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Understanding your rights under North Carolina’s workers’ compensation laws is an important part of receiving the benefits you should have. However, for someone who does not deal with these laws regularly, comprehending all the rules and regulations is a significant challenge.
Our Tryon workers’ compensation lawyer is ready to help your case move forward. We understand how important it is for our clients to receive benefits after an injury at work, and we take our role in your case very seriously. Our attorney team can help with workers’ compensation cases in several ways. You can learn more during a free consultation with us.
Who Qualifies for Workers’ Compensation?
If you suffered injuries on the job in Tryon, you likely qualify for workers’ compensation benefits. According to the North Carolina Industrial Commission (NCIC), all businesses with three or more employees must have workers’ compensation insurance.
However, there are some exceptions, such as government employees and some agricultural workers. Our attorney can answer any questions you may have about your eligibility.
Covered injuries are those that occur under the scope of your employment. Therefore, you cannot seek benefits under workers’ compensation for injuries that happen outside the workplace, even if they prevent you from working. You also cannot seek benefits if you:
- Caused the accident on purpose
- Were drunk or under the influence at the time of the accident
- Were threatening a coworker at the time of the accident
Benefits Available Under Workers’ Compensation in North Carolina
The Workers’ Compensation Act is a North Carolina law that covers all aspects of workers’ compensation, including determining which benefits you could receive when filing a successful claim.
When you hire the attorney team at Farmer & Morris Law, PLLC, we will work as hard as possible to help you receive your due benefits. These benefits can provide significant financial assistance for your family when you cannot earn your salary. If your injury leaves you needing medical care and prevents you from working, our lawyers are ready to help.
Wage Reimbursement
When you cannot work because of injuries you suffered at the workplace, you can try to receive a reimbursement for some of your wages under workers’ compensation. Under the law, you are only eligible for wage compensation once your disability exceeds 21 days. You also are only eligible to receive two-thirds of your normal weekly wage.
Sometimes, your wage compensation does not start as early as it should. You also may find disagreements regarding when your wage reimbursement should stop. For example, the insurer may believe you can return to work earlier than you think you can. Our lawyer team will help with these situations.
Medical Cost Reimbursement
After you suffer an injury at your Tryon employer’s worksite, you must seek prompt medical treatment. You also must show you suffered an injury that leaves you unable to work. This allows you to file a workers’ compensation claim. Your workers’ compensation benefits should cover all necessary work-injury-related treatment, including:
- Emergency department care
- Medical procedures
- Physical therapy
- Medications and medical equipment
- Hospital stays
- Follow-up treatments
- Medical travel expenses
Always tell your doctor if your injuries are related to a work accident so that it results in filing the proper paperwork. You then need to make sure you follow all of the state’s rules regarding seeking medical treatment going forward.
If you do not follow the rules, you could end up with a denial of reimbursement for your medical costs. Our legal team can help you understand the rules and maintain your eligibility for workers’ compensation.
Disability Settlement
After a particularly serious accident, you may end up with some disability. You could also face an uncertain future if exposed to a dangerous substance while at your North Carolina job.
If your injury or illness creates a disability that leaves you unable to use certain parts of your body, you could seek a disability claim as part of your workers’ compensation judgment. This disability judgment may compensate you for an inability to work in the same job going forward.
It also may provide compensation for ongoing medical bills you may have related to your injury. Our attorney can provide the evidence required to help you work toward receiving disability payments under workers’ compensation.
Compensation for COVID-19 Infections
It can be difficult to prove that your illness—as opposed to an injury, like a concussion or a broken arm—is work-related. However, if you can show sufficient evidence linking your coronavirus infection to your job, you are entitled to workers’ comp benefits.
To receive compensation for a COVID-19 infection, you need to show that your employer was especially careless when it came to protecting employees from this virus, and that your risk of contracting the illness at work was significantly higher than your risk of contracting it anywhere else (at home, at the store, etc.).
Death Benefits
Some workplace injuries are too severe for their victims to survive. If this happened to your loved one, please accept our condolences for your loss. Know that workers’ compensation includes death benefits that can be issued to the victim’s surviving relatives.
Death benefits help those who lost a spouse or parent in a workplace accident. You can put this money towards paying funeral expenses, supporting yourself as you take time away from work to grieve, and paying bills that the deceased’s income would have covered.
We Will Help You with Workers’ Compensation Claim Denials
Unfortunately, the law’s gray areas can delay or derail a workers’ compensation claim. You may think you have a legitimate claim, but an insurer may see it differently and issue you a denial.
The NCIC oversees and administers the state’s workers’ compensation act. It can hear cases involving disputes with the insurer, working toward the fastest settlement possible. Our team will figure out the reason for your denial and help you fight for the benefits you need.
Understanding Why Your Tryon N.C. Workers’ Compensation Claim Was Denied
Reasons for a denial may range from petty to serious. They include:
- Technical issues, such as missed deadlines or a missing answer on a form
- Lack of evidence—for example, the insurer is not satisfied with the amount of supporting paperwork you submitted regarding your injury
- The insurer’s own interests—they do not want to spend the money to fulfill your claim, so they simply decide to deny it
The insurer will not say they do not feel like paying your claim. Rather, they will come up with another reason, such as a technical issue, and tell you that is the real reason for the denial. Our team can investigate any denials you receive to determine whether or not the reasoning behind them is valid.
Our lawyer will represent you in any dispute or a denial hearing, presenting your side of the case professionally. We understand how the commission works and are ready to apply our experience in past cases to your advantage.
We can help you understand why you received a denial of your claim. We then can work with you to find the evidence we need to persuade the commission to reverse the decision. These types of cases can be quite complex.
Missing Workers’ Compensation Deadlines Can Affect Your Case
Workers’ compensation cases have numerous specific deadlines that you must follow to keep your case moving forward. Some of the reasons employees miss deadlines in workers’ compensation cases include:
- Not understanding the rules about deadlines
- Failing to alert the employer to the injury promptly
- Submitting the forms to the wrong place
- Completing the wrong forms
- Filling out the forms incorrectly or providing incomplete information
Hiring our attorney team early in the process allows us to advise you about the deadlines that apply to your case immediately.
Be Sure to Disclose All Relevant Information
After a workplace injury, you must disclose exactly how the injury occurred and information about any past injuries. Failing to include any of this information on your form could lead to a denial of your claim—the insurer may accuse you of lying or purposely trying to withhold information.
We can help you avoid this situation by asking questions about your work-related injury and health history. We then can ensure your forms are complete and accurate.
We Do Not Back Down from Tough North Carolina Workers’ Compensation Cases
The legal team at Farmer & Morris Law, PLLC, knows that workers’ compensation situations do not always follow the same path. Each Tryon workers’ compensation case has slightly different nuances and aspects. We can tailor our strategy to fit the specific situation you are facing, no matter how challenging the case is. Our lawyer can:
- File your claims, handle your paperwork, and track and adhere to deadlines
- Gather evidence to prove your injury is work-related
- Obtain your medical bills and records, and consult health care professionals about your injury and treatment
- Communicate with insurance companies on your behalf and fight for fair benefits
- Handle your workers’ compensation appeals if necessary
Appealing your case often involves several steps, although you may not have to go through them all before we reach an agreement with the insurance company. Here is how your appeal may go and how we may help you with it:
- Mediation: Before we truly start the appeals process, you and the other side could have one last chance to sit down and come to an agreement. A trained mediator would facilitate the discussion and try to identify common ground.
- Negotiation: If mediation fails, our side and the insurer’s lawyers could sit down together. We would each present our side of the issue, and our team would fight hard to get them to agree to pay what you have earned.
- Settlement: If our negotiations are successful, we can take care of all the paperwork for finalizing that agreement. We never accept a settlement offer without our client’s consent, so we would discuss any offers with you before drawing up the settlement agreement.
We May Be Able to Assist You with a Third-Party Lawsuit
Under the workers’ compensation system, you cannot receive benefits and sue your employer. However, if a third party’s negligence caused your workplace injury, you may have grounds for a personal injury lawsuit. For example, if you suffered an injury due to a faulty piece of equipment, you could have a suit against the manufacturer. Other potentially liable third parties may include:
- A contractor or subcontractor
- A property or job site owner
- A supplier
- A driver, if you were involved in a car accident while on the job
- Another employee
Lawsuits Allow You to Seek Damages Not Covered by Workers’ Compensation
A personal injury lawsuit allows you to seek awards for intangible damages not included in a workers’ compensation claim. With a lawsuit, you can pursue monetary awards for:
- Pain and suffering
- Mental anguish
- Stress and depression
- Loss of bodily function
A lawsuit also allows you to pursue the value of miscellaneous expenses stemming from your injury. This may include the cost of hiring help with household services such as cooking, cleaning, and transportation, as well as the cost of medically necessary home modifications. Furthermore, you can seek the full value of your lost wages, not just the two-thirds replacement benefits offered by workers’ compensation.
If you file suit, you are bound by North Carolina’s statute of limitations. According to G.S. § 1-52, you usually have three years to file a personal injury lawsuit. G.S. § 1-53 generally allows two years to take action for the wrongful death of a loved one.
Contact Farmer & Morris Law, PLLC for Help with Your Case
Our Tryon workers’ compensation lawyer is here to help you seek the benefits you need to get back on your feet. We can serve you on a contingency-fee basis, meaning we will not collect any attorney’s fees unless and until we achieve a financial award for you.
To learn more about what our team can do for you, call Farmer & Morris Law, PLLC today for a free consultation to learn more about your options.
