When Your North Carolina Workers’ Compensation Claim Is at Risk, Who Speaks for You?

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Video Summary

Navigating a workers’ compensation claim in North Carolina requires careful attention to strict filing deadlines and proper documentation from the very start. Because insurance companies often prioritize minimizing expenses over providing comprehensive medical care, injured employees frequently face denied coverage or premature termination of benefits. Seeking dedicated legal representation early in the process ensures that patients receive necessary treatments, such as surgeries, rather than the bare minimum. Attorneys also play a vital role in protecting a worker’s financial stability by verifying that weekly wage replacements are calculated and paid accurately. Ultimately, having an experienced legal team acts as a safeguard against the adversarial tactics used by insurers to reduce the value of a claim.

Transcription of the Video

Clarke: Jeff, let’s talk for a minute about workers’ compensation claims. What are some of the things that a person who’s been injured on the job and is interested in protecting themselves, protecting their rights, and protecting their ability to provide for their family needs to think about?

Jeff: Well, we want to make sure that the claim is documented and filed properly. You must have representation early to make sure that it is a covered claim. In other words, they can just deny it and say that it is not covered. So, we want to make sure they cover the claim and that they are providing the proper care. Because in workers’ compensation, they control the care; they say who you go to and who you are treated by. Often, it is their goal to provide you as little treatment as possible, and so we want to make sure that our clients are receiving the right treatment and securing their wage payments.

Clarke: There are time limitations right from the very beginning. In many traditional personal injury claims, there is a longer window of time between when an accident happens and when something has to be done. But here, employers have to be notified; these claims have to be set up correctly from the very beginning, especially in terms of determining average weekly wage and those types of things. The initial setup is critical. What should someone look for with respect to a personal injury law firm?

Jeff: Well, you want someone who has a workers’ compensation team, not just someone who occasionally handles workers’ compensation. There are times when you have to fight, go to court, and make these insurance companies cover these claims. Sometimes you have to seek second opinions from doctors to prove that this injury needs surgery, which the insurance company is trying to avoid.

Also, sometimes they stop paying your wages. Usually, you receive approximately two-thirds of what your normal wages would be throughout the claim. A lot of times, they will stop paying that or pay it late, and people find themselves in financial difficulty. You need to have lawyers involved early so that the insurance company behaves itself.

Clarke: One of the things I see is that the insurance company will start off doing exactly what they should. But they are an insurance company; their job is to bring in premiums and protect their owners and shareholders by managing expenses. Your claim is an expense, and they want to manage that expense by paying the least amount they can for your medical care. They will often start off doing the right thing when a work injury is unavoidable, but as time goes on, they start pulling back services or compensation. At the end, people frequently do not know how much they should be able to recover for these kinds of accidents. It is important to involve an experienced personal injury lawyer right from the very beginning.

Clarke: If you or someone you know has been injured at work, call us. We will answer your questions and make sure your claim is set up right from the very beginning.