“Disabled” is one of those words that means different things to different people. There are a many different standards used to determine disability for various disability plans and programs, including disability in NC workers’ comp, Social Security disability, and state and private long-term and short-term disability plans. In developing your claim for disability it is critical to understand the applicable disability standard.
Under North Carolina workers’ compensation law, disability is the “incapacity because of injury to earn the wages which the employee was receiving at the time of injury in the same or any other employment.” N.C. Gen.Stat. § 97-2(9) (2007). Substitute employment must be “suitable.”
The term “suitable employment” means employment offered to the employee or, if prohibited by the Immigration and Nationality Act, 8 U.S.C. § 1324a, employment available to the employee that (i) prior to reaching maximum medical improvement is within the employee’s work restrictions, including rehabilitative or other noncompetitive employment with the employer of injury approved by the employee’s authorized health care provider or (ii) after reaching maximum medical improvement is employment that the employee is capable of performing considering the employee’s preexisting and injury-related physical and mental limitations, vocational skills, education, and experience and is located within a 50‑mile radius of the employee’s residence at the time of injury or the employee’s current residence if the employee had a legitimate reason to relocate since the date of injury. No one factor shall be considered exclusively in determining suitable employment. N.C. Gen.Stat. § 97-2(22)
The Social Security Administration has a stricter definition of disability. For Social Security disability, “you must not be able to engage in any substantial gainful activity (SGA) because of a medically-determinable physical or mental impairment(s): That is expected to result in death, or that has lasted or is expected to last for a continuous period of at least 12 months.”
Some private disability plans have an “own occupation” disability standard, meaning the insured is disabled unless he can return to his previous occupation.Other private disability plans have an “any occupation” standard, similar to social security disability.
There are multiple definitions of disability in the State of North Carolina’s short term and long term disability benefit plans. Which standard applies depends on the date of employment.
If you have questions or concerns about whether of not you are disabled please call or email to discuss your concerns with a Board Certified NC Workers’ Compensation Attorney. Kevin Bunn is a workers’ comp lawyer in the Raleigh, NC area.
