Forms of Benefits

Before injured workers can receive any form of compensation listed below, their employer’s insurance company must accept the claim. If their claim is denied, or they feel they are not getting a fair deal, they can appeal to the North Carolina Industrial Commission.

Such appeals can be complicated and an injured worker facing an appeal should seriously consider consulting with a legal team that includes North Carolina Board Certified Specialists in Worker’s Compensation law. 

The experienced Workers’ Compensation Department at James Scott Farrin has dealt with thousands of Workers’ Compensation cases over the years. Four of our attorneys are Board Certified Specialists in Workers’ Compensation law by the North Carolina State Bar. Two have worked at the North Carolina Industrial Commission, the legal body charged with administering and enforcing Workers’ Compensation laws. Four of the attorneys in the Workers’ Compensation Department formerly defended insurance companies in Workers’ Compensation cases. Several have more than 10 years of experience and the Workers’ Compensation Team has access to several staff members who are bilingual in English and Spanish.

Click here to learn more about the Workers’ Compensation process and how to file a claim.

Wage Replacement and Cash Benefits:

Death Benefits

Under North Carolina Law, if an employee dies as a result of a work-related accident or injury, or dies as a result of an occupational disease, his or her family may be eligible to receive up to 400 weeks of benefits, up to $3,500 in funeral expenses, and reimbursement for medical expenses incurred prior to death. A minor child or disabled spouse may be entitled to receive benefits beyond the 400 weeks.

Temporary Total Disability (TTD)

Temporary Total Disability (TTD) checks are the law’s main financial protection for an injured worker’s family expenses.  Temporary Total Disability (TTD)  benefits are payable when employees becomes totally disabled on a temporary basis as a result of workplace activities. After a seven day waiting period, employees are entitled to obtain weekly benefits equal to two-thirds (2/3) of their average weekly wage up to the maximum compensation rate set by the North Carolina Industrial Commission. If the disability continues for more than 21 days, the employee is entitled to receive these Workers’ Compensation benefits for the first seven days as well.

The circumstances surrounding how and why a worker receives Temporary Total Disability (TTD) are the most significant issues in the vast majority of disputed Workers’ Compensation cases. Consulting a North Carolina Board Certified Specialist in Workers’ Compensation law may be the best way to plan for and handle a Temporary Total Disability (TTD) dispute.

Temporary Partial Disability (TPD)

Temporary Partial Disability (TPD) is a form of Workers’ Compensation benefits that employees may be entitled to receive after they have returned to work, but are earning less than they were prior to the injury. In such a case, employees may be entitled to compensation equal to two-thirds (2/3) of the difference between their post- and pre-injury weekly wages, so long as the amount does not exceed the maximum weekly benefit set by the North Carolina Industrial Commission. A worker who is receiving Temporary Partial Disability (TPD) should consult with a Workers’ Compensation lawyer to ensure that their right to an appropriate job is protected.

Permanent Partial Disability (PPD)

Permanent Partial Disability (PPD) Workers’ Compensation benefits are those which employees may be entitled to if they have sustained a permanent disability to certain body parts (e.g., arms, legs, back, hands). Benefits for less than the total loss of a body part are calculated by the treating physician on a percentage basis. This calculation is referred to as a “PPD rating.”

Regarding Permanent Partial Disability (PPD), it’s important to know that you have a right to a second opinion by the provider of your choice at the insurance carrier’s expense.

Permanent Partial Disability (PPD) sounds like a final and determinative matter. The reality is that Permanent Partial Disability (PPD)  may be only a fraction of many final Workers’ Compensation settlements. Many Workers’ Compensation claimants find out about their PPD rating by exploring the Form 26 case resolution. If you are considering a Form 26 resolution, think about consulting a team with North Carolina Board Certified Specialists in Workers’ Compensation law to explore other settlement options.

Total and Permanent Disability

Workers’ Compensation benefits may be potentially paid to the employee for a lifetime when the employee’s injury renders him or her unable to return to any form of suitable employment.

Disfigurement

Scarring or damage to internal organs not specifically covered under “permanent partial disability” (PPD) rules may be entitled to additional compensation up to $10,000.

Other forms of Workers’ Compensation Benefits:

Vocational Rehabilitation (Voc Rehab)

In North Carolina, insured workers who cannot return to their former employment are entitled to Vocational Rehabilitation (Voc Rehab) at the expense of their employers. These may include on-the-job training; transferable skills analysis and testing; resume, interviewing and job application services; job search assistance; education and tuition payment for retraining; among other things.

Medical Care

The employer’s Workers Compensation carrier should pay for medical care related to employee injuries – including a physician’s care, diagnostic testing and medications. However, the insurance carrier has the right to direct medical care and send injured workers to the provider it selects, which can be frustrating to many injured workers.

If the insurance carrier denies medication or medical treatment as unnecessary, an employee may file a motion with the North Carolina Industrial Commission to compel such treatment. An employee may also be entitled to receive a pre-authorized medication account set up by the insurance carrier in order to avoid the hardship of out-of-pocket costs.

If there is a disagreement about the direction of medical care the North Carolina Industrial Commission may be petitioned to intervene. Employees can benefit from the assistance of our Workers’ Compensation team to navigate this complex process.

Travel Mileage

Employees are entitled to collect for mileage for travel to medical treatment facilities when round trip mileage exceeds 20 miles. In the event injured workers cannot drive themselves, the insurance carrier should provide transportation.

Information on this page is not intended as a substitute for a medical evaluation by a qualified provider or consult with an experienced Workers’ Compensation attorney.