Suffering an injury on the job can be one of the most disruptive experiences in a worker’s life. Worries about your health and your livelihood can feel overwhelming. North Carolina law requires businesses with three or more employees to have workers’ compensation insurance. Workers’ compensation should pay your medical expenses and provide weekly checks during your period of disability to replace a portion of your lost income.
You may wonder how long you can rely on these benefits. Workers’ compensation should cover you until you have recovered from your injuries and have been cleared by your doctor to return to work. In North Carolina, the insurance company only has to pay a weekly check for 500 weeks from when you first become disabled, unless you qualify for one of the exceptions to receive extended benefits beyond the 500 weeks.
How Long Do Lost Wage Replacement Benefits Last?
If you sustained an injury on the job that prevents you from working, you may be eligible for temporary total disability benefits. The length of time these wage replacement benefits last under workers’ compensation law varies from state to state.
In North Carolina, as an injured worker, you are eligible to receive two-thirds of your average weekly wage as a temporary total disability benefit until you are able to return to work.
if the disability is temporary, the employee might be eligible to receive the payments for up to 500 weeks. If an injured employee can work but can only perform a job that pays less than their previous job, the worker may qualify for wage replacement benefits equal to two-thirds of the difference between their former and current income. These benefits also last for up to 500 weeks.
Are There Exceptions?
It’s not guaranteed that you will receive 500 weeks of Total Temporary Disability (TTD) benefits. The insurance provider will seek to terminate your benefits once your doctor has determined that you have achieved maximum medical improvement (MMI) and can return to full-duty work. Under such circumstances, you can ask for a second opinion with an independent medical professional who can assess you to determine whether you need more time to recover and should continue receiving benefits.
It may become apparent that you will need to receive benefits beyond the 500-week mark. An experienced North Carolina workers’ compensation attorney can help you seek extended benefits. Your lawyer must request a hearing after your 425th week of first becoming disabled. The attorney must convince the North Carolina Industrial Commission that you have suffered a total loss of wage-earning capacity and, therefore, cannot engage in any type of gainful employment.
Altering your Total Temporary Disability status into a Total Permanent Disability status is challenging. The process requires precise timing, well-organized evidence, and a thorough understanding of North Carolina workers’ compensation law. Having a seasoned workers’ compensation lawyer at Younce, Vtipil, Baznik & Banks advocating for you can optimize your chances of a favorable outcome.
What Does the Workers’ Compensation Timeline Look Like?
The timeline for filing for workers’ compensation benefits in North Carolina is as follows:
- Notify your employer – You must begin the workers’ compensation claim process by notifying your employer of your injury in writing within 30 days of the injury or diagnosis. The sooner you notify the employer, the more quickly the documentation of the workplace injury can get underway.
- Seek medical attention – Even if you have already been to a doctor, your employer may require you to consult their designated medical professional for treatment and diagnostic tests.
- File the appropriate forms – Within five days of receiving your notification, your employer or their insurance carrier must file form 19 with the North Carolina Industrial Commission. You must file form 18 within the same timeframe.
- Receive notification of acceptance or denial – The employer’s insurer or the Commission must respond to your request within 14 days.
- Receive payments – If the Commission accepts your workers’ comp benefits application, you will receive payments immediately provided that you are disabled. However, you will not receive payment for your first missed week of work unless you miss 21 or more work days due to your injury.
If the Commission denies your application, you can appeal their decision. Working with a knowledgeable and skilled attorney can help the process move as efficiently and effectively as possible.
How to Protect Your Right to Full Workers’ Compensation Benefits
Understanding how the workers’ compensation system works can be challenging, especially if your employer or their workers’ comp insurance administrator disputes your claim or tries to end your benefits prematurely. An experienced workers’ compensation attorney can deal with the insurance company on your behalf and advocate for your rights as a worker with an occupational injury.
Here are some ways a knowledgeable lawyer can help:
- Review your case to determine whether you qualify for benefits – A workers’ compensation attorney can examine the circumstances of your injury and employment status to build the strongest possible case.
- Gather evidence such as medical records, witness statements, and vocational assessments to prove your claim – Strong documentation makes it harder to deny benefits.
- Negotiate with insurance adjusters to get approvals and prompt payment – Skilled negotiators can often resolve issues quickly.
- Represent you at hearings before the Industrial Commission if your claim is disputed – Experience presenting evidence and arguing before judges can make all the difference.
- Appeal rulings when necessary to fight denials and terminations – A skilled lawyer has a thorough understanding of the workers’ compensation appeal process and how to effectively argue to overturn unfavorable decisions.
Having an experienced advocate in your corner can help you maximize your compensation and continue receiving benefits for as long as you qualify.
Get in Touch with Our Workers’ Compensation Lawyers
If you have suffered an on-the-job injury in the Triangle area, the workers’ compensation attorneys at Younce, Vtipil, Baznik & Banks, P.A. can help. With decades of experience, we have helped clients throughout North Carolina protect their right to workers’ compensation benefits following workplace accidents and illnesses. We are ready to fight for you.
Don’t leave your workers’ compensation benefits up to chance or an insurance adjuster. Call our office today at 919-661-9000 or contact us online for a free consultation with a seasoned North Carolina workers’ compensation lawyer. Let us help you get the support and peace of mind you deserve at this challenging time.
About the Author
Robert C. Younce, JR
Robert C. Younce is an attorney at Younce, Vtipil, Baznik & Banks, P.A. and concentrates his law practice on personal injury and workers’ compensation law. He has tried over 100 workers’ comp cases to Opinion and Award and about a dozen personal injury jury trials to verdict. He has been board-certified by the North Carolina State Bar as a specialist in workers’ compensation law since 2001.
