North Carolina workers’ compensation pays benefits to employees who are injured on the job. Workers may receive medical treatment, compensation for wage loss, and other financial assistance. To collect benefits, you must report your injury to your employer and make a timely claim for benefits.
In North Carolina, most employers must have workers’ compensation coverage—either by purchasing a workers’ comp policy from a private insurance company or by receiving certification from the state to self-insure. (In general, only large, financially stable employers will qualify to self-insure.) The North Carolina Industrial Commission (NCIC) oversees all workers’ comp claims in the state.
Like all other states, North Carolina has a no-fault workers’ compensation system. You do not need to show that your employer acted carelessly in order to receive benefits. As long as your injury happened on the job or was caused by your work activities, you will typically be eligible for benefits.
Eligible workers may receive a variety of benefits, including:
Notifying your employer is the first step to starting a workers’ compensation claim. In North Carolina, you must promptly notify your employer of a work-related injury in writing. If you do not notify your employer within 30 days, you may lose some or all of your benefits.
When you notify your employer, provide as much detail as possible, including:
Once you report an injury, your employer should send you to an occupational doctor. It is important to provide the doctor with accurate information about the cause of your injuries and the severity of your symptoms. Insurance companies rely heavily on medical records of initial treatment when they evaluate claims. Either downplaying or exaggerating your symptoms may result in a denial of benefits.
Reporting a work injury does not automatically start a North Carolina workers’ compensation claim. Your claim officially begins when you file a completed Notice of Accident to Employer and Claim of Employee (Form 18) with the NCIC. You should also send a copy of this form to your employer.
You must file your workers’ compensation claim within two years of your workplace injury. If your injury or illness develops over time, you must file your claim within two years of discovering its relationship to your work.
Once the NCIC receives your claim, it will forward it to your employer’s insurance company or workers’ compensation administrator. The insurance company will then determine your eligibility for benefits. Its investigation may involve:
Under North Carolina law, the insurance company must approve or deny your workers’ compensation benefits within 14 days of receiving your claim. If your claim is approved, you will start receiving disability payments and other benefits. Unfortunately, insurance companies deny many workers’ compensation claims.
If your claim is denied, you have the right to appeal. To begin the process, you must file a request for a hearing with the Commission. North Carolina’s Information Specialists Section assists injured workers with their claims, but it cannot provide legal advice. Unless your claim is very simple, you should consider hiring a workers’ compensation lawyer. The insurance company will have a lawyer and you may be at a disadvantage if you proceed without an attorney. To learn more, see Should I Hire a Workers' Comp Attorney or Can I Handle My Own Case?