Harman Law offers FREE Workers' Comp Consultations!
People get hurt at work all the time. Depending on what kind of work you do, this could be a risk you face every day. Workers’ compensation insurance is meant to take care of people who get injured while on the job. It provides medical care and replacement wages while you recover from your accident. It can be devastating to learn that your workers’ comp claim has been denied. If you are injured on the job, call Harman Law right away for a FREE workers’ comp consultation!
How Does Workers' Comp Work in North Carolina?
Most employees are protected from workplace injuries by workers’ compensation insurance. Your employer is required to carry this insurance in case any of their employees get hurt while on the job.
In order to qualify for workers’comp benefits in North Carolina, you must meet the following criteria:
- You were on the clock at the time of your accident
- The injury took place on company property or while on duty
- You weren’t under the influence of drugs or alcohol at the time of your accident
- After the injury, you reported it to your employer
- You were treated by a company approved doctor
- The injury wasn’t caused by some outside factor or pre-existing condition
What Should I Do After Suffering a Workplace Injury?
Your company should have a policy that outlines the procedure employees must follow if they get hurt at work. It’s important that you follow these procedures. If you don’t, you can jeopardize having your claim paid.
Once you report your injury to your manager or Human Resources department, they’ll reach out to their workers’ comp insurance carrier. The company must have you complete an accident or incident report to document the injury. This form will be forwarded to the insurance carrier.
Your employer will make a recommendation as to whether or not your claim should be paid. This is why you want an experienced North Carolina workers’ compensation lawyer by your side. They will communicate with the insurance adjuster to check the status of your claim.
If your claim is denied, your attorney will ask for the reason. Once they have this, they can get started on your appeal. You have a right to workers’ comp benefits. If you didn’t do anything wrong, there’s no reason why you shouldn’t receive them.
Why Should I Hire a Workers’ Compensation Lawyer?
When you get injured, you have no idea if your claim is going to be approved or not. If your employer knows you have representation, they’ll be more likely to handle your claim properly.
They’ll also be less inclined to try to take advantage of you. If your employer knows you don’t have a lawyer, they may try to force you back to work early. Or, they’ll deny your claim and hope you simply walk away.
What Happens if I’m Denied Workers' Comp Benefits?
You may be told that your workers’ comp claim has been denied. If this happens, you won’t be receiving your workers’ comp benefits. Your claim could be denied for a variety of reasons. Some of these reasons include:
- You didn’t file your claim by the due date
- Your employer doesn’t think the injury happened at work
- There could be a clerical error on the claim paperwork
- You didn’t follow protocol or didn’t wear personal protective equipment at the time of your injury
- You got hurt on purpose in order to collect workers comp
- If you were drunk or high at the time of the accident
If your claim is denied, your workers’ comp lawyer will file an appeal. You do this by filing your claim with the North Carolina Industrial Commission. You can ask them to review your case and make a determination.
You can request a hearing before the Commission. They’ll determine if your claim should be approved. They’ll also determine what wages and benefits you’re entitled to. Your attorney will continue to try to negotiate a settlement of your claim while your hearing is pending. They understand that you still need to feed your family despite what’s going on with your claim.
How Much Will I Be Paid While I’m on Workers’ Comp?
If your workers’ comp claim is approved, you’ll be entitled to medical treatment and replacement wages. For the most part, your medical care has to be provided by a company-approved doctor. However, your lawyer can certainly obtain independent evaluations and second opinions where warranted.
You’ll also be entitled to receive replacement wages. In North Carolina, the 4 types of replacement wages you can receive are as follows:
Temporary total disability benefits
These are wages you’ll receive while you recover from your injuries. The point of TTD benefits is to help you pay your bills while you’re waiting to return to work. You can receive these benefits for up to 500 weeks. Most people don’t receive benefits for nearly that long. While on TTD, you’ll only receive 2/3 of your average weekly wages. The good news is that you don’t have to pay taxes on this money.
Temporary Partial Disability Benefits
You may be able to return to work but unable to work full time. It may take a bit longer for you to fully recover. During this period, you’ll receive 2/3 of the difference between your current wages and what you would’ve received had you been working full time. Things like carpal tunnel syndrome or a broken finger may qualify for temporary partial disability benefits.
Permanent Partial Disability Benefits
You may never fully recover from your injuries. At some point, your doctor is going to say you’ve reached your Maximum Medical Improvement (MMI.) Each body part is worth a certain amount of money. For example, a back injury is worth more than a finger injury. You’ll also receive a determination of how many weeks’ worth of benefits your injury is. You may be told that your back injury is worth 200 weeks at $80 per week. That would be a total of $16,000.
Permanent Total Disability Benefits
If it’s determined, after you reach your MMI, that you’ll never be able to work again, you may be entitled to permanent disability. This means you’ll receive disability benefits for the rest of your life. In order to qualify for total permanent disability, you must suffer the following type of injury:
- Loss of both hands, arms, legs, feet, etc.
- Spinal injury involving partial or total paralysis
- Brain or head injuries
- Burns over at least 30% of your body
It’s important that the correct Average Weekly Wage (AWW) be calculated. Your Huntersville workers’ compensation lawyer can help do this at the start of your claim. If the AWW is wrong, your entire claim will be reduced.
AWW is the basis on which your weekly benefits are paid. It’s also the number used to determine if you’re entitled to partial disability. Finally, it’s the amount of money you’ll receive if you qualify for permanent total disability.
Does a Positive Drug Test Affect a Workers' Comp Claim?
Your employer has a right to test you for drugs following any workplace injury. They have a right to know whether you were the one responsible for your accident. Most employers include this in their workplace accident policies and procedures.
If you test positive for drugs, your employer will most likely deny your workers comp claim. They’ll argue that you only got hurt because you were under the influence of illegal drugs. Even if the drugs were legal, if the concentration is too high, your claim can still be denied.
Intoxication is the actual basis for your claim being denied. Even if you test positive for drugs, it doesn’t mean you are intoxicated. It means there is a presence of drugs in your system. Your workers’ comp lawyer in Huntersville or Lake Norman will try to show that the drugs had nothing to do with your accident.
Most employees are aware of this defense. That’s why so many companies test for both the presence of a drug and its concentration. If the concentration is high, your employer will argue that you were indeed intoxicated at the time of your injury.
Be honest with your attorney. If you were using drugs a few days prior to the accident, let them know. This can be a possible defense to your workers’ comp claim being denied.