Personal Injury Lawyer
Office Locations
Contact the Law Offices of James Scott Farrin
1-866-900-7078
Contact the Law Offices of James Scott Farrin 1-866-900-7078

Charles’ Story Pt. 3: Benefits, Return to Work, and Life After the Injury

When a worker is injured on the job, Workers’ Compensation is supposed to kick in and replace the earnings he or she is missing due to the injury. But how much does Workers’ Comp cover? How long do the benefits last? An experienced Workers’ Comp attorney can help answer these questions.

For now, we return to the story of Charles, our fictional example worker who was hurt on the job in North Carolina. If you have not, you may wish to read part one and part two of this series to get up to speed.

Wage Replacement Benefits of Workers’ Compensation in North Carolina

Whether they’re living alone or providing for their families, workers depend on their earnings to stay afloat. The bills keep coming in even if the paychecks do not. So how much can an injured worker get, and for how long?

The answer is, it depends. How much an employee gets to replace wages depends on a few factors, and is governed by North Carolina General Statute 97-2(5).

How Much Did the Worker Make Before the Injury and How Much of His or Her Wages Are Replaced by Workers’ Comp?

This seems simple, but it’s deceptive. How much Charles gets when he is unable to work depends on how much he earned in an average week before he got hurt. This is called the Average Weekly Wage (AWW). To start with, there are four ways to calculate AWW:

  • If Charles worked for his employer for more than a year before getting hurt, his earnings over the last year are divided by 52 weeks. This excludes any period of seven or more days that the workers was not earning. Ex: $52,000 / 52 weeks = $1,000 per week. In this example, Charles’ AWW is $1,000.
  • If Charles worked for his employer for less than a year, his earnings during that time are divided by the number of weeks worked. So if a worker has been employed for six months, the earnings are divided by 26.
  • If Charles had worked for his employer for less than three months, and the period of work is too short to provide a fair amount, then the earnings of a similar worker can be substituted. So, the wages of a worker performing similar duties at a similar skill level in the same location could be used to determine his average weekly wage.
  • In case where none of these methods would produce a fair result, other methods can be used to try to approximate how much Charles would be earning if he had not gotten injured.

The numbers are based off the gross, or pre-tax, wages of the worker. It counts as income things like bonuses, overtime, stipends, per diem, and allowances in addition to wage, such as those for housing or fuel. Whatever all of those sums add up to is the gross income. That number is then divided as necessary to provide the Average Weekly Wage.

Average Weekly Wage is important because in North Carolina, the Workers’ Compensation wage replacement benefit is set at two-thirds of that AWW, up to a maximum amount set by the North Carolina Industrial Commission each year. This two-thirds is called the Compensation Rate.  For 2020, the maximum compensation rate was set at $1,066.

So, if Charles was earning $52,000 a year, divided by 52 weeks, his AWW would be $1,000, and his Compensation Rate would be two-thirds of that, or $666.66.  Therefore, he would be entitled to receive a check for $666.66 from the insurance company every week that his authorized doctor said he was unable to work because of his injury.  No taxes are taken out of these checks.

How Long can a Worker Receive Wage Replacement Benefits?

Injured workers, like Charles, can get weekly checks at their Compensation Rate, as long as their authorized doctors says they are completely unable to work, up to a maximum of 500 weeks. This is called Temporary Total Disability or TTD.

If an injured worker, like Charles, is capable of doing some work, but cannot earn as much as he earned before he got hurt, he can receive partial payments from the insurance company.  These checks will be two-thirds of the difference between what Charles earned before his injury and what he earns after his injury.  This is called Temporary Partial Disability or TPD.

  • For example, Charles’ doctor says he can only work 20 hours a week. Charles goes back to work, but instead of earning $1,000 a week, he is only earning $500.00 a week.  He would be entitled to get two-thirds of the difference from the insurance company.  $1,000.00 - $500.00 = $500.00 ÷ 2/3 = $333.33.

A Word on Permanent Partial Disability (PPD)

This part of Workers’ Compensation law can be very confusing, so it is important to understand that each worker’s situation is unique, and the most beneficial course of action may be different from case to case. Here is a barebones explanation.

Payment for a Permanent Partial Disability is calculated by looking at North Carolina General Statute 97-31 and figuring out how many weeks of benefits the injury is worth. For example, a 100% injury to the knee is worth 200 weeks of benefits at the employee’s compensation rate. If an employee was given a disability rating of 10%, it would be worth 20 weeks of benefits.  In this case, he would be entitled to receive a payment of 20 weeks at his compensation rate.

The Benefits and Battling to Keep Them

It happens all the time. A worker is receiving treatment and wage replacement benefits and, after a period of time, the insurance company stops paying them, or pushes the worker to return to the job. Again, this is all part of doing business and insurance companies are businesses. Paying less in benefits equals more profit.

However, injured workers should never be rushed back to work. This only increases their risk of getting reinjured and poses a risk to those around them.

There are only two reasons an insurance company is technically allowed to cancel Charles’ benefits – if he returns to work or if they get permission from the NCIC. Lots of battles arise when the authorized doctor says the injured worker is ready to go back to work full duty, but the injured worker disagrees.

In this situation, the insurance company will file an application with the Industrial Commission for permission to terminate the worker’s benefits.  The worker, or more likely the worker’s attorney, will fight back by seeking a second opinion with another doctor.  If that doctor believes that the injured worker is NOT able to return to full duty work, the worker’s attorney can submit that doctor’s opinion to the Industrial Commission to try to protect the worker’s benefits.

Returning to Work

We’ve followed Charles from the beginning. Now his saga is coming to an end. After six months of treatment, he’s feeling better. Not quite 100%, as he still has very little strength in his hurt shoulder due to not being able to use it. His back, however, is feeling a lot better and improving every day, for which he feels fortunate.

 

Charles’ doctor finally clears him to return to work, but not at his full pre-injury level. His shoulder is not yet ready for that. So the doctor recommends a trial return to work. This is basically a time when Charles goes back to work to see what he’s capable of doing. Medical benefits are still in force, but the wage replacement may be suspended depending on how much he is earning. (See TPD explanation, above).

There are a number of things that can happen at this point, and handling them can be complicated:

  • Charles can accomplish the modified or reduced tasks that his employer assigns him until he’s fully capable again of returning to his pre-injury job.
  • Charles has difficulty performing the modified or reduced tasks provided by his employer. He needs to return to the authorized doctor and see about getting more appropriate restrictions.
  • Charles reinjures his back while performing the modified or reduced tasks. Again, he should return to his physician, be restricted from all work until his condition improves, and have his wage loss benefits reinstated.
  • Charles continues working at the modified job until his doctor says he has completed his treatment. Unfortunately, his doctor says he is not able to physically handle his original pre-injury job. It may be time for Charles to . Alternatively, instead of settling, the insurance company may decide to try to locate a new job for Charles at a different company.

Vocational Rehabilitation for Injured Workers

If a worker is injured and cannot return to his or her former job, the insurance company may choose to provide vocational rehabilitation. This training can include:

  • transferable skills analysis and testing
  • resume, interviewing and job application services
  • job search assistance
  • retraining/education
  • other services deemed appropriate

The End of Charles’ Story of Workers’ Compensation in North Carolina

Our friend Charles has been through a lot. From a hurt back and shoulder through the workers’ comp process, he’s been faced with many challenges. Everyone likes a happy ending, so Charles is able to return to work and makes a full recovery. Many, many workers in North Carolina are not so lucky.

In fact, many find themselves at the mercy of a system that they do not fully understand. In many of the examples of the process with and without an attorney in parts one and two of this series, the main takeaway may appear to be convenience. The truth is far deeper. A worker can, if he or she is so inclined, read everything possible on workers’ comp law in North Carolina and still miss something small that leads to big problems.

Charles was an example, and it is easy to minimize the differences when you’re not actually injured and in the system. Having an advocate with experience working in the system, battling insurance companies, and looking out for your best interests is a huge advantage in terms of both time and stress. While no result is guaranteed, who has a better chance of successfully navigating the workers’ comp system: an attorney who is dedicated solely to the practice of workers’ compensation law, or a worker who is in pain and finding his or her way through the system for the first time?

If You Were Hurt at Work, Contact an Experienced, Dedicated Workers’ Compensation Attorney

It’s not just a case, it’s your livelihood. From medical coverage to the money to pay bills, you need help as soon as possible. There are many great workers’ advocates in North Carolina. To speak with one of ours, just call 1-866-900-7078. You’ll hear a friendly voice, and get a free case evaluation, with no obligation. You can also chat with us, or contact us online. Whatever is easiest. Don’t sit and suffer. Tell them you mean business.

Charles’ Story Pt. 2: Filing for a Hearing, Medical Treatment and What to Watch For

Workers’ Compensation claims in North Carolina are a matter of process. The process for Charles, our fictional injured worker, has just begun. As we proceed, we’ll show how the process differs with and without an experienced Workers’ Compensation attorney, and in this installment, how medical treatment works under NC Workers’ Compensation law.

In part one, Charles filed for Workers’ Compensation and received a Form 61 – the insurance company has denied his claim. Now what?

Requesting a Hearing After a Workers’ Compensation Claim is Denied

Charles’ claim being denied should not come as a surprise. Insurance companies make money by limiting their payouts – that’s simply the nature of the business. Denying claims may make workers who are mildly injured simply give up. Charles, however, has serious upper and lower back pain and left shoulder pain as well. He’s not going to give up.

Knowing that the bills for his treatments are going to pile up, Charles decides to press forward on his claim. To do that, Charles must file a Form 33 Request for Hearing with the North Carolina Industrial Commission. This is Step 5 of the claim process. For information on Steps 1-4, please refer to part one of this series.

Preparing for a Hearing
To read the NCIC’s own information on preparing for a hearing, you can read this document. It can seem overwhelming to anyone who isn’t an attorney, and even to attorneys who do not focus their practice in Workers’ Compensation. A general practice or family law attorney may miss some of the nuances of the Workers' Comp processes, which is why it is preferable to enlist the services of an attorney with experience, There are a lot of great Workers’ Comp attorneys. Hopefully, you’ll consider ours. You can call 866-900-7078 for a free case evaluation or contact us online.

STEP 5: File Form 33 with the North Carolina Industrial Commission (NCIC).
IF FILING WITHOUT AN ATTORNEY, Charles must file Form 33 with the NCIC. At a glance, it seems like a restatement of a lot of the information from Form 18. Some is, but there are other important aspects that Charles may not know how to handle, including the length of the hearing and the written reason he and the insurance company disagree.

IF FILING WITH AN ATTORNEY, Charles would simply review this document, as the attorney would be the one completing it and submitting it. An experienced attorney will know how to complete this form effectively, and word it properly for the desired result. The attorney will also know what compensation and benefits to ask for and how to push for the maximum compensation.

It’s important to know that filing for a hearing isn’t “suing the employer.” This not a civil lawsuit, but a request to the NCIC to hear the claim and decide whether or not the employer and insurance company should be responsible for providing Workers’ Compensation benefits.

Required Mediation, the NCIC Hearing, and Beyond

Before a worker like Charles ever gets to plead his claim before the North Carolina Industrial Commission, the Commission will probably order the insurance company and the worker to sit down and try to work out their differences through mediation.

STEP 6: Go to the NCIC-ordered mediated settlement conference.
WITHOUT AN ATTORNEY, when an injured worker is not represented by an attorney, the case usually bypasses mediation. This is unfortunate because mediations are the best opportunity that an injured worker may have to resolve their issues quickly without having to go through the lengthy and frustrating hearing process.  If Charles had an attorney, he would have a chance to negotiate a reasonable settlement and would have more control over the outcome of his case than he would have by just letting a hearing officer decide what he deserves.

WITH AN ATTORNEY, Charles has a seasoned, knowledgeable, and experienced advocate to help him prepare for mediation.  His attorney will correspond with the insurance company in advance, setting out the strengths of Charles’ case and making an appropriate settlement demand.  At the mediation, Charles will have his attorney with him the entire time. The longer the attorney has had his case, the more firepower he or she can probably bring to bear on his behalf. An experienced attorney will know the strengths of Charles’ case, be able to argue effectively for the best outcome possible, and explain the details and consequences of any settlement he’s offered. Charles will understand his options and his attorney will help him make the decision that is best for Charles.

Cases are often settled at mediation, but not always. It’s simply something the NCIC requires before they take their time to hear the claim.  For our example, we’ll say that Charles and the insurance company can’t agree, and the claim pushes forward to the hearing.

STEP 7: The NCIC hears the worker’s claim.
WITHOUT AN ATTORNEY, Charles will be answering the Commissions questions without any idea what to expect. He’s gotten this far on his own, and it hasn’t been easy. By now, he might wonder if he will ever get relief. If the NCIC rules against him, he will have very few options left.

WITH AN ATTORNEY coaching him and setting his expectations, Charles will likely be more comfortable in front of the Commission. The questions will likely be the same, but he will at least know what to expect and have time to consider his answers before the hearing. It’s still stressful, but not as much.

If the hearing officer, who is a Deputy Commissioner, denies Charles’ claim, he can appeal to a panel of three Commissioners.  If the worker is denied coverage at this level, the only avenue remaining is to appeal the decision to the North Carolina Court of Appeals, and then the North Carolina Supreme Court – at which juncture a lawyer is highly advised and perhaps too late! Fortunately for Charles, the NCIC rules in his favor, and the insurance company does not appeal.

Medical Treatment and Workers’ Compensation

Workers’ Compensation laws are focused on getting workers healthy enough to return to work. The law provides that the insurance company should pay for treatment that will enable a worker to get better and get back to work, including:

  • Medical Treatment: The services of a doctor or specialists to diagnose and treat the injuries
  • Hospital Care: Whether it’s day-of-injury or part of recovery for a surgery or medical treatment
    - Surgical Procedures: Getting the procedures necessary to treat the worker’s injuries
    - Nursing Care: If the worker requires the support of a nurse, or simply receives such care at a facility
  • Medicines: Anything the worker needs to take, including prescription medications, while recovering
  • Sick Travel: Reimbursement for any travel to authorized medical providers or pharmacies more than 10 miles away
  • Rehabilitative services, such as:

- Attendant care services for at-home care or physical therapy

- Vocational rehabilitation to find another job; the insurance company may pay for retraining or for a specialist to help a worker retrain

  • Other treatment: A catch-all category

KEEP IN MIND:  If the insurance company is paying for treatment, the insurance company gets to select the doctors.  It will be up to the doctor’s chosen by the insurance company, and not Charles, or his personal doctors, to decide what treatment Charles needs.

The Insurance Company Chooses the Care Provider

In North Carolina, the workers’ compensation insurer chooses the care provider for the injured worker. They’re paying for the care, and they choose who provides it.

Remember that insurance companies are in business to make money. It stands to reason that, given the choice between care providers who claim to be able to accomplish the same treatments or results, they’re going to choose the least expensive option. They’ll also look at which option claims it can get the worker back to work the quickest, which saves them money in the long run.

Even if Charles’ doctor recommends a course of care, specific treatment, or recovery period for his injuries, the insurance company is not obligated to authorize it. The truth is, even when workers like Charles win benefits, the fight is only beginning. They often find themselves fighting for treatments and second opinions as well.

STEP 7: Getting optimal medical treatment.

WITHOUT AN ATTORNEY, Charles is not happy with the treatment he is getting from the doctor that the insurance company sends him to see.  The doctor says he just needs some physical therapy and some muscle relaxants and he should be able to return to work in a month or so.  Charles does the physical therapy and the doctor releases him to return to full duty work.  Charles is frustrated because he is still in the same amount of pain that he had in the beginning.  He knows something is wrong, but he doesn’t know what to do.

It’s important to note that even if the doctor recommended by the insurance company recommends more helpful treatment, the insurance company may still refuse to pay for it.

WITH AN ATTORNEY handling the claim for him, Charles will have more options.

If the insurance company refuses to pay for treatments recommended by the doctor they authorized, the attorney will know how to fight for the treatment.  And when the authorized doctor releases Charles from treatment before Charles feels he is ready, his attorney will know how to go about trying to get a second opinion for him with another doctor, who hopefully will be more helpful in recommending necessary and appropriate treatment.

It’s also important to note that the insurance company may deny suggested treatments even if those suggestions are from a doctor of their choosing!

In the Next Installment…

Charles finally gets the medical treatment he needs. We’ve covered the medical portion above, and even that’s not entirely complete. We just want to give you a feel for how the process can work – and how much work is involved.

In the next installment, we’ll take a look at the payments that Charles receives when he is unable to work because of his injury, how they’re calculated, what insurance companies may do to limit their payout, as well as Charles’ return to work and life after the injury.

If You Were Injured on the Job and Would Like to Know Your Options, Contact Us

Why go it alone? Being hurt on the job is a life-changing event and can be a source of immense stress. How will the bills get paid? What will you do if you can’t work? How can you get treatment? Call our experienced North Carolina Workers’ Compensation attorneys at 1-866-900-7078, or contact us online for a free case evaluation.

 

The Case of Charles Part 1: Hurt at Work and the Journey of a NC Workers’ Comp Claim

Hurt at work? Most North Carolina workers have no idea how the Workers’ Compensation system functions. Once they’ve suffered an injury, they’re at the mercy of a process they do not understand. So how does it work? What happens next?

To help you understand what goes into a Workers’ Comp claim, how they’re processed, and how an experienced Workers’ Compensation attorney can improve your claim and outcome, let’s explore the example of Charles.

Introducing Charles: a Fictional Worker Who Gets Injured on the Job

We’re going to show you how the system works with the help of a fictional character, we’ve named Charles.

Charles lives in and works construction in North Carolina. He’s worked for the same company for about five years, and the company employs more than forty workers like him. He’s an hourly employee, who received a raise about six months ago. He was doing well until he was injured. Now he has a Workers’ Comp claim. This is his story.

The Day of an On-the-Job Injury

We’re not going to describe the accident in which Charles was hurt, but it’s important to know that there are three primary ways a person can become eligible for Workers’ Comp in North Carolina.

  • Injury By Accident:The interruption of the regular work routine due to an unusual circumstance. Examples include an employee’s foot is run over by a forklift while she works in a warehouse, or an employee hurts his shoulder after falling off a ladder while doing construction work. In general, the injury cannot occur while the employee is performing a task the same way as always (e.g., he is bending down to lift a box when his knee pops).  Something out of the ordinary has to happen. NOTE: If an employee says he was doing his job in the normal way when the injury happened, the insurance company will deny it.
  • Specific Traumatic Injury (Back/neck injuries only):The law says you don’t have to have an injury by accident to have a compensable back or neck injury.  All you need for neck or back injuries is to be able to point to a specific time period when your back or neck began to hurt.
  • Occupational Disease: The NC Workers' Compensation Act provides a list of all the diseases which are considered occupational at C. Gen. Stat. § 97-53. Conditions specifically listed in include asbestosis, lead poisoning, carbon monoxide poisoning, silicosis, and chemical exposure.
  • Other conditions, which are not listed, can be considered compensable as occupational diseases if the employment was a significant factor in the disease's development and the employment exposed the worker to a greater risk of contracting the disease than the public generally. An example is a factory worker who develops carpel tunnel syndrome from repetitive motion.

Charles’ injury was a workplace accident, not a specific trauma, or an occupational disease. You can find more information on occupational diseases on this page.

The Claim Begins – the Process (With vs Without an Attorney)

Everything starts the moment Charles is injured. Clocks begin to tick. Generally, the injured worker should immediately notify his supervisor. The only exception is if the injury is so severe that emergency medical treatment must be sought first. Charles’ injury did not require immediate emergency care, but he was unable to continue working. Here are the steps Charles must follow:

STEP 1: Immediately inform the supervisor, employer, or owner of the company of the injury, first verbally and then in writing, as appropriate.
As soon as practical after the accident, and within thirty days, Charles should give written notice to his employer. A simple written statement giving the date of the accident and a brief description of the injury is all that is necessary.

Charles told his supervisor he was hurt right after it happened.  The next day he submitted written notice, though if he had been unable, a family member could have done it for him. It’s a good idea keep a copy of this document, and a record of when and where it was delivered to the supervisor. Simply snapping a photo with a smartphone is a good idea if this is done on-site immediately. Electronic notification is also acceptable, as emails can be sent with a “read receipt” to prove the other party has read the message.

Note that some employers may have an on-site care provider, and the employer may instruct workers to report to a designated health care office in case of work related injuries. If appropriate to the seriousness of the injury, workers should report to that facility. If there is no employer on-site or designated off-site health care provider, workers should seek medical care appropriate to their medical needs.

STEP 2: Seek treatment for the injury.
It is vital that injured workers seek care as soon as they’re able. This is obvious for serious trauma, but any injury that doesn’t require emergency care still requires care for two reasons.

  • One, treatment can help relieve pain and suffering, and is the first step to possible recovery.
  • Two, the employer and insurance company have no reason to compensate a worker who does not seek care or treatment for an injury.

Unless the injury requires emergency treatment, the employee should wait for the employer and insurance company to tell him/her where to go for treatment.  An employee who feels he/she needs treatment before it is authorized should be aware that they may end up being responsible for paying those bills out of pocket.  Insurance companies generally will not pay for medical treatment unless they chose the provider.

However, if the insurance company ends up denying responsibility for the claim, then the injured worker is free to get all the treatment they want from any provider they want.  Again, they will be responsible for paying the bills until or unless the insurance company changes its mind or is ordered to pay for the treatment later on by the NCIC.

For more on how medical care works, you’ll want to read part two .

Charles heads to his doctor the following morning after getting almost no sleep due to pain and discomfort. It is important that Charles tells his health care provider that his injury is related to his work and the name of his employer. This information allows the health care provider to bill treatment as a Workers’ Compensation claim.

STEP 3: File Form 18 within 30 days.
IF FILING WITHOUT AN ATTORNEY, Charles must file Form 18 with the North Carolina Industrial Commission (NCIC). Form 18 is also called Notice of Accident to Employer and Claim of Employee, Representative or Dependent for NC Workers' Compensation Benefits. The form can be found on the North Carolina Industrial Commission website here.

IF FILING WITH AN ATTORNEY, Charles would simply have his lawyer complete and file Form 18. If you look closely at the lower right part of the form, you’ll notice that the Commission has instructions on how lawyers are to file it. The information on this form is vital to the workers’ claim, obviously, but as you’ll learn, the information will likely be repeated.

About Form 18

Form 18 is just the beginning. Look at what it’s asking for. The contact information of the employee and employer are obvious. The next section talks about the injury itself. When and where did occur? What was hurt? How did it happen? There are very few lines offered to describe the injured body parts or how the injury occurred. In Charles’ case, let’s say that he hurt his back and his left shoulder.

Charles noted “upper and lower back, left shoulder” in the specific body parts field. In the following field, he must describe how the accident happened. What’s said here matters. “I was lifting a crate and my back went out,” is different from, “A crate slipped as I was carrying it and I was injured.” The idea here is to be truthful and complete. Don’t omit or incorrectly describe a detail that might get your claim denied.

Also note that the actual deadline to file a Form 18 is two years from the date of the injury. In practice, this is more a time period for those who develop occupational diseases, but it also helps those who suffer an injury that becomes worse over time. However, the sooner you file the Form 18, the more likely it is that the claim will be accepted. Late reporting is often why the insurance company will deny a claim that would otherwise be accepted.  Anyone who is hurt on the job should immediately seek benefits to continue to support his or her family and pay the bills.

In Charles’ case, his Form 18 is filed within a week of his injury. In practice, the Form should be filed as soon as possible, and a signed copied should be sent to the NCIC and Charles’ employer, with Charles keeping a signed copy for himself.

The Workers’ Comp Claims Process – Employer Response, and Charles Is Denied

STEP 4: Wait for a response to the claim.
Within 14 days of filing a claim, an injured worker should receive one of three forms in response to his or her claim, although in practice, these forms are VERY rarely sent within 14 days. All three are filed by the employer/insurance company.

  • Form 60, Employer's Admission of Employee's Right to Compensation
    This Form essentially accepts that the worker’s injury is real and compensable.
  • Form 61, Denial of NC Workers' Compensation Claims
    This Form is the employer’s denial of the worker’s claim, and should explain why the claim was denied.
  • Form 63, Notice to Employee of Payment without Prejudice
    This Form is only a provisional acceptance of the worker’s claim that the insurance company can revoke at any time. The term “without prejudice” basically means that the filer of the Form reserves the right to deny the claim later on.

No matter which Form is filed, Charles’ journey isn’t over. Even if a Form 60 is filed, the employer can still cut off benefits in the future for various reasons. In Charles’ case, he receives a Form 61 stating that his employer has denied his claim. Now what?

There are no statistics for the percentage of claims that are initially denied in North Carolina. Many claims are denied, some for legitimate reasons and many without. Any claim, no matter how worthy, can be denied.

To Hire an Attorney or Not to Hire an Attorney

For many workers, the denial of a claim is the trigger to hire an attorney. An attorney can be a great help in explaining the process, setting expectations, and handling the communication, forms, and details. Many people tell us they wish they’d hired an attorney sooner. Having an attorney takes the burden of managing a claim off the worker and allows them to focus on healing.

Of course, handling your own claim seems simple at first. The forms are all available, after all. Any worker can read the steps he or she has to take, and for the most part, can do it themselves. Functionally, however, there are a few things worth noting before making this decision.

  • There are a number of deadlines for filing different forms and requests with the NCIC. Missing any of them can harm or totally destroy a claim.
  • Knowing what to send and what to say. It’s not uncommon for workers to describe their injuries poorly, or to falter in communicating with their employer. Talking to the insurance company is usually a bad move unless you know exactly what to say – and not to say. There are a lot of traps that the insurance company has set for you. If you say the wrong thing, your case can be denied.
  • Losing patience. The process of a Workers’ Comp claim can take many months, depending on the insurance company, employer, worker, and the NCIC. An experienced attorney knows how to navigate the process and where it can be accelerated.
  • Maximizing benefits. Injured workers often think, “It could have been worse.” And, of course, it could have. Minimizing the injury is also something that some workers do because they do not want to seem weak. An attorney takes the ego out of the equation, and knows how to pursue the maximum compensation a worker is owed, often negotiating better settlements than a worker could have on his or her own.
  • Having a support system. A legal team can help the injured worker understand and prepare for what to expect at each step of the way and thereby reduce a lot of stress and anxiety.

In the Next Installment…

This series is meant to walk people through the claims process of Workers’ Comp in North Carolina, so we’ll continue to cover the process step by step – one path with an attorney, and one path without. Every time it seems like the battle for benefits is over, it’s just another step.

The process of making a claim is really just the beginning. Getting medical coverage isn’t the end of the story either. We’ll cover that in part two!

If You Were Injured on the Job and Would Like to Know Your Options, Contact Us

Why go it alone? Being hurt on the job is a life-changing event and can be a source of immense stress. How will the bills get paid? What will you do if you can’t work? How can you get treatment? Call our experienced North Carolina Workers’ Compensation attorneys at 1-866-900-7078, or contact us online for a free case evaluation.

How Do Settlements Work in Workers’ Compensation Cases?

Settlements in workers’ compensation cases are very different than settlements in other kinds of personal injury matters. It is important to understand why.

Many people assume that when they get hurt at work, workers’ compensation insurance will reimburse them fairly for everything they have suffered and lost. Many people also assume that workers’ compensation will pay for all their medical treatment and pay their wages while they are unable to work.

This is partially, but not entirely, true.

The 3 Kinds of Workers’ Compensation Benefits You Can Receive If You Are Injured at Work in North Carolina

The actual benefits that an injured worker gets through workers’ compensation are determined by state law. North Carolina workers’ compensation law says that there are three benefits you can receive if you are injured at work:

  1. Wage loss,
  2. Medical treatment, and
  3. Payment of a permanent impairment rating if your doctor gives you one at the end of your treatment

However, there are limitations on all these benefits. The law also says:

  • You are only entitled to get two-thirds of your normal wages while you are recovering from your injury and unable to work.
  • The workers’ compensation insurance company gets to select your doctors, not you.
  • The amount of your permanent impairment rating depends on how much money you make – if you earn less, your permanent impairment rating will be worth less than someone who earns more.

There is a lot that is unfair in the way North Carolina workers’ compensation law was written, which is why it’s important that you speak with an experienced workers’ comp attorney.

People are most shocked when they find out that workers’ compensation law does not include any settlement money for the pain and suffering they and their family go through. This is perhaps the most upsetting thing of all.

Maximum Medical Improvement or MMI

In most cases, settlement does not take place until the medical treatment is completed and the doctor releases you from treatment. This is called reaching maximum medical improvement, or MMI, for short.

At MMI, the doctor will decide:

  1. Whether you have any permanent impairments
  2. Whether you have any permanent physical restrictions
  3. The doctor may also address your risk of any additional necessary medical treatment in the future.

These are the things that determine how much your case is worth in settlement.

Settling a Workers’ Compensation Case

Your workers’ compensation attorney will analyze the factors the doctor provided to determine how much money they believe workers’ compensation should pay you to settle your case fairly.

If you have no physical restrictions and can return to your regular job, your settlement will be based on the value of your rating, but there will be no money offered for wage loss. You will be expected to return to your pre-injury job. In this situation, you will still be able to get additional medical treatment if you need it within a two year period from when the payment for your rating was issued.

On the other hand, if your physical restrictions prevent you from returning to your pre-injury job, your settlement will include money for future wage loss benefits and future medical treatment. You will generally be expected to resign from your job. In this situation, we will have to negotiate with the workers’ compensation insurance company because your settlement will be based on how long it takes you to find another job, what your earnings will be at the new job, and the cost of future medical treatment you might need for your work injury. Since neither side has a crystal ball, there is usually a lot of room to negotiate.

What Happens at a Workers’ Compensation Settlement Negotiation?

Settlement negotiations are usually done at a mediation, which is also known as a settlement conference. You will be expected to attend the mediation with your attorney. There will also be an attorney there representing your employer and their workers’ compensation insurance company. Both attorneys have to agree in advance on selecting a professional mediator to run the mediation. These professional mediators are attorneys who are very knowledgeable about NC workers’ compensation law, but they do not know anything about your case until the opening session. Mediations usually last about three to four hours and are held in one of our offices that is closest to where you live.

  • The first thing that happens at the mediation is called an opening conference. This is when all the parties meet together in one room. The mediator starts out by explaining the process and then asks your attorney to explain the facts of your case. It is not necessary for you to say anything during the opening conference.
  • After your attorney has told the mediator what is important about your case, the employer and insurance company attorney will have a chance to tell the mediator what their clients want the mediator to know about the case.
  • After the mediator understands the issues and the differences between how the attorneys see the case, the sides will separate into different rooms.
  • From then on, the mediator will move between the two rooms exchanging information, monetary offers, and counter offers.
  • The mediation will continue until the sides have reached an agreement to settle the case or the mediator decides that the sides are too far apart in their evaluations of how much the case is worth. In that situation, the mediator will close the mediation and call an impasse.

If the parties agree on a settlement amount and other terms, a document will be signed, which is a binding legal contract that a court would enforce if either side tried to back out later.

If the parties don’t agree on a settlement amount, there could be a hearing at the North Carolina Industrial Commission (NCIC) if either side has filed a hearing request. If no hearing request has been filed, the case will continue until such time as a settlement can be reached in the future.

Why Settle a Workers’ Compensation Case?

A large majority of workers’ compensation cases settle at mediation. Both sides generally prefer to have some measure of control over the outcome, which they don’t have if a NCIC hearing officer is the decision maker.

In addition, mediation is much faster than going to court. It can take almost a year to get a decision from the NCIC hearing officer, and the decision can be appealed by either side, which can add more years to the process.

Finally, the hearing officer at the Industrial Commission is not allowed to decide what a case is worth. The hearing officer can only make limited decisions, such as whether an injured worker is entitled to more treatment or to see a different doctor.

If you settle at mediation, you will generally receive your settlement within several months and you can move forward with your life on your own terms without the interference of the workers’ compensation system.

Contact a North Carolina Workers’ Compensation Lawyer

The workers’ compensation team at the Law Offices of James Scott Farrin includes nine North Carolina State Bar Board Certified Specialists in Workers’ Compensation Law. Our team of legal professionals is ready to serve you in your workers’ compensation matter. Please call 1-866-900-7078 today, or contact us here for a free, no-obligation case evaluation.

What Happens if You Can’t Recover From an On-the-Job Injury?

When you’re injured on the job, getting better becomes your job. What happens, though, if you can’t recover fully? Following medical treatment due to a work injury, a medical provider or physician will release an injured worker from treatment once he or she believes that they have reached “maximum medical improvement” or MMI. Basically, the worker is “as good as he or she can get.”

What Happens if I Reach MMI?

Often, despite this release from treatment, an injured worker has not necessarily made a full recovery and continues to suffer from some permanent partial impairment or disability. A medical provider will assign a percentage of impairment to the injured body part once the worker has reached MMI.

Previously, an injured worker could only recover a specified amount if the injury to their particular body part was listed in the WC statutes – and that was their only remedy. This was and is referred to as a “scheduled injury.”

This changed more than 30 years ago, and now, an injured worker may elect the most beneficial remedy available to them, depending on whether it makes more sense to either recover for the scheduled injury or receive partial or total disability benefits. The choice between recovering for the injury and the disability benefits is an important one to consider. For this reason, it is important to consult an attorney to make sure an injured worker is receiving the best outcome for their situation.

What Happens if I am Disfigured, or Have Permanent Scarring?

Sometimes there are instances of serious facial or head disfigurement or serious bodily disfigurement as a result of the work injury. The workers’ compensation law allows certain benefits to be “stacked” or combined.

For example, if an injured worker is assigned an impairment percentage rating to their arm following a surgical procedure, but the arm has permanent disfigurement due to surgical scarring, then he or she may be able to recover not only for the percentage that was assigned by their doctor upon reaching MMI, but also due to the disfigurement. The two benefits stack.

Here’s another example. Let’s say a worker sustains serious burn injuries to their leg, resulting in permanent impairment of the leg. That leg is also permanently disfigured due to the scars from the burns. In this case, he or she may be able to recover for the scheduled injury and percentage of disability that was assigned by their doctor in addition to recovery for disfigurement.

Who Decides How Am I Compensated for Being Disfigured?

Compensation for serious bodily disfigurement is discretionary. Prior case law has defined serious bodily disfigurement as “an outward or external, observable blemish, blot, scar, or mutilation” that is permanent and mars the appearance to the extent it is repulsive to others and it may reasonably impair that person’s ability to secure future employment considering their past work experience, age, and other factors.

There is wide discretion for the North Carolina Industrial Commission (NCIC) to determine awards for serious bodily disfigurement and no present loss of wages is required. Compensation for serious facial or head disfigurement, on the other hand, is not discretionary and it is mandatory.

Under the law, the determination of whether an injured worker has sustained serious facial or head disfigurement is a question of fact to be decided by the NCIC. The definition of facial disfigurement is similar to the previous definition for bodily disfigurement but it is slightly different with regard to the ability to obtain future employment. Under the law, the Industrial Commission may award proper and equitable one-time distribution not to exceed $20,000 for serious facial or head disfigurement or an amount not to exceed $10,000 in the case of serious bodily disfigurement.

When Is Permanent Disability Certain?

With regard to permanent disability, under the law, the loss of both hands, or both feet, or both legs, or both eyes, or any two thereof shall constitute total and permanent disability. Regarding vision loss, where there is 85% or more loss of vision in any eye, then this is deemed “industrial blindness” and the injured worker will be compensated for the total loss of vision of that eye.

If You’ve Been Injured at Work, Consult an Experienced Workers’ Compensation Attorney

Being hurt on the job is tough situation, and some injuries can be truly life-altering. It’s important to know you’re getting the benefits to which you’re entitled, especially if your injury has long term effects. Contact the Law Offices of James Scott Farrin for a free case evaluation by calling 1-866-900-7078, or you can reach us online.

Can You Claim Workers’ Compensation If You Were Exposed to Coronavirus at Work?

If you haven’t heard of the coronavirus (COVID-19) pandemic, you’ve probably been living under a rock. And if that’s the case, you may want to stay there. We’ve all heard stories about people getting quarantined on cruise ships or at hotels due to the fear of the disease spreading. You may have seen someone walking around with a mask covering their face while out at a store or at an airport.

COVID-19 symptoms may manifest anywhere between 2 to 14 days after you’ve been exposed.* Moreover, the symptoms can closely resemble the common cold or flu, so it’s important to stay vigilant with washing your hands and staying home if you feel unwell.

*According to the CDC, this is based on what has been seen previously as the incubation period of MERS-CoV viruses.

What Happens If You Were Exposed to Coronavirus (COVID-19) or Another Dangerous Virus at Work?

Your work may have taken steps to help contain the spread, like asking employees to work from home and grounding all travel. But what happens if you were exposed to coronavirus at work anyway? What if your symptoms don’t show up until later? Does your employer have to cover your medical bills through their workers’ compensation coverage? Are you legally entitled to benefits if you can’t work due to the disease?

As with many things in law, there are no clear-cut black and white answers to whether an infectious disease contracted at work could be covered by workers’ compensation laws. In North Carolina, coverage for workers’ compensation injuries is divided into two broad categories:

  1. Injuries that occurred by an accident or sometimes a specific traumatic event (i.e. spinal injuries or hernias); and
  2. Those caused by an occupational disease

We focus on occupational diseases below, as it is the most directly related to a potential workers’ compensation claim for coronavirus.

North Carolina Workers' Compensation Occupational Diseases

North Carolina Workers’ Compensation: Occupational Diseases

In North Carolina, occupational diseases can be covered either by:

For example, certain conditions like asbestosis and silicosis are assumed to be occupational diseases in nature. They fall under a category that is listed and covered by state law.

Diseases that are not listed are only covered by workers’ comp if they are peculiar to a trade, occupation, or employment. The law goes on to exclude ordinary diseases of life when the public is equally exposed to the risk, like the common cold or flu.

COVID-19 is, for now, a relatively rare condition in the state, but there are already several confirmed cases in North Carolina. Exposure to the condition has been limited as those infected were told to self-quarantine in their homes. However, just because it is a rare condition does not mean it is an ordinary disease like the flu or a common cold.

Does the Nature of Your Work Put You More at Risk to Exposure to Coronavirus?

A person’s employment may put them in contact with the virus if they travel for work to an area where they are unwittingly exposed to other carriers of the virus. So if you travel for work and are exposed to coronavirus, do you automatically have a workers’ compensation claim? It depends. Simply being exposed in a work setting will not likely be sufficient for it to be covered under workers’ compensation laws. In North Carolina, for an injury to be covered by workers’ comp insurance, the person’s occupation would have to place them more at risk for contracting the virus than the general public. So you may want to ask yourself: Does the nature of my job place me more at risk of being exposed and contracting coronavirus than the general public? One large, and perhaps most obvious, example of a group that this may apply to is healthcare workers.

North Carolina Healthcare Workers, Coronavirus, and Workers’ Comp Laws

At the forefront of the battle against novel coronavirus, healthcare workers serve a vital role for diagnosis and treatment of the illness. Healthcare workers certainly would be a category of people who cannot avoid contact with a potentially infected person due to the nature of their work. We also know that more healthcare workers have contracted the virus than any other profession, and it has recently been reported that nearly 3,000 Chinese healthcare workers have gotten the coronavirus.

In North Carolina, simply being a healthcare worker may not be sufficient for employers to be required to extend coverage through workers’ compensation laws in the state. Even if a healthcare worker could prove that they were more at risk for contracting the disease, they would not necessarily be able to prove the claim.

A final element of proving you are entitled to coverage would be showing the work caused the condition. If a condition becomes commonplace, it is unlikely that you would be able to prove the condition arose at the employment. This may be a smaller hurdle due to the limited number of cases of coronavirus currently. However, it still could be a hurdle that would prevent a healthcare worker from obtaining necessary medical and disability coverage.

One fix for healthcare workers who are particularly at risk would be for the North Carolina legislature to mandate coverage for COVID-19 as a listed disease. It may be worth considering from a public policy standpoint to protect people who are placing their lives at risk to care for the injured and sick. Healthcare workers are in a demanding occupation with long hours and difficult jobs. Providing special protection for these workers would perhaps make sense given the nature of the risk we currently face.

NC Workers’ Compensation Lawyers: We’re Here for You

As we at the Law Offices of James Scott Farrin continue to closely monitor the COVID-19 pandemic, we also continue to serve our clients who were injured at work. We are committed to working with, and for, our clients, even as we remain vigilant of how this pandemic will affect our state.

If you were injured at work in North Carolina, please do not hesitate to call us at 1-866-900-7078 or contact us here.

¿Puede Usted Reclamar Compensación Laboral si Usted estuvo Expuesto al Coronavirus en su Trabajo?

Si no ha escuchado de la pandemia del coronavirus (COVID-19), usted probablemente ha estado viviendo bajo una roca. Si este es el caso, es preferible que se quede allí. Todos hemos escuchado historias de personas aisladas en cruceros o en hoteles por miedo a propagar la enfermedad. Usted puede haber visto a alguien caminando con una máscara cubriendo su rostro en una tienda o en un aeropuerto.

Los síntomas del COVID-19 pueden manifestarse en cualquier momento entre 2 a 14 días luego de haber estado expuesto.* Además, los síntomas son muy parecidos a los del resfriado o influenza, así que es importante mantenerse vigilante al lavarse las manos y quedarse en su casa si se siente enfermo.

*Según el CDC, esto se basa en lo que previamente se ha observado sobre el período de incubación del virus MERS-CoV.

¿Qué sucede si usted estuvo expuestos al Coronavirus (COVID-19) u otro Virus Peligroso en el Empleo?

Su empleo puede haber implementado medidas para contener el propago, como solicitar a los empleados que trabajen desde su casa y detener los viajes. Pero, ¿qué sucede si aun así usted estuvo expuesto al coronavirus en su empleo? ¿Qué tal si sus síntomas no se presentan hasta más tarde? ¿Tiene que su patrono cubrir sus cuentas médicas mediante su cubierta de compensación laboral? ¿Tiene usted derecho a recibir beneficios si no puede trabajar a raíz de la enfermedad?

Como en muchos otros casos, no existe una contestación clara sobre si contraer una enfermedad infecciosa en el trabajo estaría cubierto por las leyes de compensación laboral. En Carolina del Norte, la cubierta de lesiones bajo compensación laboral se divide en dos amplias categorías:

  1. Lesiones que ocurren por accidente o por eventos específicos traumáticos (ej lesiones de la espina o hernias); y
  2. Aquellas ocurridas por enfermedades ocupacionales

A continuación, nos enfocamos en las enfermedades ocupacionales, ya que es lo más directamente relacionado con a una potencial reclamación de compensación laboral por coronavirus.

Compensación Laboral en Carolina del Norte: Enfermedades Ocupacionales

En Carolina del Norte, una enfermedad ocupacional puede ser:

  • Una condición médica o enfermedad que los legisladores determinen esta comúnmente asociada con una ocupación y está incluida en la ley del Estado (vea aquí la lista completa y enumerada de las enfermedades ocupacionales), o
  • Cuando una ocupación pone a alguien en mayor riesgo, que al público en general, de contraer una enfermedad

Por ejemplo, ciertas condiciones como asbestosis y silicosis, se presumen son enfermedades ocupacionales por su naturaleza. Estas caen bajo una de las categorías enumeradas en la ley estatal.

Enfermedades que no están enumeradas, estarán cubiertas por la compensación laboral, solo si son peculiares al oficio, ocupación o trabajo. La ley excluye enfermedades ordinarias de la vida cuando el público está igualmente expuesto al riesgo, como la gripe o influenza.

COVID-19, por ahora, es una condición relativamente rara en el estado, pero ya tenemos varios casos confirmados en Carolina del Norte. La exposición a esta condición ha sido limitada ya que se les ha solicitado a aquellos infectados que permanezcan aislados en sus hogares. No obstante, el que esta sea una condición rara no significa que es una enfermedad ordinaria como la influenza o la gripe.

¿La Naturaleza de su Trabajo lo Pone en Mayor Riesgo de Exponerse al Coronavirus?

El trabajo de una persona puede ponerlos en contacto con el virus si viajan por su trabajo a un área donde pueden estar expuestos a portadores del virus sin su conocimiento. Por tanto, si usted viaja por su trabajo y está expuesto al coronavirus, ¿tiene automáticamente una reclamación de compensación laboral? Depende. El simple hecho de estar expuesto en un escenario de trabajo probablemente no sea suficiente para que esté cubierto bajo las leyes de compensación laboral. En Carolina del Norte, para que una lesión esté cubierta por el seguro de compensación laboral, la ocupación de la persona debe ponerla en mayor riesgo de contraer el virus que al público en general. Así que debería preguntarse a sí mismo: ¿la naturaleza de mi lugar de trabajo me pone en mayor riesgo de estar expuesto y contraer el coronavirus que el público en general? El ejemplo más grande, y tal vez el más obvio, los son los trabajadores del campo de la salud.

Trabajadores del Campo de la Salud de Carolina del Norte, Coronavirus, y Leyes de Compensación Laboral

A la vanguardia de la batalla contra el coronavirus, los trabajadores del campo de la salud sirven un rol vital para el diagnóstico y tratamiento de la enfermedad. Los trabajadores de salud ciertamente pueden ser una categoría de personas que no pueden evitar contacto con sujetos potencialmente infectados, por la naturaleza de su trabajo. Además sabemos que más trabajadores de salud han contraído el virus que en cualquier otra profesión, y recientemente se ha reportado que cerca de 3,000 trabajadores de salud chinos contrajeron el coronavirus.

En Carolina del Norte, el solo hecho de ser un trabajador de salud, puede no ser suficiente para que se les requiera a los patronos extender la cubierta de la ley de compensación laboral en el estado. Aun cuando un trabajador de salud pueda probar que ellos estuvieron en mayor riesgo de contraer la enfermedad, no necesariamente podrán probar su reclamación.

Un elemento final para probar que se tiene derecho a la cubierta, es mostrar que el trabajo causó la condición. Si la condición se torna común, es poco probable que se pueda probar que la condición surgió en el empleo. Esto puede ser un pequeño obstáculo por la cantidad limitada de casos de coronavirus actualmente. No obstante, puede ser un obstáculo que prohíba que los trabajadores de salud puedan obtener la cubierta médica y de incapacidad necesaria.

Un arreglo para los trabajadores de salud que están particularmente en riesgo, sería que la legislatura de Carolina del Norte ordene cubierta para el COVID-19 como una enfermedad enumerada. Se debe considerar, desde el punto de vista de la política pública para proteger a las personas que están arriesgando sus vida para cuidar de los enfermos y lesionados. Los trabajadores de salud están en una ocupación exigente con largas horas y trabajos difíciles. Proveer una protección especial para estos trabajadores tendría sentido dada la naturaleza del riesgo al que actualmente nos enfrentamos.

Abogados de Compensación Laboral de NC: Estamos Aquí para Usted

Mientras nosotros, Las Oficinas Legales de James Scott Farrin, continuamos monitoreando la pandemia del COVID-19, continuamos sirviendo a nuestros clientes que se lesionaron en el empleo. Estamos comprometidos con trabajar con y para nuestros clientes, aun cuando permanecemos vigilantes de cómo esta pandemia afectara nuestro estado.

Si usted sufrió una lesión en el trabajo en Carolina del Norte, no dude en llamarnos al 1-866-900-7078 o contáctenos aquí.

El Sr. Harbin se unió a Las Oficinas Legales de James Scott Farrin en el 2003 y se convirtió en accionista de la Firma en el 2008. Practica en el Departamento de Compensación Laboral de la Firma y es un Especialista Certificado por la Junta de Carolina del Norte. El Sr. Harbin recibió su J.D. de la Escuela de Derecho de la Universidad de Carolina del Norte, y su B.A. de la Universidad de Carolina del Norte en Charlotte. Previo a unirse a la Firma, el Sr. Harbin trabajó en la Comisión Industrial como un SubComisionado Especial.

Learning From the Brier Creek Trench Collapse – a Workers’ Compensation Case

The trench collapse in Brier Creek, Durham, NC, on Wednesday, January, 15, 2020, was a tragedy in every sense of the word. The accident happened on a construction site where workers were digging for a new gas station. While the direct cause of the accident is unknown, the heartbreaking effects are. Two men were injured – one seriously. Another man lost his life.

Our thoughts and prayers go out to those who were injured, and especially to the loved ones of the man who was killed. Now, we want to understand the accident, the aftermath, and the actions they may be able to take.

What Happened in Brier Creek?

The construction company in charge of the project is D R Mozeley out of Charlotte. Their subcontractor, J Squared Plumbing out of Georgia, was performing the work. The company reported that workers were scheduled to be performing work in a three foot well, not a deeper trench. However, a worker on site stated that the hole they were working in was deeper. Durham Fire Chief Iannuzzi said he did not know how deep the trench was originally, but it was six- to eight-feet deep after the collapse.

A supervisor for a construction team that was not working on the site, but was nearby, mentioned that the recent period of rainfall made conditions more difficult, adding the weight of water to the earth being excavated.

Once the truth is known, more legal proceedings may come. One thing that is not in doubt, however, is that the workers involved need help.

What’s Next: Taking Care of Injured Workers

In the aftermath of a work-related accident, there are investigations and often the shifting of blame. In the meantime, the injured workers and their families are likely entitled to workers’ compensation benefits. For the worker who lost his life, the process and benefits are slightly different.

For the injured workers, they’ll need to file a workers’ compensation claim. You can learn how to file and possible benefits by clicking here. There are time limits involved, and a specific order in which to do things.

For workers killed on the job, a wrongful death claim must be entered. You can learn more about wrongful death claims and survivor benefits by clicking here. There are still time limits involved, so it is important to act as soon as possible.

It’s worth noting that workers may also be able to file third party liability claim in addition to a workers’ compensation claim. Third party liability claims are levied against someone besides the employer whose negligence or recklessness may have contributed to the worker’s injury.

What Is Trenching and Who Makes the Safety Rules?

Construction work is one of the more dangerous day-to-day jobs. Opportunities for injury are present throughout the working day, from tools, to vehicles, to environmental hazards.

Construction sites have strict safety regulations and protocols in place to keep workers safe, and the Occupational Safety and Health Administration (OSHA) enforces those rules. There are specific safety rules for excavation and trenching. OSHA defines excavation as “any man-made cut, cavity, trench, or depression in the earth’s surface formed by earth removal. A trench is defined as a narrow underground excavation that is deeper than it is wide, and is no wider than 15 feet (4.5 meters).”

Federal regulations applicable to trenching and excavation operations are located in Title 29 of the Code of Federal Regulations (29 CFR) States may have similar, stricter codes in place.

In the case of the Brier Creek trench collapse, an investigation will likely be conducted to see if proper safety protocols were followed, and if not, who was negligent in their omission.

Tragedies and Trends in Excavation Work

After a spike in trench-related construction deaths in the early 2000s, OSHA performed an investigation, which led to an emphasis campaign to highlight ways to trench safely. At the time, the study showed that proper protective systems were only used 24% of the time. In 68% of the accidents, environmental factors played a role, but in 86% of the accidents, the supervisor was not on-site at the time the accident occurred.

A report from the Bureau of Labor Statistics showed that, between 2014 and 2016, trench-related deaths rose dramatically. In 2013, there were 13 deaths. In 2016, there were 36.

An additional complication for workers’ compensation claims in cases of trench collapse is that there are often multiple contractors or companies working the same site. This may complicate the workers’ compensation claim, but there also may be reason to file a third party liability claim. An experienced North Carolina workers’ compensation attorney can analyze the facts and explain your options.

Contact an Experienced Workers’ Compensation Attorney

For victims of workplace injuries and their families, that weekly paycheck is a lifeline. Medical benefits can keep the bills from piling up as well. Some insurance companies may try to deny benefits when possible, so it’s important to have someone working for your best interest.

Call 1-866-900-7078 or contact the experienced workers’ compensation attorneys at the Law Offices of James Scott Farrin by clicking here. We’ll fight to protect your rights, your benefits, and try to help ensure you’re treated fairly.

Shocking Story of Denied Workers’ Comp Claim

Jolene* was a 32-year-old beautician when she suffered a significant wrist injury working for her employer. Her wrist was hurt so badly that within a few months of her injury, she needed surgery to get better. Then she spent a lot of time out of work and couldn’t earn wages.

The workers’ compensation insurance company should have accepted responsibility for Jolene’s injury and paid her benefits, but it didn’t. Instead, the insurance company denied the claim. (Shockingly, this happens more than you might realize.)

This is the story of how the workers’ compensation attorneys at the Law Offices of James Scott Farrin successfully* fought the insurance company on Jolene’s behalf.

Workers’ Comp Insurance Company Pretends to Do the Right Thing

In the early weeks after Jolene was hurt at work, the insurance company acted like it was going to do the right thing. It sent Jolene to the doctor to see why her wrist hurt and why she couldn’t lift anything with her arm. An honest individual, Jolene told the doctor that during her freshman year in college, she had a few minor problems with her other wrist, but nothing that ever required medical treatment.

That was all the insurance company needed to know. Even though Jolene’s prior wrist issues happened over a decade earlier and never required medical treatment, the insurance company used this irrelevant medical history to deny responsibility for the recent work-related injury to the wrist.

Workers’ Comp Insurance Company Denies Rightful Claim

By the time Jolene got to the Law Offices of James Scott Farrin, her claim had already been denied. We see this a lot. Some people may not consider hiring a workers’ comp attorney until their claim is denied. Waiting until the claim is denied, however, is often a mistake for many reasons – not the least of which are medical considerations.

As we typically do, we went right to work and filed a hearing request to challenge the denial. This would get us in front of a judge so we could plead Jolene’s case. But, as sometimes happens, this can take time. Meanwhile, Jolene got medical treatment using her husband’s health insurance – treatment that included wrist surgery, numerous follow-up visits with the doctor, and extensive physical therapy.

Before an injured worker can make their case to a judge, they and their attorney have to meet with the attorney for the workers’ compensation insurance company to try to reach a settlement. This is called mediation. At Jolene’s mediation, the workers’ compensation insurance company tried to lowball Jolene and pressure her to accept an insultingly low settlement. We told Jolene we should take the fight to court, and she agreed.

We Convinced Judge to Order Insurance Company to Pay Up*

After the first hearing in Jolene’s case, the judge ruled that she was indeed hurt on the job and that the insurance company was responsible for her injury. The judge ordered the insurance company to pay Jolene medical and wage benefits. Jolene had waited a long time for this decision – two years after her injury, in fact.

The insurance company wouldn’t stop fighting. It appealed to a panel of several judges. Again, the judges ordered the insurance company to accept responsibility for Jolene’s injury and to pay medical and wage benefits. By this time, Jolene was on the hook for tens of thousands of dollars in medical bills and was owed tens of thousands of dollars in wage benefits.


The insurance company in Jolene’s case hoped she would just go away or accept a lowball offer.


But Jolene didn’t do either. With the help of her workers’ comp attorney and the worker’s comp team, Jolene had her day in court and got several different judges to tell the insurance company that they were wrong to deny her any longer.

Insurance Company Ignores Judge – Still Wont’ Pay

Alas… the fight isn’t over. As sometimes happens, work injuries (any injury) can require subsequent medical treatment. Jolene was recommended to undergo another surgery, and the insurance company started its old tricks again – refusing to pay for the surgery. And just like last time, Jolene and the Law Offices of James Scott Farrin went back to court to fight them, so she could get the treatment she needed to get better, get back to work, and support her family.

Free Workers’ Comp Case Evaluation From James Scott Farrin

This story could be any one of a hundred cases we handle at any given time.

It is not until some injured workers realize that they may not be in good hands with their workers’ comp insurance company that they come to us.

If you have been injured on the job, contact us immediately or call 1-866-900-7078 for a free case evaluation. We’ll let you know what we can potentially do to help you try to get maximum benefits for your injury.

*Name and personal information have been changed to protect privacy. Each case is unique and must be evaluated on its own merits. Prior results do not guarantee a similar outcome.

 

Will workers’ comp pay for new injuries that develop after my initial work injury?

“I injured my left knee at work, but now my right knee is hurting because I am putting more weight on it. Will workers’ compensation pay for treatment to my right knee?”

I guess some insurance company adjusters never learned the kids song, Dry Bones … “The foot bone’s connected to the leg bone…and the leg bone’s connected to the hip bone…”

While I mention this example in jest, there’s nothing to joke about when another part of your body starts hurting after your initial work injury. While this can happen quite often, just as often I have found that many insurance adjusters try to refuse to pay for medical treatment for other body parts that start hurting after the initial injury.

The good news is our experienced workers’ comp lawyers know how to try not to let them get away with this one-sided tactic.

Common Examples of Referred Pain

Referred pain is common. For example:

  • Joe injures his right foot. After using a cane for month or so, he starts having pain in the left hand from the pressure of leaning on the cane. Will the insurance company pay for left hand treatment?
  • After a shoulder injury, Mary starts feeling pain in her neck which radiates down her arm. Will the insurance company pay for her to have an MRI of her neck?
  • Martin hurts his knee at work. After a few months of limping, he starts having low back pain because of an altered gait. Is the insurance company going to pay for back treatment?

In each of these instances, my experience has been that some insurance companies will do everything they can to deny new treatment. Here’s why.

The majority of insurance companies are for-profit businesses. They may try very hard to pay as little as possible on claims because this is more money they get to keep. That is why when you report your work injury, you had better tell them about every single body part you injured. If you fail to mention a body part at the beginning of a claim, it can often be difficult to get the insurance company to pay for any medical treatment for it. (That is why we suggest injured workers to contact us immediately after an injury. We can help frame initial injuries in a way that may potentially help get other parts paid for if they stem from the work injury.)

Will Workers’ Comp Pay for New Medical Issues?

It is difficult to get insurance companies to pay for new medical problems that arise while your body is recovering from the initial work injury. Let’s say an infection set in after surgery from a work injury, and you had to take strong antibiotics, which resulted in severe ulcerative colitis. According to workers’ compensation law, a subsequent injury, whether an aggravation of the original injury or a new and distinct injury, is compensable if it is the direct and natural result of a prior compensable injury.

In order to get the insurance company to accept responsibility for the new medical problems that crop up after a work injury, you must have medical evidence from doctors that the new problems are the direct and natural result of the work injury. But don’t think that the hand-picked workers’ comp doctor will simply agree that subsequent issues are indeed the direct result of your initial injury. I have often seen the opposite to be the case.

Contact NC Workers’ Comp Attorneys Soon After Your Work Injury

Err on the side of caution and contact the Law Offices of James Scott Farrin as soon as possible after your work injury. Our experienced and formidable lawyers will fight for your right to get medical treatment, not only for your immediate work injuries, but also for all the medical conditions that you may develop as a result.

There is a lot to know about workers’ compensation law, and the system is difficult, if not nearly impossible, to navigate successfully on your own. The sooner you hire the professional legal team at James Scott Farrin, the better we can fight to protect your rights.

Even if you don’t think you may need a lawyer, contact us anyway, or call 1-866-900-7078 for a free case evaluation. Sometimes we are able to offer simple and direct advice even if we don’t think you need a lawyer.

Contact Information

Asheville Law Office

300 Ridgefield Court Suite 309
Asheville, NC 28806
Phone: 828-552-8215
Toll Free: 1-866-900-7078

Charlotte Law Office

301 S McDowell St, Suite 900
Charlotte, NC 28204
Phone: 704-599-1078
Toll Free: 1-866-900-7078

Durham Law Office

280 South Mangum Street, Suite 400
Durham, NC 27701
Phone: 919-688-4991
Fax: 800-716-7881

Fayetteville Law Office

2915 Raeford Road, Suite 204
Fayetteville, NC 28303
Phone: 910-488-0611
Toll Free: 1-866-900-7078

Goldsboro Law Office

1308 Wayne Memorial Drive, Suite B
Goldsboro, NC 27534
Phone: 919-731-2581
Toll Free: 1-866-900-7078

Greensboro Law Office

300 N. Greene Street, Suite 850
Greensboro, North Carolina 27401
Phone: 336-665-7072
Toll Free: 1-866-900-7078

Greenville Law Office

702 Cromwell Dr. Suite G
Greenville, NC 27858
Phone: 252-355-5205
Toll Free: 1-866-780-3227

Henderson Law Office

514 Dabney Drive, Suite 200
Henderson, NC 27536
Phone: 252-492-4600
Toll Free: 1-866-900-7078

Morganton Law Office

216 N. Sterling Street, Suite B
Morganton, NC 28655
Phone: 828-219-3080
Toll Free: 1-844-520-2894

New Bern Law Office

1505 South Glenburnie Rd, Unit P
New Bern, NC 28562
Phone: 252-634-9010
Toll Free: 1-866-780-3422

Raleigh Law Office

4325 Lake Boone Trail, Suite 100
Raleigh, NC 27607
Phone: 919-834-1184
Toll Free: 1-866-900-7078

Roanoke Rapids Law Office

709 Julian R. Allsbrook Highway
Roanoke Rapids, NC 27870
Phone: 252-537-9670
Toll Free: 1-866-900-7078

Rocky Mount Law Office

144 Woodridge Court
Rocky Mount, NC 27804
Phone: 252-937-4730
Toll Free: 1-866-900-7078

Sanford Law Office

703-B South Horner Boulevard
Sanford, NC 27330
Phone: 919-775-1564
Toll Free: 1-866-900-7078

Wilson Law Office

2315 Airport Blvd Suite A
Wilson, North Carolina 27896
Phone: 252-246-9090
Toll Free: 1-866-900-7078

Winston-Salem Law Office

301 N. Main Street, Suite 2409-C
Winston-Salem, NC 27101
Toll Free: 1-866-900-7078