Filing a Workers' Compensation Claim
Your Responsibility
If you are injured in a workplace accident or by an occupational disease, you should file the proper paperwork to protect your right to compensation under the North Carolina Workers’ Compensation system. The law requires that you give your employer and the Industrial Commission notice of the accident as soon as possible after the injury occurs. Filling out and submitting a Form 18 provides this notice, which is called claim. You must file the original form with the Industrial Commission and send copies to your employer. In most cases, your employer’s insurer will actually handle the processing of your claim.
If you fail to file a claim within 30 days of a workplace accident, your employer may consider that grounds to refuse to pay you compensation. If you have an occupational disease, you must give notice of your disease at the time you are first diagnosed by a competent medical authority. Your claim will usually be barred by law if it is not filed within two years of your accident or occupational disease diagnosis.
Your Employer’s Response
If you experience a workplace injury that requires you to miss more than one day of work or if the cost of your medical treatment is more than $2,000, your employer is required to file a Form 19 with the Industrial Commission. A copy of this form will also be provided to you, along with a Form 18, which you or your lawyer must file to protect your rights.
Once you initiate a claim for compensation, your employer may either accept the claim or contest it. If the employer is unsure about whether to accept or contest the claim, it may go ahead and begin making payments to you without prejudice. This means that the employer is not immediately accepting liability for the claim, but will begin to pay you while it investigates further. These payments will continue until the employer formally accepts or denies liability or until 90 days have passed without the employer doing either one.
If the employer decides to contest your claim, it may stop making payments immediately and notify you and the Industrial Commission of its decision. The notice, filed on Industrial Commission Form 61, includes a detailed statement of the grounds for the denial.
Settlement or Denial
If you and your employer agree on the compensation that is to be paid to you, you may jointly complete a Memorandum of Agreement (on Form 21) and file it with the Industrial Commission. Alternatively, your employer may simply acknowledge the compensability of the claim on a Form 60. If you are seeking death benefits for the death of a loved one, you and the other dependents are required to sign and submit a Form 30, agreeing to the death benefit offered. Once you have signed this agreement, it is binding upon all parties.
If the insurer denies your claim, you are entitled to a hearing before the Industrial Commission. To request a hearing, you must submit a Form 33.
You have a voice.
Although the system was established to make it easier for employees or their dependents to receive compensation, it is not always easy to get the compensation to which you are entitled. At every step of the way, there are forms to file and decisions to be made. There are rights to be preserved and payments to maximize.
If you have suffered from a work-related injury or illness or you have lost a family member because of either one, you have a place to turn. At Ward Black Law, we work hard to get our clients the compensation they need to meet their medical needs and provide for their families. We exist to give a voice to ordinary people facing extraordinary struggles. Contact us today for a free consultation.
