Getting injured at work can be an overwhelming experience. Not only is the injured worker facing medical costs and time missed from work, but there is usually an uncomfortable strain on the employment relationship. Lawyers at Cardinal Law Partners have been there with hundreds of clients over the last 15 years.
One of the first things every injured worker needs to know is that some claims are denied by the workers’ compensation carrier and some claims are accepted by the carrier.
What Injured Workers Need to Know about Workers’ Compensation Claim Denials
Denied workers’ compensation claims mean that the carrier is taking no responsibility for the worker’s injury. Insurance carriers typically deny claims on a North Carolina Industrial Commission Form 61. This also means that:
- The Industrial Commission will ultimately decide whether the injured worker has suffered a compensable claim. The injured worker will need to file an Industrial Commission Form 33, Request for Hearing, to force the Industrial Commission to rule on the issue of compensability.
- The injured worker will not need to see the physicians that the workers’ compensation carrier selects. The injured worker is free to see their own physician and they will provide opinions on medical causation and disability instead.
- Injured workers will typically be forced to use their own employment benefits (paid time off, health insurance, short term disability, etc.) while they recover from their injuries and while the Industrial Commission determines whether the claim is compensable or not.
What Injured Workers Need to Know about Accepted Claims
Accepted claims are just the opposite of denied claims. When the workers’ compensation carrier accepts a claim, typically on a North Carolina Industrial Commission Form 60, the carrier is alerting the injured worker and the Industrial Commission that the injured workers’ claim is compensable and that it is liable for any necessary medical treatment and disability. Accepted claims mean:
- The Industrial Commission will not revisit the issue of whether the claim is compensable later. If the workers’ compensation carrier accepts the claim on a Form 60 then the form serves as an order of the North Carolina Industrial Commission.
- The workers’ compensation insurance company will direct treatment. This means that the physicians will be selected by the insurance company and the injured worker will be expected to comply with the medical treatment being offered.
- The injured worker will be eligible for temporary total disability benefits (TTD checks) for weeks that he or she missed work. If the authorized treatment physician writes the injured worker out of work than the injured worker can receive 2/3 of the average weekly wage for those weeks that they cannot work.
How Cardinal Law Partners Can Help
Attorneys Kristin Henriksen, Justin Wraight, Megan Callahan, and John Landry are all Board-Certified Specialists in North Carolina Workers’ Compensation law. Their experiences are available for those injured workers who have questions or concerns about their own claims.
Cardinal Law Partners offers free consultations for injured workers. If you would like to speak to an attorney at the office nearest to you, please contact them today.