Who Pays for Workers’ Compensation in North Carolina?

Workers' compensation in Wilmington, North Carolina

If you’ve been injured at work, you may not know what to do next. Should you file a workers’ compensation claim? Does your injury qualify for benefits? Who pays for these benefits?

Ted A. Greve & Associates is here to answer your questions and provide the support that you need. Our workers’ compensation attorneys in Wilmington will help you deal with the aftermath of your work-related accident and will fight to collect any benefits that you’re entitled to.

What Is Workers’ Compensation?

Workers’ compensation is a type of insurance that’s designed to protect both employers and employees. Under the North Carolina Workers Compensation Act, most employers are required to carry workers’ compensation coverage. If employees suffer a job-related illness or injury that keeps them from working, they’re entitled to receive compensation.

North Carolina is a no-fault workers’ compensation state, which means employees can receive benefits even if they are partially responsible for their injury. However, this also means that employees cannot sue their employer over an injury unless that injury was caused by the employer’s intentional misconduct.

Who Pays for Workers’ Compensation in North Carolina?

Any business with three or more employees is required to obtain workers’ compensation insurance. The employer will pay for insurance coverage, and in return, the insurance company will be responsible for paying out workers’ compensation benefits. Many nationwide insurance companies offer this type of coverage.

Some businesses may be able to qualify as self-insured, which means that the business would be fully responsible for covering workers’ compensation benefits. In order to qualify, the business must demonstrate that they have the assets necessary to cover these benefits. Companies that are self-insured may be subject to periodic oversight to confirm that the business is providing workers with the benefits they’re owed under the law.

In some states, businesses aren’t required to carry workers’ compensation coverage for workers classified as independent contractors. However, this isn’t necessarily the case in North Carolina. The Industrial Commission will look at several factors when determining whether a worker is entitled to coverage, including the degree of control the employer has over the work being done.

It can be difficult for workers to collect benefits for a number of reasons. Insurance companies delay or deny valid claims for a number of reasons. If a business is self-insured or is not carrying the coverage required by law, the process can be even more challenging. That’s why any worker injured in an accident can benefit from consulting with a workers’ compensation attorney in Wilmington.

Worker filing claim for workers' compensation in North Carolina

What Does Workers’ Compensation Cover?

In North Carolina, workers’ comp is designed to cover economic losses related to an on-the-job illness or injury. If an injury is covered under workers’ comp, the employer’s insurance company is required to cover any medical treatments that will:

  • Help heal the injury
  • Reduce the impairment caused by the injury
  • Provide pain relief

Injured workers are not responsible for covering co-pays or deductibles. Furthermore, workers are entitled to receive medical coverage even if their injury has not caused them to miss work.

If workers do miss work because of a compensable injury, they may also be eligible to receive disability benefits. These benefits are intended to compensate workers for missed wages and are based on the worker’s average weekly wage. Workers may receive benefits on a temporary or permanent basis.

Temporary Partial Disability Benefits

If an employee is able to return to work but is not able to earn the same wages they did before the injury, they may qualify for TPD benefits. Workers can receive two-thirds of the difference between their current wage and their average wage pre-injury for up to 500 weeks.

Temporary Total Disability Benefits

If an employee is unable to return to work for 7 days or more, they may be entitled to TTD benefits. These benefits are equivalent to two-thirds of the worker’s average weekly wage. Workers can receive benefits until they are able to return to work, for up to 500 weeks.

Permanent Disability Benefits

If an injury has left a worker with a permanent disability, they are entitled to receive additional benefits. These benefits can vary based on the type of injury sustained and the severity of the injury. While some workers are eligible to receive disability payments for life, many others will be paid a lump sum based on their impairment rating.

What Kinds of Injuries Qualify for Workers’ Compensation in North Carolina?

To qualify for benefits, an injured worker must meet specific criteria. The injury must occur during the “course and scope” of your employment. This means that qualifying injuries must occur while you are carrying out the business of your employer.

In North Carolina, injuries must also be accidents in order to be eligible for compensation. This means that the injury must have an identifiable cause that is separate from an employee’s standard routine. Some repetitive strain injuries, such as carpal tunnel, are not eligible for coverage, but injuries caused by a specific incident may still qualify.

While an accident must play a role in the injury, it does not have to be the sole cause. For example, if a worker with an existing back injury slipped and fell, and that fall caused the original injury to be disabling, that injury would be eligible for benefits. If a qualifying injury leads to an additional injury, both injuries are compensable.

Contact Our Wilmington Workers’ Compensation Lawyers

Covering these benefits can be costly for insurers, which is why claims are frequently contested or denied. This makes it all the more important for injured workers to have the support of a qualified attorney.

Filing a successful workers’ compensation claim isn’t always easy, but luckily, this isn’t something that you have to handle on your own. Ted A. Greve & Associates has helped many injured workers file workers’ compensation claims and collect the full benefits that they’re owed.

Worried about the cost of hiring a lawyer? Not sure that you have a case? We offer free case consultations, which means you can get the information you need before moving forward. If we do take your case, you won’t owe us anything until we secure compensation for you. Call (844) 387-8677 if you’d like to know more.