WORKERS' COMPENSATION
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Most areas of civil and criminal law are based in what's called "common law", developed by judges ruling certain ways over hundreds of years. Laws against hearsay, for example, started because judges began disallowing such statements in the 1500's.
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Workers' Compensation laws are often strange and overly technical because they are NOT based in common law. Instead, they come from statutes, like the North Carolina Workers' Compensation Act (NCGS Chapter 97). Why is the compensation for the loss of a pinky toe two-thirds of your average weekly wage times 10? Because the statute says so. Why can an injury still be compensable, even if it was entirely your fault? Because the statute says so.
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Even with the rigid, statutory nature of Workers' Compensation laws, there are still two frequent sources of controversy:
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(1) is a work-related injury actually compensable, and
(2) if so, is the employer actually doing what the law requires?
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What is a compensable injury? If you think the answer is "an injury while on the clock", you're unfortunately mistaken. Under the NC Workers' Compensation Act, an injury is compensable if it occurs "by accident" "within the course" and "scope" of "employment". There is a mountain of cases regarding the meaning of those words and how they apply to a certain set of facts. For example, if a construction worker hurts his knee when he hops off the back of a pickup truck, was that an "accident"? What if it happened on his lunch break, is that "within the course and scope"? What if he's paid cash under the table, is he still an "employee"?
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None of these questions have clean answers, not without more information, more context, and more facts. A consistent, detailed account of exactly how an injury occurred is critical to determining compensability. Even if everyone agrees to the facts of what happened, don't be surprised if employee and employer still end up disagreeing about compensability.
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What is an employer supposed to do for a compensable injury? In short: provide medical treatment and compensate for lost wages. An employer is supposed to send you to (and pay for) a medical provider who will treat your injuries and "lessen the period of disability." Is the employer getting you a doctor? The right kind of doctor? Are they actually paying these bills? Are the doctors actually addressing all your symptoms? Are your prescriptions getting covered? If you've been out of work for more than a week, are you getting wage compensation? Is it the right amount? Does it actually arrive on time, every week? If they want you to go back to work, does the work fall within your restrictions? If you're permanently injured, does your doctor acknowledge that?
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If an employer (or, more often, their Work Comp insurance carrier) isn't doing what they're supposed to, there's a variety of options about what to do next, including motions and hearing requests before the Industrial Commission.
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Call the Law Office of Thomas W. Gooden, PLLC at 704-360-0719 to found out more about how to navigate the complexities of Workers' Compensation claims.