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How Do You Qualify for Workers’ Compensation?

Wed Oct 6th, by Workers Compensation |

Opening a workers’ compensation claim isn’t always a straightforward process. Before you can even get your case in action, you’ll have to ensure that you are actually eligible to receive the benefits you’re seeking. Otherwise, you could simply be wasting your time and money.

Assuming that your North Carolina employer has more than three employees, it is legally required to possess workers’ comp insurance. Because the North Carolina Industrial Commission (NCIC) administers workers’ comp laws, it also determines who does and doesn’t qualify for benefits.

Unsure whether you qualify for workers’ compensation in North Carolina? You could benefit from reaching out to a workers’ comp lawyer for a consultation. Namely, be sure to turn to M. Reid Acree, Jr., for legal aid. Given the fact that he has more than 30 years of legal experience and a track record of success, Mr. Acree is one of the top workers’ comp resources you can speak with.

Is Your Work-Related Injury or Illness Covered?

As long as you received your injury or illness in the course and scope of your job, then it is covered by North Carolina workers’ compensation laws. However, if your injury or illness was received during a commute to or from your place of employment, it isn’t covered by these laws.

Otherwise, you don’t need to have received any specific type of illness or injury to qualify for workers’ compensation.

Are You Eligible for Workers’ Compensation?

To successfully file a workers’ comp claim, there are a few requirements you’ll need to meet first. These eligibility requirements are:

You Must Be Considered an Employee of the Establishment

To receive workers’ comp, then you must be deemed an employee. This includes both full and part-time workers.

Although this sounds relatively straightforward, there are points where this rule can grow complicated. For example, maybe you’re currently working for a subcontractor. If you’re injured on the site of the job, who are you actually an “employee” of, in the context of workers’ comp? Would whatever company that owns the project you’re working on be responsible for your benefits? What about the general contractor? Would you even qualify for workers’ comp benefits?

If you are at all unsure whether you qualify, get in touch with a North Carolina attorney at your earliest convenience. They will be able to guide you in determining whether you fit these particular criteria, as well as figuring out which party is responsible for providing the benefits.

Alternatively, if you are considered an independent contractor, you don’t qualify for workers’ comp benefits in North Carolina. So naturally, sole proprietors, business owners, and partners also fail to qualify for workers’ compensation. While most volunteers for nonprofit organizations aren’t covered, an exception is made for volunteer firefighters.

Traditional state-run workers’ comp insurance doesn’t cover some forms of employment; this includes railroad employees, dock workers, and federal employees. Instead, these individuals receive their benefits from plans that are authorized via Congress.

Your Employer Must Be Insured

If your employer doesn’t have workers’ comp insurance, then you would be unable to receive benefits. However, as was mentioned earlier, this is rarely the case in North Carolina. For an establishment to be legally required to possess workers’ compensation insurance, they only need to have a minimum of three employees. If your employer isn’t insured for some reason, you still have the right to pursue legal action against them following a work-related injury or occupational illness.

The Injury or Illness Must Be Work-Related

Of course, if your injury or illness isn’t work-related, you do not qualify for workers’ compensation benefits. However, as long as the accident resulting in your injury occurred on the job, and this accident wasn’t a consequence of the employee’s own misconduct, the employee would qualify for workers’ comp. This includes injuries related to repetitive motion, even if they occurred over an extended period—all that matters is that they were a direct result of your employer’s negligence.

If you develop mesothelioma due to asbestos exposure at work, for instance, it would also be considered a work-related illness. In a similar vein, if you experienced an allergic reaction due to exposure to hazardous materials, it is also possible for this to be deemed work-related.

Finally, it is also possible for psychological or emotional injuries to be considered “work-related” by a court—and, thus, these could also qualify an individual for workers’ compensation. For example, this could be the case if someone developed PTSD as a result of their job.

If your injury occurred on your commute to work, or if it occurred while you were off the clock or off the premises, you won’t qualify for workers’ comp benefits.

You Must Meet Reporting Deadlines

Timeliness matters when it comes to workers’ compensation law. In fact, waiting too long to report an instance of work-related injury could mean you’ll no longer be eligible for benefits—whether or not your employer’s negligence caused the injury in the first place.

In North Carolina, a workers’ comp claim must be filed within two years of the date of your injury. If you instead file outside this two-year window, you will be barred from making a claim due to North Carolina’s statute of limitations.

You Must Attend Any Required Treatments, Appointments, or Examinations

Make sure to stay on top of any required treatments or medical appointments if you’re looking to succeed with your workers’ comp claim. Suppose you fail to keep up with these appointments. In that case, the insurance provider or your employer may retaliate against you, possibly claiming that you’ve been deceitful about your injury. The more appointments you miss, the more you are putting your workers’ comp benefits at risk.

M. Reid Acree, Jr., Helps Injured Workers in North Carolina

Even if you’re unsure about your eligibility status, it’s beneficial to speak with an experienced workers’ comp lawyer following an injury or illness. If you’re in North Carolina, be sure to get in touch with M. Reid Acree, Jr., through his website today.