Quick Contact
Name:
Phone:
Email:
How did you hear about Us?
Comment / Questions:

Charlotte, North Carolina Workers' Compensation Lawyer
Board Certified Workers' Compensation Specialist

Cop stopping someonePlease take a minute to review your rights under the N.C. Workers’ Compensation Act. If you feel that you will require legal assistance with your claim, I would be happy to talk with you and discuss ways in which I can help.

KNOW YOUR RIGHTS

It is always a stressful time when you get hurt at work. In addition to dealing with the physical injuries and your employer, you must also deal with the insurance company, doctors’ offices, nurse case managers, and the workers’ compensation system. Knowing your rights is half the battle.

Frequently Asked Questions

  1. What injuries are covered by Workers’ Compensation?

    If your company has three or more employees, you may be eligible for workers’ compensation benefits. This is true regardless of your immigration status. North Carolina's Workers' Compensation laws cover injuries that result from an accident arising out of and in the course of employment. The law also covers "occupational diseases," which include some lung conditions such as asbestosis and some repetitive-motion conditions, such as carpal tunnel syndrome. The law is very specific and insurance carriers are skilled at applying these rules to limit or deny claims. The issue of "fault" or “negligence” does not matter in Workers' Compensation. You can recover compensation even if you are at fault in the accident. In most cases, you cannot sue your employer outside of the workers’ compensation system for your injuries. Workers’ compensation benefits are considered an “exclusive remedy” against your employer.
     
  2. What benefits are available under Workers' Compensation?

    Workers’ compensation benefits fall into three basic categories: (1) payment for your medical treatment and related medical expenses; (2) compensation for lost wages at 2/3 your average weekly earnings, including overtime and bonuses (often called “TTD”); and (3) compensation for permanent disability (often called a “rating” or “PPD”). Pain and suffering is not recoverable under workers' compensation law. Workers’ compensation benefits are not taxed.
     
  3. How do I report my claim?

    The law says that you have 30 days from the date of your accident to report any injury to your company. However, the sooner you can notify your company, the better. The best way to give notice is in writing to your immediate supervisor or to the human resources department. Be sure to keep a copy of your written notice because it will help you prove your case. Your written notice should include the day of the accident, the time of the accident, a small description of the accident, and a list of what parts of your body you hurt. It does not have to be a formal letter. Writing a short note will satisfy the notice requirement.

    If your injury prevents you from giving written notice, ask a friend or a co-worker to tell your employer what happened and that you will give written notice as soon as your are able to do so. Also, it is a good idea to tell your co-workers what happened in case your supervisor denies receiving notice of your claim.
     
  4. What is a Form 18?

    This is a form that must be filed with the North Carolina Industrial Commission within 2 years from the date of your injury. If you do not file this form within two years, you may be disqualified from receiving workers’ compensation benefits. You can contact a friend, an attorney, or the North Carolina Industrial Commission for help filling out this form. The number for the NCIC is (800) 688-8349. You will need to send two copies of this form to the Industrial Commission, one copy to your employer, and keep one copy for yourself. Click here for a Form 18.
     
  5. Does my immigration status matter?

    You are entitled to workers’ compensation benefits even if you are an undocumented worker. The insurance company is not allowed to ask you about your immigration status. Although your job can fire you if it discovers you are undocumented, the workers’ compensation carrier cannot deny your claim based on your immigration status if you get hurt at work. If you are medically unable to return to work, the insurance company must continue to pay your time out of work even if you are undocumented.
     
  6. How are my weekly benefits calculated?

    You should receive time and a half for every hour worked over 40 hours per week. The insurance company must take into account overtime when calculating your weekly benefits. Your weekly benefits are calculated by averaging your wages in the one year before your injury. You receive two-thirds of this amount for any week that you miss work due to your injury. Workers’ compensation benefits are not taxed, so the 2/3 wages is roughly your after-tax weekly earnings. This is called your “compensation rate” and must be paid to you for the times you miss work due to your injury. The adjuster may refer to this check as “TTD” which stands for “temporary total disability.”

    The first week you miss work due to your injury is considered to be a waiting period. You do not get reimbursed for that week unless you are out of work for more than 21 days. If you are out of work for more than 21 days, then you get reimbursed for the first week. If you are only out of work for two weeks, then you do not get paid for the first week, but will get paid for the second week.
     
  7. What if I get paid in cash?

    Some employers pay their workers “under the table” and in cash. This does not mean that the company does not have to pay workers’ compensation benefits. However, it will be your burden to show how much you were earning before your injury. If you are paid cash, it is a good idea to keep a weekly diary of how much you are paid, including overtime.
     
  8. What if my company doesn’t want me to file a claim?

    Many times, a small employer may offer to pay for you to go to the doctor and to pay a couple of days of missed days of work in return for you not making a claim. This is not a good idea because you are entitled to benefits under the Act in addition to medical care and wage replacement. For example, if you break your leg at work, you get payment for your medical treatment, time out of work, AND a cash payment for the disability rating you may receive at the end of your case (sometimes called “PPD” or “permanent partial disability.”) It is never a good idea to refuse to report your claim to the insurance company because you will not know how severe your injury is until you receive proper medical treatment. Also, the employer may not know that it is supposed to pay for PPD, mileage to and from doctor’s appointments, and prescriptions.

    Also, your employer cannot fire you, demote you, or take any adverse employment action against you for filing a workers’ compensation claim. This is a violation of the Retaliatory Employment Discharge Act (REDA). Any attempts to do this should be reported to the North Carolina Department of Labor.
     
  9. Do I get paid for mileage?

    If your doctor’s appointment is more than 10 miles one way from your home, you are entitled to mileage reimbursement at the rate of 44.5˘ per mile. If you do not have transportation, the insurance company must arrange for a car to come get you and take you to the doctor.
     
  10. What if I do not speak English?

    The insurance company must provide an interpreter if the doctor’s office does not have someone on staff who speaks your language.
     
  11. Am I allowed to choose my own doctor?

    If the insurance company accepts your claim, it gets to direct your medical treatment. However, if you are unhappy with the treatment you are receiving, you can request a change of physician to your own doctor. At the end of your treatment period when you have reached “maximum medical improvement” or “MMI,” the doctor may issue a “permanent partial disability rating” or “PPD” to the part of your body that was injured. The higher the rating, the more money your injury is worth. If the insurance company’s doctor gives you a low rating, you are always entitled to a second opinion on this rating with a doctor of your choice.
     
  12. What if I can’t do my job?

    If there is no work available at your job within your restrictions, the insurance company must help you find a job that earns roughly the same amount of money and fits within your physical limitations. An attorney can make sure that the insurance company does not try to send you back to a job that is unsuitable for your age, physical limitations, education, salary, and experience.
     
  13. What is a Form 21?

    The insurance company may offer to pay your rating on a “Form 21 Agreement.” This is a one page form that shows how the adjuster calculated the value of your rating. This Form 21 must be signed by both you and the insurance adjuster. The insurance adjuster then sends the Form 21 to the Industrial Commission along with your pertinent medical records for approval by a Deputy Commissioner. You will also be asked to sign a Form 25A certifying that you agree that your medical records were submitted to the Industrial Commission. Settling on a Form 21 Agreement is the best option if you want to keep the medical portion of your claim open and if you are still working for the same employer.
     
  14. How long can I receive medical treatment?

    You have two years after the insurance company pays your rating to see the doctor for your injury. For example, if you see the doctor six months after you receive payment for your rating, the two-year clock starts again from the date of your last medical appointment. As long as you are seeing the doctor at least once every two years, you should be entitled to medical benefits for as long as you need to see a doctor for your work-related injury.
     
  15. What is a Clincher Agreement?

    The insurance company likes to close its file after you have reached maximum medical improvement and are released by the doctor. The insurance company may pay you a premium for settling your case if you are willing to leave your job. A “clincher agreement” is a formal contract between you, the employer, and the insurance company that closes out your claim. Unlike a Form 21, a clincher agreement usually takes into account the cost of any future medical treatment, your rating, and a period of time for you to find a job within your restrictions. It is a formal 8-10 page document drafted by an attorney hired by the insurance adjuster. It also must be sent to the Industrial Commission for approval.

    The advantage to settling your case on a clincher agreement is that you get more money in your pocket for the claim. The disadvantage is that you are now responsible for your own medical treatment and, in most cases, for finding a new job. The insurance company is usually only willing to settle a claim this way if there is no longer any work available for you at your old job, or if you are willing to resign from your old job. Please note that if you resign, you are not entitled to unemployment benefits.

    It usually takes between 6-8 weeks between the time you agree to settle your case and when you can expect to receive the money from the insurance company. If you have an accepted claim, you will continue to receive your weekly TTD checks while the clincher is being approved. The adjuster cannot deduct the value of these checks from your final settlement. The insurance company’s obligation to pay your weekly TTD checks stops on the date the Deputy Commission issues the Order approving your clincher.
     
  16. What if my claim is denied?

    The insurance company must make a decision if it is going to accept or deny your claim within 30 days of receiving your Form 18. (In some cases, it will file a conditional acceptance if it needs more time to investigate the claim.) If the insurance company accepts your claim, follow the advice above. If it denies your claim, you may still have rights under the law. It may be wise to hire an attorney to determine if there are grounds for filing an appeal of the denial. If the case has merit, your attorney will file a request for hearing with the Industrial Commission. This is a formal lawsuit against your company and its workers’ compensation carrier. Your attorney will gather evidence and respond to questions from the insurance company’s lawyer.
     
  17. What is Mediation?

    Mediation is an informal meeting between you, your lawyer, the insurance adjuster, and the insurance company’s lawyer to discuss your case with a neutral “mediator.” A mediator is an experienced local workers’ compensation attorney or former judge who will help both sides come to a mutual agreement as to the value of the case. This is not a trial and you do not have to do any speaking. It is simply a way for your lawyer to explain to the other side why you feel your injury should be paid. Insurance companies end up settling most denied cases at mediation.
     
  18. Do I need a Lawyer?

    The employer will have an experienced claims adjuster working on its behalf. The insurance adjusters are familiar with the legal requirements of workers' compensation law. These adjusters are evaluated based on their ability to pay the least amount on a claim as possible. If you are unfamiliar with workers' compensation law or if English is not your primary language, a lawyer can help make sure that you receive all the benefits to which you are entitled.

    A lawyer can often add substantial value to a workers' compensation claim by helping you take full advantage of all available benefits. For instance, a lawyer will make sure your weekly checks arrive on time, make sure that your medical treatment is authorized, file your travel reimbursement requests, order your medical records, discuss your treatment with your doctor, file the correct forms with the Industrial Commission, recommend physicians for second opinions, negotiate a settlement to your claim, and if necessary, try your case before the Industrial Commission.

    A lawyer will also explain how Medicare, Medicaid, Social Security Disability, Short Term Disability, Long Term Disability, your Health Insurance policy, and any third party claims will affect your workers’ compensation claim. Most of all, hiring a lawyer gives you peace of mind that your claim will be processed correctly and that someone is looking out for your interests, and only your interests.
     
  19. When should I hire a lawyer?

    It is always helpful to hire a lawyer at the beginning of your claim. As soon as a claim is reported to the insurance company, an insurance adjuster will call you to take your “recorded statement.” This is a telephone conversation that is used by the insurance company to make a decision as to whether to accept or deny your claim. It is helpful if you have an attorney present at this telephone conference to assist you and to discuss the merits of your case.
     
  20. How much will a lawyer charge for handling my case?

    All workers’ compensation cases are taken on a “contingency fee” basis. This means that you pay no money up front for your lawyer. Instead, your lawyer will take his or her fee as a percentage of your settlement. The law in North Carolina generally restricts an attorney from charging more than 25% of your settlement or award. You are still responsible for any costs associated with obtaining the settlement or award, such as the fees for gathering your medical records. These costs are in addition to the percentage fee, but these costs do not have to be paid up front. They will be reimbursed to the attorney out of the settlement proceeds.
     
  21. How can our law firm help you?

    Attorney Annemarie Pantazis began her legal career defending workers’ compensation claims on behalf of employers and insurance companies. She understands the arguments, tactics, and evaluations used by the insurance industry in processing your claim. She is one of only 13 lawyers in Charlotte certified by the North Carolina State Bar as a Specialist in Workers’ Compensation Law. She is one of only 8 Certified Specialists in Charlotte who represent injured workers, and of those 8 lawyers, she is the only woman specialist.

    Ms. Pantazis takes pride in her responsiveness to your questions and concerns. From her experience on the “other” side, she saw how the insurance companies often did not explain the whole story. She is here to tell you the things that the insurance company leaves out, and to help take the mystery out of the claims process. She makes herself as accessible as possible to all of her clients. She personally returns all phone calls by the end of the business day when she is in the office, and by the next business day when she is out of the office.

KNOW YOUR RIGHTS!

If you find that you need assistance with your workers’ compensation claim, or would like to learn more about your rights under the Workers’ Compensation Act, please call 704-342-2243 or click here to Request a Free Consultation.


Copyright ©, Law Office of Annemarie Pantazis, Board Certified Workers Compensation Attorney, Workplace Injuries Lawyer, Work Injury Law Firm, Traffic Law, Traffic Ticket Legal Assistance, Charlotte, Mecklenburg and surrounding North Carolina (NC) Counties.