Medical And Wage Benefits

Medical Benefits

Workers’ Comp laws in NC provide injured workers medical treatment for their injuries as well as wage replacement when they are disabled.  Unlike the tort/negligence system which allows recovery for pain and suffering NC workers’ compensation laws provide coverage primarily for economic losses. Because the benefits are limited it is very important that injured North Carolina workers be sure they are fairly compensated.

Medical Treatment

The employer or their workers’ comp insurance company must pay for medical treatment that will cure the injury, give relief from pain, or lessen the employee’s disability. There is no deductible, no co-pay, and no requirement that you miss work to receive medical benefits under workers’ comp laws in NC. Not every workplace injury is covered. Injured North Carolina employees may be able to get a second opinion on their condition or on any permanent disability rating. Frequently in North Carolina workers’ compensation cases there is a tug-of-war between the insurance company and the employee to control the medical care. Injured NC workers have the right under workers’ comp laws in NC to request a hearing before the North Carolina Industrial Commission to resolve medical treatment issues. Injured NC workers who go two years without receiving medical treatment or any other benefits paid for by the workers’ compensation insurance carrier may lose their right to medical treatment.

For information on medical treatment in NC workers’ compensation cases see our full article here.

Disability Benefits

Injured NC workers who suffer wage loss because of a compensable injury are entitled to disability payments under workers’ comp laws in NC.  These benefits are based on the employee’s Average Weekly Wage and can be temporary or permanent, and partial or total.

o Temporary Disability Benefits are paid during the injury healing period, and for up to 500 weeks. If a doctor writes an injured North Carolina employee out of work for more than seven days then they are entitled to receive Temporary Total Disability (TTD) benefits. If the workers’ comp disability lasts three weeks then the employer must pay that first week as well. TTD payments are calculated based on two-thirds of the injured NC worker’s average weekly wage prior to the accident (AWW). If the injured employee is able to return to some work after the injury but has a reduced ability to earn wages compared to before the accident then the employee is entitled to two-thirds of the difference in wages for up to 500 weeks. These payments are called Temporary Partial Disability (TPD).  Law enforcement officers and teachers may be eligible for full salary continuation for some time after their accident.

o Permanent Disability Benefits.  Permanent injuries to certain body parts are presumed to be disabling under workers’ comp laws in North Carolina whether there is actual wage loss or not.  When an injured worker who has sustained an injury to one of the body parts reaches the end of the healing period (called Maximum Medical Improvement) their doctor will determine the percentage of impairment. This impairment rating represents the percentage loss of function to the injured part.  The rating, multiplied by the injured workers’ compensation rate and the number of weeks assigned to the injured body part yields  the rating benefit.  For example, an injured worker with a back injury might be rated as follows: 20% Rating x 300 weeks (weeks assigned for a back) x $300 (employee’s compensation rate) = $18,000. An injured worker should be very careful about accepting a rating payment.  n injured worker who meets certain strict criteria may be entitled to disability payments for life; this is called Permanent Total Disability (PTD).

For more information about disability payments in NC workers’ compensation click here.

Clincher Settlements

Injured North Carolina workers are frequently asked to settle or “clincher” their case. Workers’ compensation recipients should very carefully consider the effect of such an agreement before executing it. It is best to discuss any clincher offer with a Board Certified Expert North Carolina workers’ compensation attorney prior to signing a clincher agreement.  For more information about clincher settlements in NC Workers’ Comp go here.

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Top Ten Tips and Traps for North Carolina Workers’ Compensation Claims

After twenty years of practicing workers’ compensation law in North Carolina I have seen just about every mistake an injured worker can make.  These mistakes range from failing to file their claim, to settling when they should not have, and everything in between. Download my Top Ten Tips and Traps for North Carolina Workers’ Compensation Claims

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