North Carolina Workers’ Compensation Process

North Carolina Workers' Compensation Process

Every state sets its own guidelines and rules for handling workers’ compensation claims. Hurt or sick employees filing a workers’ compensation claim in North Carolina should follow the steps we’ve outlined below. In addition, you’ll find a helpful chart showing how the program’s statistics have changed within the last five years.



How the North Carolina Workers’ Compensation Process Works

According to the North Carolina Industrial Commission (NCIC), any employers with three or more part-time or full-time employees must provide workers’ compensation coverage. Further, part-time and most temporary workers also count as employees who are eligible for workers’ compensation coverage under North Carolina state law, including special rules for contractors and truck drivers. This policy protects employees as well as employers in the event of a workplace accident or occupational illness, provided it can be attributed to performing job duties that fall within the scope and course of your employment. For example, straining your back while restocking product shelves is likely to be covered, but getting hurt in a car accident on the way to work is not. In addition, your first seven days of missed work will not be covered by workers’ compensation unless you are disabled for more than 21 days. When you’re ready to file your own North Carolina workers’ compensation claim, follow these steps:

  1. Get medical treatment immediately and report the accident or illness to your employer. You may have an on-site health care provider who can treat you or a designated one off-site you must report to if a work-related illness or injury occurs. Otherwise, be sure to inform your doctor that you became ill or got hurt in the workplace and the name of your employer.
  2. As soon as possible, notify your supervisor or a manager that you’ve experienced a workplace accident or illness and are receiving appropriate medical treatment.
  3. You must notify your employer within 30 days of the accident or illness and briefly describe what happened. If you cannot write it down yourself, have a family member or your health care provider notify your employer in writing on your behalf. Be sure to keep a copy for your personal records.
  4. After you’re released from medical treatment for your illness or injury, file a workers’ compensation claim using a Notice of Accident to Employer and Claim of Employee, Representative, or Dependent form (also known as Form 18). Your employer will complete a similar form called Form 19 to the company’s insurance provider as well as the NCIC.
  5. In the event that your employer fails to properly file Form 19 with the NCIC, you may submit your own Form 18 directly within two years of the date of your workplace accident or illness.
  6. If your claim is approved, all medical bills are paid directly through your employer’s insurance provider. You will also receive temporary disability wages equal to 66 and 2/3% of your usual weekly earnings (maximum pay for 2017 is $978 per week).
  7. If your claim is denied, you will receive written notice explaining why within 14 days of submission. To appeal, complete and file a Request That Claim Be Assigned For Hearing form (also known as Form 33) within two years of your workplace accident or illness. This grants you a formal hearing before the NCIC to appeal your claim’s denial.
  8. Before the NCIC schedules your formal appeal hearing, you’ll be asked to take part in a mediation conference using an approved mediator from the list provided to you by the NCIC. Approximately 70% of North Carolina workers’ compensation disputes are resolved at this stage without continuing on to a formal hearing before the Commission.

Bear in mind that every North Carolina workers’ compensation claim is different, so your own filing process may vary slightly from the steps outlined above.

North Carolina Workers’ Compensation Statistics

The Bureau of Labor Statistics (BLS) releases a report every year on the workers’ compensation program statistics for most U.S. states. Each state’s report shows the total number of claims filed, how many employees had to miss work, changed jobs or received restrictions, and claims submitted within each individual industry. Below are the North Carolina workers’ compensation program statistics for the years 2011-2015.

As you can see, the North Carolina workers’ compensation program has been quite stable over the past five years. The only notable change is a drop in total claims from 2011 to 2013; since then, claims have remained below 95,000 across the entire state. In fact, the program shows only slight variations during that time period, but lower claims overall may mean faster approvals for applicants.

Can A North Carolina Workers’ Compensation Attorney Help?

If you get sick or hurt on the job, you may find it helpful to consult with a workers’ compensation attorney before you file your claim. For example, if you think your claim might be disputed or you’re facing an appeal, experienced legal representation gives you the best chance of winning your dispute. These lawyers already know the ins and outs of the North Carolina workers’ compensation process. An attorney can negotiate on your behalf with your employer’s insurance carrier, help you collect the right paperwork to support your claim and represent you during your appeal hearing, if needed. Contingency representation means that you pay no legal fees unless you’re awarded benefits.

To see if you may qualify for legal assistance from an attorney in your area, please complete your free workers’ compensation evaluation below.

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