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July 15, 2023
Clarke Speaks

What are the Four Types of Workers' Compensation Benefits in North Carolina?

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Workers’ compensation is a vital lifeline if you’ve suffered an injury or illness due to your job. But navigating the complex world of workers’ compensation laws can be challenging, especially when you’re already dealing with the physical and emotional toll of an injury.

You might have questions like, “What benefits are available to me?” “How does the system work in North Carolina?”

This blog post answers those questions and more, including “What are the four types of workers’ compensation benefits,” so you can understand the benefits you’re entitled to if you’re injured on the job in North Carolina.

If you have questions or need help with a workers’ comp claim, don't hesitate to contact a member of our legal team now. Call Speaks Law Firm at (910) 341-7570 for a FREE case review. Who speaks for you? We do!
North Carolina workers'

Key Points

  • Understanding the four types of workers’ compensation benefits is essential for navigating the complex world of workers’ compensation.
  • Employers must carry insurance to protect their employees and meet legal requirements, and injured workers should be prepared with comprehensive documentation when dealing with insurance companies.
  • Reporting injuries timely, seeking medical treatment from authorized providers, and documenting injury/treatment process are key tips for successful claims.
  • Why hiring a North Carolina workers’ compensation attorney is crucial for the success of your claim.

Understanding the Four Types of Workers' Compensation Benefits

Compensation Benefits
In North Carolina, there are four primary types of workers’ compensation benefits available to injured workers:

  • Medical benefits
  • Disability benefits
  • Rehabilitation benefits
  • Death benefits

Each type of benefit serves a different purpose and can provide crucial assistance during your recovery process.

To make the most of these benefits, it’s essential to have a solid understanding of what each one entails and how it can help you get back on your feet.

In the following sections, we’ll explore each type of benefit in detail, providing you with the knowledge you need to confidently navigate the complex world of workers’ compensation.

    • 1. Medical Benefits for Injured Workers

Medical Benefits for Injured Workers

When you suffer a work-related injury, one of the first concerns is receiving proper medical treatment and covering those expenses.

Fortunately, workers’ compensation provides medical benefits covering:

  • Doctor's Visits: All appointments with healthcare providers necessary for the diagnosis and treatment of your workplace injury or illness
  • Hospital Care: This includes both inpatient stays and outpatient procedures that are necessary due to your workplace injury
  • Prescription Medications: Any medications prescribed by your treating doctor to manage pain, aid recovery, or treat side effects are typically covered
  • Medical Procedures and Surgeries: Any medical procedures, surgeries, or treatments necessary to treat your workplace injury or illness should be covered
  • Physical Therapy: Rehabilitation and physical therapy needed to regain function or manage symptoms of your workplace injury are covered

Physical Therapy

  • Medical Devices: If your injury requires the use of medical devices or aids, such as crutches, wheelchairs, or braces, these should be covered
  • Mileage Reimbursement: Some workers' compensation programs also reimburse travel to and from medical appointments related to the workplace injury.

Always consult with your workers' compensation attorney or insurance provider to confirm what your plan covers. This ensures you can focus on your recovery without the added stress of mounting medical bills.

However, it’s important to note that you need to seek treatment from authorized providers within your employer’s network to ensure coverage. Be sure to verify with your employer which medical providers are authorized under their workers’ compensation insurance.

Consult with a Charlotte workers' compensation lawyer if you encounter any issues in this process.

  • 2. Disability Benefits for Lost Wages

Disability Benefits for Lost Wages

In addition to covering medical expenses, workers’ compensation provides disability benefits to compensate for lost wages due to your inability to work. There are four categories of disability benefits:

  • Temporary Partial Disability (TPD)
  • Temporary Total Disability (TTD)
  • Permanent Partial Disability (PPD)
  • Permanent Total Disability (PTD)

Each category corresponds to the severity and duration of your injury and the benefits you receive will be based on your average weekly wage at the time of the injury.

For example, temporary total disability benefits are paid when you cannot work temporarily, while temporary partial disability benefits are paid when you can still perform some work duties but at a reduced capacity.

Understanding these categories and how they relate to your situation is crucial for ensuring you receive appropriate compensation for your lost wages. The chart below describes these four categories in more detail.

Type of Disability Description
Temporary Partial Disability (TPD) Applicable for injured workers who are able to return to work in a lower-wage position:
  • Can receive two-thirds of the wage difference
  • Benefits are available for up to 500 weeks from the accident date
Temporary Total Disability (TTD) This is for severely injured workers who are unable to return to work until they are healed:
  • Benefits equate to two-thirds of an employee’s typical weekly salary
  • Compensation rate is capped and adjusted annually by the North Carolina Industrial Commission
Permanent Partial Disability (PPD) Applicable for workers who are unable to return to work even after reaching maximum medical improvement. PPD benefits are split into:
  • Scheduled loss awards: These are covered by the Workers’ Compensation Act and calculated based on the severity of impairment
  • Unscheduled loss awards: These are calculated just like any other North Carolina disability benefit
Permanent Total Disability (PTD) Applies to workers with severe limitations such as:
  • Loss of limbs
  • Severe burns
  • Severe brain injuries
  • Spinal injuries resulting in paralysis
  • 3. Rehabilitation Benefits for Vocational Support

Rehabilitation Benefits for Vocational Support

In some cases, your work-related injury may require vocational support to help you return to work or find new employment.

Rehabilitation benefits are designed to provide this support through job training, job placement assistance, and counseling. These benefits are crucial in helping you regain your independence and re-enter the workforce.

Not all injured workers will require vocational rehabilitation services, and the specific services provided may vary depending on your individual needs and circumstances.

Nevertheless, knowing that these benefits are available can provide peace of mind and support during recovery.

  • 4. Death Benefits for Dependents

Death Benefits for Dependents

In the tragic event that a work-related injury or illness results in death, workers’ compensation provides death benefits to the deceased worker's dependents. These benefits include financial support calculated based on the worker’s average weekly wage and coverage of funeral expenses.

While no compensation can truly make up for the loss of a loved one, death benefits can help ease the financial burden dependents face during an incredibly difficult time.

If you need to navigate the process of claiming these benefits, consulting a workers’ compensation lawyer can provide invaluable guidance and support.

Navigating North Carolina's Workers' Compensation Laws

Navigating North Carolina's Workers' Compensation Laws
Next, let’s discuss the legal framework that governs these benefits. The North Carolina Industrial Commission (NCIC) is the state agency responsible for administering workers’ compensation claims and ensuring that employers comply with the North Carolina Workers’ Compensation Act regulations.

Understanding the NCIC's role and employers' responsibilities in providing workers’ compensation insurance is key to navigating the system effectively.

In the following sections, we’ll delve deeper into the role of the NCIC and the employer's responsibilities regarding workers’ compensation insurance, providing you with the knowledge you need to navigate North Carolina’s workers’ compensation laws successfully.

Role of the North Carolina Industrial Commission

The NCIC plays a crucial role in overseeing workers’ compensation claims in North Carolina and ensuring employers adhere to the required insurance regulations.

In addition to managing and executing workers’ compensation cases, the NCIC can provide assistance to both employees and employers with inquiries or issues related to workers’ compensation.

By understanding the role of the NCIC, you can better navigate the workers’ compensation process and ensure that your rights are protected. If you encounter any difficulties or need additional guidance, contact your attorney for support.

You can read more about your rights in our blog, “What Are My Rights Under Workers’ Compensation in Wilmington, North Carolina?

Employer Responsibilities and Insurance Requirements

In North Carolina, employers with three or more employees must carry workers’ compensation insurance to protect their workers. This insurance requirement ensures injured employees have access to the benefits they need to recover from a work-related injury or illness.

It’s essential to be aware of your employer’s responsibilities and the insurance requirements in place to protect your rights as an employee. If you suspect your employer is not compliant with these regulations, you can report your concerns to the NCIC or to your attorney.

Challenges Faced by Injured Workers in Workers' Compensation Claims

Challenges Faced by Injured Workers in Workers' Compensation Claims
Filing a workers’ compensation claim can be challenging, and injured workers often face various difficulties along the way. Some common challenges include dealing with uncooperative insurance companies and proving eligibility for benefits.

Overcoming these obstacles can be challenging, but being prepared and knowledgeable about your rights can increase your chances of a successful claim.

In the next sections, we’ll explore these challenges in more detail and provide tips for overcoming them to ensure a smooth and successful workers’ compensation claim process.

Dealing with Insurance Companies

One challenge many injured workers face is dealing with insurance companies, which may attempt to minimize or deny claims. Insurance companies focus on their bottom line and may not have your best interests at heart.

As such, it’s crucial to be prepared with comprehensive documentation and evidence to support your claim, including medical records and proof of lost wages.

If you struggle to navigate the complex interactions with a workers' compensation insurance company, consider consulting with your workers' compensation attorney for guidance and support.

An experienced workers’ compensation attorney can help protect your rights and advocate on your behalf to secure the benefits you’re entitled to receive.

Proving Eligibility for Benefits

Another challenge injured workers may encounter is proving their eligibility for workers’ compensation benefits. To successfully claim benefits, an injured worker must provide appropriate evidence to demonstrate the injury occurred while on the job and illustrate the extent of the injury and its impact on their ability to work.

Gathering and organizing the necessary documentation and medical records can be time-consuming and overwhelming, but it is essential for proving your eligibility for benefits.

By diligently documenting your injury and treatment process, you can build a strong case for your workers’ compensation claim.

Tips for a Successful Workers' Compensation Claim

Now that we’ve discussed the challenges injured workers face in the workers’ compensation claim process, let’s explore some tips for ensuring a successful claim.

Adhering to these best practices can increase your chances of receiving benefits and pave the way for a smoother recovery process.

In the following sections, we’ll share tips related to reporting injuries and filing claims, seeking medical treatment from authorized providers, and documenting the injury and treatment process.

Reporting Injuries and Filing Claims Timely

Reporting Injuries and Filing Claims Timely
One of the most important factors in a successful workers’ compensation claim is reporting your injury and filing your claim on time.

Prompt reporting allows for a thorough accident investigation, reduces claim costs, and ensures you receive the appropriate medical care and benefits.

In North Carolina, if you're injured at work or diagnosed with an occupational disease, you should notify your employer as soon as possible but no later than 30 days after the accident or diagnosis.

After notifying your employer, the next step is to file a claim with the North Carolina Industrial Commission. Being proactive in this process can set the stage for a successful claim and a smoother recovery.

Seeking Medical Treatment from Authorized Providers

As mentioned earlier, seeking medical treatment from authorized providers within your employer’s network is crucial to ensure workers’ compensation covers your medical expenses.

Failing to do so may result in the denial of your claim, leaving you with the burden of covering your medical bills out of pocket.

By verifying which medical providers are authorized under your employer’s workers’ compensation insurance and obtaining treatment from them, you can avoid potential complications and ensure that your medical expenses are covered.

Documenting the Injury and Treatment Process

Keeping thorough records of your injury, treatment, and recovery process is essential for supporting your workers’ compensation claim and ensuring that all entitled benefits are received.

Documentation should include medical records, proof of lost wages, and any other relevant information that may support your claim.

Maintaining comprehensive records and staying organized throughout the process can help build a strong case for your claim and increase your chances of receiving the benefits you’re entitled to once you reach maximum medical improvement.

How a North Carolina Workers' Compensation Attorney Can Help

How a North Carolina Workers' Compensation Attorney Can Help
Navigating through the world of workers' compensation can be overwhelming, especially when you're dealing with the physical and emotional fallout of a workplace injury. This is where a skilled North Carolina workers' compensation attorney can make a significant difference.

Guiding You Through the Process

The workers' compensation system is complex, filled with legal jargon, strict timelines, and required procedures.

An experienced North Carolina workers' compensation attorney can explain the process in plain English, guide you through every step, and ensure that all necessary documentation is completed accurately and submitted on time.

Defending Your Rights

Insurance companies often try to minimize the compensation you receive or deny your claim altogether. A workers' compensation attorney can defend your rights, ensuring that you receive the full benefits you're entitled to under North Carolina law.

Calculating Accurate Benefits

The calculation of benefits, particularly for permanent disabilities, can be complex and involves considering future medical costs and lost wages.

A seasoned attorney can accurately calculate these benefits, ensuring that you don't settle for less than you’re entitled to receive.

Representation at Hearings

If your claim is disputed or denied, you may need to present your case at a hearing before the North Carolina Industrial Commission.

A workers' compensation attorney can represent you at these hearings, advocating for your interests and presenting compelling evidence to support your claim.

Exploring All Avenues

In some cases, you may be eligible to file a third-party claim in addition to your workers' compensation claim, such as when a defective product or someone other than your employer or a co-worker was partially responsible for your injury. An attorney can help you explore all potential avenues for compensation.

Your attorney can serve as a powerful ally in your pursuit of fair compensation. With their help, you can focus on your recovery while they handle the intricacies of your claim.

Frequently Asked Questions

Q: What if my employer doesn't have workers' compensation insurance?
A: In North Carolina, all employers with three or more employees are required to have workers' compensation insurance. If your employer is uninsured, you can report them to the North Carolina Industrial Commission, which can take legal action against them.

Q: Can I sue my employer for a workplace injury?
A: Workers' compensation is a "no-fault" system, meaning you can't sue your employer for a workplace injury. However, in certain cases, such as if your employer intentionally injured you, you might be able to bring a personal injury lawsuit.

Q: What if I'm injured by a third party while on the job?
A: If you're injured by a third party (someone other than your employer or a co-worker), you may be able to file a third-party claim in addition to your workers' compensation claim. This could be relevant in cases such as car accidents while on the job or injuries caused by defective equipment.

Q: Can I be fired for filing a workers' compensation claim?
A: It's illegal for an employer to retaliate against an employee for filing a workers' compensation claim. If you believe you've been retaliated against, you should seek legal advice immediately.

Q: Can I receive compensation for pain and suffering?
A: You cannot recover damages for pain and suffering in a workers’ compensation claim.

Maximize Your Workers’ Compensation Benefits with Speaks Law Firm

If you've been injured at work and are navigating the complexities of workers' compensation, don't hesitate to seek professional help. Speaks Law Firm is here to stand by your side, defend your rights, and ensure you get the compensation you're entitled to.

Our experienced Charlotte workers’ compensation attorneys understand the intricacies of North Carolina workers' compensation laws and have a proven track record of success in helping injured workers just like you.

Don't struggle alone. Let Speaks Law Firm be your advocate in this challenging time. Whether you need help filing your initial claim or a neglected claim, we'll handle the legal complexities so you can focus on your recovery.

Call us at (910) 341-7570 or complete our online form to schedule your FREE case review with one of our workers' compensation lawyers. Remember when you ask, "Who speaks for me?" The answer is Speaks Law Firm!

Copyright © 2024. Speaks Law Firm. All Rights Reserved.
The information in this blog post (“post”) is provided for general informational purposes only and may not reflect the current law in your jurisdiction. No information in this post should be construed as legal advice from the individual author or the law firm, nor is it intended to be a substitute for legal counsel on any subject matter. No reader of this post should act or refrain from acting based on any information included in or accessible through this post without seeking the appropriate legal or other professional advice on the particular facts and circumstances at issue from a lawyer licensed in the recipient’s state, country, or other appropriate licensing jurisdiction.
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