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Workers’ Compensation Lawyers – What You Need To Know
If you were injured on the job or suffer from a work-related illness, you may be entitled to medical care paid by your employer. However, the process involved in receiving workers’ compensation payouts is often stressful and confusing. Here’s a guide to help you understand some of the ins and outs of workers’ comp, including knowing when it’s time to hire a lawyer to help.
What Qualifies for a Workers’ Compensation Claim?’
In order to qualify to make a workers’ compensation claim in North Carolina, you must have a work-related injury or illness. Workers’ compensation entitles you to receive medical care, as long as your employer has workers’ compensation insurance. In North Carolina, like all states, there are specific requirements for employers that dictate when the employer should obtain insurance and when he or she need not.
While most work-related injuries are covered by workers’ compensation, there are a few outliers. Generally, workers’ compensation does not cover:
- Injuries that occurred when the employer was intoxicated or using illegal drugs.
- Injuries that are self-inflicted such as injuries caused in a fight.
- Injuries that occurred while the worker was committing a crime.
- Injuries when the worker was not on the job.
- Injuries that occurred when the worker was violating company policy.
There are also some gray-areas where it’s unclear whether the injury qualifies for workers’ compensation benefits, and further investigation may be necessary. In these cases, it’s a good idea to speak with an experienced workers’ compensation lawyer to review your case details then help you fight for your case should it be deemed by your attorney that you may qualify.
Here are some examples:
Lunch breaks. Injuries that occur during lunch breaks don’t always qualify for workers’ comp. If the break took place off company property it probably won’t be covered. However, if you were walking off property to pick up lunch for your team and sprained your ankle, it might be covered. If it took place on company property, it also may be covered.
Company events. Injuries at company events such as holiday parties are generally not covered by workers’ comp. However, there are outliers to this.
Travel. If you sustain an injury while using a company vehicle, it generally will be covered even if it occurred outside of your normal work hours.
What Does a Workers’ Compensation Settlement Cover?
Workers’ compensation claims generally cover:
- Hospital and medical expenses for diagnosis and treatment.
- Disability payments while you are unable to work (at a reduced wage).
Depending on the injury, they may also cover rehabilitation, retraining, and other benefits.
When It’s Time to Get a Workers’ Compensation Lawyer
Workers’ compensation claims are complicated, involving many rules and regulations. Oftentimes the worker may become a victim in the insurance company’s operative to cut costs. If you are not receiving adequate medical care or if the insurance company is trying to minimize the extent of your injuries, illness, or disability, you should speak with a workers’ compensation lawyer.
A workers’ compensation attorney can help you navigate this complicated process and make sure you get the care to which you are entitled.
Rules on Selecting a Doctor
When filing a workers’ compensation claim, the state of North Carolina sets strict rules that limit your choice of health care provider. The physician will play an important role in treating your injury or illness, and also is the deciding factor in two key elements of your claim. First, he or she will decide how much time off work you need to recover. Second, he or she decides whether the injury has left you with a permanent disability that may require long-term care or permanently affect your ability to work.
In North Carolina, the employer’s insurance company greatly influences the kind of care you will receive, including choosing the doctor, health care office, or managed care organization (MCO). If you feel that the doctor or treatment you are receiving is not adequate, you can fight for better care. Hiring a worker’s compensation attorney can help you get the treatment you’re entitled to.
Settling Your Claim
Oftentimes, workers’ compensation claims end in settlements where the worker receives an agreed upon amount of cash. Settling may make sense in your case to pay off medical bills or avoid a stressful workers’ compensation hearing. Before you pursue settling, it’s important to understand the most common types of workers’ compensation settlements and the rights you will have should you choose to settle.
If it’s unclear to you which type of settlement claim is in your best interest, or if you want to explore other options, consider speaking with a lawyer.
Compromise Settlement Agreements
Compromise settlement agreements (sometimes called “clinchers”) result in the worker receiving a sum of money, and in return giving up their rights to a workers’ compensation claim. Generally, you will receive a lump sum payment in these agreements. However, settlements that involve long term care (in the case of a severe and permanent disability) may be given in installments over time.
Form 26A and Form 21 Settlements
Form 26A and Form 21 settlements involve cases where the insurance company has agreed to giving the worker a partial disability rating. In the case of Form 26A, this rating is permanent and the insurance company may pay the value of the disability rating in weekly installments. In exchange, you agree to forego your right to any future disability agreements. Form 21 holds the same agreement, but it is used for temporary disabilities.
In these situations, the case is not fully settled and you have an opportunity to receive medical benefits beyond the period of the original agreement. Clearly there are different approaches and many things to consider, hence our recommendation is always to seek professional legal advice from a North Carolina Licensed Attorney.
The content on this website is provided for general information only. It should NOT be construed by the reader as LEGAL ADVICE. The LAWS of the Nation and of the State of North Carolina are subject to frequent change and addition. Such changes and additions may periodically render the general information on our website out-of-date, thus, we disclaim any and all liability in respect to actions taken or not taken by the reader based on his or her interaction with the content of this website.
OUR ADVICE TO YOU:
It’s often the case that the outcome of an accident or injury claim can hinge on the smallest of details. While it may seem appealing to try to handle a case on your own, it’s rare that acting independently of a lawyer will yield the best results for the plaintiff. Therefore, whilst we encourage you to read the useful articles at our website, we strongly recommend that you seek sound legal advice before attempting to deal with any type of accident or injury claim on your own.