A work-related injury or illness can cause major disruptions to your health, finances, and overall well-being. The North Carolina workers' compensation system is designed to compensate you for some of those losses and help you get back to work as soon as possible. This article explains the most important workers' comp benefits available in the state.
Can You Get Workers' Comp Benefits in North Carolina for COVID-19?
In order to get workers' comp benefits in North Carolina for an occupational disease, you must prove that (1) your job put you at greater risk of exposure to the illness than the general public experiences, and (2) you actually contracted the disease because of your work. In the context of the COVID-19 pandemic, most employees would find it very difficult to meet those requirements. Even if you have a job that puts you at a significantly higher risk of exposure to the coronavirus—such as providing health care or emergency services to infected people—you would also need evidence showing that you contracted the illness on the job rather than during the rest of your life.
You could try claiming that you contracted COVID-19 as a result of an accidental injury at work rather than an occupational disease. But North Carolina law defines an accident as an interruption of the normal job routine, not something resulting from regularly occurring events. So you would need to prove that your exposure to the virus not only happened because of your job and while you were working, but that it resulted "naturally and unavoidably" from an unusual, accidental incident. (N.C. Gen. Stat. §§ 97-2(6), 97-52 (2020).)
Several states have enacted measures to make it easier for certain frontline workers to get workers' comp benefits for COVID-19, but North Carolina has not yet joined that cohort.
If you aren't able to work at all while you're recovering from your work-related injury or illness, you'll be entitled to temporary total disability (TTD) benefits. However, these benefits aren't paid for the first seven days of disability, unless you end up being away from work more than 21 days.
TTD benefits amount to two-thirds of your average weekly wages at the time of your injury, up to the legal maximum for the year when you were hurt or became disabled. For injuries that happened in 2020, the maximum benefit is $1,066 per week. (You can find a list of the maximum weekly rates for other years at the website of the North Carolina Industrial Commission.) There's also a minimum amount: $30 per week.
You may receive temporary partial disability benefits if you're able to return to work in some capacity, but not at the same level as before your injury. Except for injuries to one of the body parts in North Carolina's schedule of injuries for permanent partial disability (discussed below), temporary partial disability benefits are equal to two-thirds of the difference between your pre-injury wages and what you're able to earn now. For example, if you earned $1,200 a week before your injury but are currently earning $600 on light duty, you would receive $400 a week in benefits. If you have a scheduled injury, you may receive benefits at the full TTD rate during your healing period.
Generally, there's a 500-week limit on how long you can receive total and/or partial temporary disability benefits. You may apply for an extension of TTD benefits, but you will have to prove that you're still completely unable to work. If you're getting full Social Security retirement benefits, your TTD benefits will be reduced by the amount of the Social Security payments. (N.C. Gen. Stat. §§ 97-28, 97-29, 97-30, 97-31 (2020).)
After your doctor finds that you've reached "maximum medical improvement" (meaning that you aren't likely to get better, even with further medical treatment), you'll be evaluated to see whether your work-related injury or illness has caused long-lasting limitations. The type and amount of permanent disability benefits will depend on the part of your body that's affected, as well as your impairment rating (generally expressed in a percentage).
If you've permanently lost vision, hearing, or the use of certain body parts (fingers, hands, arms, toes, feet, legs, or back), your permanent partial disability benefit will be based on a schedule that lists the maximum number of weeks for each of these body parts or senses. The award is calculated as two-thirds of your average weekly wages multiplied by the appropriate number of weeks in proportion to your impairment rating. For example, the schedule in North Carolina law lists 200 weeks for the total loss of a hand. If you've lost 50% of the use of your hand as a result of your injury, you would receive 100 weeks' worth of payments. In the case of a back injury, however, partial loss of 75% or more will be compensated at the same level as total lost use. These weekly payments are subject to the same maximum and minimum as TTD benefits. (N.C. Gen. Stat. § 97-31 (2020).)
As part of a settlement of your workers' comp case in North Carolina, you may agree to receive these permanent disability benefits in a lump sum rather than in weekly payments.
If you still have reduced earning capacity after you've been assigned a permanent partial impairment rating for a scheduled loss of use, you may opt to continue receiving temporary partial disability benefits (based on the difference between your pre-injury wages and current earning capacity). (Outerbridge v. Perdue Farms, Inc., 638 S.E.2d 564 (N.C. Ct. App. 2007).)
North Carolina law also allows lump-sum awards for other types of partial disability:
You may be eligible to receive permanent total disability benefits for the rest of your life—at the same rate as TTD benefits—if you have one or more of the following serious injuries:
(N.C. Gen. Stat. § 97-29(d) (2020).)
North Carolina workers' compensation also provides additional benefits, including:
If your employer's insurance company has denied your workers' comp claim, is holding back benefits, or won't authorize needed medical treatment, you should probably speak with a workers' comp lawyer. A North Carolina attorney who's experienced in this area can evaluate your case, give you advice as to whether it's worth filing an appeal, and help you get all of the benefits you deserve. (Learn more about how a good workers' comp lawyer can help.)