North Carolina Workers' Compensation |
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Wage Replacement and Cash Benefits Information
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Temporary Total Disability |
| If the employee remains unable to earn wages after the first seven (7) days of disability, he or she is entitled to weekly benefits equal to two-thirds (2/3) of his or her average weekly wage up to the maximum compensation rate. |
Temporary Partial Disability |
| If upon obtaining post-injury employment the employee is unable to earn wages as great as those earned pre-injury, the employee is entitled to compensation equal to two-thirds (2/3) of the difference between average weekly wages, so long as the amount does not exceed the statutory maximum. Temporary partial disability benefits may not continue beyond 300 weeks from the date of injury. |
Permanent Partial Disability |
| If, at the end of the healing period, there is a permanent impairment to a specified part of the body, the employee may receive a set period of benefits without regard to his ability to earn wages. Total loss of use of the part entitles the employee to two-thirds (2/3) of his average weekly wage, times a set number of weeks depending on the body part. Benefits for less than total loss are figured on a percentage basis. Alternatively, in cases where the employee has a permanent impairment and is unable to earn wages as great as before the injury, the employee may choose to receive the temporary partial disability benefits discussed above. The percentage of disability is determined based on physicians' ratings of the percentage of physical impairment. If either party is dissatisfied with the treating physician's rating, it may obtain the "second opinion" of another doctor. The employee, upon approval by the Commission, is entitled to a single second opinion rating by a doctor of his or her choice at the employer's expense. |
Total and Permanent Disability |
| The loss of both hands, both arms, both feet, both legs, or both eyes, or any two thereof, constitutes total and permanent disability, and entitles the worker to weekly benefits and medical compensation for life. |
Disfigurement and Damage to Other Organs |
| Disfigurement and Damage to Other Organs: If the injury leaves facial or head scars which seriously disfigure the person, or causes the loss or permanent injury to an important organ of the body, the employee may be awarded additional compensation not to exceed $20,000.00. The maximum payable for bodily disfigurement is $10,000.00. |
Figuring the Compensation Rate |
| The weekly rate of compensation cannot be less than $30.00 nor more than $588.00 for injuries occurring after January 1, 2000. The maximum weekly benefit is adjusted annually to equal approximately 110% of the average North Carolina wage. The rate of compensation remains the same during the life of the claim. The average weekly wage is usually computed by averaging all wages earned by the employee in the employment in which he or she was injured during the 52 weeks prior to the injury. |
Medical
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| Employers must provide, and injured employees must accept, all reasonable medical, surgical, hospital, nursing, rehabilitative services, medicines, sick travel, artificial members, and other treatment as may reasonably be required to effect a cure, give relief, and tend to lessen the period of disability, which are needed due to the compensible injury. The costs of medical compensation are in addition to cash benefits, and do not offset or reduce them. If the employer denies liability, the employee may obtain treatment from a physician or hospital but must request a hearing before the Industrial Commission to determine whether the claim is compensible and the employer owes medical compensation. If the employer accepts liability and fails to provide treatment, or in the case of an emergency, the employee may obtain treatment from a physician or hospital but must request Industrial Commission approval within a reasonable time. The employer or its insurance carrier may select the treating physician and other providers of medical compensation. If the employee is dissatisfied with the services rendered by providers selected by the employer, the employee may request the Commission order a change of treatment, or approve treatment by providers of employee's selection. |
Death Benefits |
| Death benefits are payable when an employee dies due to an occupational disease or an accident if the death occurs within six (6) years thereafter, or within two (2) years of the final determination of disability, whichever is later. The claim must be filed within two (2) years of the date of death in the name of the dependents or next of kin of the decedent employee. Death is compensated by payment of two-thirds (2/3) of the decedent employee's average weekly wage, or the maximum compensation rate for a minimum period of 400 weeks and any medical expenses incurred due to the mortal injury or disease. |
Denial of a Claim |
| An employee who submits a written claim (I.C. Form 18, or its equivalent) in a case where no compensation has been initiated by the employer to the employee, is entitled to a detailed statement from the employer or insurance carrier of grounds for denying the claim within 45 days of receipt, unless time is extended by the Commission's Claims Section. The employee desiring a hearing on the claim before the Industrial Commission must make the request on the I.C. Form 33. (pull up form) A statement making a claim or requesting a hearing must be received by the Commission within two years of the date of injury to preserve the employee's right to pursue the claim. |