Health Care

“Hacking” Your Workers’ Compensation Claim: What To Do If You’re Injured At Work

There are a couple surefire 3 steps you can take to “hack” your Workers’ Compensation claim at the beginning. These steps are truly critical anytime you suffer a work-related injury.

1.) Make a report to your employer.

The North Carolina Workers’ Compensation Act requires that you give notice of an accident to your employer within 30 days of its occurrence. This notice can be verbal or in writing. However, it’s much more advantageous for you to submit your notice in writing and keep a copy of it for your records. In this way, if your case is disputed and winds up in trial, there will be no question of your report of injury to the employer in a timely manner.

2.) Collect evidence about the scene of the accident.

If you are able, document everything you can about your accident right away. This can include taking videos of the scene, photos of your injuries, collecting the names of witnesses, and more. Often, this is the only opportunity you’ll have to take these steps. You may find that this evidence isn’t needed later on, but if it is, you will be grateful to have it on hand.

3.) Go to the doctor.

Even if you don’t think that your injury is serious, it’s crucial to go to the doctor for a medical evaluation. In your evaluation, you can have a physician document your injuries and make a decision regarding treatment and your return to work. In fact, it’s critical to your case that you receive an opinion from a doctor about whether or not you should return to work. If the doctor who is seeing you doesn’t mention your fitness for work, you should ask about it specifically.

Likewise, if the doctor suggests any treatments (physical therapy, medication, etc.), be sure to leave your appointment with an order or prescription for that treatment.

Additionally, at any following appointments, make sure to ask about your work status. And again, if your doctor doesn’t mention your limitations or comment about the fact that you are out of work — it’s best to bring it up yourself.

If you make a point to take these steps along the way, you can have the information you need on-hand and save yourself time trying to track it down later on.

4.) Contact an attorney.

It’s essential to consult with an attorney early on in your case so that you don’t miss any important steps. Speaking with legal counsel is especially vital before filing your claim for benefits, as the language you use to describe your injuries can greatly impact your case down the road.

By having a skilled Workers’ Compensation attorney on your side, you have access to an expert at every turn. And especially when it comes to your initial filing, your attorney will play a critical role in ensuring that your case is set up for success.

5.) File a claim for benefits with the North Carolina Industrial Commission.

To set a Workers’ Compensation claim in motion, you must file Form 18 with the North Carolina Industrial Commission within two years of the date of your injury. In reality, there’s rarely a reason to wait — it’s best to file your claim right away. This way, you can get your case moving as soon as possible. What’s more, it will force the promptest response from your employer and their insurance company concerning an acceptance or denial of liability for your claim.

The sooner that you find out whether your case has been accepted or denied, the sooner you can take the next steps for your claim, regardless of if its accepted or denied.

The Role Of A Nurse Case Manager

In some Workers’ Compensation cases, your employer and their insurance provider will assign a “nurse case manager”. This is a nurse who will appear at your doctor’s appointments as a medical liaison.

There are a couple of things to keep in mind here…

A nurse case manager has some abilities and restrictions in their role. Primarily, they are present to help facilitate and document your medical treatment. Therefore, the nurse can schedule appointments and document your doctor’s recommendations as to your treatment and return to work.

You are able to request and obtain a private examination with the medical provider in which the nurse case manager is not present. However, this does not mean that the information you share in the private exam will be 100% confidential. Instead, anything you discuss with your doctor in a private exam may be shared at some point with the nurse case manager.

On the other hand, the nurse case manager cannot have private conversations about your treatment with your doctor. In fact, any communication regarding medical treatment with your doctor must occur within your presence.

Of course, the nurse can document the doctor’s recommendations and ask clarifying questions in regards to those recommendations.

For example, if your doctor recommends light-duty work restrictions, the nurse can ask the doctor to be more specific. These questions could sound something like, “How many pounds should they be lifting, pushing, or pulling?” or, “How many hours of the day should this person be seated as opposed to standing?” and more.

Such questions make up a large portion of the nurse case manager’s role. However, the nurse cannot make recommendations of their own or advocate for one position or another.

For example, asking questions such as, “Don’t you think they should be allowed to perform heavy duty work?” or, “Shouldn’t this person receive X treatment?” would be inappropriate.

Any situation in which a nurse case manager asks a question like the ones just mentioned above is one where they are crossing the line. That’s because these questions are not meant to clarify or document. Instead, they are used to advocate for a specific position or outcome.

If at any point you believe that your nurse case manager is acting outside of their duty, it’s important to get an attorney involved immediately. Your attorney can either correct the situation or take action with the North Carolina Industrial Commission to have your case’s nurse removed or replaced.

Return To Work Issues

Return to work issues tend to be pretty hot-button topics.

Prior to any return to work, it’s important to obtain a copy of your job description. This is a written document that describes what your employer alleges that your job will require.

You’ll do this for a few reasons…

First, it’s important to have a clear idea of the expectations your employer will have of you when you return to work.

Second, it’s important for your doctor to have this information so that they can make an accurate recommendation whether a return to work at the position is safe and appropriate.

Now, there is a formal return to work process that can be facilitated in Workers’ Compensation cases.

In this process, the injured party can request a job description, along with seven business days to review the document and offer any comments. This provides an opportunity to make note if you disagree with the description, or feel that it is missing key responsibilities that are important for your doctor to be made aware of. After your comments are added, they are included with the copy that you present to your doctor. At this point, your doctor can determine if your return to work is safe and appropriate.

If your doctor recommends a return to work (especially if the recommendation comes with limitations), you may find it advantageous to bring a copy of your agreed-upon job description with you.

This step can be important because not everyone in the workplace may be aware of your work restrictions. For example, you may have a supervisor come to you and ask you to do things that are outside of your limitations. In this case, you could politely present the job description and note, “Well, this is all that my doctor has approved me to do.”

Having this on-hand can help you to avoid some of the conflict that so often comes up when injured employees return to work. What’s more, it helps to protect you from any situation in which you may otherwise be terminated or sent home.

Documenting Your Work Search

If your employer is not offering work because of your medical restrictions, you will need to perform job search activities. When it comes to your Workers’ Compensation case, it’s crucial to document the efforts that you have made to find work elsewhere.

Why? Because the disability benefits that are paid in the Workers’ Compensation system have very specific requirements. These benefits are not just based on your inability to perform the same job. They are not just based upon your inability to do some other work for the same employer. Disability benefits are based on the injured individual not being able to perform work in any capacity for any employer.

If your entitlement to these benefits is ever called into question, it’s critical to have a work search log on hand so that you can avoid missing out on any future disability benefits you may be entitled to receive.

At our office, we ask that clients complete work search logs. These are printed forms that we pass onto you so that you can easily keep track of your weekly requirements to look for employment. At the end of the week, you just send them back to us for review.

This way, if your employer and their insurance company asks you to prove your entitlement to disability payments via a trial, you don’t show up to the trial empty handed – you’re ready.

Why An Attorney Is So Important

It’s understandable that some folks are reluctant to hire an attorney. Especially so when finances are a major concern. But it’s important to keep in mind that there’s no risk or harm in hiring a Workers’ Compensation attorney.

In fact, the only way that Workers’ Compensation attorneys are paid in our state is when it’s ordered by the North Carolina Industrial Commission.

So, how does this work? Let’s say that you hire an attorney and they file your claim for benefits. After receiving your filing, your employer and their insurance company accept liability for your claim and start paying for the medical treatment and issue any disability checks for the lost time from work recommended by your designated treating doctor.

In this situation, there is absolutely no attorney’s fee involved in that case. The reason for this is that the Industrial Commission does not have to order an employer and insurance company to do anything — they’ve done it on their own.

Now, on the other hand, let’s say an attorney files your claim for benefits, and your employer and their insurance company come back with a denial. If you choose to have your attorney go through trial, and through that trial, the Industrial Commission orders benefits, they will order an attorney’s fee to be paid as well. But this fee is ordered and set by the Industrial Commission only because benefits are now in place that would not have come about without the help of your attorney.

This standard creates a situation wherein if you hire an attorney and your employer does everything right — there’s no attorney’s fee. If your employer does not cooperate and legal force needs to be placed on them — there will be an attorney’s fee awarded based on the benefits ordered by the North Carolina Industrial Commission.

When you think about it in this way, it seems that there is nothing to lose and everything to gain in this process. Especially when you consider the fact that an attorney is such a resource to their client throughout the lifetime of the case. This way, you don’t have to feel in the dark about what will come next. You can call your attorney to discuss your goals, concerns, and get an idea of how things are progressing at any point or how things may play out for the claim in the future.

What’s more, having an attorney involved from the beginning of your case can help you avoid some of the common roadblocks people face along the way. If medical records or forms are needed, your attorney won’t have to wait. They’ll have everything at the ready, and will be able to address any issues that comes up without any delay.

If you think you would like to handle their Workers’ Compensation case on your own, you can absolutely do that.  In all honesty, you don’t have to have a workers’ compensation attorney. The only thing to keep in mind is that it is much easier to have an attorney involved at the beginning of your claim to address any issues than it is to bring them in after the fact to try to correct any issues thus far in the claim.

Not only is it difficult to correct some of the problems that may come up in a preexisting case, but it can also take quite a long time — sometimes up to a year or more.

This is one reason why, although you can certainly handle a case on your own, involving an attorney can help you to avoid some of the pitfalls that are so easy to occur in a Workers’ Compensation case.

The Cardinal Law Partners Difference

Let’s, for a moment, talk about Cardinal Law Partners in particular and what really sets our firm apart.

Part of our unique quality lies in the way our firm is structured. The other part lies in who we have handling cases.

When it comes to our structure, we find that we are able to achieve desirable outcomes by managing our caseloads. Some law firms model themselves by focusing on getting as many cases as they can while getting them out the door as quickly as possible.

We are happy to practice law as a smaller firm. This is because we believe that by focusing on client care instead of case turnover, we can provide the best services to our clients. And this is just one way that we set ourselves apart.

When it comes to the people who are handling our cases, we talk about the most distinct aspect of this firm. At Cardinal Law Partners, the only person handling your claim is a board-certified Workers’ Compensation specialist.

You won’t be speaking with an associate attorney, someone who has just started practicing Workers’ Compensation law, or someone who has to have a more senior attorney overseeing the process. You will have a bonafide expert tailoring services to meet your specific needs, which is something that can’t be said for every law firm.

This is something that we pride ourselves on — that every attorney at Cardinal Law Partners is a board-certified Workers’ Compensation specialist. (A distinction held by fewer than 1% of practicing attorneys in the state of North Carolina.)

When you have Cardinal Law Partners on your side, you can be confident that you are working with a qualified expert who will make the time to focus your goals, concerns, and any questions along the way. Our greatest concern is that you receive the benefits that you need and deserve — and we are committed to ensuring that this goal is apparent in every aspect of your experience as our client.

For more information regarding Workers Compensation Law 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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