Employees who have been hurt at work often have questions about worker’s compensation. It’s helpful to understand that worker’s compensation is an employer-funded insurance program that provides benefits for workers who are injured on the job and can’t work for a period of time. There are some exceptions, but in most situations, employers are required to offer worker’s compensation to employees. This fund pays for medical bills, and some of the lost wages a person might suffer when out of work.
Unfortunately, injured workers sometimes run into trouble when trying to claim these benefits. Employers may discourage employees from filing a claim or may fight the claim on a variety of grounds. In some cases, a worker may worry that they will face retaliation simply for filing a worker’s compensation claim. Others may wonder if they should file a lawsuit against their employer instead.
How Can A Worker’s Compensation Lawyer Help?
If you have questions or concerns about a potential worker’s compensation claim, the best thing you can do is to speak with a workers’ compensation lawyer. They can advise you on your specific case, explain your options, and answer any questions you have. If you or a loved one have been hurt at work, Tatum & Atkinson is always happy to offer a free, confidential consultation about a possible worker’s compensation claim. In the meantime, we’ve put together a list of frequently asked questions to help you learn more about the process:
Does My Injury Qualify For Worker’s Compensation?
This depends on your specific injury and circumstances, but in general, an injury caused by an accident or incident that happened in the course of doing your job will usually meet the criteria for a worker’s compensation claim. This can also include repetitive injuries like carpal tunnel syndrome, or certain illnesses associated with working in specific industries, like lung disease in coal miners or some types of cancer in people who work with asbestos.
What If I’m An Independent Contractor And I Got Hurt On The Job?
Unfortunately, employers are not required to provide worker’s compensation coverage for independent contractors, only employees. However, that does not mean you’re out of luck in getting your medical expenses covered and your bills paid. There are still several possible options to consider.
First, speak with a worker’s compensation attorney to ensure that you have been correctly classified as an independent contractor. It’s not unusual for employers to incorrectly classify employees as contractors to save money on benefits. If your client has erroneously classified you as a contractor when your actual situation more closely resembles an employee/employer relationship, your attorney may be able to secure your workers’ compensation benefits on the grounds that you are actually an employee. (If this is the case, you may also be due back pay for other benefits you were eligible for but did not receive.)
If you are correctly classified as a contractor, there may be other options for getting at least some of your bills paid. Depending on your occupation, you may have insurance that covers some or all of your medical bills. Another option is the insurance coverage of the person or entity responsible for your accident. For example, if you were hurt at work due to the negligence of your employer, or a third party such as another contractor, you could file a claim with the other party’s insurance, or sue them directly.
What Should I Do After Being Hurt On The Job?
It’s essential that you report your injury, in writing, to your employer as soon as you can. Write down what happened, when, and where. If you’re unable to write due to your injuries, ask a friend or family member to do it and review the letter when they’re done. Make sure you turn this written statement over to your employer within 30 days. If you can, deliver a paper copy and an email copy, keeping a copy for yourself, so you have records that you reported the injury.
Seek medical care to document your injury, even if you don’t have to miss work because of it. If your employer asks you to see a specific provider, you are required to do so, but you’re also entitled to be reimbursed for travel expenses if the provider is more than 20 miles away.
When speaking to your doctor, be sure to tell them how the injury happened and that you were at work at the time. Give them your employer’s name and information so they can correctly code the treatment as a workers’ comp expense.
Follow your doctor’s treatment plan and be sure to mention that you’ve done everything they recommended at your follow-up visits. If they write down that you didn’t follow medical advice, your employer’s workers’ compensation insurance adjuster may decide that’s a reason not to pay your claim. Remember that the goal of workers’ compensation is to help you get better so you can return to work.
You will also need to file a workers’ compensation claim, even if your employer tells you it’s not necessary. If you feel that someone at your employer has been threatening or aggressive in trying to discourage you from filing a claim, write down exactly what was said. If there are any emails or written communications about the topic, save those because you may need them later.
Your claim should be filed with the N.C. Industrial Commission using Form 18. This form is available in paper and electronic form and should be filled out completely. Submit it following the instructions on the N.C. Industrial Commission’s website. If you have questions or are unsure how to answer some questions, speak with an attorney to ensure you’ve filled out the form correctly. Your lawyer can also help you make sure you’ve followed the submission requirements.
But you’re not done yet! Most workers receive more forms to fill out later on in the process. Make sure you complete these and return them promptly, as instructed. The workers’ comp insurance adjuster is probably hoping you’ll get overwhelmed and stop filling out forms, giving them an excuse to deny your claim. Again, if you need help, your workers’ compensation attorney can assist you or answer questions you have about the forms.
Continue to document everything – make copies of claim forms, bills, response letters, medical reports, etc. It’s a good idea to save hard copies and scan them into a computer then back them up in the cloud. Many people lose these documents and can’t prove they turned in a form, etc.
How Long Can You Continue to Receive Workers’ Compensation Benefits?
Injured employees should receive workers’ compensation benefits for as long as they’re out of work, starting the second week they’re off the job. If it takes several weeks after that to have your claim approved, you should get back benefits, then receive weekly benefits until you’re able to work again.
Can The Insurance Company Have A Private Investigator Follow Me?
Unfortunately, yes. This is a common practice. The insurance carrier often sends investigators to ensure people aren’t “faking” their injuries. If you notice someone following you, it’s a good idea to make note of their description and mention it to your lawyer, but in most cases, it’s nothing to be worried about. Many times, they will just gather info to show that you were injured, that you went to physical therapy, etc.
What If My Employer Says They’re Exempt From Workers’ Compensation Coverage?
Almost all companies with three or more employees are required to provide these benefits, with part-time and even temporary workers serving as employees. Corporate officers are also considered employees unless they opt-out of coverage. There are some special rules for contractors and non-profit organizations, so it’s a good idea to check with a lawyer if your employer says they don’t have to fund workers’ compensation. It’s also important to remember that workers’ compensation is a right that can’t be waived, even if both the employer and employee agree to it. If your employer wants you to sign something saying you waive the right to workers’ comp, there’s a good chance this is illegal, and also that it can’t be enforced in court. Speak with your attorney right away.
What If My Employer Retaliated Against Me For Filing A Workers’ Compensation Claim?
Unfortunately, this also sometimes happens. Employers don’t want their insurance rates to go up after the carrier pays a workers’ compensation claim. For this reason, they may try to talk you out of filing a claim, and they may not be happy if you do it anyway.
Retaliation can take many forms. Your employer may drum up an excuse to fire you. They may suddenly start finding in flaws in your work, such as things they never objected to before. They might start writing you up for things your coworkers do without issue. When they have a sufficient number of writeups/demerits, they may then terminate you, claiming it’s for “cause.”
On the other hand, some employers instead try to make you so miserable that you’ll quit. You might notice that your boss or other employees are suddenly treating you differently. They may give you the cold shoulder, harass you, make rude or abusive remarks, and generally go out of their way to create a hostile workplace. You may feel that your boss or others are attempting to sabotage you – for example, they may repeatedly forget to tell you the information you need to do your job, or do other things to ruin your work. It may be just your boss who does these things, or your colleagues may join in as well (likely due to being pressured by someone in power).
Again, if you feel you’re experiencing harassment or retaliation, you should document everything that happens. Take pictures of any sabotaged work, abusive notes, writeups, instructions that don’t make sense, etc. Try to save any problematic work communications, like emails, to an external drive you can take home. Let your lawyer know what’s going on, and document any efforts you’ve made to address the issues in the workplace (such as fixing a sabotaged project). The North Carolina Retaliatory Employment Discrimination Act (REDA) prohibits such retaliation against a worker who filed a workers’ compensation claim, but it will be necessary to prove the following:
The more you document any retaliation you experience, the more likely it is that your attorney will be able to demonstrate you experienced retaliation in court. If you’re in this situation, don’t hesitate to contact an attorney. You only have 180 days after the termination or other adverse act to file a retaliation claim under REDA with the North Carolina Department of Labor. Your attorney can walk you through this process if they believe you have a strong case. After investigating the claim, the Department of Labor may try to resolve the situation. Alternatively, they may send you a “right to sue” letter advising you that you may proceed with a lawsuit against your employer.
Our goal at Tatum & Atkinson, PLLC is to help our clients throughout NC quickly and efficiently with their workers’ compensation cases. We know that time is of the essence to help you receive a fair settlement. That is why if you call now, you can speak to Robert Tatum or Season Atkinson. Our experience and knowledge of workers’ compensation law will help you get the process started FAST! We’ll work hard to get you the settlement you deserve quickly, and hopefully keep you out of court. Contact us now by email or call 800-LAW-0804 (800-529-0804).