North Carolina Workers’ Compensation Guide

The experienced North Carolina workers’ compensation attorneys at Stewart Law Offices fight for the rights of employees who are injured at work or diagnosed with a job-related disease. Call or contact us today to learn how we can build a workers’ compensation claim that demands maximum benefits for your injuries and losses.

What is Workers’ Compensation?

North Carolina workers’ compensation (or “workers’ comp”) provides medical coverage, wage reimbursement and other non-monetary benefits to workers who are involved in workplace accidents or diagnosed with an occupational disease. North Carolina employers with three or more employees are required to carry workers’ compensation coverage, with certain exceptions.

Who Handles North Carolina Workers’ Compensation Claims?

The North Carolina Industrial Commission (NCIC) oversees the state’s workers compensation system. Its deputy commissioners and commissioners are in charge of resolving disputes between injured workers, employers, and employers’ insurance companies over access to appropriate workers’ compensation benefits.

Workers’ Comp Statute of Limitations in NC

Workplace injury: 2 years from date of injury

Occupational disease: 2 years from date of diagnosis

Death benefits: 2 years from date of death

Failure to file on time can bar a workers’ compensation claim forever.

Notification Requirements for Workers’ Compensation

Worker must report the injury to employer within 30 days

File a Form 18 —Notice of Accident to Employer and Claim of Employee with the N.C. Industrial Commission (provide copy to employer)

Employer has 5 days from the date of injury or allegation of injury to file a Form 19 — Employer’s Report of Injury to Employee with its insurance carrier

Filing Requirements

All forms and documents must be filed with the NCIC electronically

Employer Response to Claims

Employer/insurance carrier has 30 days to admit, deny or pay the claim without prejudice (by completing Form 60, 61 or 63, whichever is appropriate)

Employee must receive written explanation for denial of benefits within 14 days of receipt

Average Weekly Wage (AWW)

Calculated by totaling the amount of wages for 1 year prior to injury and dividing by 52

If employee worked less than one year, divide wages by the number of weeks worked

Any period in which employee missed more than 7 consecutive calendar days of work not included in calculation

Workers’ Comp Claim Compensation Rates

Calculation: 66⅔ percent of average weekly wage not exceeding the state’s maximum rate

Maximum rate: Adjusted annually ($1,028 for 2019)

Minimum rate: $30 a week

Mileage: Reimbursed for medical treatment more than 20 miles from home (Also adjusted annually — 58 cents per mile for 2019)

Other costs: Travel, hotel and food costs may also be reimbursed

Waiting Period For Payment

Must wait 7 days before benefits (aside from medical expenses) can be paid

If you are out of work for more than 21 days, you will be reimbursed for the first 7 days

Payments made weekly unless NCIC directs otherwise

Medical Benefits For Eligible Workers

Covered costs: Employer must pay for medical treatment that can cure an injury, relieve pain or help the employee get back to work. Includes payment for medical conditions that are a “direct and natural consequence” of job injury.

Handling Workers’ Comp Disputes in North Carolina

If medical treatment and wage reimbursement does not happen promptly, employee can call the insurance carrier or request a hearing with the NCIC by filing a Form 33 — Request That Claim Be Assigned for Hearing

Types of Disability Benefits

Temporary Total Disability (TTD)

For workers who are totally disabled (but temporarily) after a workplace accident

66⅔ percent of AWW wage not exceeding the state’s maximum compensation rate

Limited to 500 weeks for accidents occurring after 6/24/11; no cap on claims before that date

Benefits still payable while employee is authorized to return to work but with restrictions

Temporary Partial Disability (TPD)

Paid when healing worker can return to work but will be earning lower wages

66⅔ percent of difference between AWW pre-injury and AWW post-injury, not to exceed state maximum

Limit of 300 weeks for injuries before 6/24/11; 500 weeks for injuries after 6/24/11

Permanent Total Disability (PTD)

For employees who can never work again

Medical compensation and 66⅔ percent of AWW paid for lifetime of employee

Certain injuries are automatically considered PTD, including loss of both: Hands, arms, feet, legs, eyes, and any combination of two of the above.

May also include some traumatic brain injuries, paralysis and severe burns to 33 percent or more of the body

Permanent Partial Disability

Payable to workers who have reached maximum medical improvement (MMI) but continue to have impairments to “scheduled” body parts according to N.C. workers’ comp law (N.C.G.S. §97-31)

MMI is determined by doctor and worker is assigned rating that represents percentage of loss of use

Scheduled body parts are entitled to benefits for a set number of weeks based on the percentage

Scheduled Members and Body Parts

Injury to Compensation (Weeks)

Arm – 240

Back- 300

*If loss of use is more than 75 percent Total disability — 100 percent loss

Ears:

One ear – 70

Both – 150

Eye – 120

Fingers*:

Thumb – 75

First (index) – 45

Second – 40

Third – 25

Fourth (little) – 20

*Loss of first phalange of thumb/ finger counts loss of half of affected digit and compensation will be for one-half the weeks specified

Foot – 144

Hand – 200

Leg – 200

Toes*:

Great – 35

All others – 10

*Loss of first phalange of any toe counts loss of half of affected digit and compensation will be for one-half the weeks specified

Serious head or facial disfigurement – Up to $20,000

Serious bodily disfigurement – Up to $10,000

Loss/permanent injury to any important organ – Up to $20,000

NC Workers’ Compensation Death Benefits

Death must be a compensable injury

Must occur within 6 years of date of accident or onset of disability, or within 2 years of a final determination of disability by NCIC (whichever is later)

Payable to dependents of employee, with burial expenses not exceeding $10,000

500 weeks after death for claims after 6/24/11; some exceptions apply