Good question. Whenever a workers’ compensation claim is started, a qualified workers’ compensation attorney has to consider the following two questions:
- Does this injury qualify for coverage under the North Carolina Workers’ Compensation Act?
- Is this covered (or should it be covered) under the employer’s workers’ compensation insurance?
When it comes to determining whether or not you have a viable claim, the answers to these two questions are a big deal. It’s all about figuring out whether you are eligible for out-of-work benefits and compensation for your medical treatment.
One thing that every experienced workers’ compensation attorney knows is that each claim is unique. The smallest detail in an employee’s claim can make all the difference when it comes to who’s entitled to receive benefits and who’s not.
When you’re trying to determine if your injury is covered, take the valuable time to consult with a workers’ compensation attorney. You want someone who is experienced with North Carolina workers’ compensation claims.
Maybe you don’t think you’re covered because you’re not sure what your employed status is. Do you work part-time? Are part-time employees entitled to benefits under the North Carolina Workers’ Compensation Act? Are you an independent contractor? Are independent contractors entitled to workers’ compensation when they’re injured on the job?
These are all reasonable questions, and the answer is: your status as an “employee” is defined under the Workers’ Compensation Act by the specific facts of your personal claim, as compared to North Carolina statutory and case law. In other words, don’t assume you’re not entitled to benefits after a work-related injury.
Let’s go over some basics. Can you establish when, where, and how you were injured? In North Carolina, a valid workers’ compensation claim typically means that you had to have been injured while performing some activity for the benefit of your employer. This could mean that you were injured at the workplace itself, but it could also mean that you were injured while making deliveries for your employer. But guess what? You may qualify if you were injured on a business trip. Or even at a business lunch. Keep in mind, if you were in the course of any activity for the benefit of your employer, you may qualify for workers’ compensation benefits.
Most of us think of injuries as happening due to some sort of accident. Maybe you fell down, or maybe something fell on your head. You could have slipped off of a roof, or caught part of your body in an industrial machine. These type of things would be considered an accident as defined by the Workers’ Compensation Act.
But understand that the lack of an accident doesn’t, in and of itself, mean that you don’t have a claim. Chemical exposures are covered by the Workers’ Compensation Act. So are overuses of particular parts of your body. In fact, injuries specifically related to an employees’s back do not require an accident to have happened for the employee in question to receive benefits.
Remember, this can’t be said enough: do not make your own determination as to whether or not you have a valid workers’ compensation claim. It is in your best interest to consult with a workers’ compensation attorney.
Does It Matter Who’s Fault It Was?
In North Carolina, you do not have to prove that you were injured due to someone else’s negligence. The North Carolina Workers’ Compensation Act is a no fault system. Employees wishing to receive benefits do not have to prove that their employer was negligent.
So. Should You File?
Serious claims go unreported all the time. A lot of employees are afraid. They worry that, if they bring up their injury, their employer will somehow be angry at them. Maybe they’ll be seen as difficult employees. Some employees feel like they caused their own injury. Maybe they think they weren’t careful enough, or maybe they think they weren’t following proper procedure in the workplace. And, in some cases, there are employees who don’t even consider the option of workers’ compensation when faced with a workplace injury. This is especially true in a lot of office environments where work injuries tend to be less than common.
A large number of these employees seek medical care through their own personal healthcare plans, and they file claims on their personal health coverage. Which is a shame, because failing to file a workers’ compensation claim and reporting the work related injury can and does impact workers profoundly. The financial and medical can have lasting, negative repercussions for employees who would have otherwise been eligible to receive workers’ compensation benefits.
Cases do exist where someone’s personal and private insurance covered their workplace injury and then later sought reimbursement for those payments when they found that the injury was work-related. This nasty mistake on the worker’s part can leave the employee owing a considerable amount of money out-of-pocket for their medical expenses. Also of note, when employees don’t recover quickly from injuries and return to work, they run the risk of losing their job and their health benefits.
Consult with a North Carolina workers’ compensation attorney. You owe it to yourself to be treated fairly. Discuss the matter with someone qualified and let your attorney make the determination as to whether or not you have a potential and valid claim. Not filing aworkers’ compensation claim could leave you without a job or health coverage when you need it most.