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Workers’ Compensation Explained

Workers’ compensation is insurance. Most businesses are required to have insurance that protects both the employee and the employer if an employee is injured while working or sick from being at work. 

Workers compensation is a promise from the employer to pay for injuries in exchange for an employee’s promise not to sue for his/her injuries. 

Charlotte, NC employers can choose to purchase a workers’ compensation policy from an insurance company or they can self-insure. If a business purchases a workers’ compensation policy, then the insurer is the one who will pay benefits to the employee. If a business is self-insured, then the business is required to have a certain amount of money set aside to cover any potential workers’ compensation claims.

Do I Have to Pay for Workers’ Compensation Coverage?

No. Unlike health insurance employees do not pay for, or even for a portion of, workers’ compensation coverage. 

Are All Employers Required to Have Workers’ Compensation Insurance?

Workers’ compensation is governed by state law so the laws vary from state-to-state; it is important to know the laws in your state. 

In North Carolina, and Charlotte in particular, businesses with three or more employees must have workers’ compensation. The North Carolina Workers’ Compensation Act, N.C. Gen. Stat. §97. Like all laws, there are exceptions to this rule. The exceptions are: 

  1. Employees of certain railroads;
  2. Casual employees. Employees who are not part of the regular course of business;
  3. Domestic servants working in a household;
  4. Farm laborers when fewer than 10 full-time non seasonal farm laborers;
  5. Federal government employees in North Carolina; and
  6. Sellers of agricultural products for the producers thereof on commission or for other compensation, paid by the producers, provided the product is prepared for sale by the producer; and
  7. Certain prisoners

N.C. Gen. Stat. §97-13.

Truck drivers in the trucking industry also have specific workers’ compensation rules that apply. Specifically, truck drivers who are independent contractors are covered by workers’ compensation. 

What Types of Injuries Does Workers’ Compensation Cover?

Injuries covered by accidents are typically covered by workers compensation. Examples include:

  • Injuries from a car accident that occurred while operating a company vehicle while engaged in company business;
  • Slip and falls on ice or because of unsafe conditions;
  • Physical injuries caused by equipment malfunction; and
  • Broken bones resulting from workplace accidents

Employees can also become sick at work due to exposure to toxins and chemicals, including mold, asbestos or carbon monoxide. Injuries resulting from this exposure are covered by workers’ compensation insurance. The North Carolina Workers’ Compensation Act contains an extensive list of occupational diseases that qualify for payment under a workers’ compensation policy. They include: 

  • Anthrax;
  • Radium poisoning;
  • Carbon monoxide poisoning;
  • Asbestosis;
  • Lead poisoning;
  • Hearing loss;
  • Vision loss; and
  • Cancer due to tar, pitch, or paraffin

NC Gen. Stat. §97-53.

What is Not Covered by Workers’ Compensation?

Typically, injuries that are caused by the employee’s own negligent actions will not be covered. For example, if an employee is hurt in a fight that they started, coverage likely would not apply. If an employee is drunk, or under the influence of an illegal controlled substance, and injured in a car accident workers’ compensation likely won’t apply. 

Back injuries are extremely common. Workers’ compensation covers back injuries in limited circumstances. For example, if a piece of machinery was falling and you injured your back trying to catch it you would likely be covered. If you injured your back because you bend over multiple times a day to retrieve items then your injury would likely not be covered. It would be considered a “routine event” under North Carolina law, meaning that you were injured doing something that you do every day.

What Monetary Losses are Covered by Workers’ Compensation? 

Since workers’ compensation is insurance, plans will vary by carrier. Typically workers’ compensation covers:

  1. Lost wages. Employees who are out of work because of their injuries will be eligible to receive at least some of their pay. In North Carolina, employees who will be out of work for more than a week are eligible for temporary benefits. If you are out for 7 days or less, you will receive no lost wages. Benefits can be temporary, meaning for a certain time period (up to 500 weeks in North Carolina), or permanent.
  2. Medical expenses. Medical expenses like emergency room visits, doctors’ visits, medicine, rehabilitation and physical and occupational therapy resulting from a workers’ compensation injury are covered. It is important to note that in most cases, the employer will have a list of certain doctors and facilities that are covered. You will not be able to go to any doctor you wish. 
  3. Death benefits. If an employee dies as a result of a work related accident, burial costs should be covered. 

What Should I Do if I Get Hurt at Work?

Employees who get hurt at work must notify their employer. While an employee should notify their employer immediately, North Carolina law, which covers Charlotte, requires that an employer be notified within 30 days of the injury. You should notify your employer both verbally and in writing about your injuries and how they were caused. If you fail to notify your employer within 30 days you can be denied coverage. 

What if My Employer Doesn’t Have Workers’ Compensation?

Assuming that your employer does not qualify for one of the exemptions listed above, your employer is in violation of the law. They could be fined, charged with a misdemeanor or felony or even put in jail. 

Should I Call a Charlotte Lawyer?

Workers’ compensation claims can be very complex. Not all injuries are covered and insurers are reluctant to pay out on claims. A Charlotte attorney will have your best interests at heart, know and understand the laws and system and help you navigate the process, which is frustrating and time consuming, while you recover from your injuries. 

If you were injured at work, it is important that you understand your rights as soon as possible to avoid any possible missteps. The Charlotte, NC lawyers at Rosensteel Fleishman, PLLC are experienced workers’ compensation attorneys and can guide you through this difficult time. Please contact our office at 704-714-1450.  There is no fee for an initial consultation.

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