When you get injured while working, you may be scared to report your injury to supervisors for various reasons. You may be worried about paying for the costs of the injury. You may be counting your savings in your head while wondering how you could pay for your bills while you miss work.
The accident and injury lawyers at Auger & Auger have seen these exact reactions in our clients before, which is why we want to help them navigate the workers’ compensation system as effectively as possible.
Filing a workers’ comp claim may be intimidating if you have never done it before, especially if your workplace has policies that actively discourage it. A workers’ compensation attorney can help you fight for the compensation you deserve.
Hiring a workers’ comp lawyer can allow you to file the strongest claim possible, with evidence backing that your injury was within the scope of employment and that all of your medical treatments were necessary. We also help injured workers seek all forms of compensation available, decreasing the chances of being left with bills and other costs they have no idea how to cover.
You may be unsure about filing a workers’ comp claim, but there are legal experts who can answer your most pressing questions. Most importantly, you have nothing to lose since your initial consultation appointment is always free.
Schedule a free, no-obligation case evaluation with one of our experienced workers’ compensation lawyers today by calling (855) 969-5671 or by using our quick form to contact us online.
Your Rights to Workers’ Compensation in the Carolinas
The vast majority of employers in the United States must carry workers’ compensation insurance for their employees. This form of insurance pays for the costs of medical treatment, partial lost wages, and other expenses in relation to an injury or illness that developed during the “scope of employment.”
Employers in North Carolina and South Carolina are required by law to carry workers’ comp insurance for their employees, with a few exceptions. In both states, certain railroad businesses may be exempt from agricultural operations with a small number of employees.
In North Carolina, certain agricultural product sellers may also be exempt. South Carolina exempts nearly all agricultural and railroad operations and employers with an annual payroll of less than $3,000. Understanding these exemptions and whether your employer qualifies is a key step in knowing how to proceed with a possible workers’ comp claim.
Employers carry workers’ comp as part of what’s known as “the grand bargain” between them and employees. By providing insurance to cover all work-related injuries, including those technically caused by the employee, employers can receive immunity from personal injury lawsuits filed by employees.
If an employer is not in compliance with state workers’ comp laws or incorrectly believes that they are exempt, then workers may have additional rights to pursue compensation. The company may also receive a citation, fines, or even criminal prosecution, depending on the circumstances.
What to Do If You Are Hurt at Work
Time is of the essence after a workplace injury. Your first step is to seek medical treatment as soon as possible. If your work-related medical condition is the result of an illness or repetitive stress-strain, you should seek medical attention as soon as you notice the first symptoms.
In addition, you should make every effort to document the accident, injury, or first symptoms of illness. For example, you can take pictures of your swollen foot, check if there is any security camera footage of your accident, or keep a diary of your symptoms and when you experienced them. It’s also a good idea to write down the names of any coworkers who were present when the accident happened. Take this documentation home with you instead of leaving it at work.
Under both North Carolina and South Carolina law, employers can choose which doctors their employees must visit to file a workers’ compensation claim for their injury. You should know in advance if you are required to visit a particular doctor, network, or provider group to comply with your employer’s policy.
Report your injury to your supervisor in a timely manner. In North Carolina, you have just 30 days to report your injury and file a claim. South Carolina has a marginally more generous window of 90 days.
Contact a workers’ compensation attorney for a free consultation to see if you have additional legal factors that must be considered for your case. You may risk having your claim denied if the injury was not job-related or “within the scope of employment.” You may also have additional forms of compensation available that are not initially offered through your claim.
Workers owe it to themselves and their families to seek the maximum compensation available for their circumstances. Doing so is fulfilling part of “the grand bargain” while enforcing your rights as a worker to be covered for your job’s inherent physical and medical risks.
Being an “Independent Contractor” Does Not Always Mean You Cannot Have Access to Workers’ Compensation
Many employers attempt to skirt workers’ comp laws by declaring their employees “independent contractors,” or ICs. Employees who receive a 1099 form for their yearly earnings are often classified as independent contractors. Since ICs are technically self-employed, businesses or persons who provide them with contract work may not be obligated to provide workers’ comp coverage.
However, state workers’ compensation commissions and appeals courts are aware of these tactics.
The North Carolina Industrial Commission notes that they “may still find that the workers were in fact employees based upon its analysis of several factors, including but not limited to the degree of control exercised by the employer over the details of the work.”
South Carolina’s Workers’ Compensation Commission states that “it is possible for an employer to pay workers via 1099 and still be required to maintain workers’ compensation insurance coverage.”
In broad terms, a contractor is someone who agrees to do a job but is generally not given detailed instructions or supervision on how to do it. They can work on their schedule, providing they get tasks done on time or by a particular date. Employees are usually told to work between certain hours and have specific training and supervision from their boss or manager. These distinctions are why we sometimes find workers have been misclassified as contractors. If you suspect this is the case with your situation, contact a workers’ compensation lawyer right away.
Do not feel reluctant to explore your options for filing for workers’ compensation, even if you think your employer may claim you are an independent contractor. An experienced workers’ compensation attorney can help you explore your available options, including the possibility of obtaining a court order forcing the company or person that pays you to cover your medical costs and lost wages.
Even if you are not eligible for workers’ compensation, you may still have options for seeking coverage of your costs outside the workers’ comp system. As mentioned above, this system was designed to spare employers and workers the costly and time-consuming ordeal of going through a lawsuit and proving fault every time someone is hurt at work. But if you are not covered by workers’ comp, and you can provide some evidence that your injury was the company’s fault and not yours, you may still be able to sue or file a claim with the company’s insurer. Additionally, there may be some situations where you can file a claim against a third party who contributed to your injury, such as a manufacturer of a defective piece of equipment that caused you to get hurt. If you were driving for work and were injured in a car accident where another driver was at fault, you can file a third-party claim against their insurance, whether or not you qualify for workers’ comp.
There are different options for seeking compensation depending on the situation, and your attorney will explain which remedies may apply in your particular circumstances.
Fighting a Denied or Partially Denied Workers’ Comp Claim
If you have had your claim denied or if your employer’s insurance carrier refuses to cover certain costs, you have rights. You can appeal your claim to the insurer with the help of a workers’ compensation attorney. If that does not work, you can bring your case in front of your state’s regulatory commission.
If your claim is still denied, you may be able to have your case heard for an appeal by the relevant state appellate court.
In most cases that we see, one of two main reasons are given for the denial:
- The insurance company handling the company’s workers’ comp claims doesn’t think your injury or illness is real, is as severe as you say, or requires the treatment your doctor has prescribed. In some cases, they claim the prescribed treatment is “unnecessary” or offer to pay for some cheaper alternative that you and your doctor may have decided against for any number of reasons. Or they may initially approve your claim, but only allow you so many appointments or sessions of treatment before they stop paying and deny future claims.
- The insurance company accepts that you have an injury or illness but doesn’t believe it’s related to your work for the company. Workers’ compensation claims are designed to be a “no fault” system, but this only applies to what happens at work. If the insurer asserts that your injury didn’t occur on the job, they often blame you for causing it. Sometimes the insurer will claim your injury happened outside of work, that it couldn’t have happened at work the way you said it did, or that an illness like carpal tunnel was caused by some activity you do at home, like playing video games.
Getting a denial for these or less common reasons can be infuriating. You got hurt at work, you’re in pain, and now you can’t get your treatment covered the way you expected. However, there are options for fighting a denial. Facing difficulty during your claims process does not have to mean giving up. You can appoint a workers’ compensation attorney to build you a strong case, back up your assertions with evidence, apply the law and prior case rulings as necessary, and generally handle all of your legal obligations during your quest for the compensation you rightfully deserve. The important thing to remember is that you don’t have to do it alone – and your chances of prevailing will be much better if you seek the help of a knowledgeable workers’ comp attorney.
Retaliation For Filing a Workers’ Comp Claim
Retaliating against an employee for filing a workers’ comp claim in good faith is illegal, but it does happen. This is a substantial concern for many people, some of whom may be hesitant to file a claim because they can’t afford to lose their job or suffer a demotion. However, you shouldn’t have to suffer in silence because you’re afraid of retaliation. You can take steps to document what happens at work after your claim and keep detailed records and any evidence of retaliation if it happens. If you believe you’re being harassed or unfairly punished at work for filing a workers’ comp claim, call a workers’ compensation attorney right away so they can help you protect your legal rights.
Speak to an Experienced Workers’ Comp Lawyer Who Cares
Learn more about your legal options and your next best steps by talking with one of the many highly qualified workers’ compensation attorneys at Auger & Auger Accident and Injury Lawyers.
Book an appointment for a free, no-obligation consultation now when you call 800-559-5741 or contact us online.
