The N.C. Workers' Compensation Act sets forth the duties and responsibilities that employers and employees have when an employee is injured on the job.
The Industrial Commission is an administrative agency that is in charge of claims under the act. But a party may appeal to state court under limited circumstances after all administrative remedies are exhausted.
Who is covered? If you work for an employer who employs three or more people, whether full time or part time, or you are an employee of a construction subcontractor, or your employer has workers' compensation insurance, you are covered by the act.
Who is not covered? Generally, agricultural, residential, domestic, casual workers and independent contractors are not covered by the act. State, county and city employees are covered. Federal, maritime and railroad workers are covered under other laws, but they have also benefits as a result of the working relationship.
What do you do when you are injured on the job? The employee has a duty to report the injury immediately, or at least within 30 days, to his employer. The employee generally has a two-year period in which to file for a hearing of his claim.
An employee also has a claim for a job-related disease or condition without a specific traumatic incident, such as a fall. An example is a lung disease caused by ingesting dust or chemicals commonly used in the work area, such as at a textile mill.
What about fault? If the employee's negligence caused the injury, that does not prohibit the employee from receiving benefits, except under very limited circumstances. But the trade-off is that the employee's claim is limited to a set amount, depending on the injury. The employee can make no separate claim for pain and suffering.
The major exception to this rule is if the employer has openly violated a clear safety rule, such as a federal Occupational Safety and Health Administration regulation. If it can be established that a clear violation caused the worker's injuries, public policy requires that the worker be allowed to be fairly compensated for that, in addition to benefits under the act.
To what benefits are you entitled? If you are injured on the job and you have a compensable claim, you are entitled to payment for your reasonable medical expenses related to the claim, disability payments for the period of time your health-care provider writes you out of work (temporary total disability), disability payments for any permanent injuries (permanent partial disability), death benefits, organ loss and disfigurement. If your injuries and impairment are significant, you may be entitled to compensation because you are totally and permanently disabled.
If your injuries keep you from performing the job you had before, and you suffer a wage reduction in your new job that you can perform, you may have a wage-reduction claim that is greater than your permanent-disability claim.
For example, if you hurt your right hand, and you are no longer able to do the work on your existing job, you may have to take a job that pays less. Your total pay reduction, multiplied by the number of weeks, may be greater than the percentage of disability payment you would receive for your hand injury.
The N.C. Bar Association publishes a useful free pamphlet on Workers' Compensation basics that you may download at www.ncbar.org.
Remember: An informed choice is a smart choice.
Mike Wells is an attorney with Wells Jenkins Lucas & Jenkins PLLC in Winston-Salem.
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