Getting injured at work can be overwhelming for workers. It’s essential to understand what to do if your workers’ comp claim was denied in North Carolina. If you face a denial, it doesn’t necessarily mean you need to give up on pursuing the benefits you deserve. Hire a workers’ compensation lawyer to help protect your employee rights.
Choose a Workers’ Comp Attorney From Law Office of Lyndon R. Helton, PLLC
When new clients work with Attorney Helton of Law Office of Lyndon R. Helton, PLLC, they know their legal rights will be protected throughout the entirety of their case. With more than 23 years’ of experience helping those throughout North Carolina, Attorney Helton has made it his goal to provide competent legal services to those who need it most.
North Carolina Workers’ Compensation Laws
In North Carolina, injured workers don’t need to prove who was at fault after a workplace injury. This means they are eligible for specific workers’ compensation benefits while they recover from their injuries, even if the incident was entirely their fault. These benefits include:
- Some wages. The wages are about 67% of the weekly wage you earn on average and are paid to you weekly while you recover.
- Medical treatment and rehabilitation services
In certain situations, your employer may reject your workers’ comp claim.
Common Reasons a Workers’ Compensation Claim May Be Rejected in North Carolina
In 2024, there were 64,200 cases of injury and illnesses throughout North Carolina’s private job industries. Of these, 35,700 required the victim to take time off work to recover, transfer jobs, or work with restrictions. While most workers are automatically able to receive benefits without needing to prove fault, some workers’ compensation claims may be denied. Common reasons for this include:
- Your employer’s workers’ compensation insurance company does not believe your injury was caused by your workplace.
- You failed to report the incident to your employer within the mandatory 30 days. In 2023, on average, injured North Carolina workers reported their workplace injury to their employer within 12.01 days.
- You didn’t seek medical attention as soon as you were injured. Failing to seek medical attention may make the insurance company question whether your injuries are severe enough to warrant benefits.
- You had a pre-existing medical condition that the insurance company may believe caused your current injuries.
- You filed your paperwork incorrectly.
No matter the reason, working with a skilled workers’ compensation lawyer is essential to making sure you can receive the benefits you need for your recovery process.
What to Do if Your North Carolina Workers’ Compensation Claim Is Denied
If your workers’ compensation claim is denied, there are steps you can take to challenge the denial. Injured workers have the right to file a request for a hearing to appeal the denial. Your case will be assigned to a judge, and you’ll be given a hearing date. During this time, you can still seek medical treatment for your injuries, and you will only be billed directly by your provider if the hearing results in a final denial.
While waiting for your hearing, it’s important to work with your lawyer to collect relevant evidence to advocate for yourself. This can include:
- Witness testimony from any people who saw the workplace incident. They can offer their official statement about what happened when you were injured.
- Testimony from professionals who can offer their opinion about what caused your injuries.
- Photos and videos of the incident site, your visible injuries, and the cause of your injuries. This can include a video of a faulty machine, a workplace hazard, or other relevant photographic proof.
- Copies of all of your medical records and any incident reports filed at the time of the workplace incident. Be sure to keep these in chronological order to make it easier during your case.
- Security footage caught the incident on tape. This will need to be collected as quickly as possible, as surveillance cameras often tape over their footage after a short period of time.
- Written proof that you reported the incident within 30 days
- Copies of your initial workers’ compensation claim
- Any other proof that can link your injuries to your workplace
FAQs
How Can a Workers’ Compensation Lawyer Help Me?
A workers’ compensation lawyer can help you through every stage of your case by explaining state laws that pertain to your situation, collecting evidence relevant to your case, advocating on your behalf during your hearing, and negotiating any settlements with the insurance company. They’ll help make sure your legal rights aren’t violated during your case.
Can I File a Personal Injury Claim Against My Employer After a Workplace Injury?
After a workplace injury, you generally cannot file a personal injury claim against your employer. Because North Carolina allows workers to receive workers’ comp benefits without proving fault, this also means that the employer is protected from legal action if the incident was their fault. However, if your employer’s reckless or intentional conduct resulted in your injuries, you could file a legal case against them.
Can I File an Injury Claim Naming a Third-Party After I Was Injured at My Workplace?
You could file a personal injury claim against a third party after a workplace injury if they caused your injuries. For example, if an outside independent contractor was liable for the accident, you can pursue a legal case against them for compensation and to hold them accountable for their actions.
What Compensation Can I Get From a Personal Injury Case?
The compensation you can get from a personal injury case depends on the seriousness of your injuries, the extent of your financial losses, and who was at fault for the incident. Victims can ask for damages to help them recover compensation for their medical bills, emotional suffering and physical pain, loss of enjoyment of life, lost income, disfigurement, and damage to their personal belongings.
Hire a Workers’ Compensation Lawyer Today
Contact our office in Hickory today to set up a meeting with our firm. Law Office of Lyndon R. Helton, PLLC, provides a full range of legal services to residents of Catawba County, Burke County, and Caldwell County and is dedicated to securing favorable outcomes for our clients.
