Protecting the Rights of Injured Clients
Durham Workers’ Compensation Lawyers
Representing the Rights of Injured Workers Throughout Durham County
You are likely entitled to workers' compensation benefits if you were injured on the job or suffered a work-related injury, illness, or medical condition. In North Carolina, any employer with three or more employees in the private sector must carry workers’ compensation insurance. This insurance covers nearly all employees and provides benefits to those who cannot work, either temporarily or permanently, as a result of their work-related injuries.
At Hyland, Padilla & Fowler, PLLC, we help clients with all aspects of workers’ compensation, from understanding their rights and eligibility for benefits to filing claims and navigating the appeals process. We have a long history of success helping injured workers recover the benefits they were owed under North Carolina’s workers’ compensation system; learn how our firm can assist you with your claim today.
Call Hyland, Padilla & Fowler, PLLC today at (919) 891-8361 or contact us online to schedule a meeting with our workers’ compensation attorney in Durham! Hablamos español.
Workplace injuries can occur in any industry, but some sectors are more susceptible due to the nature of their work. Here are the common industries that typically experience higher rates of workplace injuries:
- Construction: This industry involves heavy machinery, working at heights, electrical work, and manual labor. Common injuries include falls, being struck by objects, electrocutions, and machinery accidents.
- Manufacturing: Manufacturing often involves repetitive motions, heavy lifting, and working with machinery. Injuries can include cuts, bruises, fractures, repetitive strain injuries, and exposure to harmful substances.
- Agriculture: Farming and agricultural work involve operating heavy equipment, working with animals, and exposure to chemicals. Common injuries include tractor rollovers, machinery accidents, animal-related injuries, and chemical burns.
- Transportation and Warehousing: This sector includes driving long distances, loading and unloading goods, and operating forklifts. Common injuries are vehicular accidents, musculoskeletal injuries from lifting, and being struck by falling objects.
- Healthcare: Healthcare workers are at risk due to handling patients, disease exposure, and long working hours. Common injuries include back injuries from lifting patients, needlestick injuries, and infections.
- Mining: Mining involves working in hazardous environments with heavy machinery, explosives, and unstable ground. Common injuries include cave-ins, machinery accidents, respiratory issues from dust, and chemical exposure.
- Public Safety (Police, Firefighters): These jobs involve high-risk situations such as firefighting, law enforcement, and emergency response. Injuries can result from physical confrontations, burns, smoke inhalation, and vehicle accidents.
- Hospitality and Food Service: Workers in this industry face risks from kitchen equipment, slippery floors, and repetitive tasks. Common injuries include cuts, burns, slips and falls, and repetitive strain injuries.
- Utilities: Workers in the utilities sector, such as those involved in electrical power generation and water supply, face risks from high-voltage equipment, working at heights, and confined spaces. Injuries can include electrical burns, falls, and exposure to hazardous substances.
- Retail: Retail workers are prone to injuries from lifting heavy items, repetitive tasks, and slips and falls. Common injuries include musculoskeletal injuries, cuts from box cutters, and falls.
What Types of Work-Related Injuries Are Covered by Workers’ Compensation?
Workers’ compensation covers all work-related injuries and occupational illnesses, including some mental health conditions. If you can prove that your injury or medical condition occurred at work or in some way related to your work, you are likely entitled to workers’ compensation benefits.
Some examples of common work-related injuries and illnesses that are usually covered by workers’ compensation include:
- Back injuries
- Head and neck injuries
- Traumatic brain injuries
- Spinal cord injuries
- Broken bones
- Traumatic amputation/loss of limb
- Burn injuries
- Sprains and strains
- Repetitive strain injuries
- Overuse/overexertion injuries
- Electrocution
- Cancer
- Mesothelioma
- Asbestosis
- Dermatitis
- Respiratory illnesses
- Hearing damage/loss
- Infectious diseases
- Stress and certain other mental health disorders
If you sustained a work-related injury or occupational illness and need help with your workers’ compensation claim, contact Hyland, Padilla & Fowler, PLLC, for a free consultation. We can discuss your legal rights and options at no cost and with no obligation to you.
What Are the Workers' Compensation Benefits in North Carolina?
The North Carolina workers’ compensation system provides several benefits to qualifying claimants. These benefits include:
- Medical Care: Workers’ compensation pays for all reasonable and necessary medical expenses related to your workplace injury or occupational disease.
- Temporary Partial Disability: Temporary partial disability (TPD) is paid to workers who can only return to work in a partial capacity due to their qualifying injuries.
- Temporary Total Disability: Temporary total disability (TTD) benefits are paid when a worker cannot return to work temporarily due to their qualifying injury.
- Permanent Partial Disability: If you suffer a permanent partial disability that prevents you from ever returning to work at total capacity, you could qualify for permanent partial disability (PPD).
- Permanent Total Disability: Permanent total disability (PTD) is awarded to workers whose injuries are so severe they are completely disabled and unable to return to any form of work.
- Vocational Rehabilitation: Vocational rehabilitation benefits help cover certain expenses associated with job retraining and reentry into the workforce.
- Death Benefits: When a worker dies in a workplace accident or as a result of an occupational disease, certain family members may be entitled to workers’ compensation death benefits.
Our Durham workers’ compensation attorneys can help you understand what benefits you may be entitled to receive and the amount you can expect in workers’ compensation.
How to File a Workers' Compensation Claim in North Carolina
Filing a workers' compensation claim in North Carolina involves several steps. Workers' compensation is a system designed to provide benefits to employees who are injured on the job.
Here's a general overview of the process:
- Report the Injury to Your Employer: As soon as you are injured at work, report the injury to your employer or supervisor. This is a critical step, and you should do it as soon as possible, ideally within 30 days of the accident. Failure to report the injury promptly could jeopardize your claim.
- Seek Medical Attention: If your injury is severe, seek immediate medical attention. Your employer may have a designated healthcare provider for workers' compensation cases. Follow their instructions or go to a medical provider of your choice. Make sure to inform the healthcare provider that your injury is work-related.
- Notify Your Employer in Writing: It's a good practice to notify your employer in writing of your injury. This could be a simple letter or email detailing the injury when and where it happened, and other relevant information.
- Complete a Form 18: In North Carolina, you may need to complete Form 18 to officially file a workers' compensation claim. This form can be obtained from the North Carolina Industrial Commission (NCIC) website or your employer. Complete the form and provide a copy to your employer and the NCIC.
- Employer's Responsibilities: Your employer must file a Form 19, which is their report on the injury. This should be filed with the NCIC within five days of your report. Your employer's insurance carrier should also be notified.
- Investigation by the Insurance Carrier: The workers' compensation insurance carrier will investigate your case after the claim is filed. They will determine your claim is validity and, if so, what benefits you are entitled to.
- Receive a Notice of Acceptance or Denial: The insurance company will send you a notice of acceptance or denial of your claim. If they accept your claim, it will detail the benefits you will receive. If your claim is denied, the notice will explain the reasons for the denial.
- File a Request for Hearing (If Necessary): If your claim is denied and you believe it should be approved, you can request a hearing before the North Carolina Industrial Commission. This formal process requires an administrative law judge to review your case.
- Mediation or Settlement Negotiation (If Applicable): In some cases, you and the insurance company may mediate or negotiate a settlement before a hearing. This is a way to potentially resolve the dispute without going to court.
- Appeal (If Necessary): If the decision at the hearing is not in your favor, you have the right to appeal the decision to the Full Commission and, ultimately, to the North Carolina Court of Appeals.
Common Reasons a Workers' Comp Claim Is Denied
Workers' compensation claims can be denied for various reasons.
Some common factors that often lead to the denial of workers' compensation claims include:
- Late Reporting of the Injury: Failing to report the injury promptly to your employer is a common reason for denial. Most states require employees to report work-related injuries within a specific timeframe (usually 30 days or less). Delaying the report can raise suspicion and make establishing the injury's connection to the workplace is harder.
- Lack of Medical Evidence: Insufficient or conflicting medical evidence can lead to claim denials. Healthcare providers must document the injury's severity, its connection to the workplace, and the need for medical treatment. It may be denied if the medical records or doctor's assessment do not support the claim.
- Injury Not Arising Out of Employment: Workers' compensation generally covers injuries arising out of and during employment. The claim might be denied if it's unclear whether the injury occurred at work or while performing work-related duties.
- Pre-existing Conditions: If the insurance carrier believes the injury is related to a pre-existing condition and not primarily caused by a workplace incident, they may deny the claim. However, you may still be entitled to benefits if the work injury exacerbates a pre-existing condition.
- Failure to Follow Medical Advice: If you do not follow the prescribed medical treatment or do not attend necessary medical appointments, the insurance company may use this as a reason to deny your claim. They may argue that your non-compliance worsened your condition.
- Disputes About the Injury: Disagreements between you, your employer, or the insurance company about the nature and extent of your injury can lead to denials. They may claim that your injury is not as severe as you say or unrelated to your work.
- Injury Outside the Scope of Employment: Injuries that occur while you are engaged in personal activities unrelated to work are typically not covered by workers' compensation. If the insurance carrier believes your injury falls into this category, they may deny your claim.
- Intoxication or Misconduct: Your claim may be denied if your injury resulted from being intoxicated or engaging in serious misconduct at work. These actions are often considered a violation of workplace safety rules.
- Missed Deadlines: Failing to meet the deadlines for filing a claim or responding to requests for information can result in a denial. Adherence to administrative and legal deadlines is crucial in the workers' compensation process.
- Employer's Dispute: Your employer or their insurance carrier may dispute your claim for various reasons, such as believing it's fraudulent, that the injury didn't occur at work, or that it wasn't properly reported.
- Administrative Errors: Sometimes, claims are denied due to administrative errors, such as incomplete forms, missing information, or clerical mistakes.
What to Do If Your Workers’ Compensation Claim Is Denied
Unfortunately, many workers’ compensation claims are denied. If this happens to you, you have the right to appeal. We strongly recommend that you work with an experienced workers’ compensation appeals attorney, like those at Hyland, Padilla, & Fowler, PLLC, as the appeals process can be lengthy, complex, and confusing. An attorney at our firm can help you file your appeal and navigate the ensuing process, including preparing for and attending appeals hearings.
'We are committed to securing maximum compensation for hard-working people who suffer devastating job-related injuries and illnesses. We are prepared to be your advocate and guide, helping you protect your rights and seek the full benefits you are owed.
Contact Our Durham Workers’ Compensation Attorney Today
At Hyland, Padilla, & Fowler, PLLC, we offer our legal services on a contingency fee basis. This means that we do not collect any upfront or out-of-pocket legal fees. Instead, our attorneys only get paid if/when they recover a settlement or verdict for you. Once we have successfully secured compensation on your behalf, our fees will be paid as a percentage of your recovery.
We are here to answer your questions and address any concerns. Our Durham workers’ compensation lawyers have extensive experience navigating workers’ compensation claims and appeals, and we are ready to help you fight for the benefits you are owed.
Contact Hyland, Padilla & Fowler, PLLC, today to schedule a meeting with our workers’ compensation lawyer in Durham!
FAQs About Workers' Compensation Claims in Durham, NC
Who is eligible for workers' compensation?
Most employees, including full-time, part-time, and seasonal workers, are eligible for workers' compensation if they are injured or become ill due to their jobs. Independent contractors and volunteers, however, may not be covered under workers' compensation laws.
How long must I file a workers' compensation claim in Durham, NC?
In North Carolina, you generally have two years from the date of the injury to file a workers' compensation claim. However, you must report your injury to your employer within 30 days to avoid complications with your claim.
Can I choose my doctor for treatment under workers' compensation?
Your employer or workers' compensation insurance carrier typically has the right to choose the treating physician. However, you can request a change of doctor by filing a petition with the North Carolina Industrial Commission if you are not satisfied with the care provided.
Do I need a lawyer to file a workers' compensation claim?
While having a lawyer to file a workers' compensation claim is not mandatory, having legal representation can be beneficial, especially if your claim is complex, involves significant injuries, or has been denied. An experienced workers' compensation attorney can help ensure you receive the benefits you are entitled to.
Can I be fired for filing a workers' compensation claim?
In North Carolina, it is illegal for an employer to retaliate against an employee for filing a workers' compensation claim. If you believe you have been wrongfully terminated or retaliated against for filing a claim, you can file a complaint with the North Carolina Department of Labor or seek legal advice.
How long does it take to receive workers' compensation benefits?
The time it takes to receive workers' compensation benefits can vary. Once your claim is approved, you should start receiving medical benefits immediately. Wage replacement benefits typically begin a few weeks after your claim is accepted. However, any disputes or appeals can delay the process.
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Experienced Legal Help from Hyland, Padilla & Fowler Since 1999
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Over 7000 Cases Handled We have represented thousands of personal injury clients since 1999.
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