Is my injury covered by NC workers’ comp?

The North Carolina workers’ comp system provides important medical and wage benefits, but only if the injury is covered.  Not all workplace injuries and occupational diseases fall within the North Carolina workers’ compensation system.  Many times injured workers will contact me to ask “is my injury covered by NC workers’ comp?”

Workers’ compensation applies to injuries that arise from an accident that occurs during the course and scope of the employment.  In general, an accident is an unexpected or unforeseen event that is outside the normal work routine.  So, an employee who is stacking boxes in their normal routine and suddenly feels pain in their shoulder may find their claim denied, while an employee who slips in a pool of water will be covered.  Common accidents include slips, trips, and falls, machine accidents, load handling accidents and automobile accidents.  Back injuries require only a specific traumatic incident and may be covered so long as the employee can identify the point in time when the injury occurred.

Workers’ comp injuries in North Carolina must also occur during the “course and scope” of the employment. This means the injured worker must be doing the business of his or her employer when the accident occurs.  Course and scope should be broadly interpreted to include activities that benefit the employer.

Employees who have been injured on the job should consider consulting an experienced workers’ comp lawyer prior to giving a statement to an adjuster.  Frequently injured workers will say they felt tricked into saying something that hurt their case.

An occupational disease will be compensable under the N.C. workers’ comp system if:  1) the employment placed the employee at an increased risk of contracting the occupational disease compared to the general public, and 2) the employment actually caused the disease.  Traditional occupational diseases such as brown lung and asbestosis fall in this category, as do carpal tunnel and bursitis conditions.

An injured North Carolina employee is covered under the NC workers’ compensation system even if he or she is at fault in the accident. However, a recovery may be denied under if the injury is intentionally self-inflicted or is a result of the employee’s use of alcohol or drugs.  An employer’s violation of a safety rule may cause the recovery may cause a recovery to be increased.

An employee injured on the job as a result of the negligence of a person who is not their employer or co-employee should file a claim in the NC workers’ compensation system with their employer, as well as in civil court against the at-fault third party. Third party workers’ comp claims in North Carolina often involve automobile accidents and defective products.  The workers’ comp insurance company may have a lien against the third-party recovery but this can be negotiated or, if necessary, compromised in court.

Frequently NC workers’ compensation insurance companies will deny valid claims, often by applying a narrow definition of “accident,”  “course and scope” or “increased risk.”  A North Carolina workers’ comp lawyer can help evaluate whether you have a claim under the NC workers’ comp system and, if so, ensure you get the benefits you deserve.

Kevin Bunn is a North Carolina workers’ compensation attorney located in Cary, NC, convenient to Raleigh, Apex, Holly Springs and Fuquay-Varina.  Please call or email for your free consultation with an experienced NC workers’ comp lawyer.

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