When it comes to whether an injury is covered by workers’ comp in North Carolina, back injuries are treated differently from injuries to other body parts.
First
Let’s look at injuries to body parts other than the back. In general, workplace injuries are covered under workers’ comp in North Carolina only if they occur as the result of an on-the-job “accident.” An accident is an unexpected event that interrupts the work routine. For example, falling off a ladder is clearly an accident (because nobody does that on purpose, right?) and an injury that is caused by the fall will be generally covered by workers’ comp. Note that an injury itself is not an accident; the accident is the unexpected event that leads to an injury.
Let’s look at an example
A convenience store clerk injures her shoulder stocking cases of water, which is part of her regular job. That claim will likely be denied. But that same employee who loses her grip on a case of water, and injures her shoulder grabbing the falling case of water, should find her workers’ claim accepted. In the first instance the injury occurred doing the normal job in the normal way. But in the second, losing her grip and the water falling was unexpected, and the shoulder injury resulted from that unexpected event. As counterintuitive as it seems, a worker who is injured doing their regular job in the regular way will likely find their NC workers’ comp claim denied. Clear enough?
Now, a few things to consider.
First, workers’ compensation insurance adjusters, safety managers and other people with significant experience with these issues know the deal here. I’ve seen tons of recorded statements where a cagy adjuster led an injured worker to the statement “yeah, I was doing what i normally do and got hurt” knowing this is the basis for a denial. So be careful out there. Second, the accident doesn’t have to be a huge event. A foot slipping, unexpected conditions, etc. can all constitute to an accident. Finally, occupational diseases are a whole different ball game, with no “accident” requirement.
Ah, but what about a back injury.
For back injuries an accident is just a “specific traumatic incident.” In very general terms, a specific traumatic incident means the worker can identify the point in time when they were doing their job that the injury occurred. For example, consider the convenience store worker above who was stocking cases of water. If that worker is doing that task in the normal way, and feels a pop in her back, that back injury is covered by workers’ comp in NC. So the exact same event resulting in a denied shoulder claim could lead to an accepted back claim. Got all that?
The key language here in case you are interested is § 97-2(6) of the North Carolina Workers’ Compensation Act:
“Injury and personal injury” shall mean only injury by accident arising out of and in the course of the employment, and shall not include a disease in any form, except where it results naturally and unavoidably from the accident. With respect to back injuries, however, where injury to the back arises out of and in the course of the employment and is the direct result of a specific traumatic incident of the work assigned, “injury by accident” shall be construed to include any disabling physical injury to the back arising out of and causally related to such incident.
If you have questions about whether your injury is covered by workers’ comp in NC I would be glad to talk with you about it. I am a board-certified NC workers’ compensation attorney. Call or email for your free consultation today.
