How to File a Workers Comp Claim in NC

When workers are injured on the job, they can usually seek workers’ compensation benefits. North Carolina’s workers’ compensation system is designed to provide the worker with medical treatment for any injuries and wage loss benefit payments if those injuries keep the employee from working.

Unfortunately, workers’ compensation requirements in North Carolina are complex. Filing a claim for workers’ compensation can turn into a complicated process, especially if the injured worker’s employer denies a claim for benefits.

If you have been injured on the job, you need to understand the process of filing a workers’ compensation claim in North Carolina to protect yourself. If you have additional questions about the workers’ compensation claim process or need legal help filing a claim, contact Ward Black Law today.

Steps to File a Workers’ Comp Claim in North Carolina

Step 1: Reporting Your Injury

Under North Carolina’s workers’ compensation system, an injured worker is expected to report an accident and injury to the employer as soon as possible after the accident, but generally no later than 30 days after the event. A worker may submit a written report to his or her supervisor, or the worker may choose to file a Form 18 with the North Carolina Industrial Commission, then submit a copy of the form to the employer.

Step 2: Filing a Form 18

An injured worker should file a Form 18 – Notice of Accident to Employer and Claim of Employee, Representative, or Dependent for NC Workers’ Compensation Benefits with the North Carolina Industrial Commission, providing a copy of the filed form with his or her employer or its workers’ compensation insurer. The worker should also keep a copy of the submission.

Form 18 is typically filed within 30 days of an injured worker’s accident. A claim for workers’ compensation benefits must be filed within two years of the date of injury.

Once a Form 18 is filed, the employer or its insurer will either accept the worker’s claim and begin paying benefits, or the employee will receive one of three forms if the employer decides to deny the claim.

Interpreting Your Employer’s Response to Your Claim

An injured employee is entitled to a response from his or her employer within 14 days of receiving the employee’s notice of claim. The response either accepts the employee’s claim or sets forth the grounds of the denial. The employer may seek an extension to the 14-day deadline from the Industrial Commission.

The employee will receive one of these three forms in the employer’s response:

• Form 60. If an employee receives a Form 60 – Employer’s Admission of Employee’s Right to Compensation, that means the employer has accepted the employee’s claim. The employer will begin paying workers’ compensation benefits for wage loss and medical treatment.
• Form 63. When an employee receives a Form 63 – Notice to Employee of Payment without Prejudice, that means that the employer has agreed to begin provisionally paying workers’ compensation benefits such as wage loss benefits or medical treatment costs. However, the employer reserves the right to terminate benefits later within a certain time frame if, after further investigation, the employer determines the employee is ineligible for workers’ compensation benefits for the injury.
• Form 61. If an employee receives a Form 61 – Denial of NC Workers’ Compensation Claims, that means the employer has rejected the employee’s claim. The form will set forth the reasons for the employer’s denial.

Your Rights If Your Workers’ Comp Claim Is Denied

If your employer denies your claim for workers’ compensation benefits, you have the right to request a hearing with the North Carolina Industrial Commission. To do so, you file a Form 33 – Request for Hearing with the North Carolina Industrial Commission. A Form 33 may also be used to seek a hearing to resolve other workers’ compensation disputes you may have with your employer. For example, the employer may not authorize medical treatment or may dispute your inability to return to work.

Requesting a hearing with the Industrial Commission does not mean you are filing a lawsuit against your employer. The Industrial Commission merely issues a formal decision on your entitlement to benefits. Before you proceed to a hearing, the Industrial Commission will typically require you and your employer to participate in mediation to try to reach a settlement.

Workers’ Comp FAQs

Your attorney can answer all of your questions relating to your workers’ compensation rights. Below are answers to common questions we receive.