One important thing to remember with work-related injuries in North Carolina is the fact that there has to be some type of accident that causes the injury. Our workers’ compensation law defines an accident as something that is…
- Unexpected, and
- A break in normal routine.
Many people are under the impression that if they’re injured at work, they are covered by workers’ compensation. That isn’t always the case. The evidence offered regarding a workplace accident which resulted in injury is so crucial in order to pursue and obtain workers’ compensation benefits.
For example, let’s assume that you work at the local grocery store. You get out a palette of materials, cut through the wrapping, and as you’re picking up boxes and putting them on the shelf, your shoulder pops. When you go to the doctor, you’re diagnosed with a rotator cuff tear that requires surgery and will prevent you from working for a given time. In this example, there’s no question that you were injured while at work and that this injury will prevent you from working due to needing surgery and recovery time.
The issue with this example is that there was no accident. You obtained the injury simply performing your regular job duties. This would be a case that would not allow you to receive workers’ compensation benefits.
Use that same example, but as you’re putting boxes on the shelf, you accidentally knock a box over. Your shoulder pops when you reach for the box to prevent it from falling to the ground. That’s actually an accident. There was a clear interruption of your normal work routine where an unexpected event took place and this interruption caused an injury. In this example, your injury would be covered by workers’ compensation benefits.
How an incident occurs, and even how an injured employee describes how the incident occurred, is so critical in terms of being able to pursue and obtain workers’ compensation benefits. Many times, an insurance company will request a recorded statement following a work-related accident. Potential clients are always advised to speak with a board-certified workers’ compensation specialist before speaking with the insurance company.
It’s really important for an individual to understand what information is going to be important for them to share. By no means should a workers’ compensation specialist tell a client what to say, but they can help a client to understand, based on what happened, what information will be critical for an insurance company to know in order to facilitate the receipt of workers’ compensation benefits.
Another issue that will come up in workers’ compensation cases is the question of what expenses will be covered by workers’ compensation insurance. The majority of those expenses are dealt with via medical compensation. For those work-related injuries, when an employer and insurance company has admitted liability for the injury, they’ll designate an authorized treating physician that can…
- Recommend treatment,
- Relate the need for treatment to the work-related injury, and
- Confirm that the individual wants the treatment.
This creates a situation where any of the following are covered by workers’ compensation insurance:
- Physical therapy,
- Injections, and
- Potential surgeries.
Many individuals don’t realize that travel reimbursement can have a big impact on a case. Any time that the injured employee is traveling more than 20 miles round trip for the purpose of medical treatment, they are entitled to mileage reimbursement. This can be extremely important to know if you are located a significant distance from medical facilities and require numerous appointments. For more information on Injuries Not Covered By Workers Comp Laws, an initial consultation is your next best step.