An “accident” is legally defined as an “interruption of the normal work routine.” Most commonly this is a slip, trip, or fall or something like that. However an interruption of the normal work routine includes moving an unusual object, or a heavier than normal object, or moving it at a faster pace than normal, or any other variation which is NOT part of the normal work routine. We have had a lot of success in showing injured workers and – more importantly – where an accident occurred. Interruptions of the normal work routine occur far more often than you would realize.
An occupational disease is a condition, which disables you due to exposure to a hazard to which the general public is not equally exposed. That’s confusing, isn’t it? In the old days it was coal miners getting black lung, or workers in a cotton mill breathing in cotton fibers. Nowadays the most common occupational diseases are repetitive motion injuries like carpal tunnel syndrome and rotator cuff tears. It is possible to win a back injury as an occupational disease but it’s tough to do so. There are special rules for back claims. This gets very specific, very fast. Succeeding with these claims is pretty difficult unless you are very experienced in the law.
In North Carolina you need to prove two things to win a workers’ compensation claim. First, that you were injured. Second, that the injury occurred while working as a result of either an accident or an occupational disease. So if you’re just doing your normal work and your knee gives way or your shoulder pops you will still have to prove that this was the result of an accident or an occupational disease. This is why it’s important to speak with an attorney early on! All too often an adjuster has gotten injured workers to say that they were just doing their normal work. Next thing you know the claim is denied. It isn’t right, but it happens. Because the system moves very slowly our approach is to be aggressive right away. If the claim is denied, looks like it’s going to be denied, or if the adjuster is dragging her feet then we don’t think there is any time for delay or hesitation. We immediately file a request for a hearing and get the Industrial Commission to push the adjuster into action. Why? In our experience injured people who get treatment are able to return to work successfully and more quickly than those who don’t get treatment. If your goal is to get better and back to work then we are the attorneys for you. That’s our goal and we work long hours to prevent adjusters from dragging their feet.
You shouldn’t. But it’s the law. We don’t like it either but there’s nothing really to be done about it. Without condoning the use of illegal drugs or what is more of an issue – the use of prescription medicine which was not prescribed for you – we don’t see what the relationship is between what happened at a party two weeks ago and how your co-worker drove a forklift into you yesterday. Obviously if you were injured because you were drunk or stoned you’re not going to get benefits and your employer shouldn’t have to pay them. But the mere presence of a drug in your system without a shred of evidence of when you ingested it? That’s a bit much.
We’ve seen cases where an adjuster denied claims when an injured worker took his wife’s painkiller while waiting for an initial doctor’s visit. Why? Because he failed the drug test. Although just about everyone does it… it’s illegal to take a prescription medicine unless it was written specifically for you. In fact within the last hour that I wrote this my father-in-law took a Cipro, which was prescribed to my wife. This isn’t exactly what the war on drugs was supposed to lead us to.
Just because you’ve partied a bit in the past doesn’t mean you shouldn’t file a claim if you were legitimately hurt. But it does give the adjuster some room if she’s inclined to deny your claim for strategic reasons. We’ll need to establish that there was no link between whatever was in your system and what happened on the job.
Under our law you are supposed to receive all medical care reasonably intended to affect a cure, provide relief, or lessen the period of disability. The medical care doesn’t have to do all three – any one will do. So even if you still aren’t going to be able to return to work you are entitled to treatment that will make you better or even just feel better. In our experience this is a point where adjusters frequently deny treatment. They may be happy to spend money if it’s going to get you back to work. But when you are still going to be drawing weekly checks they often balk at authorizing the necessary and appropriate treatment. So don’t be surprised if the adjuster is suddenly less cooperative with you. The Industrial Commission has systems in place for getting medical treatment approved. It surprises us that more attorneys do not utilize this process but we file requests for expedited medial hearings constantly.
