How to File a Workers’ Compensation Claim in North Carolina
Injured workers must meet several deadlines to pursue workers’ compensation benefits in North Carolina. Notify your employer as soon as possible if you get hurt in an accident or are diagnosed with an occupational disease, and within no longer than 30 days. Your employer is then responsible for notifying its insurance carrier to initiate the workers’ comp process. If they don’t, you can take action to pursue benefits yourself.
If you have any questions about filing a workers’ compensation claim in North Carolina, an experienced attorney can advise on the process and collect the documentation you need to build a strong case.
Contents
- What Steps Should I Follow When Filing a NC Workers’ Compensation Claim?
- What is the Employer’s Responsibility When a Worker is Injured?
- What Sort of Response Could I Receive from the Insurance Company?
- How Long Can It Take to Get My Workers’ Comp Benefits Approved?
- What Do I Do If My Claim is Denied?
- Contact a North Carolina Workers’ Compensation Lawyer
What Steps Should I Follow When Filing a NC Workers’ Compensation Claim?
The North Carolina workers’ compensation system requires that you take specific steps to pursue benefits for your occupational injury or illness. Here’s what you should do:
- Report the injury to your employer – Inform your employer about your work injury promptly but no later than 30 days after the incident. Provide a detailed account of the incident so your employer can accurately report what happened. If you are severely hurt and can’t notify your employer right away, do so as soon as your condition is stable or ask someone you trust to do it for you. It’s best to provide this notice in writing and keep a copy for your records as proof that you met the reporting requirement. Failure to report in 30 days can make you ineligible for workers’ comp benefits.
- Seek medical treatment – Getting appropriate medical care should be your priority after a work-related injury. Your employer has the right to select your healthcare provider in North Carolina, except in emergencies where immediate care is necessary or you successfully apply for an exemption to choose your own doctor. Follow your physician’s advice and keep records of all treatments. These documents will be necessary for your claim.
- Fill out and submit a Form 18 if necessary – Sometimes, your employer’s workers’ compensation insurance carrier might not start paying the benefits you are due. If this happens, you can be proactive by filing a Form 18 with the North Carolina Industrial Commission (NCIC). This form is crucial for documenting your injury and initiating the claim process independently. You have two years from the date of your injury or from the last date of continuous medical treatment to do so.
- Wait for a decision – Your employer, its insurance company, or the NCIC will notify you if your claim is approved or denied. During this period, maintain communication with your employer or the NCIC to check the status of your workers’ compensation claim.
What is the Employer’s Responsibility When a Worker is Injured?
When employees sustain work-related injuries in North Carolina, their employers have several responsibilities. First, they must provide immediate help and ensure the injured worker gets medical attention. Next, the employer must promptly report the injury to their workers’ compensation insurance company. This report typically begins the process of pursuing benefits for the employee’s medical expenses and lost wages.
Additionally, the employer should cooperate with any NCIC investigations and provide all necessary documentation related to the worker’s employment and injury. This assistance is crucial for injured workers to receive the appropriate benefits quickly and efficiently. If your employer fails to take the proper steps after your work injury, contact a workers’ compensation lawyer for guidance on filing your benefits claim.
What Sort of Response Could I Receive from the Insurance Company?
When you file a workers’ compensation claim in North Carolina, the insurance company could respond in several ways. First, it can approve your claim. This means the insurer agrees you suffered a qualifying job-related injury and will pay for your medical treatments and lost wages. Alternatively, they could deny your claim. If they do, they must provide an explanation for their denial.
Sometimes, insurers deny claims by arguing your injury is not work-related. Other times, claims get rejected if the insurer believes you have insufficient documentation or failed to file your claim correctly.
In some cases, the insurance company might request more information before deciding. It could ask for additional medical records, details about your injury, or more documentation about your employment. Responding to these requests promptly is important to ensure timely processing of your claim. Always keep copies of all records sent to the insurance company as part of the claims process.
How Long Can It Take to Get My Workers’ Comp Benefits Approved?
The time it takes to get your workers’ comp benefits approved in North Carolina varies. Generally, the insurance company has 14 days to respond after you file your claim. If the insurance company approves your claim, you should start receiving benefits shortly after this 14-day period. However, it could take longer if your claim requires additional information or disputes arise.
If the insurance company denies your claim or you believe it is undervalued, you can appeal the decision, which lengthens the timeline. Contact a workers’ compensation attorney if you need help or experience delays.
What Do I Do If My Claim is Denied?
Swift action is essential if your workers’ comp claim gets denied. First, review the denial letter carefully to understand why the insurance company rejected your claim. Often, they will specify whether it was due to missing information, eligibility issues, or doubts about your injury occurring at work.
Once you know the reason for the denial, contact a trusted workers’ compensation lawyer. They can gather additional evidence for your claim, correct errors, and guide you through the appeals process. They will also represent you at hearings and push to get your claim approved. The NCIC is a formal legal body with policies and procedures that must be followed. Handling your claim alone could create setbacks that lead to unfavorable outcomes.
Contact a North Carolina Workers’ Compensation Lawyer
Feeling overwhelmed by the workers’ comp process in North Carolina? Don’t lose hope. Call The Law Offices of John Drew Warlick, P.A. today for a free initial consultation. Our experienced team is here to help you with your claim and fight for your rightful benefits.
