Workers Comp FAQ
1. What kind of disability benefits does workman’s comp cover?
Workers’ compensation offers three major types of benefits, including:
- weekly checks for time missed from work,
- payment for related medical expenses,
- and payment for permanent injuries.
The severity of your injuries or the length of time you’re away from work determines which benefits you may be eligible to receive.
At Henson Fuerst, we’re familiar with workers’ compensation laws in North Carolina, and we can determine the types of benefits you’re owed. If you need help filing a benefits claim, contact our North Carolina workers’ compensation lawyers at (919) 781-1107 or fill out a free initial consultation form. Let us put our experience to work for you—call today.
2. Does workers’ comp pay for long-term damages in North Carolina?
While your doctor has you written out of work, you are entitled to Total Temporary Disability (TTD). These are weekly checks in the amount of two-thirds of your gross weekly pay at the time of your injury. You also are entitled to payment for related medical expenses. Depending on the outcome of your treatment, your doctor may also assign something called a disability rating, which allows you to be paid for a permanent injury.
3. When should I consult a lawyer in North Carolina over a workers’ compensation claim?
It depends on the severity of your injury. If you have a minor injury that doesn’t require surgery and your doctor expects you to make a full recovery and return to work, then you probably don’t need an attorney. However, if you have a more severe injury that requires surgery and your ability to return to your previous employment is in doubt, then it’s advisable to talk with an attorney.
4. Will workers’ comp pay lost wages in North Carolina?
Your sick days will be used for the first seven days you are out of work from your injuries. After the first seven days, if your doctor still has not permitted you to return to work, then lost wage payments (called Total Temporary Disability or TTD) should start. If you are out of work for more than 21 days, the insurance company may go back and pay you for the first seven days. In most cases, though, there is no way to recover vacation or sick time.
5. How much money does workers’ comp pay?
If you’re eligible to receive workers’ compensation benefits, you may receive up to 66.7 percent of your average weekly wage. However, this amount cannot exceed $862 per week. The maximum weekly benefit is adjusted every year to match cost of living increases.
6. Do I have to file my claim if my employer has already reported the accident?
Yes. Whenever an accident happens, two reports must be made: one by your employer and one by you. You must file a Form 18.
7. How much is the maximum weekly benefit from workers’ comp?
According to the North Carolina Industrial Commission, the maximum weekly benefit for 2012, applicable to all injuries and claims arising on and after January 1, 2012, is $862.00. The minimum weekly benefit is $30.00.
8. Am I responsible for my own transportation to doctors’ appointments?
If you have no way to get to the doctor, the insurance company will usually provide transportation. However, many times the transportation provided by the insurance company is less than reliable. It’s always better to use your own means of transportation, if possible.
If you decide to use your own car or have somebody drive you, you will be entitled to mileage reimbursement.
9. Should I call my employer every day I am absent because of my injury?
Generally, no. Your doctor will provide you a written excuse to be out of work for blocks of time, and your employer will likely have a copy of the doctor’s note. However, if your company has a policy making it appropriate or essential for you to call in sick each day, be careful to limit the conversation. Many people say too much to their employer about their injuries, and their words come back to haunt them.
10. What do I do when my claim is denied by my employer or the workers’ compensation company?
Consult an attorney. Workers’ compensation law may be too complicated to handle on your own. Many people try to go it alone and make mistakes that can be irreversible. You need a knowledgeable North Carolina workers’ compensation lawyer to help you navigate the process. Your employer and the insurance company will definitely have attorneys, which puts you at a disadvantage unless you have your own representation.
11. What should I do when the doctor releases me with restrictions that prevent me from doing my job?
This question is actually a lot more complicated than it sounds. If this happens, you should consult an attorney. The insurance company will likely assign a vocational rehabilitation counselor to work with you or ask you if you want to settle your case. There are restrictions on how a vocational rehabilitation counselor can work with you, and it’s important that you protect your rights when interacting with them. HensonFuerst can help.
12. Should I use my health insurance if my claim is denied?
Yes. Use any means available to you to seek medical treatment. From a health standpoint, you want to minimize the amount of time between an injury happening and having that injury treated. From a claims standpoint, you want to make sure that you are building a record of your injuries and resulting treatment from the very beginning. More claims are lost due to lack of documentation than almost any other reason.
13. What is a vocational rehabilitation counselor?
The North Carolina Division of Vocational Rehabilitation Services uses vocational rehab counselors to help people with disabilities and injuries live more fulfilling lives. These counselors assist by:
- assessing their clients’ capabilities and limitations
- working with their clients to set goals for employment and independent living
- arranging training and therapy to meet those goals
- facilitating job training and placement
14. Should I look for another job if my restrictions will not allow me to return to my job?
Yes. You should look for another job and keep a log of all efforts you make along the way. Having a record of your job search may help prove that you are unable to work, which will allow you to keep receiving your TTD checks. This documentation is critical in hearings or settlement conversations.
15. What is a permanent restriction?
A permanent restriction is a doctor’s order that says you can’t perform the work you did before you were injured. If you can’t perform your former job duties, your employer may give you an alternative work assignment. But if your employer can’t accommodate your restrictions, you may be eligible for TTD benefits while you look for another job.
16. Do I have to allow my nurse case manager to attend my doctors’ appointments?
Yes. The nurse case manager has the right to attend your doctor appointments. However, he or she has no right to be in the room with you while you are being examined by the doctor. If you elect to have a private exam, the nurse case manager must respect that request. When the exam is complete, the nurse case manager has the right to speak to your doctor, but you should always try to be in the room while your nurse case manager is talking to your doctor.