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Workers’ Compensation: Frequently Asked Questions Part I

NOTE: Many individuals will qualify for workers’ compensation under North Carolina’s Workers’ Compensation Act. All questions except the first discuss workers’ compensation under this state Act.

What Does Workers’ Comp do Exactly?

The NC Workers’ Compensation Act, adopted in the 1930s, aims to compensate employees who are injured by accidents at work and occupational disease. Workers’ comp aims to make “industry pay for its own wreckage,” in the words of the court. It strikes a balance between employers and their employees.

  • For employers, workers’ comp provides the benefit of reduced liability expenses because it:
    • 1) Sets full disability compensation rates at two thirds of the employee’s average weekly pay instead of 100 percent
    • 2) Excludes employee compensation for pain and suffering
    • 3) Is the “exclusive remedy” for employees. This means an employee cannot usually sue their employer in a personal injury suit for workers’ comp injuries.
  • For employees, workers’ comp provides the following in accepted cases:
    • Medical care at no cost to the employee
    • Prompt temporary full or partial disability payments that continue weekly as the case goes on.
      • By contrast, in standard personal injury cases, the insurance company or other defendant does not have to pay for medical bills or lost wages until the case settles or trial concludes.
    • Permanent disability benefits if applicable
    • Contributory negligence is eliminated as a defense. North Carolina is one of two states that still use a contributory negligence model in injury cases. This means that if a person’s own actions contributed in any direct amount to their injuries, they cannot sue to recover against the person that caused the majority of the injury. For example, a driver that was found to be 10 percent at fault in a car accident could not recover in damages from the driver who was 90 percent at fault. Eliminating contributory negligence as a defense in workers’ comp means that an employee’s contributory negligence will not be a bar to them receiving workers’ comp benefits.
How do I Know What Workers’ Compensation act Applies to me?

If you are injured on the job, in most cases you may be entitled to make a claim for workers’ compensation insurance benefits. Depending on your employer, you may need to file a federal or state claim for workers’ compensation. If you are a veteran, there are further resources available to help you file your claim.

  • Federal employees: The Federal Employees’ Compensation Act (FECA) gives compensation benefits to civilian employees of the United States federal government who sustain a personal injury or disease related to performing their job duties. The FECA can also provide the payment of benefits to the injured employee’s dependents if the injury or disease results in the employee’ death. The online guide to FECA resources can be found at http://www.dol.gov/owcp/dfec/regs/compliance/ca-11.htm.
  • Private or state employees in NC: The North Carolina Workers’ Compensation Act requires almost all employers that regularly employ three or more employees to either carry workers’ compensation insurance or qualify with the North Carolina Department of Insurance as a self-insured employer. The North Carolina Industrial Commission’s online guide to filing a claim under the NC Workers’ Comp Act can be found at http://www.ic.nc.gov/claimants.html.
  • Veterans of the United States Armed Services: The Veterans Health Administration’s National Workers’ Compensation Program provides staff, support and resources to help members and veterans of our nation’s armed services apply for and obtain the workers’ compensation to which they are entitled under the Federal Employees’ Compensation Act. Although this is the same federal act that applies to other federal workers, the VHA’s Workers’ Comp staff are much more suited to helping individuals file non-civilian claims. Find the VHA’s guide to Workers’ Compensation at http://www.publichealth.va.gov/about/occhealth/workers-compensation.asp.
Why do I Need a Workers’ Compensation Attorney?
  • If you are not sure whether you have a claim or not: The experienced workers’ compensation attorneys at Arnold & Smith, PLLC are ready to step in to help ensure that you do not miss out on a claim you might not think is covered. Our attorneys handle the stress and worry of dealing with your employer, the insurance company and the North Carolina Industrial Commission. Mr. Arnold is experienced in handling injury claims, having formerly worked as an insurance defense attorney handling injury claims for insurance companies.
  • If your injury is minor and your employer does not dispute your workers’ comp claim: You still may be able to benefit from contacting the dedicated attorneys at Arnold & Smith, PLLC to ensure that your matter is handled efficiently and correctly while avoiding costly mistakes.
  • If your injury is more severe or your employer is refusing to compensate you: Our experienced attorneys are ready to intervene and fight on your behalf. Our attorneys are skilled at preliminary negotiations and mediation, but unafraid to take the fight to the courtroom all the way to trial if necessary to get you the compensation you deserve. Our attorneys will not settle until you are satisfied.
  • If your claim is denied: You still have options. Deserving victims’ claims are often denied, and this is where your attorney will step in to fight for just compensation.

Contact the experienced and passionate attorneys at Arnold & Smith, PLLC today for an initial consultation about your claim.