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If I File a Workers’ Compensation Claim in NC, How Do I Receive Medical Treatment and Who Controls It?

As a worker's compensation attorney in NC, I receive lots of questions about medical treatment after job-related injuries.

If I get hurt at work, should I go straight to the hospital? What should I tell them when I get there? Can I choose my own doctors? More importantly, who pays for my treatment?

You simply must be prepared. After all, if you ever find yourself struggling to recover from a serious work injury, the last thing you'll want to worry about is a growing stack of medical bills.

The goal of this article is to provide you with some basic information about what to do and where to go after a workplace injury in North Carolina.

What is covered?

If you have an accepted workers' compensation claim in North Carolina, you are entitled to medical benefits. This usually includes things like doctor's appointments, physical therapy, prescriptions, and even surgery. To put it simply, medical benefits are any treatments that help you recover from your injury.

In many cases, the term "medical benefits" even applies to:

  • Travel costs to and from your medical appointments (if more than 20 miles round-trip)
  • Attendant care
  • Medical equipment
  • Home or vehicle modifications

Unlike a typical health insurance plan, there are no co-pays or deductibles in workers' compensation cases. The insurance company is responsible for 100% of your approved medical expenses. It sounds pretty good, right? But there's a catch.


Medical41_06062014Who chooses the doctors?

In North Carolina, the workers' compensation insurance company has the right to direct your medical care. This means they choose which doctors you see, when you see them, and which treatments you receive.

What if I refuse the treatment?
The insurance company might try to cut off your benefits altogether.

What if I request a second opinion?
The insurance company might deny the request or try to weigh in on which doctor you see before agreeing to pay for it.

What if I go to my own doctor?
The insurance company will probably refuse to pay for it. If your doctor makes any new treatment recommendations, they will probably refuse to pay for those as well. If you choose to pay for the treatment on your own, you might not be reimbursed.

As you've probably guessed, these issues can (and usually do) lead to lots of problems. Many injured workers in North Carolina eventually find themselves wrestling with an insurance company over the issue of medical care.


So what should I do after an injury?

Report! Report! Report!

If you've been injured on the job, immediately (or as soon as possible) tell your coworkers and supervisors what happened. Written notice is even better. Fill out an incident report. Make sure the details of your accident are consistent. When you get to a doctor, make sure he or she is aware that you had an accident on the job. Your medical records are going to become very important so make sure the doctor knows exactly what happened to you.

Get to a Doctor
If your injury is serious enough, you may be taken to the hospital by ambulance. For all other non-emergencies, ask your employer whether they have an onsite or designated offsite healthcare provider for workers' compensation patients. If so, tell them you need an appointment. Alternatively, work with your employer to locate a nearby healthcare facility that accepts walk-in patients. It could be an urgent care clinic or a hospital, depending on the severity of your injury. When you arrive, make sure you tell the doctor(s) that you were injured on the job and give them the name of your employer.

Establish Treatment
As you recover from your injury, follow your workers' compensation doctor's instructions with regard to medical treatment. If your injury is severe enough, you may be referred to a specialist for further testing, pain management, or surgery. At any point, if you feel uncomfortable or dissatisfied with the quality of your healthcare, it might be a good time to consult with an attorney and explore your legal options within the workers' compensation system.


Law0_07312014Call Experienced North Carolina Workers' Compensation Attorneys

You are now armed with some basic knowledge about your right to medical treatment after a work-related injury. However, in our experience, some insurance companies are always finding creative new ways to save money, which could mean denying you benefits.

Even if you are receiving some benefits now, it doesn't mean that it's everything you may be entitled. So, pick up the phone and contact an experienced workers' compensation attorney at the Law Offices of James Scott Farrin at 1-866-900-7078. Your initial case evaluation is free. Remember, nothing is more important than your health.

Mr. Bliss joined the Law Offices of James Scott Farrin in 2012 as an attorney in the Firm’s Workers’ Compensation Department. Mr. Bliss received his J.D. from the University of North Carolina School of Law in Chapel Hill, NC. He received his B.A. in English from North Carolina State University in Raleigh, NC, graduating magna cum laude. Prior to joining the Law Offices of James Scott Farrin, Mr. Bliss worked as a Workers' Compensation defense attorney. This experience allowed him to see how Workers' Compensation law is practiced from both sides.

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