The attorneys at the Arthur M. Blue Law Office,
P.A. have assisted hundreds of individuals with their workers’
compensation claims and have successfully resolved many of those claims
in litigation and at mediation.
The Arthur M. Blue Law Office, P.A. has experienced attorneys and
staff who are available to represent injured persons in workers’
compensation cases throughout North Carolina. Our attorneys are
experienced in mediation and litigation and are dedicated to protecting
the rights of injured workers.
WHAT IS WORKERS’ COMPENSATION?
Workers’ Compensation is a system
that provides certain benefits to workers who sustained a compensable
injury by accident arising out and in the course and scope of their
employment. Benefits can also be paid for "occupational diseases" such
as asbestosis, chemical exposure, bursitis, carpal tunnel syndrome,
and hearing loss.
WHAT IS THE NORTH CAROLINA INDUSTRIAL COMMISSION?
The North Carolina Industrial
Commission is the state agency which regulates and oversees workers’
compensation claims that have been filed in North Carolina. The
Industrial Commission is made up of Commissioners and Deputy
Commissioners who essentially act as judges. The Commissioners and
Deputy Commissioners make rulings on motions and preside over hearings
involving disputes between you, your employer and the insurance
WHAT MAKES MY CLAIM COMPENSABLE?
You Must Show that You Sustained
an "Injury by Accident". The North Carolina Workers’ Compensation
Act defines an "injury by accident" as an unlooked for or untoward
event such as a slip, trip, fall or other unexpected event that
interrupts your usual work routine. If the injury occurs while you are
performing a task in the same way you always perform it (bending down
to lift a box and your knee pops), chances are that the claim is not
going to be compensable.
Your Injury Must also "Arise Out
of and in the Course and Scope of" your Employment. Basically, the
phrase "arising out of" refers to the origin or cause of the accident.
You must show a causal connection between your employment and the
injury. The phrase "course and scope of employment" refers to the
time, place and circumstance surrounding your injury. For the injury
to occur during the course and scope of your employment, you must be
engaged in an activity which you are authorized to undertake and which
furthers the employers business.
WHAT IS AN OCCUPATIONAL DISEASE?
"Occupational Diseases" are specific
conditions which are listed in the North Carolina Workers Compensation
Act. These conditions include, asbestosis, silicosis, synovitis,
tenosynovitis, bursitis, and chemical exposure.
There is also a "catch all"
provision which defines an "occupational disease" as any disease where
your job exposed you to a greater risk of contracting the disease than
members of the public generally and that your exposure significantly
contributed or was a significant causal factor in the disease’s
development. A common "occupational disease" that is included under
this provision is carpal tunnel syndrome.
CAN I SUE MY EMPLOYER?
Generally, you cannot
sue your employer in the North Carolina Courts for a work-related
However, there are two (2)
exceptions to this rule: First, if the employer intentionally engages
is misconduct knowing with substantial certainty that serious bodily
injury or death would result from the misconduct, a direct civil
action can be pursued; second, you can sue your employer if he or she
intentionally harms you.
WHAT IS A THIRD PARTY CLAIM?
A third party claim results from
your having an injury at work but the responsible party who causes the
accident is a person who is outside of your company. For example, you
are making a delivery for your employer and you are involved in a
motor vehicle accident. If the party who causes the accident is not a
co-worker and they are at fault, you can sue this person in the North
Carolina Courts for their negligence in addition to filing a workers’
It is extraordinarily important that you
pursue such a claim as you may be entitled to additional compensation
beyond what you would receive under the North Carolina Workers’
WHAT DO I DO AFTER I HAVE BEEN INJURED ON THE JOB?
Immediately Report the Injury
to Your Supervisor. Under North Carolina law and the North
Carolina Workers’ Compensation Act, you are required to report your
injury to your employer within thirty (30) days of the accident.
However, it is recommended that you report the injury as soon as
Notify your supervisor of the injury
and document the report in writing. Many employers have a form for
this purpose and you should request the form and complete it. If
possible, have your supervisor sign the written report and request a
copy of the report for your own records. In addition, if there are
witnesses to the accident, bring them along, have them make a written
statement and get a copy for your records.
If a written report is not made, the
door is left open for the employer and insurance company to deny that
you ever gave them notice of the injury.
Seek medical attention.
Workers are strong, tough people who believe the pain they feel from
an injury will go away after just a couple of days. However, if the
pain does not go away and you wait a long time before you go to the
doctor, you may have armed the insurance company with "evidence" they
can use to deny your claim. If you wait to go to the doctor, the
insurance company may doubt that your injury occurred at work and
contend that your injury occurred outside the workplace at a time
later than what you have claimed. A timely report from a doctor that
outlines the time, place and circumstances surrounding your injury can
go a long way in helping you prove your case.
Make your own file and journal.
Every time the insurance company contacts you, they make an entry in
their records. You should do the same thing. Keep a journal or diary
and write down the date and time of all calls concerning your case.
Write down who you spoke to and the subject of the conversation. Keep
copies of all Industrial Commission Forms that have been filed, all
letters about your case and all medical records in your own file.
Make sure your claim is filed
properly. The North Carolina Industrial
Commission in Raleigh is is the state agency which regulates and
oversees workers’ compensation claims. All claims must
be filed with the North Carolina Industrial Commission before the
Commission can take jurisdiction over your case.
A claim is filed with the North
Carolina Industrial Commission by completing and submitting an
Industrial Commission Form 18. Failure to file a claim within this two
year period will result in a time bar to your claim unless you can
show that your employer and/or the insurance company intentionally
engaged in conduct intended to deliberately mislead you about your
right to seek workers’ compensation benefits.
In "occupational disease" claims,
you must file an Industrial Commission Form 18 or Form
18B within two (2) years of being advised by a doctor that you have a
work related "occupational disease".
You should also make sure that your
employer files a notice of injury with the Industrial Commission. The
form that an employer is required to complete is an Industrial
Commission Form 19.
CAN I BE FIRED BECAUSE I FILED A WORKERS’ COMPENSATION
Your employer cannot fire you
because you have filed a workers’ compensation claim. If you believe
that your employer has engaged in such conduct, you should
immediately contact the North Carolina Department of Labor at
(800) 552-6762. You must take action within 180 days of the
termination or your claim may be lost.
WHY DO I NEED THE ATTORNEYS OF THE ARTHUR M. BLUE LAW
Chances are that the insurance
adjuster handling your case will, at least, consult an attorney.
You should do the same thing. Workers’ Compensation law in North
Carolina is a very complicated and specialized area of the law and an
experienced attorney can help preserve evidence, obtain photographs of
the accident scene and find experts to assist you in the prosecution
of your case. A person who is injured on the job in North Carolina has
the right to enforce his employer’s liability under the North Carolina
Workers Compensation Act through appropriate proceedings, motions and
hearings against the insurance company. The Arthur M. Blue Law Office,
P.A. has the attorneys and staff to assist you with this process.
We can assist you if your claim is
denied. An employee who files a written
notice of claim (Form 18) with the Industrial Commission is entitled
to a detailed statement from the employer or insurance company within
fourteen (14) days that explains the Defendants’ position on
acceptance or denial of your claim. On occasion, the insurance company
may not admit or deny your claim in this time period. If this happens,
we can assist by filing a "Motion to Compel" the insurance company to
promptly admit or deny your right to benefits under the North Carolina
Workers’ Compensation Act.
If the claim is denied, you are
entitled to request a specific statement from the insurance company
which details the reasons for the denial of your claim. If the claim
is denied, you have the right to request a hearing before a Deputy
Commissioner of the North Carolina Industrial Commission. Deputy
Commissioners essentially act as judges and preside over the hearings
of workers’ compensation cases. A hearing is requested by filing an
Industrial Commission Form 33 with the Industrial Commission. When a
hearing has been requested, the Industrial Commission will, in most
cases, order that the parties attend a mediation and attempt to settle
the claim prior to a hearing.
We can advise you through the
investigation process. Before the insurance
companies pay workers’ compensation benefits, they will want to make
sure that your injury actually happened at work. For you to be
entitled to benefits the injury must have been one "by accident"
and it must have occurred "in the course and scope of employment".
An insurance adjuster may contact you and ask to take a recorded
statement. The adjuster will ask you questions that are designed to
obtain an answer which gives them the ability to deny your case. We
can help you through this process and our attorneys will be present
for the recorded statement to make sure that your rights are being
We can assist in making sure that
you are getting the correct medical treatment.
You must cooperate with your medical care providers. You should be
dressed cleanly and neatly for all appointments with your medical
providers. Listen carefully to all instructions given to you by your
treating physician and follow those instructions carefully. If you
cannot make an appointment, notify the doctor’s office. If you fail to
show up, a notation will be made in your medical chart that the
insurance company will claim shows that you have not cooperated in
your medical care.
If your treating physician is not
cooperative or you feel that you are not getting the treatment you
need or if the doctor seems to be in your employer’s corner, we can
assist you in changing physicians and ensuring that you are getting
proper medical attention. Sometimes, a motion must be filed with the
North Carolina Industrial Commission and an attorney can assist with
this process. It is the North Carolina Industrial Commission, not
the insurance company, that has the final word on medical care.
We can assist in making sure you are getting all
benefits to which you are entitled under the North Carolina Workers
Compensation Act. You may be entitled
to benefits for lost wages, permanent disability, medical compensation
and vocational rehabilitation.
An injured employee is entitled to 66 2/3% (.6667) of their average
weekly wage after the first seven (7) days of disability. The
average weekly wage is usually calculated by looking at the gross
(pre-tax) wages earned in the 52 weeks preceding the injury. Once
calculated, the average weekly wage is multiplied by .6667, which
yields the weekly compensation rate. An injured employee will
receive weekly checks at this rate until their period of disability
Sometimes an injured body part does not heal 100%. When this occurs,
the treating physician will assign an "impairment rating". Benefits
for this rating are calculated using the "Schedule of Injuries; Rate
and Period of Compensation" set forth in N.C.G.S. § 97-31. Benefits
under this schedule will vary depending on the body part injured and
the rating assigned by the treating physician.
If the insurance company has accepted your claim, all medical bills
related to your workers’ compensation claim, including
prescriptions, and travel to and from your doctor’s office should be
paid by the insurance company.
In regard to travel expenses, you
are entitled to collect for milage for travel to treatment
facilities at the rate of $0.31 per mile, provided that travel is 20
miles or more per round trip. In addition, injured workers with
special needs may be provided with transportation to and from their
Sometimes, an injured employee is unable to return to his/her
previous job because of physical restrictions that have resulted
from their workers’ compensation injury. In those instances, the
employee can seek vocational rehabilitation. Vocational
Rehabilitation can assist in finding a new job that meets the
restrictions imposed by the treating physician or even help the
employee get the training and education needed to find work in a new
HOW MUCH WILL I HAVE TO PAY MY LAWYER?
All attorneys fees must be
approved by the North Carolina Industrial Commission. An injured
worker should not be making any payment to an attorney for his or her
workers’ compensation claim without that approval.
We handle all workers’ compensation claims on a
"contingency fee" basis. This means that we do not charge any fees
unless there is a recovery of benefits. It will not cost you anything to
come in for a consultation. All consultations for workers’ compensation
cases are given free of charge.
SOCIAL SECURITY DISABILITY BENEFITS
Eligibility for disability insurance benefits (SSDI) or supplemental security income (SSI)
is determined by complex regulations. Beneficiaries must not yet be
retired and must have physical or mental health limitations which
prevent the ability to work in
the national economy. Disability must
be expected to last for 12 months or more. Additional
considerations for disability payments are age, education, past
employment, and job qualifications.
If you believe that you fulfill these requirements, you should go to your Social Security Administration's (SSA) local office and apply for benefits as soon as possible. After reviewing the
application, medical records and other documentation, SSA will advise you of their decision by mail. Most applications are denied benefits at the initial application process.
The next step is an appeal called "Reconsideration." It is in your best interest to hire an experienced Social Security lawyer after initial denial. Reconsideration must be requested within 60
days after initial denial. Most Reconsideration applications are also denied and must be appealed within 60 days by requesting a hearing before an Administrative Law Judge (ALJ).
The Arthur M. Blue Law Offices are located in Carthage and Asheboro, NC. Call us today for a consultation. We will fight for you to make sure your rights are protected and that you are
Abuse / Auto Accident / Slip & Fall / Medical Malpractice / Negligence / Personal Injury Claims / Products Liability Claims / Social Security Disability Appeals / Social Security
Disability Claims / Slip & Fall / Worker's Compensation
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Arthur M. Blue Law
Office, P.A., Carthage & Asheboro, North
Carolina Attorneys at Law
Durham, Chapel Hill, Research Triangle Park, Troy, Asheboro, High Point,
Rockingham, Albemarle, Pittsboro, Siler City, Raeford, Sanford, Cameron,
Pinehurst, Robbins, Laurinburg, Carrboro, Roxboro
Concentrating in Personal Injury Law, Family Law, Bankruptcy, Criminal Defense
Law, Civil Litigation, North Carolina Traffic
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