North Carolina’s Workers’ Compensation Act is the law that provides a system of medical benefits and disability payments to workers injured in the course and scope of their employment. The system provides a limited but guaranteed remedy for injured workers. Our Courts have ruled that the Act is to be liberally construed to benefit the injured worker. Nonetheless, workers compensation insurance companies constantly attempt to avoid the payment of full benefits for various reasons. Some adjuster will insist that the employer did nothing wrong; therefore, the employer’s insurance carrier should not have to pay benefits to the injured employee. Under North Carolina, the injured worker does NOT have to show that the employer or any other party acted negligently in causing the injuries. In fact, EVEN IF the injured worker was negligent in causing his/her own injuries, he/she may still recover benefits under the Act. The injured worker ONLY has to show that he/she was injured “by accident” while on the job. Once this is shown, the employer’s insurance company has a legal duty to provide the medical treatment necessary to treat the worker’s injuries. In addition, the insurance company must pay disability benefits to the injured worker for the period of time he/she is physically unable to perform his/her job duties. (The injured worker may also qualify for Social Security Disability Benefits.)
If a worker’s compensation insurance company denies a claim for benefits or simply denies a requested medical procedure, the matter must go before the North Carolina Industrial Commission for a hearing. In such a case, it is important to have a knowledgeable and experienced attorney.
If the injuries are deemed permanent in nature, the worker is entitled to additional compensation for that injury. If the injured worker is unable to return the work, the insurance company must continue paying the out-of-work benefits and for continued medical treatment. In such a case, the insurance company may want to settle or “clincher” the claim, wherein they will pay a lump sum of money to the injured worker to compensate him/her for the future medical expenses and lost wages in exchange for the worker permanently closing the claim/case. When considering settling a worker’s compensation claim, the worker MUST ensure that he/she is receiving enough compensation to fully make him/her whole. It is important to have a knowledgeable and experienced attorney on your side when making such a decision. Just because you have been injured on the job does not necessarily mean that you need an attorney. To find out if the insurance company is doing all that it is legally required to do, please call Owens & Miller at 919-480-8152 for a free, no-obligation consultation.