When workers are injured on the job, the workers' compensation system is designed to ensure that they are not forced to deal with these injuries alone. Workers' comp provides critical benefits, such as payment for medical care and wage replacement for time away from work.
To ensure access to these benefits, though, it is important for workers to follow certain procedures. Workers' compensation is a highly regulated area and the failure to follow the required processes may limit access to these benefits.
Any time you are seriously injured, the first priority must be getting medical attention. However, if you are physically able to report your injury to your employer immediately, you should do so. It is best to report in writing. By simply reporting the injury orally, you run the risk that your supervisor will deny you ever reported the injury; a written report ensures a paper trail, and you should keep copies of everything. Also, there is a chance that failure to report in writing or within 30 days will allow the employer to deny your claim on a technicality.
The biggest problem with late reporting, though, is that it can raise a credibility issue as to whether your injury happened at all. It is best not to risk these problems, but you shouldn't give up your claim if notice is late, because late notice can sometimes be overcome.
Unless your employer accepts your claim and starts paying benefits, you must file a Form 18 with the North Carolina Industrial Commission within two years of your injury. The two years usually starts running from the time an injury happens, but the triggering dates for occupational diseases can be more complicated. If your claim is not filed within the time limit, it will die, regardless of how obviously valid it is.
If your employer accepts your claim and starts paying workers' comp benefits, you may not have to file, but it is usually best to do so anyway, just to be safe. There are a couple of things to remember about filing:
The filing must be with the Industrial Commission, not just with the employer;
If you think you are excused from the requirement because your employer has accepted the claim, make absolutely sure that the benefits you are receiving include wage replacement and that they are actually workers' compensation benefits, and not just wage continuation or disability benefits from another source.
After you file a Form 18, you will receive an acknowledgment letter from the North Carolina Industrial Commission. The Commission will also send a copy of the acknowledgment to your employer or your employer's workers' compensation insurance carrier.
Once your employer's workers' compensation insurance carrier has been notified of the work-related injury, they will likely open an investigation. You will receive a call from an insurance adjuster, who will seek to determine the severity of your injuries and whether these injuries actually occurred while you were working.
In a routine, uncontroversial claim, it is usually all right to cooperate with the insurance adjuster and provide information as requested - but you should also recognize that the insurance adjuster's job is not to look out for your best interests. The insurance adjuster is seeking to minimize costs for the workers' compensation insurance company.
If you think there is a chance that the insurance company may deny your claim and you think you will be hiring a lawyer, you should speak with your lawyer before you talk to the adjuster about your claim. Honesty is the best policy, so your lawyer will not help you make up things that are not true, but an injured worker can sometimes be tricked into saying things in statements in a way that will damage his or her case, so preparation can be important.
Make sure that you keep your own records of the accident, your injuries and your interactions with representatives from the insurance company. It is easy to forget the day-to-day details following an accident. Keeping a clear record will help ensure that you can provide accurate and consistent information.
It is always a good idea to follow the instructions of your doctor; after all, the doctor is the professional and can only help if you follow his or her directions. When you are seeking or receiving workers' compensation benefits, though, this is particularly true.
Under North Carolina law, you are required to follow the instructions of your doctor while receiving workers' comp benefits. If you think that you would do better with a different doctor, you can request a change, first from the workers' comp insurance company and then from the Industrial Commission. Failing to follow the doctor's instructions can jeopardize your access to benefits, though, so it is important that you don't simply refuse to comply.
In most cases, claims for workers' compensation benefits are accepted without the assistance of a lawyer. However, even claims that are running fairly smoothly, and especially claims involving severe injuries, may contain issues that require a lawyer's help. If you have questions about your claim, a workers' compensation attorney can provide invaluable assistance. Speak with a knowledgeable workers' comp lawyer to discuss your legal claims and options.
Article provided by Jay Gervasi, P.A. Visit us at www.lawyerforinjuredworkers.com
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