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 during the last five years.
Do You Have North Carolina Workers’ Compensation Coverage?
State law requires North Carolina workers’ compensation coverage for all employers with at least three part-time or full-time employees. This law also covers temporary workers, contractors and TXDOT-licensed truck drivers. Workers who are exempt from this automatic coverage include:
- Federal employees (i.e., postal carriers, railroad workers)
- Domestic workers employed in someone else’s home
- Workers employed at farms with fewer than 10 total employees
- Workers with self-inflicted injuries
Can You Get Workers’ Comp Benefits for Covid-19?
At this time, there are no specific laws defining Covid-19 as an occupational disease in North Carolina. If you get Covid-19 and apply for workers’ comp, here’s what you must do in order to qualify for benefits:
- Prove your job exposed you to greater 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.
Frankly, it’s almost impossible to win workman’s comp for Covid-19 without help from a skilled attorney.
How to Apply for North Carolina Workers’ Compensation Benefits
When you’re ready to apply for benefits yourself, follow these steps:
- Ask your employer to refer you to an approved medical provider for treatment immediately. This may include an on-site doctor or designated off-site provider you must report to instead. Inform any doctor who treats you that your injury’s work-related and the name of your employer.
- Notify your employer in writing about your accident and whether you already received treatment within 30 days. If you can’t provide this yourself, have a friend or family member do this as soon as possible.
- File a Notice of Accident to Employer form (also known as Form 18). Your employer will also complete Form 19 for the company’s insurer and the NCIC. Filing this form starts your North Carolina workers’ compensation claim and must occur within two years of your injury.
- Your employer’s insurer must approve or deny your claim within 14 days.
- Approved claims don’t pay lost-wage benefits until you miss 7 days of work due to your injury. Prior to that, your employer’s only responsible for paying your injury-related medical bills. If you miss 21 days total for a workplace injury, you can then collect compensation for your first week off. These benefits should equal 67% of your average weekly paycheck.
- If denied benefits, file Form 33 to request a formal hearing before the NCIC. However, you must go through NCIC-approved mediation first. Mediation resolves about 75% of claim disputes prior to formal hearings.
Since every North Carolina workers’ compensation claim is different, your own experience may vary.
North Carolina Workers’ Compensation Statistics, 2015-2019
The Bureau of Labor Statistics (BLS) releases an annual statistical workers’ compensation program report that includes most U.S. states. It lists total claims, how many employees missed work, changed jobs or received restrictions, and claims submitted by individual job sector. Below are the North Carolina workers’ compensation program statistics for 2015-2019:
We noted a 5% drop in total claims during this five-year period. Service-industry workers file 2 out of every 5 claims in any given year. A little more than half of all North Carolina workers’ comp claims each year qualify for lost-wage benefits (51%-53%).
You May Qualify for Legal Assistance
Think you can’t afford a workers’ compensation attorney? If your employer denies your initial claim and you want to appeal, you still have to pay for mediation. In fact, this may be one reason why the state touts the fact that it resolves 3 in every 4 disputed claims during mediation. Of course, if you win your appeal, you can request your employer pay back those out-of-pocket expenses. Since state law requires you to split the mediation costs evenly with your employer, why not get professional help from an attorney instead?
The state’s own website says mediation will cost you $150/hour. By contrast, all North Carolina workers’ compensation attorneys work on contingency. In other words, you’ll pay $0 for legal assistance if you don’t win benefits. And if you do win, then you’ll only pay a small, one-time fee.
Ready to see if you may qualify? Click the button below to start your free online benefits evaluation now!
Lori Polemenakos is Director of Consumer Content and SEO strategist for LeadingResponse, a legal marketing company. An award-winning journalist, writer and editor based in Dallas, Texas, she's produced articles for major brands such as Match.com, Yahoo!, MSN, AOL, Xfinity, Mail.com, and edited several published books. Since 2016, she's published hundreds of articles about Social Security disability, workers' compensation, veterans' benefits, personal injury, mass tort, auto accident claims, bankruptcy, employment law and other related legal issues.