Extended Benefit Cases

Extended Benefit Cases From Industrial Commission

Someone told me I can continue to receive disability checks for my workers’ compensation claim even after 500 weeks, is this true?

N.C. Gen. Stat. Sec. 97-29(b) notes that an injured employee shall not be entitled to disability checks for a period greater than 500 weeks from the first date such disability checks were issued. However, N.C. Gen. Stat. Sec. 97-29(c) does offer a possible opportunity for an injured employee to continue receiving disability checks beyond the above noted 500-week limit.

Several cases have recently been decided by the North Carolina Industrial Commission addressing the issue of extended disability checks beyond the 500-week limit. These cases offer the following items to consider when addressing a claim for disability checks beyond the 500-week limit:

1. There is no presumption that the injured employee is entitled to receive disability checks beyond the 500-week limit, even if there was a prior ruling from the N.C. Industrial Commission awarding the injured employee ongoing disability checks. This means an injured employee when making a claim for disability checks beyond the 500-week limit must prove her/his entitlement to such disability checks.
2. In order to receive disability checks beyond the 500-week limit either your authorization treating physician will need to testify that due to your injury at work that you are permanently and totally disabled from all work with any employer or your authorization treating physician will need to testify concerning your permanent work restrictions due to the injury at work as well as testimony from a vocational rehabilitation professional noting there is no work available for you given your permanent work restrictions.
3. Any time there are two physicians offering differing opinion about whether an injured employee is permanently and totally disabled from all work with any employer or any time there are two vocational rehabilitation professionals offering differing opinions about whether work is available given the injured employee’s permanent work restrictions, your approval or denial for disability checks beyond the 500-week limit will all come down to how the Deputy Commissioner/Full Commissioners hearing your case decision to weigh these differing opinions.

However, please keep in mind that pursuant to N.C. Gen. Stat. 97-29(d) an injured employee may also qualify for disability checks beyond the 500-week limit if as the result of the accident at work she or he has:

1. Loss both hands, both arms, both feet, both legs, both eyes or any two of these previously noted body parts.
2. Suffered a spinal injury resulting in paralysis of both arms or both legs.
3. Sustained severe brain or closed head injury.
4. Suffered 2^nd or 3^rd degree burns over 33% of her/his total body surface.

These legal issues in workers’ compensation cases can oftentimes be complicated and confusing. For this reason, I always recommend an injured worker speak with a N.C. Board Certified Workers’ Compensation Specialist to understand their legal rights and what actions may or need to be taken in order to address any issues to assure the injured worker receives all the benefits she or he is entitled to as a result of the work injury.

Should you have any questions about this or any other issues involving your workers’ compensation case, please feel free to contact one of the four N.C. Board Certified Workers’ Compensation Specialists at Cardinal Law Partners for a free consultation.