Charlotte Workers’ Compensation Lawyer for Nurses

Nurses are a crucial part of the healthcare system, caring for people who are sick or injured every day. They should not be expected to bear the resulting costs when they get sick or injured on the job. Workers’ compensation is meant to provide benefits for those who become injured or get ill while working, a benefit that is especially vital for nurses. A Charlotte workers’ compensation lawyer for nurses can help you get the compensation you deserve.

Unfortunately, navigating a workers’ compensation claim can be difficult. The language that you use is incredibly important in ensuring your claim is approved. At The Bollinger Law Firm, PC, our team is well-versed in the required phrasing to prevent insurance adjusters from denying your claim. We can help you understand the process and ultimately earn you the benefits that you are entitled to as a dedicated member of the nursing profession.

Understanding Workers’ Compensation

Workers’ compensation is a type of no-fault insurance that provides medical care and/or cash benefits for employees who become ill or are injured as a direct result of their employment. It is considered a social insurance because it depends on a social contract between labor and management. Once a business purchases workers’ compensation insurance, they are protected from civil suits from any workers who become ill or injured on the job.

Workers’ compensation provides lost wages, medical expenses, and rehabilitation costs to employees who become ill or injured while working within the course and scope of their jobs. It can also pay death benefits to the families of employees who are killed while working.

Employers that choose to purchase workers’ compensation insurance are responsible for paying for this insurance and should not mandate that employees contribute to the cost. Coverage is set by each state, and the benefits recoverable vary depending on each state’s laws.

The North Carolina Workers’ Compensation Act

The North Carolina Industrial Commission was developed to administer the North Carolina Workers’ Compensation Act. This act requires all businesses with three or more employees to obtain workers’ compensation insurance or qualify as self-insured employers. This mandate includes employers operating as corporations, limited liability companies, sole proprietorships, and partnerships.

There are some exceptions, so it is important to clarify if your employer carries workers’ compensation insurance when you are hired. This will help you create a plan in the event you become injured or ill while working.

Four Types of Workers’ Compensation

There are a variety of benefits offered under workers’ compensation insurance. This is to provide different benefit packages that fit the specific circumstances of the nurse’s illness or injury. The different types of workers’ compensation are:

• Medical expense assistance. The most common benefit of a workers’ compensation claim, medical expense assistance ensures employees are not responsible for covering any medical expenses pertaining to the workplace injury or illness.
• Disability benefits. There are four types of disability benefits that someone experiencing a workplace injury or illness can collect: temporary partial disability, temporary total disability, permanent partial disability, and permanent total disability.
• Vocational rehabilitation assistance. It is not uncommon for an employee to be unable to return to the position they filled before the illness or injury. When this occurs, vocational rehabilitation assistance can be used to acquire training and re-enter the workforce in a different capacity.
• Wrongful death benefits. The family or dependents of someone who dies because of a fatal work accident or occupational illness can file for wrongful death benefits. These benefits are meant to offset some of the family’s loss associated with losing the income and emotional support of the employee.

Potential Injuries While Working as a Nurse

Nurses are often overworked due to insufficient staff numbers in medical facilities. This creates a situation where nurses may avoid reporting and treating an illness or injury in favor of continuing to treat patients. This choice is often bolstered by nurses not wanting coworkers to pick up any extra slack if an injury or illness prevents them from working. Unfortunately, there are a number of illnesses and injuries that should not be taken lightly or ignored.

Injuries common among nurses and other healthcare workers include:

• Strains and sprains from lifting, moving, and transporting patients
• Infections from patients
• Physical attacks from patients and their family members
• Exposure to hazardous materials such as radiation and chemicals

Though admirable, this focus on the health of their patients makes it too easy for nurses to ignore their own injuries. This is especially true if their employer pressures them to leave the incident unreported and untreated. Taking care of oneself is a crucial choice that must be made, ultimately for the benefit of coworkers and patients.

Filing Workers’ Compensation as a Nurse

Nurses are a demographic at significant risk for failing to file a workers’ compensation claim when they are injured or become ill at work. There are numerous reasons why this is not a beneficial choice to make:

• Paying out of pocket. If you choose not to file a workers’ compensation claim, you will be responsible for paying any medical costs out of pocket. You will also not be eligible for any compensation to offset the wage loss from not being able to work. Even what appears to be a minor issue could become a major issue as time progresses, potentially resulting in significant financial loss.
• Fatigue. Failing to properly take care of one’s health can result in fatigue and stress. These emotions dramatically increase the likelihood of making mistakes like medication errors and failing to follow proper cleanliness protocols. This can negatively impact patient care, putting their lives and your job at risk.
• Increased damage. Minor illnesses or injuries can become worse if they are ignored. For example, a back injury can easily become worse if you continue to lift patients without treating the original injury. Minor health issues could spiral into a problem that becomes a lifelong issue.

While the dedication to patients is commendable, failing to care for yourself appropriately can cause terrible consequences. If you need to file a workers’ compensation claim, an experienced Charlotte workers’ compensation lawyer for nurses can help improve the likelihood of success.

Benefits Available Under Workers’ Comp Insurance

Workers’ compensation is meant to restore an employee to the state they were in before the injury or illness. As a result, there are a number of medical benefits generally available to those with approved claims. The exact benefits you qualify for depend on the recommendations from the treating physicians, but potential options include:

• Doctor visits and hospital stays. Workers’ compensation can help to cover the costs of any necessary appointments with healthcare professionals to manage and treat the illness or injury resulting from the workplace incident.
• Diagnostic tests and imaging. Diagnostic tests and imaging, like bloodwork, radiographs, and MRIs, required to evaluate your illness or injury are paid for by workers’ compensation insurance.
• Surgical procedures. Any surgeries required as a result of the workplace incident are covered by workers’ compensation.
• Chiropractic care. Up to 20 chiropractic sessions are covered if they are deemed medically necessary, but further approval is required for additional treatment.
• Dental services. Dental work, such as repairs, reconstructions, or extractions, is covered if it is tied to the workplace injury or illness.
• Physical therapy. Physical therapy and other rehabilitation services are covered if they are required in your recovery plan.
• Prosthetic devices. If they are deemed necessary due to the work injury, artificial limbs or other prosthetic devices are covered by workers’ compensation.
• Medical equipment. Any medical equipment or devices prescribed to support your recovery or compensate for any loss of function are covered. Examples include crutches or wheelchairs.
• Mileage or travel expenses for appointments. Costs associated with travel to and from medical appointments can be reimbursed with workers’ compensation.
• Coverage for ongoing care. Some claims require long-term, ongoing care in the form of follow-up visits and maintenance care. They will be covered if they result from the workplace incident.

Regardless of the medical treatment you receive, you should never get a bill for any approved treatment. All medical bills should be sent directly to the carrier of your employer’s workers’ compensation. If you do receive a bill, the issue should be resolved by contacting your employer or their insurance carrier.

It is recognized that employees also require compensation outside of medical benefits if they are affected by a workplace injury or illness. Other workers’ compensation benefits include:

• Lost wages you would have otherwise earned
• Disability coverage if you cannot return to work or can only return in a limited capacity
• Time off to recover from the illness or injury
• Ensuring your position, or a position of equal pay, will be open when you return

Workers’ compensation benefits play a crucial role in ensuring you heal properly from a workplace illness or injury. If you are unsure which benefits you qualify for, speaking with a workers’ compensation attorney can help you clarify.

Reporting a Work-Related Injury

It is important to follow the appropriate steps if you become ill or injured as a result of your job. Failure to follow these steps can delay or inhibit your ability to collect benefits.

Step 1: Seek Appropriate Medical Treatment

You should be aware of your employer’s workers’ compensation process before an injury or illness occurs. Some employers will have on-site health providers or designated healthcare providers that you should first present yourself to. This is something often true for nurses since they work within the healthcare system, but it is not always the case.

In employment locations that do not have access to an on-site or designated healthcare provider, you should seek appropriate medical care for your needs. Depending on the circumstances, this could be with your normal family doctor or an emergency room.

Step 2: Inform Your Healthcare Provider

While you are seeking medical treatment, you must inform your provider that the injury is work-related and the name of your employer. This will ensure the healthcare provider can bill any treatment as a workers’ compensation claim.

Step 3: Inform Your Employer

Once you are able, inform the appropriate supervisor or manager that you have experienced a work-related injury or illness. This notice may be given before you seek care, but medical care should not be delayed to inform your employer of the incident. If you can, personally report the incident. If not, have a healthcare provider, friend, or family member notify your employer.

Step 4: Provide Written Notice

Though you have informally notified your employer of the incident previously, you are required to submit a written incident report within 30 days. This written notice should include the date of the incident and a brief description of the illness or injury. If you cannot do this, a family member or friend can write the letter and send it to your employer. You should keep a copy of this notice for your own records.

Written notice should also be submitted to the North Carolina Industrial Commission (NCIC) in the form of a Notice of Accident to Employer and Claim of Employee, Representative, or Dependent, or Form 18.

Step 5: Follow Healthcare Recommendations

The intent of the workers’ compensation system in North Carolina is to provide quality healthcare that restores you as near to your health and ability to work as you were before the injury or illness. Following recommendations from your healthcare provider is a crucial part of the healing process.

Potential Issues With Workers’ Compensation

Workers’ compensation insurance was created to protect both employers and employees. Unfortunately, some issues can arise during the process.

Physician and Treatment Location

Only certain physicians and treatment facilities are covered under workers’ compensation. In most instances, you will be given the option to choose from a panel of physicians approved by workers’ compensation. Likely, your personal physician will not be on this pre-approved list. If you still choose to see your doctor, the cost will not be covered by workers’ compensation.

You must also get approval from the North Carolina Industrial Commission if you want to request a second opinion or change doctors during the claim process.

An important exception to this pre-approval requirement is in the event of an emergency. If you require emergency treatment, you should direct yourself to the closest emergency department. Once you are stabilized, you should then be transferred to an in-network healthcare provider.

Short Filing Window

he statute of limitations for reporting an injury to your employer is 30 days. This deadline is clearly stated in the law, and a workers’ compensation claim will be denied if your employer is not made aware of the injury or illness within this time frame. Though the notice is not required to be written, it is often recommended so that there is a physical record of it.

Though the window to inform an employer of the illness or injury is only 30 days, the window to file a claim is slightly longer at two years. However, even this longer time period can quickly fly by when you are working and attempting to recover from this incident.

This filing window is strict and one of the most common reasons why a workers’ compensation claim is denied.

False Denials

In an attempt to avoid paying you the benefits you deserve following a work-related injury or illness, your claim may be incorrectly denied. For example, the insurance company and your employer may claim you were engaging in horseplay, or the injury was not work-related, two conditions that can justify denying a workers’ compensation claim.

Speaking with an attorney familiar with North Carolina workers’ compensation immediately after experiencing an illness or injury can help mitigate some of the issues that can arise during a workers’ compensation claim.

When Workers’ Compensation Does Not Pay

There are some instances where a claim will be denied, and no benefits will be awarded. Workers’ compensation insurance will not pay if the injury or illness was caused:

• While the employee was intoxicated or under the influence of illegal drugs
• Intentionally by the employee
• By someone else for personal reasons unrelated to the job
• While outside of work or while voluntarily participating in an off-duty social or sports event
• By an “act of God,” like a hurricane or flood, unless that specific job is identified as having a higher risk of exposure

In some instances, a claim will be wrongfully denied under one of these conditions. If this occurs, a skilled workers’ compensation attorney can help you fight for the benefits that you are owed under the law. An attorney can phrase the claim to most correctly reflect the facts of the incident and ensure your claim is not denied under a clause that does not apply to your circumstances.

Civil Liability and Workers’ Compensation

North Carolina’s workers’ compensation system is meant to ensure injured workers have the necessary financial support in the event of a workplace illness or injury. It also protects the employers that pay for the insurance from most civil liability when these instances arise. In most cases, you cannot bring a lawsuit against your employer if you experience a workplace injury or illness and they carry workers’ compensation insurance.

However, if your employer has failed to acquire appropriate workers’ compensation insurance, they interfered with your claim, or they intentionally caused your injury, may have the option to file a civil suit against your employer. This civil suit would be filed in addition to a workers’ compensation claim.

Reasons To Retain a Workers’ Compensation Attorney

Workers’ compensation insurance is ultimately that — insurance. Most often, the insurance company has an interest in downplaying or denying your claim to reduce the money they must pay. Retaining an attorney familiar with North Carolina workers’ compensation laws can help get your claim approved and the appropriate benefits applied to your case. Other benefits of working with a Charlotte workers’ compensation lawyer for nurses include the following.

Meeting All Legal Requirements

To be eligible for workers’ compensation in Charlotte, North Carolina, you must explicitly show you meet all the requirements to collect those benefits. A workers’ compensation attorney can help you establish your eligibility in a way that eliminates common rejection reasons.

An attorney can also correctly complete the paperwork and file it all within the appropriate timeline. Even a single day late is enough reason for a workers’ compensation insurance agency to deny your claim, so filing paperwork correctly and on time is a vital part of the process.

Seeking Appropriate Benefits

It is not uncommon for nurses to not seek the right benefits or enough benefits. You must determine the benefits and the amounts you are authorized to receive. These numbers can be difficult to figure out if you are unfamiliar with workers’ compensation protocols.

An attorney can help you objectively find out which benefits you should be receiving and how much of those benefits you qualify for.

Overcoming Challenges

An experienced workers’ compensation attorney is going to have already seen many of the issues that can arise during the claim process. This experience can help them craft responses quickly to things like partial approvals and complete denials of benefits.

Settlement Negotiation

Some workers’ compensation insurance agencies will attempt to terminate coverage before you have been completely treated, another issue attorneys can fight. One route to prevent this is negotiating a lump-sum settlement. An attorney can help you craft an appropriate settlement offer and then negotiate with the insurance provider on your behalf.

Additional Compensation

Workers’ compensation may not be your only available resource if you are injured on the job. You may have options like filing a personal injury claim or requesting Social Security disability benefits that can help improve your situation until you can return to work or determine your disability status.

Ultimately, retaining a workers’ compensation attorney can help you protect your rights and ensure you are awarded everything you are entitled to following a workplace injury or illness. Their experience enables you to avoid being taken advantage of during the process and bolsters your position as a formidable force standing against a workers’ compensation insurer.

The Bollinger Law Firm, PC: Your Workers’ Compensation Claim Attorneys

Bobby L. Bollinger from The Bollinger Law Firm, PC, understand how important workers’ compensation benefits are to nurses and their families. Our skilled team can also help prepare your claim and fight for you if any issues arise during the process. If you need to file a nurse workers’ compensation claim, contact our office today.