation system, injured employees generally cannot sue their employers. They can do so only if their employers have been grossly negligent or deliberately caused harm. However, they can sue their co-workers or any third party responsible for the injuries. In North Carolina, all personal injury lawsuits must be filed within three years after the injury happened.
How to File a Workers’ Compensation Claim in North Carolina
All employees must report verbally or submit a written notice to their employer within 30 days of the accident. Employers, in turn, must notify their insurers immediately.
When Is the Deadline for Workers’ Compensation Claims in North Carolina?
Workers’ compensation claims in the state must be filed within two years after the injury or diagnosis of the work-related disease. Failure to do so can result in non-payment of benefits.
Step-By-Step Guide on Filing a Workers’ Compensation Claim in North Carolina
It is important for employees to complete the requirements and properly follow the procedures when filing a workers’ compensation claim. This can result in a smoother reporting process and the prevention of problems.
1. See a doctor and inform your employer
Seek medical treatment suitable for your injuries. This can be at an onsite healthcare treatment provider, a hospital emergency room, or a doctor’s clinic. Follow your employer's procedure, if there is any, for dealing with workplace accidents. Inform your employer if you are able to do so. If not, have a family member, co-worker, or friend report the incident.
2. Inform the doctor of your work-related injuries
Inform the medical provider that your injury is work-related and give your employer's name. You must also inform the doctor if you believe your illness resulted from workplace exposure.
This allows the provider to bill your expenses under workers’ compensation claims.
3. Submit a written notice to your employer
Submit a written notice to your employer within 30 days. Briefly detail what happened and the date of the incident. Complete this step regardless of whether the employer has already been verbally informed. If you cannot do so, have another person do it for you. Do not forget to keep a copy of the notice for record-keeping purposes.
4. Always follow the doctor’s orders
Keep in mind to always follow the doctor’s orders during the course of your treatment. Failure to do this may result in problems with your workers’ compensation claim. Additionally, you have the right to a second opinion if the doctor orders surgery as part of your treatment.
5. Gather important documents
Always keep a copy of your medical bills and other relevant documents. You may be required to complete some additional paperwork as well.
6. Properly submit your workers’ compensation claim
In most cases, complete Form 18 and submit it to the Industrial Commission at the following email address: email@example.com. If the claim is for lung disease, such as silicosis or asbestosis, use Form 18B. All forms can be obtained on the NCIC Forms page. Your employer can provide this to you as well. Remember to submit a copy to your employer and keep one for yourself. Watch the mail for the acknowledgment notice from the Industrial Commission.
7. Contact the N.C. Industrial Commission for guidance
If, at some point in preparing your claim, you need guidance, you may call the Industrial Commission’s Workers’ Compensation Information Specialists Section toll-free at 800-688-8349. You can also call 919-716-1700 between Mondays and Fridays from 8:00 a.m. to 5:00 p.m. The specialists can also be reached through email at InfoSpec@ic.nc.gov or by mail at the following address:
Workers’ Compensation Information Specialists
N.C. Industrial Commission
1233 Mail Service Center
Raleigh, NC 27699-1233
8. Check with your employer if they filed Form 19
Employers are required to file Form 19 if the injured employee is unable to report to work for more than one day or their medical bills top $4,000. They must do so within five days after being notified about the injury or illness.
What Should One Do If a Workers’ Compensation Claim in North Carolina Has Been Denied?
Some common reasons why a claim is denied by the employer or insurer are disputes over the cause of the injury, failure to provide notice of the injury and employment classification issues. If your claim has been denied, these are the steps you can take to file an appeal:
Consult a lawyer
After receiving Form 61, or Denial of Workers’ Compensation Claim, from your employer, you are given 14 days to appeal to the Industrial Commission. It is important to consult a lawyer at this stage. Form 33, or Request That Claim Be Assigned for Hearing, must be completed to initiate the appeal process.
In many cases, mediation is automatically ordered by the Industrial Commission. A few cases, such as those involving administrative appeals and medical motions, are not included. Cases involving uninsured employers and self-represented employees may be referred to mediation only if both parties consent. During this process, you have to present evidence to back up your claim. The mediator will decide on the matter and inform the Industrial Commission.
Attend a hearing before the administrative law judge
If you do not agree with the mediator’s decision, you can take your case before the administrative law judge. It works like a trial where both parties present evidence to support their claim, after which the judge will issue a decision. Should you not agree with the decision, you have to submit Form 44, or Application for Review, to the Industrial Commission within 15 days.
Request a panel hearing
A panel hearing consists of three administrative law judges who will review the previous hearing. The panel may also request oral arguments during the hearing. They can then either overturn the previous decision or uphold it.
Filing a court appeal
Legal Resources for Injured Workers in North Carolina
One of the urgent concerns when you are hurt on the job is financial resources. Some of these concerns can be income sources, daily living expenses, recuperation costs, and legal fees. Read on to find more information on how to maximize community and state-funded resources as you recover from your injuries or illnesses. These resources can also provide direction to get your life back on track after a workplace injury.
Legal Aid of North Carolina
The non-profit law firm Legal Aid of North Carolina provides legal assistance to low-income injured workers across the state. It can help with matters such as workers’ compensation, unemployment, health care, and government benefits. To apply for free assistance, interested parties may call 1-(866)-219-LANC (5262) Mondays through Fridays, from 8:30 a.m. to 4:00 p.m., and Mondays and Thursdays, from 5:30 p.m. to 8:30 p.m. The firm’s office is located at 319 Chapanoke Rd., Suite 104, Raleigh, NC 27603.
North Carolina Assistance Programs
Injured workers in the state can apply for benefits and services from the North Carolina Department of Health and Human Services. They can begin by calling 1-800-662-7030 to talk to a customer service representative who can find programs suited to their needs. Some of the benefits they can obtain are Food and Nutrition Services, Medicaid, and Work First Family Assistance. Workers with a disability can also ask for help from the DHHS to find employment, gain access to technology for independent living, and apply for community rehabilitation services. They can find a local office near them through the Vocational Rehabilitation Local Offices.
North Carolina Bar Association's Free Legal Answers
This free virtual legal advice tool allows injured employees to ask a lawyer about their workers’ compensation case. To get started, the employee has to answer some questions and register first. They can then check their email for replies to their legal questions. They can also ask additional questions by simply logging in to their account.
North Carolina Bar Association
The Lawyer Referral Service of the North Carolina Bar Association can connect injured workers to lawyers. Using the service costs $50 for an initial 30-minute consultation. Call 919-677-8574 to get started. Take note that many workers’ compensation attorneys provide free consultations and work on a contingency basis. Most of the time, they will get a portion of what their clients obtain—somewhere between 10% and 20%. However, the Industrial Commission must approve the fees before the attorney gets paid.
North Carolina Department of Labor
The North Carolina Occupational Safety and Health Act empowers workers to file complaints against their employers for related non-compliance. Injured workers with workplace safety and health issues can confidentially call the North Carolina Department of Labor at 1-800-625-2267 for guidance. However, a complaint has to be filed first before a proper investigation can be launched. The Occupational Safety and Health Division takes complaints seriously and ensures an appropriate response will be provided in a timely manner. Before filing a complaint, workers are encouraged to answer questions on the NCDOL’s web page: Do I have a safety and health complaint? Should they fear retaliation from their employer, they can ask for more information from the Retaliatory Employment Discrimination Bureau at 919-807-2831 or send an email to firstname.lastname@example.org.
Charlotte Center for Legal Advocacy
The Charlotte Center for Legal Advocacy fights for the rights of people with disabilities and advocates for access to resources that improve their quality of life. They serve low- to moderate-income community members in the Charlotte and Mecklenburg County areas. Indigent injured workers can seek help for healthcare and income support, such as Social Security, Medicare, and SSI. To get started, they can call 704-376-1600 or 800-438-1254 if outside the county. Spanish speakers can call 800-247-1931. The Charlotte Center for Legal Advocacy’s office is located at 5535 Albemarle Road, Charlotte, NC 28212.
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