Good question. Whenever a workers' compensation claim is started, a
qualified workers' compensation attorney has to consider the following
- Does this injury qualify for coverage under the North Carolina Workers'
- Is this covered (or should it be covered) under the employer's workers'
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'
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 a
workers' compensation claim could leave you without a job or health coverage when you need it most.