Additional Frequently Asked Questions regarding North Carolina or Virginia Workers Compensation Benefits

Posted on Friday, January 4th, 2019 at 12:41 pm    

Some more answers to commonly asked questions when workers are injured in North Carolina or Virginia include the following:

How long can I receive worker’s compensation benefits?

The maximum insofar as the weekly checks are concerned is generally up to 500 weeks, but other than the most severely injured workers, most will stop receiving benefits long before the end of the 500 weeks.

When a worker reaches maximum medical improvement, then an analysis is made of the worker’s physical health. Maximum medical improvement is the time when additional medical treatment isn’t expected to improve the worker’s health or physical capacities any further.

During the analysis, referred to as a Functional Capacity Exam (FCE) a judgment will be made whether the worker has a permanent disability of any kind such as hearing loss or the loss of a body part and whether the worker is suffering from permanent physical restrictions.  If a worker has a partial permanent disability, the worker may be entitled to additional wage loss benefits, even if he or she is able to return to work.

Workers can receive medical benefits for as long as they need medical help. Even if they have reached maximum medical improvement, they can still treat with doctors so their health doesn’t get any worse. Many injured workers who hurt their back, for example, may benefit from continual physical therapy or pain management.

Do other claims/benefits affect my worker’s compensation benefits?

Workers may be entitled to a pension, to social security, or to a personal injury accident settlement or award.  If you are undergoing ongoing treatment and disability, you should NEVER settle your personal injury case before your workers compensation claim is fully settled and resolved. Doing so will essentially end your workers compensation case because of very harsh setoff rules.

Insofar as Social Security Disability, there are sometimes when it is advisable to make a claim, such as when your comp claim is denied and it may take a long time to get you money. In either event, a workers compensation attorney who knows what he or she is doing can make sure you’re your settlement will only minimally effect your rights to file and still obtain Social Security Disability benefits.  Your North Carolina or Virginia worker’s compensation benefits lawyer can explain if any of these benefits affect your worker’s compensation case.

Are worker’s compensation benefits taxable?

Generally, worker’s compensation benefits are not taxable. If you receive Social Security disability insurance (SSDI) or Supplemental Security Income (SSI) or Social Security Disability (SSDI) and worker’s compensation, then some tax issues may arise depending on the amount of the combined income.

What happens if the accident happened away from the employer’s main site?

The main requirement is that the accident occur during the scope of your employment. This can be complicated sometimes. If you are commuting to work, you may not be eligible unless you were doing a work chore for the employer or you are picked up by a supervisor and transported to the job site.  If you are a sales representative, then it’s pretty much a given that you won’t be at the company site during work hours and you would still be covered. You are generally covered if you are on the employer’s premises, even if you take a brief break from work and your employer agrees to such breaks. There are many just reasons for a worker to be away from the main job site and still be considered working on the job, such as being sent on an errand for the employer.

What is an impairment or permanency rating?

This is an analysis of the worker’s loss of ability to function. It can apply to any part of the worker’s body. Doctors generally use impairment guidelines created by the American Medical Association to determine the percentage (impairment rating) loss of function. Workers with a permanent disability are generally entitled to additional work loss benefits if they lose function. The impairment rating adjusts the entitled amount by the percentage loss. For example, if a work loses the ability to hear, then the worker is entitled to an additional number of weeks benefits. If the impairment rating (the loss of hearing) is 10%, then the benefit amount may be just 10% of the total additional weeks of pay, as set forth in the statute books.

What are the different types of disability?

Generally, work injury disability falls in the following categories:

  • Temporary total disability.  (TTD) These benefits are paid while the worker is injured and unable to return to work, and receiving medical treatment to get better for a maximum of 500 weeks. Workers are normally paid 2/3rds of the average weekly wages while out of work, or sometimes even on light duty, if the employer is unable or unwilling to accommodate the employee’s light duty restrictions.  
  • Temporary partial disability (TPD) These benefits are paid when the worker’s physical restrictions prevent him or her from returning to pre-injury employment, but the worker or the vocational rehabilitation counselor finds the worker a lesser-paying job that accommodates the worker’s restrictions. In those cases, the worker is entitled to 2/3rds of the difference between the light duty job pay and the pre-injury job pay.
  • Permanent & total disability. These are additional weekly benefits payable at the 2/3rds rate beyond the 500-week limit, to potentially lifetime TTD benefits, if a worker can never return to any type of work because of his or her work injuries Workers may be entitled to lifetime payments based on the type of disability they have – if they have an special loss or disfigurement of two or more ratable body parts, a serious brain injury, are paralyzed, or have suffered extremely severe burns. In Virginia, one must suffer an injury in one of those categories to be considered permanently and totally disabled. In North Carolina, those categories also qualify for permanent and total benefits.
  • North Carolina “Extended Compensation.” In North Carolina (not in Virginia) there is an additional category known as “extended compensation.”  An injured worker may qualify for extended benefits beyond the 500-week limit, and proof may be offered to receive such benefits once the worker has reached 425 weeks of TTD benefits.  At that point, a motion may be made for the worker to be declared entitled to extended benefits beyond the 500-week limit, but the worker must show that he or she has suffered a total loss of wage-earning capacity. The big difference with extended benefits vs permanent and total benefits is that any serious injury may qualify—it does not have to belong to one of the permanent and total categories; however, the ongoing extended compensation may be challenged by the insurance company at any time, if the insurance company and employer can show that the employee no longer has a total loss of wage earning capacity.
  • Permanent partial disability or impairment. (PPI) These are the ratings benefits that a worker may be entitled to, based on injury to a ratable body part. In Virginia, this generally refers to the extremities, but does not include injuries to the spine. In North Carolina, these DO include injuries to the spine and the extremities as well. The physician typically rates an injury through the use of a Functional Capacity Exam (FCE) and comes up with a percentage rating of impairment. Then one looks at the statute to determine how many weeks of TTD payments the worker is entitled to based on that percentage rating. Generally, ratings are only important in two instances. One is where the worker has returned to work. This is because in any event, the maximum once can receive is usually 500 weeks. The 500 weeks cannot be increased through the use of ratings.

The other circumstance where ratings are important is if a worker has a rating to two or more ratable body parts. That could qualify the injured worker for permanent and total disability.  

Do I need a workers’ compensation attorney?

Yes. While employees can file their own claim, there are many reasons why it’s wise to hire an experienced North Carolina or Virginia work injury lawyer. Skilled work injury lawyers help with following:

  • They make sure you process your claim correctly
  • They understand how to verify your employee status if it is challenged by the employer
  • They work to show the accident or illness was work-related
  • Skilled lawyers help you get better assistance from your doctors when company doctors aren’t helping
  • They present your case before a hearing office if it is contested
  • They work with your physicians to verify your inability to work and why you still need medical care
  • They contest efforts by the employer or employer insurance company to force you to return to work when it is not medically feasible
  • They explain what a nurse case manager does and what the manger can’t do and prevent them from managing your care against the advice of your treating physicians
  • They help verify what type of disability you have and make sure you are paid accordingly
  • They work with vocational professionals when necessary to make sure they are doing their job in accordance with guidelines established by the Workers Compensation Commission.

Experienced attorneys guide you through each stage of the litigation process. They also explain when you can make a long-term settlement and what the terms of that settlement should be.

Experienced work injury lawyers understand how to question and cross-examine witnesses.

In most cases, a skilled worker’s compensation helps the client get a just recovery – one that is much better and stronger than the recovery the client would obtain on his or her own.

What is discovery?

The injured worker and the employer both have the right to certain types of information in order to prepare their case for trial. The lawyers for each side can request:

  • That the other side answer written questions called interrogatories.
  • That the parties answer oral questions called depositions. These questions and answers usually take place before a Court Reporter or stenographer who transcribes the oral Q and A into a written document.
  • That each side produce certain types of records such as wage-earning records and medical bills and reports through something called requests for production
  • To Subpoena certain documents if necessary from health care providers or other third parties whose information is needed to proceed with the claim.

Attorney Joe Miller Esq. has the experienced and resources to help injured workers get justice. He anticipates many of the arguments insurance adjustors and defense lawyers make. He’ll fight to help you get the wage loss benefits, medical bill payments, and other benefits you deserve. To make an appointment or have your claim evaluated in our 7-step elite and easy case evaluation process, please call 1-(888) 667-8295 or fill out my contact form.