Health Care

How Are Workers’ Compensation Benefits Calculated In North Carolina?

In North Carolina, indemnity benefits (or, benefits that are used for lost wages) are paid weekly. The way to determine the specific benefit is by calculating the injured worker’s previous year of pay (the year before the day they were injured) and coming up with their average weekly wage.

For example, if someone made $52,000 the year before they were injured, their average weekly wage would be $1,000. Under the law, injured workers are entitled to two-thirds of that amount for every week of work that they missed due to their injuries. So, an injured worker that made $52,000 the year before their injury would be entitled to $666.67 each week for as long as they’re unable to return to work.

There are different rules for employees who haven’t worked a full year yet, which can often be the case.  Sometimes in these situations the employer will use a “similarly situated employee”, and look at their previous year of calculations.  Along with this, there may be a contract involved, and having a legal professional look at this to determine your benefits is very helpful.

The North Carolina Industrial Commission Form 22 lists out the amount of pay the injured worker had earned before they were hurt. If the injured worker missed a week here or there for whatever reason, that week of zero income from the employer doesn’t count.  The biggest factor to consider in the Form 22 is the weeks that the injured worker worked the year before they were hurt. Once this is established, as stated above, you will work to find the average weekly pay. Whatever that equates to, the injured worker is entitled to two-thirds of that tax-free.

It is important to note that there are also disability ratings in North Carolina. If the injured worker can return to work, but perhaps the injury caused some kind of permanent disability, then they are entitled to what’s called the “Disability Rating”. Every body part has a number of weeks that coincide with their benefit duration. For example, a back injury is worth 300 weeks, a leg injury is worth 200 weeks, an arm is 240 weeks, and so on.

If a disability rating is 10% for something such as a back injury, then the injured worker would be entitled to 10% of the 300 weeks for the back injury. That equates to 30 weeks of compensation, which is added in addition to the time missed from work for their partial or permanent loss of that body part.

What If My Injuries Resurface Or Get Worse After I Resolve My Case?

This all depends on how your case was settled. If you settled your case in a way that’s referred to as a  “clincher” (clinchers mean that the case was closed permanently), it was settled for good. In this scenario, you would not be able to reopen your case because it was settled permanently, and the case is not allowed to be reopened. If injuries resurface or get worse, the hope is that you’ve been paid enough in your clincher to have the means to deal with any increase in your symptoms.

Now, if your case was settled on the “rating”, this would mean that you filed forms with the Industrial Commission and you accepted payment just for the ratings that you’re entitled to. After you’ve been paid the final amount for your rating, you have 2 years from that payment to reopen your case.  If this occurs, you must have what’s called a “change of condition”. This means that the condition that you settled on for your rating has become worse in some way and is affecting your ability to earn wages.

For example, if you have a change of condition where your previous injury now needs surgery or additional medical treatment, as long as it occurs within a two year period of when your last payment was received, you can reopen your case and get the additional medical treatment and/or compensation for the resurfaced injury.

 

Should I Hire A North Carolina Workers’ Compensation Attorney Right After An Injury Or Should I Wait For A Denial?

Our firm has a clear perspective on the timeline of workers’ compensation reporting, and it is worth knowing that it is easier for attorneys to prevent issues in claims than it is for them to fix them.

If you prefer to handle your claim yourself as an injured worker, this can make the attorney’s job and their chances of getting a great result more difficult.  Our recommendation is to always hire an attorney as soon as you think you might need one. You should not wait to see what happens with your case, as having an attorney can help you avoid problems.  Having an experienced attorney on your side is the most effective approach to attacking workers’ compensation claims.

In addition to this, it is worth noting that it doesn’t cost more to hire an attorney quickly than it would be to wait.  If an attorney is working on a contingency (which is what they generally do), whether they work on your case for a week or for 3 years, they will still get the same percentage when your settlement comes.

Our firm always recommends that you have an attorney work on your case for as long as possible to earn the full contingency payment. Otherwise, you are effectively giving the attorney a discount by waiting any longer than you should.  We understand there may be reasons why you don’t want to hire an attorney, but our recommendation is to do it right away.

Very often, attempting to handle the investigation process early on without an attorney increases the chances that your claim will be denied. This can be due to the fact that many workers don’t understand the full scope of the workers’ compensation claim process, and they can often overlook important details crucial to the acceptance of their claim.

For more information on Workers’ Comp Cases in North Carolina, an initial consultation is your next best step. Get the information and legal answers you are seeking by calling (833) 444-4127 today.

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