Case Study : Workers' Compensation

Trucker Injured Out of State

Out of State Injuries

Keith is an over-the-road truck driver. While he lived in North Carolina, his employer was based in Mississippi. He was hired in North Carolina. Unfortunately, Keith sustained an on-the-job back injury while picking up a load in California.

Keith reported the injury to his dispatcher shortly after it happened. He had hoped his back pain would go away but it did not. The long drive back across the country was too difficult and he never made it past Texas. He sought medical treatment there. The employer sent another driver to pick up the truck and deliver the load. Keith was left to find his own way back to North Carolina. When he got home, he was in need of significant medical treatment for a herniated disc in his back. He would ultimately have surgery and extensive therapy for his injury.

His employer was self-insured. In North Carolina, employers with three or more employees are required to carry workers’ compensation insurance for its employees. One way to do this is to purchase coverage from insurance companies. Another way is to be self-insured. That is where the employer provides its own coverage for its employees. Most self-insured employers are larger employers.

Even though the injury was reported soon after it happened, the employer was slow to do anything. Keith wanted medical treatment but the in-house workers’ compensation adjuster refused to approve benefits. Months passed and Keith found himself out-of-work, injured and desperate.

When he came to us, we immediately filed for a hearing to force the employer to properly provide benefits under the Workers’ Compensation Act. The employer’s first response was that this claim was not under North Carolina’s jurisdiction. It produced a letter that Keith had signed when he was originally hired that any and all workers’ compensation claims must be filed in Mississippi. Workers’ compensation laws vary greatly from state to state. Some states provide significantly less benefits than others. Mississippi was one of those states.

Letters like the one Keith signed do not prevent injured workers from pursing claims in North Carolina provided the claim meets the other necessary jurisdiction requirements. The North Carolina Workers’ Compensation Act does not allow employers to contract around the requirement to carry coverage for its employees. In North Carolina, the employer must provide coverage for its employees and cannot have the employee assume the risks, even if both parties previously agree in writing. Some states may allow this. North Carolina does not.

And this was good for Keith. At the time, Mississippi capped weekly benefits at $387 per week; North Carolina allowed for weekly benefits as much as $754 (in 2014 the max rate is $912). If forced to bring the claim in Mississippi, the maximum he could have received was nearly $400 per week less.

Keith’s employer ultimately resolved the claim in a lump sum settlement based on North Carolina Workers’ Compensation Laws. He was able to get the treatment he needed and move on with his life.

As general rule, for accidents occurring outside of North Carolina, a claim can be brought in North Carolina if: (a) the contract of employment is made in this state; (b) the employer’s principal place of business is in this state; or (c) the employee’s principal place of employment is within this state.

What happens if my injury by accident occurs outside of North Carolina? Why does it matter if my employer is self-insured? What happens to my claim if my employer forced me to sign an agreement to only bring workers’ compensation claims in other states? Why should I care what state the claim is brought in?

LESSONS TO BE APPLIED…

  • You can still bring a claim in North Carolina even if the injury by accident occurs outside of North Carolina.
  • Because benefits vary greatly, you want to make sure that you bring your claim in the state that addresses your condition the best. Some states provide fewer benefits than North Carolina does.
  • Self-insured employers sometimes contest claims more aggressively because the money used to pay claims comes from it directly rather than a third party insurance company.
  • Don’t fall for an employer’s claim that you can sign away your workers’ compensation rights. An employment contract signing away your rights before a claim is brought, does not prevent you from obtaining benefits under the North Carolina Workers’ Compensation Act.
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