North Carolina Workers' Compensation Claims Process

North Carolina Workers' Compensation Claims Process

Filing a workers’ compensation claim in North Carolina involves different stages and requirements. For best results, hire an experienced workers’ compensation attorney to represent you in filing your claim and seeking the compensation that you need.

The first thing you’ll need to do is seek medical attention for your injuries and notify your employer. You need to see the employer or insurance company recommended doctor, unless they do not recommend one. If you don’t receive a recommendation, inform your doctor that the injury is work related and give the name of your employer.

You must also be sure to notify your employer of the injury as soon as possible, and in writing. North Carolina law allows up to 30 days from the date of injury for you to notify your employer. If you do not, then you cannot receive workers’ compensation benefits. You can also choose to submit North Carolina Industrial Commission Form 13, which also serves as notice to the employer.

If you have not already submitted Form 13, your employer should provide it when you report your injuries. Fill this form out entirely and list all of your relevant conditions and injuries. If you do not include something, then you may not be able to seek benefits for that injury.

Choosing a Medical Care Professional

Your employer or your employers insurance company will contact you and refer you to a doctor for an evaluation if you have not already done this. The insurance adjuster will ask you a lot of questions, and you should be honest and discuss the incident and the injuries in detail.

If you would prefer to see a different doctor, you cannot do so without receiving permission to do so. If you act in this manner without permission and authorization, you will not be able to recover the medical expenses. You will hear from the insurance company again after your evaluation. They will deny your claim or they will accept it and begin a treatment plan. If they deny your claim, then they must offer a detailed explanation.

Filing Appeal For Denied Claim

You have the option of filing an appeal with the Industrial Commission if your claim is denied. In some cases, you may be denied because there is not causal link between your accident and your injury or because a pre-existing condition is deemed to be responsible for your injury. The Commission will investigate your request for an appeal and may side with you or with the employer. You can then receive a right to sue letter or you may go to mediation.

Returning To The Job

As you continue to see the workers’ compensation physician, she will eventually give you the go-ahead for returning to work. This cannot occur until your physician signs off on and gives you permission to continue working. If you require additional training or retraining before returning to work the employer will arrange for it to occur. You will either return to work in your previously held position or return to another position that is comparable to your old position.

Eventually, your physician should determine that you are okay to return to the job. He or she will sign off and give you permission to return to work and your employer will arrange any training or retraining that may be necessary. You may still receive benefits for medical expenses, but your lost pay benefits will stop when you return to work.