Practice Areas
Workers’ Compensation
in North Carolina
Workers’ Compensation
in South Carolina
What is Workers’ Compensation in North Carolina?
Workers’ compensation is a no-fault limited recovery insurance system that is governed by the North Carolina Industrial Commission. The “no-fault” component of the system means that an injured worker is entitled to benefits even if the injury is the result of their own negligence. In exchange for the no-fault component, an injured worker is not entitled to any additional compensation beyond what is provided under workers’ compensation if the employer’s negligence caused the injury. In addition, an employee may not sue the employer for negligence by way of a civil lawsuit. The inability to sue the employer civilly means that an injured worker’s recovery is limited to only what is provided under workers’ compensation law. Importantly, this means that an injured worker is unable to receive compensation for pain and suffering as it is not a benefit provided in workers’ compensation.
What Injuries Are Covered?
1. General Injuries
Generally, all injuries or deaths that occur as the result of an “accident” while working for your employer are covered under workers’ compensation. For an event causing an injury to be considered an accident, there must be something unusual or unexpected that happens while performing your job that causes your injury.
2. Back Injuries
Back injuries are treated differently in North Carolina. In the case of a back injury, the injury must be the result of a “specific traumatic event,” which means that nothing unusual or expected must occur while performing your normal job to cause your back injury. However, you must be able to point to a specific point in time when you were working that your back injury occurred.
3. Occupational Diseases
What Benefits Are Paid?
1. Medical Compensation
Workers’ compensation will pay your medical bills related to the treatment you receive for your injury. This includes prescriptions and reimbursement for mileage if the round trip is 20 miles or more. However, the insurance company or your employer have the right to choose what medical provider or doctor you see for your injury.
2. Disability Compensation
3. Death Benefits
How is my weekly disability benefit amount calculated?
1. Benefit Amount Calculation
Common Reasons Injuries Are Denied
1. Insufficient proof that your injury was caused by a particular event at work
Under the workers’ compensation law, an injured worker has the burden to prove that his/her injury resulted from something that happened while he/she was working. If your workplace accident was not witnessed, or not reported immediately to your employer after it occurred, or there is some suggestion that you may have been hurt doing something outside of work, the workers’ compensation carrier may decide to deny your case. Often an insurance adjuster will look for any reason to deny your case. If your employer is unwilling to vouch for the fact that you got hurt at work, this could also give the adjuster a reason to deny your case. This is why it is so important to (1) immediately report your work-related accident to your employer (and follow up with an email, text, or written note); (2) go to the doctor that the employer tells you to go to; and (3) tell the first doctor or medical provider that evaluates you exactly how your accident occurred at work.
2. Insufficient medical evidence that the event at work aggravated a pre-existing medical condition
3. The way you were injured does not qualify as an “accident” to be covered by workers’ compensation
4. The time, place or circumstance surrounding when, where, or how the event that caused your injury occurred is not covered by workers’ compensation
5. Failure to timely report the accident to your employer or file your claim with the Industrial Commission
What is Workers’ Compensation in South Carolina?
Workers’ compensation is a no-fault limited recovery insurance system that is governed by the South Carolina Workers’ Compensation Commission. The “no-fault” component of the system means that an injured worker is entitled to benefits even if the injury is the result of their own negligence. In exchange for the no-fault component, an injured worker is not entitled to any additional compensation beyond what is provided under workers’ compensation if the employer’s negligence caused the injury. In addition, an employee may not sue the employer for negligence by way of a civil lawsuit. The inability to sue the employer civilly means that an injured worker’s recovery is limited to only what is provided under workers’ compensation law. Importantly, this means that an injured worker is unable to receive compensation for pain and suffering as it is not a benefit provided in workers’ compensation.
What Injuries Are Covered?
1. General Injuries
2. Occupational Diseases
What Benefits Are Paid?
1. Medical Compensation
2. Disability Compensation
3. Death Benefits
How is my weekly disability benefit amount calculated?
1. Benefit Amount Calculation
Common Reasons Injuries Are Denied
1. Insufficient proof that your injury was caused by a particular event at work
Under the workers’ compensation law, an injured worker has the burden to prove that his/her injury resulted from something that happened while he/she was working. If your workplace accident was not witnessed, or not reported immediately to your employer after it occurred, or there is some suggestion that you may have been hurt doing something outside of work, the workers’ compensation carrier may decide to deny your case. Often an insurance adjuster will look for any reason to deny your case. If your employer is unwilling to vouch for the fact that you got hurt at work, this could also give the adjuster a reason to deny your case. This is why it is so important to (1) immediately report your work-related accident to your employer (and follow up with an email, text, or written note); (2) go to the doctor that the employer tells you to go to; and (3) tell the first doctor or medical provider that evaluates you exactly how your accident occurred at work.
2. Insufficient medical evidence that the event at work aggravated a pre-existing medical condition
3. The time, place or circumstance surrounding when, where, or how the injuring event occurred is not covered by workers’ compensation
4. Failure to timely report the accident to your employer or file your claim with the Workers’ Compensation Commission.
In South Carolina, you have 90 days to days to report your workplace injury to your employer. This should be completed in writing (email, text, or written on a piece of paper). You have two years to file your claim with the Workers’ Compensation Commission.