One of the worst scenarios for an injured worker in North Carolina who has a workers’ compensation claim pending is being notified that their case is “under investigation” regarding certain aspects of the claim. While many employers will not contest the filing of a workers’ compensation claim, workers’ compensation insurance companies in North Carolina will often thoroughly investigate the case first before approving benefit payments. In some cases, an investigation may include such measures as hiring private investigators to determine the extent of injury along with gathering information regarding how the injury occurred. In such circumstances, the insurance provider is generally looking for a reason to deny the claim or to provide reduced benefits, so it’s important to have some legal assistance when filing the claim initially, particularly when the circumstances surrounding the accident/injury might be less than clear.
Delaying Claim Benefits
The first issue a claimant may have is that their benefits do not begin in a timely manner. Workers’ comp. is designed to provide timely income replacement for affected workers while also covering medical bills for claimed injuries. In exchange for this benefit package, employers are exempt from costly personal injury claims as long as they are compliant with all OSHA regulations and there is no evidence of negligence in the workplace. In more serious injury cases, the law firm representing the insurance company may conduct an investigation into the details of the accident/injury, including an assessment of employer compliance, any mitigating circumstances leading to the cause of the injury, etc, and they may request more information from the injured party during the process of the investigation. We recommend that if a request for additional information is made of you, at any time following the submission of your workplace injury claim, you should consult with a legal representative before providing more information, as the information you provide may be incriminating to your case and negatively impact your claim.
Total Claim Denial
The real problem for an injured worker comes when the claim is denied in totality by the workers’ compensation insurance company. North Carolina is unlike other states that require insurance be purchased through state-designated providers, so the insurance company handling your case may have a dubious track record of claims denials, and, in fact, an initial denial may be their default position. A total claim denial that is supported by the NCIO will result in a need for a workplace injury law firm to investigate the case, including employer OSHA compliance and negligence issues, and potentially file a civil lawsuit in a state court.
You May Have a Negligence Lawsuit
Workplace injury lawsuits in North Carolina can be difficult due to the state contributory negligence law. Any plaintiff in an injury case cannot have even the slightest evidence of proven personal contribution for causing the injury. The workplace injury law firm representing the case will need to perform a full claim review on your behalf, gathering evidence and ensuring you are free from any personal fault before determining whether or not a successful negligence lawsuit can be launched on your behalf.
What a Workplace Injury Law Firm Can Do
After filing a notice to sue a respondent employer and/or their insurance provider, your attorney can request full documentation of all reports and evidence collected during the investigation. They can also conduct a full investigation regarding OSHA compliance and investigate any history of failure to maintain a safe work environment for employees. This includes a situation where an employer has been demonstrated to impose demands on workers in the form of unreasonable job responsibilities. These and other steps can be taken by your attorney to establish any negligence claim against the employer as well as a potential bad faith claim against the workers’ compensation insurance company.
Contact Our Law Firm ASAP
Any injured worker in North Carolina who has a claim currently under investigation should contact our office as soon as possible. Time is of the essence in workers’ compensation claims. The insurance company may be placing unreasonable hurdles in front of you in an attempt to have you cease pursuing the claim or have you agree to a reduced settlement. Having an experienced legal professional representing the case can mean a maximized financial compensation package and avoidance of costly and lengthy court proceedings. Contact us today for a free case evaluation.
