A common question we hear in workers' compensation claims is whether the client has reported the injury or accident to his employer. This reporting issue is critical. And often, the answer will determine whether the client is entitled to workers' compensation benefits.
If you suffer an injury on the job, report it to your employer immediately - in writing if possible.
Why report an injury IMMEDIATELY and IN WRITING?
I'll give you two good reasons. First, North Carolina law requires an employee to report an injury within 30 days. Immediately reporting your injury significantly reduces the chance that your claim will be denied. The employee's failure to report an injury is one of the most frequent reasons insurance companies cite for denying a claim. Second, a claim in which written notice has not been provided within 30 days can be barred.
Let's examine these reasons more closely.
The law requires written notice
The Workers' Compensation Act instructs an injured employee to give written notice to the employer immediately after the injury occurs. Section 97-22 states:
"Every injured employee or his representative shall immediately on the occurrence of an accident, or as soon thereafter as practicable, give or cause to be given to the employer a written notice of the accident..." (emphasis added). If written notice is not given within 30 days, "no compensation shall be payable."
This rule can be harsh. Some assume that verbally reporting their injury - telling a manager, supervisor, or coworker what happened - is sufficient.
Not so. I cannot emphasize enough that failing to provide written notice can legally bar you from recovering any benefits.
Exception to the rule
Thankfully, there is a common-sense exception that makes this rule less of a pitfall for injured workers. If the employee has a reasonable excuse for not providing written notice within 30 days, and the employer is not harmed by the delay, the employee can still receive compensation.
This exception arises most frequently when the employer has "actual notice" of the workplace injury -when the employer is notified immediately or knows of it first-hand.
The real concern is whether an employer and its insurance company are harmed by the injured worker's failure to provide notice. If an employer is aware that an injury occurred, it would be difficult to argue that they were harmed by a lack of written notice. With actual notice of a workplace injury, the employer has an opportunity to investigate, interview witnesses, and send the injured worker to a doctor of their choosing.
As a practical matter, however, even if your employer has actual notice of your injury, you should always submit a written notice of injury as soon as possible. Providing written notice fully complies with the law and documents that notice was given.
Bottom line: Don't rely on your employer's knowledge of your injury. Be safe, comply with the law - provide written notice.
Immediate written notice helps support your claim
The second reason you should report your injury immediately is that it greatly reduces the chances that your claim will be denied. As noted above, one of the most frequent reasons claims are denied is an injured worker's failure to provide a timely injury report.
That being said, running to your employer at the first sign of a tweaked back can go against the grain of our culture's emphasis on ruggedness and "sticking it out." Many clients have confided in me that they didn't report a back injury right away because they thought it was only a minor sprain or tweak, and they didn't want to cause trouble at work. You can see the dilemma for employees. They want to push through minor aches and pains so they won't be considered weak or whiny. However, by not reporting minor tweaks and sprains, they jeopardize their workers' compensation claim if the injury proves to be more serious.
This may come as a surprise, but it's been our experience that some workers' compensation insurance companies all too often have little interest in "doing the right thing" for an injured worker. If the insurance company can latch onto any reason for denying a claim, more often than not they will. Failing to immediately report an injury provides a technical and legal basis for them to deny you.
What's more, employers can have a deeply ingrained suspicion of workers' compensation claims. Experience tells us that some employers can be much too quick to discredit an employee who reports an injury. Reporting delays merely heighten these suspicions and can adversely affect the injured worker's claim credibility. Time and time again, we've seen that the injured workers who report their injury immediately are more likely to be believed and to have their claim accepted.
If you didn't report right away DON'T WORRY
All is not necessarily lost. At the Law Offices of James Scott Farrin, we have considerable experience dealing with these reporting issues and challenging claims where the insurance company refused to pay benefits because of reporting issues.
Our workers' compensation department offers five Board Certified Specialists in North Carolina Workers' Compensation Law - the highest level of workers' compensation specialization possible in North Carolina. We even have attorneys, paralegals, and other staff members who've worked for "the other side."
Make no doubt about it - we will utilize these and other vast resources to fight for you and try to help see that reporting issues do not potentially ruin your claim. Click here for a free case evaluation or call us at 1-866-900-7078.