Who Pays Workers’ Compensation Claims?

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Female Construction Worker Carrying PlywoodWorkers’ Compensation laws exist in every state and are designed to allow injured workers to receive compensation for medical expenses and lost wages without having to sue their employers. Workers’ Compensation laws are no-fault, meaning that an injured employee does not have to prove that his employer was negligent in order to be compensated for an on-the-job injury. Laws vary from state to state.

Who Needs Workers’ Comp Insurance?

In North Carolina, most employers who have three or more employees are required to carry Workers’ Compensation insurance. Employees may be full time, part-time, or seasonal, and include corporate officers and business owners. The three-employee rule covers most, but not all, employers. Agricultural businesses, for example, are required to maintain insurance if they employ more than 10 employees, while companies that handle any type of radioactive material must have insurance even if they employ only one person. Special rules also apply to trucking companies and contractors. Employers who fail to maintain Workers’ Compensation insurance may be fined, like drivers who fail to maintain auto insurance.

Where Does The Employer Get Workers’ Compensation Insurance For The Employee?

Employers typically purchase Workers’ Compensation insurance through a licensed insurance broker and pay monthly, quarterly, or yearly premiums based on their number of employees and various risk factors associated with their type of business. Employers may also opt for an approved and certified self-insurance program, maintaining their own fund for Workers’ Compensation claims. Compensation is paid by an employer and not from an employee’s salary.

How Is A Workers’ Compensation Claim Processed?

Once a claim is made, the employer’s insurer will assign an adjustor to the case. The insurance company will then pay medical bills associated with the injury and will pay a portion of the employee’s salary while he is unable to work. Workers’ Compensation insurance will also cover funeral expenses and death benefits to surviving family members if an employee is killed or dies from injuries sustained on the job. Benefits are also paid to employees who suffer permanent damage or disability related to a workplace injury.

Occupational diseases may also be covered by the insurance as well. The North Carolina Workers’ Compensation statute includes a list of occupational diseases, including illnesses like asbestosis, bursitis, and lead poisoning, among others that are presumed to be employment-related. A worker must only show that conditions at his place of employment caused or substantially contributed to the disease. It is presumed that his employment placed him at a greater risk for the disease or condition than that of the public. For any illness not on the statutory list, the worker must prove that his employment caused or substantially contributed to the condition and that his exposure at work caused him to be at greater risk for developing the disease than the public. All benefits are paid by the insurance company, not the employer, so all decisions regarding the amount and type of benefits to be paid to an injured employee are made by the adjustor assigned to the case.

If an employer meets one of the exceptions to the requirement to carry Workers’ Comp insurance, the employer’s general liability policy will cover damages from job-related injuries to employees. In such a case, though, the employee will have to sue his employer and prove that the employer’s negligence or intentional act caused the injury.

What To Do If You’ve Been Injured At Work

If you have been involved in an accident on the job, you may be entitled to compensation. Contact us right away to speak to an experienced attorney at 704-769-2316

2018-06-15T05:28:02+00:00
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