Durham Workers’ Compensation Lawyers

Fighting for Injured Workers in Durham Since 1999. Over $40 Million Recovered.

If you were injured on the job or developed a work-related illness, you may be entitled to workers’ compensation benefits. In North Carolina, any employer with three or more employees must carry workers’ compensation insurance, which covers nearly all employees and provides benefits to those who can’t work, temporarily or permanently, due to a qualifying injury or illness.

At Hyland, Padilla & Fowler, PLLC, we help injured workers in Durham and throughout Durham County with every aspect of a workers’ compensation claim, from understanding their rights and eligibility to filing claims and navigating the appeals process. Since 1999, we’ve handled more than 7,000 cases and recovered over $40 million for our clients. Our founding partners, Chris Hyland, John Padilla, and Andrea Fowler, are active members of the North Carolina Advocates for Justice and the American Association for Justice. We intentionally limit our caseload so clients receive direct attorney attention, and we’re available 24/7 in both English and Spanish.

Call Hyland, Padilla & Fowler, PLLC today at (919) 891-8361 or contact us online to schedule a free consultation with our Durham workers’ compensation attorneys. Hablamos español.

Workplace injuries can occur in any industry, but some sectors carry greater risk by nature of the work involved. Durham’s economy spans healthcare facilities like Duke University Hospital, Research Triangle Park employers, construction, manufacturing, transportation, and food service. North Carolina private-sector employers reported 68,600 workplace injuries and illnesses in 2023, with nearly 41,000 involving days away from work, job transfers, or restrictions.

Industries that consistently experience the highest rates of workplace injuries include:

• Construction: Heavy machinery, working at heights, electrical work, and manual labor create constant hazards. Common injuries include falls, being struck by objects, electrocutions, and machinery accidents.
• Manufacturing: Repetitive motions, heavy lifting, and proximity to machinery put workers at risk for cuts, fractures, repetitive strain injuries, and chemical exposure.
• Agriculture: Operating heavy equipment, working with animals, and handling chemicals contribute to injuries like tractor rollovers, machinery accidents, animal-related injuries, and chemical burns.
• Transportation and Warehousing: Long-haul driving, loading and unloading, and forklift operation lead to vehicular accidents, musculoskeletal injuries, and struck-by incidents.
• Healthcare: Patient handling, disease exposure, and demanding schedules put healthcare workers at risk for back injuries, needlestick injuries, and infections.
• Mining: Hazardous environments, heavy machinery, and unstable ground produce cave-ins, machinery accidents, respiratory disease from dust, and chemical exposure.
• Public Safety (Police, Firefighters): Emergency response and law enforcement carry risks of physical injury, burns, smoke inhalation, and vehicle accidents.
• Hospitality and Food Service: Kitchen equipment, slippery floors, and repetitive tasks result in cuts, burns, slips and falls, and repetitive strain injuries.
• Utilities: High-voltage equipment, elevated work areas, and confined spaces expose workers to electrical burns, falls, and hazardous substances.
• Retail: Heavy lifting, repetitive tasks, and slip hazards lead to musculoskeletal injuries, cuts, 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 show that your injury or condition arose out of or is related to your employment, you may be entitled to benefits. A pre-existing condition doesn’t automatically disqualify a claim. If a workplace incident aggravated or worsened a condition you already had, that injury may still be compensable.

Common work-related injuries and illnesses covered by workers’ compensation include:

Workers’ compensation may also cover psychological conditions like post-traumatic stress disorder (PTSD) when they are directly linked to a specific work incident or environment. Documenting that connection thoroughly is important to a successful claim.

If you sustained a work-related injury or occupational illness and need help with your 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.

What Are the Workers’ Compensation Benefits in North Carolina?

North Carolina workers’ compensation provides several categories of benefits to qualifying claimants. Temporary total disability (TTD) benefits are calculated at two-thirds of the worker’s average weekly wage, subject to a state-set maximum, and begin after the worker has missed more than seven days of work. The first seven days are compensated only if the disability extends to at least 21 days.

Available benefits include:

• Medical Care: Workers’ compensation pays for all reasonable and necessary medical expenses related to your workplace injury or occupational disease, including mileage reimbursement for travel to medical appointments when qualifying distance thresholds are met.
• Temporary Partial Disability: Temporary partial disability (TPD) benefits apply when a worker returns to work in a reduced capacity due to a qualifying injury.
• Temporary Total Disability: Temporary total disability (TTD) benefits are paid when a worker can’t return to work at all on a temporary basis.
• Permanent Partial Disability: If you suffer a permanent impairment that prevents a full return to work, you may qualify for permanent partial disability (PPD) benefits based on a disability rating assigned to your condition.
• Permanent Total Disability: Permanent total disability (PTD) benefits are awarded when injuries are so severe the worker is completely unable to return to any form of work.
• Vocational Rehabilitation: These benefits cover job retraining and workforce reentry costs when a worker can’t return to their previous occupation.
• Death Benefits: When a worker dies in a workplace accident or from 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 and what you can expect in terms of compensation.

How to File a Workers’ Compensation Claim in North Carolina

Filing a workers’ compensation claim in North Carolina involves several steps. Here’s a general overview of the process:

1. Report the Injury to Your Employer: Report your injury as soon as possible. North Carolina requires written notice within 30 days of the accident. Delaying this report can jeopardize your claim.
2. Seek Medical Attention: Get treatment promptly. Your employer may have a designated health care provider for workers’ compensation cases. Tell the provider your injury is work-related.
3. Notify Your Employer in Writing: Follow up with a written notice detailing the injury, when and where it happened, and any other relevant information.
4. Complete Form 18: You must file Form 18 (Notice of Accident to Employer and Claim of Employee) with the North Carolina Industrial Commission (NCIC) to formally establish a legal claim. This form must be filed within two years of the injury date and can be obtained from the NCIC website or your employer.
5. Employer’s Responsibilities: Your employer must file Form 19 with the NCIC within five days of your report, and the insurance carrier must be notified.
6. Investigation by the Insurance Carrier: After receiving notice, the employer or insurer generally has 14 days before the first compensation installment is due. They must formally accept the claim (Form 60), deny it (Form 61), or file Form 63 to pay benefits without prejudice for up to 90 days while the investigation continues.
7. Receive a Notice of Acceptance or Denial: The insurance company will notify you whether your claim is accepted or denied. An acceptance notice details your benefits; a denial explains the reasons.
8. File a Request for Hearing (If Necessary): If your claim is denied, you can file Form 33 (Request for Hearing) with the NCIC. The case will first go to mediation before proceeding to a formal hearing before a Deputy Commissioner.
9. Mediation or Settlement Negotiation (If Applicable): You and the insurance company may reach a resolution through mediation or settlement negotiation before a hearing is held.
10. Appeal (If Necessary): If the hearing decision goes against you, you have the right to appeal to the Full Commission and, ultimately, to the North Carolina Court of Appeals.

Accuracy in documentation and tracking all correspondence are critical throughout this process. In the most recent NCIC fiscal year, more than 48,000 workers’ compensation cases were opened in North Carolina, and nearly 18,000 claim denials were filed by employers. Careful preparation matters from day one.

Common Reasons a Workers’ Comp Claim Is Denied

Workers’ compensation claims are denied for a range of reasons, and insurance companies sometimes use delays in care or gaps in documentation to downplay even valid claims. Knowing the most common pitfalls can help you avoid them.

Common factors that lead to claim denials include:

• Late Reporting of the Injury: North Carolina requires written notice to your employer within 30 days. Delays raise questions about the injury’s connection to the workplace and can trigger a denial.
• Lack of Medical Evidence: Insufficient or conflicting medical documentation is a frequent denial trigger. Health care providers must record the injury’s severity, its link to your work, and the need for treatment.
• Injury Not Arising Out of Employment: If it’s unclear whether your injury occurred at work or while performing work-related duties, the claim may be denied.
• Pre-existing Conditions: Insurers may deny a claim if they believe the injury stems from a pre-existing condition. However, if a workplace incident aggravated that condition, you may still be entitled to benefits.
• Failure to Follow Medical Advice: Skipping prescribed treatment or missing medical appointments gives the insurance company grounds to question your claim.
• Disputes About the Injury: Disagreements between you, your employer, or the insurer about the nature or extent of your injury can lead to denial.
• Injury Outside the Scope of Employment: Injuries that happen during personal activities unrelated to work aren’t covered.
• Intoxication or Misconduct: Claims may be denied if the injury resulted from intoxication or serious misconduct at work.
• Missed Deadlines: Failing to meet filing deadlines or respond to information requests can result in denial regardless of the injury’s validity.
• Employer’s Dispute: Your employer or insurer may dispute the claim on grounds such as fraud or questioning whether the injury occurred at work.
• Administrative Errors: Incomplete forms, missing information, or clerical mistakes can result in denial even when the underlying claim is valid.

Reporting your injury promptly, keeping thorough medical records, and maintaining clear communication with your employer all reduce the risk of a denial.

What to Do If Your Workers’ Compensation Claim Is Denied

A denied claim isn’t the end of the road. Many valid workers’ compensation claims are initially rejected, and North Carolina law gives you the right to fight back. You can appeal by filing Form 33 (Request for Hearing) with the North Carolina Industrial Commission. The case goes first to mediation. If mediation doesn’t resolve the dispute, the matter proceeds to a formal hearing before a Deputy Commissioner. If that ruling goes against you, the case may be appealed to the Full Commission and ultimately to the North Carolina Court of Appeals.

Building a successful appeal typically requires additional medical evidence, witness statements, or independent medical evaluations. Our attorneys at Hyland, Padilla & Fowler, PLLC help clients file workers’ compensation appeals and work with them directly through every stage, from preparing the record to attending hearings. For workers who have suffered catastrophic job-related injuries that result in lasting disability or prevent a return to work, we pursue compensation. When insurance companies won’t offer fair terms, we take the fight to court.

Contact Our Durham Workers’ Compensation Attorneys Today

We represent injured workers on a contingency fee basis. You won’t pay any upfront or out-of-pocket legal fees, and our fee is only collected as a percentage of the compensation we recover for you. We offer a free consultation with no obligation, we’re available 24/7, and we serve clients in both English and Spanish.

Contact Hyland, Padilla & Fowler, PLLC at (919) 891-8361 to schedule your free consultation with our Durham workers’ compensation attorneys. We’re ready to help you pursue the benefits you may be owed.

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’re injured or become ill due to their jobs. Independent contractors and volunteers are generally not covered. In North Carolina, your employment classification determines eligibility. If you’re unsure how your role is classified, an attorney can help clarify your standing under state law.

How Long Do I Have to File a Workers’ Compensation Claim in Durham, NC?

You generally have two years from the date of injury to file Form 18 with the NCIC. You must also report the injury to your employer in writing within 30 days to avoid complications. These deadlines are firm, so consult an attorney as soon as possible after a workplace injury.

Can I Choose My Doctor for Treatment Under Workers’ Compensation?

Your employer or insurance carrier typically directs medical care. If you’re dissatisfied with the care provided, you can petition the North Carolina Industrial Commission for a change of physician. An attorney can help facilitate that request and ensure your medical needs are properly documented throughout the process.

Do I Need a Lawyer to File a Workers’ Compensation Claim?

Legal representation isn’t required, but it’s particularly valuable for complex claims, denied claims, or cases involving significant injuries. When a claim is contested or negotiations with the insurance company stall, having an attorney on your side can make a meaningful difference in the outcome.

Can I Be Fired for Filing a Workers’ Compensation Claim?

North Carolina law prohibits retaliation against employees for filing a workers’ compensation claim. This protection falls under the Retaliatory Employment Discrimination Act (REDA), which bars employers from terminating or otherwise punishing workers who seek benefits. If you believe you’ve been retaliated against, you can file a complaint with the North Carolina Department of Labor or speak with an attorney.

How Long Does It Take to Receive Workers’ Compensation Benefits?

Once your claim is approved, medical benefits should begin promptly. Wage replacement benefits typically start within a few weeks of claim acceptance. Disputes or appeals can extend these timelines significantly. Staying in regular contact with your attorney and the insurance company helps keep the process moving and surfaces any delays early.