Frequently Asked Questions

Workers’ Compensation

What is the NC Industrial Commission? What is the SC Workers’ Compensation Commission?

They are the governmental agencies that have jurisdiction over workplace accidents and disabilities. While the state legislatures write the laws of Workers comp, the Industrial Commission and the Workers’ Compensation Commission sets regulations for how the claims are handled. They act as the “court” for a Workers’ Compensation claim.

What should I do if I am injured on the job?

Depending on the severity of your injury, the first thing you should do is report the injury to your employer. If your employer does not offer you one, ask if they have accident report forms on hand. Always remember to keep a copy for your records. Next, you should ask your employer if they have certain doctors that they would prefer you to go to. If they have no preference, then seek medical attention as soon as possible from a doctor of your choosing.You will also need to file official notice of your injury with the North Carolina Industrial Commission. You do this by submitting a Form 18 to the North Carolina Industrial Commission. The simple document will also need to be given to your employer or its workers’ compensation insurance carrier. Your employer is supposed to give you one of these, but we can do so or you can obtain it from the North Carolina Industrial Commission’s website.

What should I do if my employer tries to get me to take sick days instead of making a WC claim?

It is imperative that the Workers Comp claim is filed but once that is done, you can also take sick days. Because you are not eligible for workers’ compensation for the first seven days of missed work for a short-term leave (less than 21 days), you may want to take those initial days as sick days so you still receive income from the company. However (and this is very important!) be sure to document your injury with a doctor right away and be certain that your employer files the paperwork for a workers’ comp claim (and you get a copy). It is absolutely imperative that your employer reports your Workers’ Comp claim because unless you have a crystal ball to predict the future, no one knows for sure how long you will be out of work or if your injury will reoccur.

What’s the definition of average weekly wage?

Average weekly wage is, well, what it sounds like! It can be measured a number of different ways but the most common, and legally preferred, method is to calculate your earnings in the 52-weeks leading up to the injury date and divide that by the number of weeks you worked. Your average weekly wage includes things like overtime pay, bonuses, per diem, certain allowances, etc., and the calculation excludes certain periods of time which you may have missed from work. In our experience defendants frequently miscalculate the average weekly wage and very, very often underpay you. Many injured workers have told us that they were plainly told that workers’ compensation does not include overtime. This simply is not true. If you are being underpaid, you can petition the Industrial Commission or the Workers’ Compensation Commission to order the insurance company to pay you the correct amount. One of the first things we do is confirm your weekly benefits and take action to have those increased if you are being underpaid.

When will my workers’ comp checks come in the mail?

You are supposed to receive your workers’ compensation checks weekly (it is occasionally on a week’s delay). If, at the beginning of your claim, you have been out of work for more than a week and have not spoken to an adjuster or received a check you should call an attorney immediately. Just because your employer or their insurance company is sending you to the doctor does not mean that they will send you a weekly check.

Why can’t I pick my own doctor?

Under North Carolina Workers’ Compensation Act, the employer or its workers’ compensation insurance carrier gets to select the treating physicians if the claim is properly accepted. However, if the insurance carrier does not accept the claim properly, they lose this right and you may go to a doctor of your choosing.In certain cases, you can petition the Industrial Commission to allow you to change doctors. You may be allowed to change doctors if you can show that you have been with their doctors for a reasonable period and made little or no progress. It has been our experience that workers’ compensation insurance carriers do not readily agree to second opinions by doctors that you choose. If you want to pick your own doctor, you usually have to involve the Industrial Commission.However, you are allowed to pick your own doctor if you have been given a permanent partial impairment rating and you want a second opinion to that rating.

Will I be required to pay taxes on my Workers’ Comp settlement money?

Workers’ Comp money is tax free. Weekly checks, reimbursements and settlements require no state or federal tax payments.

Will my attorney keep our conversations confidential?

Yes. Absolutely. A lawyer can never repeat what has been said to him or her. That’s true whether or not we agree to represent you. Being confidential is one of the most important aspects of being a lawyer. You never have to worry about your personal business getting out.

Why is it taking so long to get medical treatment?

The workers’ compensation system is set up to allow for delay. If the insurance company properly accepts your claim, it is allowed to direct medical treatment. This can result in a much slower process than what most of us are used to. Often before approving more expensive procedures or referring out to specialists, the adjuster will only authorize treatment with a general practitioner or basic physical therapy. This can go on for quite a while. If the delay is unreasonable, you can ask the Industrial Commission to get involved to force the insurance company to provide adequate care. We often file medical motions to force insurance companies to speed up authorization of treatment.

My adjuster says I don’t need an attorney. Is she right?

No matter how nice your adjuster or case manager is treating you, she is not your advocate. She is an employee of the insurance company. This doesn’t mean she is a bad person but there are company rules that she must follow which put the company’s interest first. The fewer benefits the insurance company has to pay you, the more it gets to keep. Unless you heal fully and return to work quickly, you should always talk with a workers’ compensation attorney about what you are entitled to. Quite often we discover that the insurance company has not told the injured worker about benefits that they clearly know or should know about. Remember, the insurance company handles thousands of these claims each and every day. They know workers’ compensation and know that you don’t.
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