Workers' compensation FAQs

You will need to file a Form 18 with the North Carolina Industrial Commission. Click here for the Form 18 and filing instructions.

Surprisingly, no! There are different legal standards for different body parts in North Carolina.  Generally speaking, you have back injuries and non-back injuries. For back injuries, you need to show a “specific traumatic” incident, or basically an identifiable incident, when your injury occurred at work. This can be while you are performing normal job duties.

For non-back injuries, it is harder to prove a claim. You have to show an “injury by accident,” which is generally considered something abnormal, something that is NOT a normal part of your work routine, or something unexpected, like a slip, trip or a fall.

It is imperative that you accurately describe and report the details of how you got hurt.  It is also imperative you relay this information to your doctors, as it may help prove your case later.  For these reasons, we highly recommend hiring an attorney to help guide you through this maze of requirements.

There are three benefits: 1) weekly wage loss/disability, 2) medical treatment, and 3) a disability rating. Unfortunately, pain and suffering is NOT available in workers’ compensation cases.  The best way to fully understand the benefits you have available and maximize your receipt of those benefits is to hire an attorney.

Unfortunately, no. If the insurance company has accepted liability for your injury, they have the right to “direct your care,” which means pick your doctors, authorize treatment, and pay the bills. If you are unhappy with your WC doctor or want another opinion, you are able to ask for a comprehensive second opinion, but it is not guaranteed.

If your case is not accepted, then you can pick your own doctor but you are also paying for your treatment, pending the outcome of your claim.

It depends. The first question to answer is whether you are physically capable of returning to your regular job at your employer, or another job at your employer. If you are able to return to work for your same employer after you are released by your doctors, then there is an option for a limited payment on permanent partial disability (or a disability rating) where your case stays partially open and you do not have to resign. However, this is not the norm. In most instances, there is a dispute about one’s ability to physically return to the job, or both parties agree that moving on is best, and you will be required to resign your job as part of a full and final settlement of your claim.

It depends. We generally recommend our clients consider how soon they want to have surgery, if they have other means to pay for the surgery like group health insurance, and what is being offered to settle your case before surgery. Generally, we think it’s best to get all the treatment you want to have in the immediate future while your WC case is open.

We generally like to see if we can settle your WC case first, but every case has to be evaluated on its own merits. You may be require to put some of your workers’ compensation settlement into a Medicare Set Aside account or informal allocation if you apply for SSD while your case is open. This is probably not as beneficial to you as it may sound, since it limits how you can spend part of your settlement funds. Most of our client wait to apply for SSD after their case settles. If you case is going to stay open for many years or may never settle, then applying for SSD while your case is open may be your best option.

You can still pursue your claim and will likely need to file a Form 33 Request That Claim Be Assigned for Hearing. Once a claim is denied, your primary options will be to settle your claim or litigate your case. It is extremely rare for the insurance company to change their denial.