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N.C. WORKERS’ COMPENSATION CLAIMS

By :Douglas A. Petho

If you have been injured while working for an employer, you may be eligible to receive Workers’ Compensation.

WHAT IS WORKERS’ COMPENSATION?

Workers’ Compensation is a state operated system that provides benefits to workers who sustain a compensable injury by accident arising out and in the course and scope of their employment. Benefits can also be paid for certain recognized occupational diseases like asbestosis, chemical exposure, bursitis, carpal tunnel syndrome, and hearing loss.

IS MY INJURY COMPENSABLE?

In order to be compensable injury must arise out of an “accident”. The North Carolina Workers’ Compensation Act defines an “injury by accident” as an unlooked for or untoward event such as a slip, trip, fall or other unexpected event that interrupts your usual work routine. If an injury, no matter how serious, occurs while performing the task in the normal manner without incident, chances are that the claim is not going to be compensable. There is an exception for back injuries. Under the North Carolina Worker’s Compensation Act §97-2(6) ,back injuries arising out of a “specific traumatic incident” are recognized.

Workers compensation also fights compensation for certain “occupational diseases”. An occupational disease is any disease that is caused by the specific type of work that you do, as opposed to the types of work that the average person might do. If your job involves a higher rate of a particular disease, it may be considered an occupational disease. A common occupational disease that is included under this provision is carpal tunnel syndrome. There are specific conditions which are recognized in the North Carolina Workers Compensation Act. These conditions include asbestosis, silicosis, synovitis, tenosynovitis, bursitis, and chemical exposure.

WHAT COMPENSATION AM I ENTITLED TO?

While workers compensation does not provide compensation for pain and suffering, it does provide benefits for the following:

Lost Wages: Lost wages are paid after the first seven days of disability. These benefits are referred to as “Temporary Total Disability” or TTD and “Temporary Partial Disability” or TPD. The amount paid is based on the “average weekly wage” of the injured worker’s earnings in the 52 weeks preceding the injury. The amount paid to the injured worker is two thirds the average weekly wage. As to disability claims arising after June 23, 2011, there is a maximum limit of 500 weeks of TTD. There are however exceptions for employees with catastrophic physical injuries which could extend benefits beyond the 500 week limit.

Medical Compensation: Workers’ compensation provides for payment of medical expenses, including hospital and rehabilitation services, prescription medication and travel expenses. The injured worker may also be entitled reimbursement of travel expenses to treatment facilities at the rate of 50.5 Cents ($0.505) per mile, provided that travel is 20 miles or more per round trip.

Permanent Disability: If an injured worker sustains a permanent injury, a Doctor may assign an impairment rating to the injured body part. Compensation based on this rating are set by statute and will vary depending on the body part injured and the rating assigned by the treating physician.

Vocational Rehabilitation: Sometimes due to the extent of an injury, an injured employee will be unable to return to work with his or her previous employer. To assist the injured employee in returning to the work force an employer may utilize the services of a vocational rehabilitation counselor to assist the employee in finding another job. Vocational rehabilitation is governed by §97-32.2 of the North Carolina Worker’s Compensation Act. Vocational rehabilitation must be performed by qualified or conditional rehabilitation professional approved by the North Carolina industrial commission. Failure to cooperate with vocational rehabilitation services can result in a termination of workers compensation