NC Worker’s Compensation Law 101
I get in trouble with the Bar Nazis if I say I’m a professor when I’m not, so I can’t really write this little piece on basic worker’s comp law the way I wanted to, with the perspective of a crotchety old law professor. My readers would enjoy it and get that I’m not actually that person, but the Bar has a problem with reality v. perceptions. Alas.
NC Worker’s Comp law is wacky. It’s not like general tort law where fault matters and pain and suffering is paid. I like to joke that the “comp” stands for “compromise” because that’s what it is, a compromise between looking out for injured workers and not exposing employers to excessive liability.
There are books written on this stuff, so it’s not necessarily appropriate for a short blog post, but I think I can give it to you in a nutshell in syllabus form. After reading this, if you think just anyone is qualified to handle a worker’s comp claim, you didn’t read it very well. This stuff is wacky, and unless you understand every bit of it now, you shouldn’t handle a worker’s comp claim (that’s why you call me). Hope you enjoy, and remember to call me if you or anyone you know has a worker’s comp claim (or think they do). Check it out:
(When I write “‘er” I mean employer, “”ee” means employee)
BASIC WORKERS’ COMP LAW
I. Jurisdiction
· Employer must have three or more employees to be covered by the act
· If the employer purchases insurance, they are covered by the act regardless of number of employees
· employer/employee relationship must exist
· accident must take place in the state
· …..OR out of the state …AND K of employment was in state
AND principal place of business is NC
AND principal place of employment is NC
· must be filed within two years of accident or last date of compensation
ELEMENTS (you have to have these three or it’s not compensable)
- injury by accident
- arising out of employment
- sustained in the course of employment
II. Accident
· = unforeseen/unusual event not expected or designed by employee
· negligence of ‘er/’ee irrelevant
· normal wackiness NOT covered (sidestepping case example - call me)
· back injury exception = “specific traumatic incident”
· assault exception - if there is an assault at work that arises out of the job, then it can be compensable
III. Arising out of
· At the time of the accident, was the ‘ee doing what he was hired to do?
· As long as authorized, intended to benefit business = OK
· Personal benefit = pure motivation = NOT covered
· Commute = NOT covered
IV. Sustained in course of
· …pretty much same as above…
· during period of employment at a place where the job was calculated to take ‘ee and activity was in the scope of employment
V. Defenses
A. notice – w/in 30 days required, but rarely a real bar
B. two years – file or this one will get ya (ie your claim is gone)
C. intoxication – hard to establish, but complete bar if done (you have to show that the intoxication was a proximate cause of the accident)
VI. Why it was created… a happy medium b/n protecting ‘ees and shielding ‘ers from unlimited liability for everything that happens to the work force.
VII. What it provides…
A. Medical Coverage
B. Temporary Total Disability
C. Temporary Partial Disability
D. Permanent Partial Disability (rating payment – see 97-31)
E. Permanent Total Disability
F. Back to work…
G. Vocational Rehabilitation
VIII. Settlements
A. Form 21 – rating calculation, lump sum, two years to come back with “change in condition”
B. Form 22 - … after coming back with change in condition, re-settling, starts two years over again
C. Clincher – Form 21 amount PLUS a premium to allow ‘er to buy out remaining two years of liability (usually accompanied by a resignation)
