Important: We updated this article in August 2023 to ensure the information below is current and correct. State law outlines who receives North Carolina workers’ compensation benefits and how the process works. If you’re an Old North Stater who’s experienced an accident or illness on the job, you should focus on feeling better ― not feeling anxious about the claims process.
We’ve gathered the information you need in order to get the workers’ comp benefits you deserve.
North Carolina Workers’ Compensation Eligibility
Important: State rules don’t cover federal employees. Learn how to file a federal claim.
State law requires all businesses employing three or more employees, must offer workers’ comp coverage. This includes corporations, sole proprietorships, limited liability companies, and partnerships. Businesses with one or more employees engaged in activities that involve the use or presence of radiation are also required to carry workers’ comp insurance.
There are some exceptions, though, including:
- Employees of certain railroads
- Domestic workers directly employed by the household
- Farm laborers when fewer than 10 full-time, non-seasonal workers are regularly employed by the same employer
- Sellers of agricultural products prepared for sale by the producers on commission, or for other compensation paid by the producers
Follow these links to find out about workers’ comp for:
North Carolina Workers’ Compensation Claims for Covid-19
Here’s what you need to do to qualify for COVID-related workers’ comp:
- Prove your job exposed you to a higher risk of contracting it than the general public. For example: You are an EMT, ambulance driver or other first-line emergency responder.
- Show you contracted the disease while performing your usual job duties in your place of employment. This means you must prove you had zero exposure to potentially infected people outside your home except while doing your job.
Learn more about filing a COVID-19 claim for North Carolina workers’ comp.
How to File Your North Carolina Workers’ Compensation Claim
Important: Get treatment immediately if you require emergency or urgent care from an on-site healthcare provider or off-site facility. Tell them your case is work-related, provide your employer’s name, and keep all receipts and bills. See what a North Carolina workers’ compensation doctor can do for you.
Every case is different, but according to the North Carolina Industrial Commission (NCIC), follow this process for filing your claim:
1. Report your illness or injury to your employer and seek appropriate medical treatment.
Follow your employer’s instructions for getting care from an on-site health provider, designated health office or another off-site health provider. As soon as possible, report your injury to your manager or the business owner. If you can’t do this yourself, have a family member, friend, or healthcare provider do it for you.
2. Provide written notice of your injury or illness.
Within 30 days, file a written report with your employer, including the date and time of the incident or onset, location, and a brief description of your workplace injury or illness. If you can’t do this yourself, have a family member, friend or health care provider do it for you. You may also file Form 18, Notice of Accident to Employer, with the NCIC.
Important: Keep a copy of the letter or form for your records.
3. Wait for a decision.
Your employer’s insurer must approve or deny your claim within 14 days. If your claim’s approved, the insurer is responsible for paying injury- or illness-related medical bills. To qualify for lost-wage payments, your illness or injury must force you to miss at least seven days of work. If you miss 21 days total, then you can collect compensation for your first week off. These benefits should equal 67% of your average weekly paycheck.
Important: In 2023, you can get up to $1,254 per week in workers comp.
4. File Form 33 if you’re denied or want to dispute benefits.
You must go through NCIC-approved mediation before getting a hearing. Three-quarters of appealed cases result in paid settlements or awards.
Important: You have to pay part of the mediation fee, which the state estimates will cost $150/hour.
If you win your appeal, then you can request your employer pay back those out-of-pocket expenses. See how to decide if you should work with a North Carolina workers’ compensation lawyer.
To learn more about the North Carolina workers’ compensation program, visit the state’s web page for injured and ill workers.
More Facts About North Carolina Workers’ Compensation
The Federal Bureau of Labor Statistics analyzes workers’ comp data on most U.S. states and territories. The total number of recordable cases in the Old North State was rising pre-pandemic before beginning a COVID-caused slide in 2019. By 2020, cases were down dramatically from the previous year to 80,300 before rebounding slightly to 83,800 in 2021, still almost 10,000 cases below the five-year high in 2018.
Claims filed in service-providing industries and the total number of employees who missed work, transferred jobs or received restrictions followed a similar, but less radical, decline over the period. Both metrics ticked up slightly in 2021, with service-sector claims approaching 2020 levels and the number of affected employees surpassing 2018’s peak.
You May Qualify for Legal Assistance
Important: You can get free, confidential help with your claim.
When you live with a workplace accident or injury, navigating the North Carolina workers’ compensation system can make you feel even worse.
That’s why we recommend working with an experienced North Carolina workers’ comp lawyer.
Important: These specialists work on contingency. If you don’t win a cash settlement, then you owe your lawyer $0. But if your case is successful, you pay only a reasonable, one-time fee.
Ready to see if you qualify? Click the button below to sign up for a free phone call during regular weekday business hours:
Margot Lester is the CEO of The Word Factory, a B2B & B2C content marketing agency that provides services for Fortune 100 brands, healthtech companies and SaaS developers. An award-winning business and brand journalist, she writes for daily and weekly newspapers and business journals, national magazines, in-flight publications and leading websites. Margot is also an in-demand writing coach and organizational communications trainer, helping individuals and teams write more effectively. Twitter/X: @word_factory LinkedIn: linkedin.com/in/margotlester.