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Navigating the complexities of workers' compensation in North Carolina can be daunting for employees and employers.
Coverage ensures that workers receive medical treatment and compensation for lost wages, helping them navigate the challenging period following a workplace accident.
Understanding how this system works, who is covered, and what benefits are available is crucial for both employees and employers in the Tar Heel State.
Let’s deep dive into the intricacies of North Carolina's workers' comp, offering insights, tips and guidance to help you make informed decisions and benefit from this vital protection.
North Carolina workers' compensation is a state-mandated insurance program for all employers with three or more employees. Coverage provides benefits such as medical care and lost wages for employees who suffer work-related injuries or illnesses.
Without workers’ compensation, the cost of medical treatment for an employee’s work-related injury or illness could become the responsibility of your business.
The North Carolina Industrial Commission administers the workers’ comp law in the state.
Passed in 1929, the North Carolina Workers’ Compensation Act requires employers with three or more employees to be covered by an active workers’ compensation insurance policy.
Businesses can obtain workers’ comp coverage through a partner like EverPeak Insurance. Alternatively, companies that meet the state’s requirements may also apply to be self-insured.
In North Carolina, workers' compensation cases are "no-fault," which means that the amount a claimant receives will not increase or decrease regardless of who was at fault.
Employees can verify online if their employer has coverage.
Policies include protection for full and part-time workers.
North Carolina workers’ comp exemptions include:
Workers' compensation covers a range of work-related injuries and illnesses, including physical injuries resulting from an accident and occupational diseases developed over time due to job conditions.
Workers’ comp insurance provides three types of benefits for work injuries:
North Carolina workers’ comp benefits include:
An employee’s workers’ compensation lost wage benefit is 66% of their average weekly wage.
As of 2023, the maximum North Carolina workers’ comp weekly benefit is $1,254.
In the event of a work-related injury or illness:
Injured workers must immediately file a Form 18 Notice of Accident with the North Carolina Industrial Commission and send a copy to the employer.
The employee should immediately seek medical attention.
If an employer’s insurance provider accepts the claim, the worker may begin receiving benefits to cover medical expenses and lost wages.
Following their recovery, the worker is to resume work safely. If a work injury left an injured employee unable to do any type of work, the employee might be entitled to permanent disability benefits.
In North Carolina, injured workers are to seek treatment from employer-selected doctors.
There are exceptions, though. In emergencies, an employee can go to the nearest emergency room. And when an injured worker’s care is inadequate, employees can contest their employer’s selection.
Wage loss benefits for the first seven missed days of work due to an injury are only provided if the employee’s disability continues for more than 21 days.
No compensation is due for the first seven (7) days of lost time unless the disability exceeds 21 days. Therefore, the first check will not include payment for days 1-7. Payment for those days will be made should the disability continue beyond 21 days.
Injured workers who disagree with their claim outcome can request North Carolina’s Industrial Commission Mediation Section to hold an appeal hearing on a disputed claim.
Unless exempt, employers in North Carolina must carry workers' compensation insurance or qualify for self-insurance. Compliance with this requirement is essential to protect both the employer and employees.
When selecting a workers' compensation insurance provider, consider factors such as the provider's experience in the industry, financial stability, coverage options, claims process, customer service, and cost.
We recommend requesting multiple quotes and comparing the offerings before making a decision.
Covering your business and employees with a trusted insurance partner — like EverPeak — brings peace of mind so you can focus on your bottom line.
In North Carolina, the penalties for businesses without workers’ compensation coverage include paying a penalty of up to $100 for a day for each employee during the time the employer and their employees were not insured.
If an employer fails to obtain coverage after being fined, they will be guilty of a class H felony or class 1 misdemeanor.
Further penalization may even result in imprisonment.
In most cases, policies bar employees in North Carolina from suing their employers for work-related injuries or illnesses. The workers' compensation system provides an exclusive remedy, meaning that employees typically cannot file a lawsuit against their employers. Instead, they must pursue a workers' compensation claim to receive benefits for their injuries or illnesses.
Generally, a business’s workers’ compensation policy does not cover independent contractors in North Carolina. Workers' compensation laws typically apply to employees rather than independent contractors.
However, it's important to note that the classification of a worker as an independent contractor or an employee can be complex, and misclassification can lead to legal disputes. If unsure whether an independent contractor should be treated as an employee, seek legal guidance.
The incident should be reported immediately or within a few days of the occurrence. Prompt reporting helps ensure the necessary steps are taken to initiate the workers' compensation claims process.
Employees can verify online if their employer has coverage.