Legal Question in Workers Comp in North Carolina

work comp

I was injured , broken foot,ran over by forklift at work. light duty after 3 month, released to full duty after 9 months. My rating is 25%....My question is this---does the money I receive from the work comp percent of disability all I can receive? My employer has paid for everything and I have not missed any money due to short term disability that supplemented the work comp payments....but my Dr. said the arthritis has already set in and there will be more surgery in the future to fuse joints to relieve pain...I asked the work comp people and they said after two years they have no liabilty. Is this true?? I do not want to get a lawyer unless I have to, the last injuried employee who got a lawyer got laid off(fired), Should I receive extra money for future surgery or do I use my regular insurance carrier later???

signed, confused

Asked on 3/02/07, 1:46 am

3 Answers from Attorneys

Stephen Camak Lennon, Camak & Bertics, PLLC
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Re: work comp

You need to file a properly executed Form 18M with the North Carolina Industrial Commission. You fill out the first part of the form. Then, your doctor needs to state on the form, specifically, what medical treatment you are at substantial risk of needing in the future related to your injury. Last, you file the form with the NCIC Executive Secretary's office and wait for approval. If approved, you have them "on the hook" for the treatment noted by the doctor. Unless this procedure is followed, and if 2 years go by without them paying anything on the case, your rights do expire.

If your condition deteriorates to the point it affects your wage earning capacity within 2 years of the last payment of rating, then you have a claim for "change of condition", whereby you can re-open your case for meds and wage loss benefits.

You can read more on the items noted above by going to the NCIC's website, a link for which can be located at our site at ncworkcomp.com. Good luck!

Neal Camak

Lennon & Camak, PLLC

Raleigh, NC

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Answered on 3/28/07, 7:59 pm
MIchael Lewis Lewis & Daggett, Attorneys at Law
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Re: work comp

If you are still working with the same employer, it sounds like a Form 21 settlement is being offered. That settlement would pay the value of the disability percentage and keep the medical bills open for two years. The full duty release means that likely no work restrictions were assigned, which would make it difficult to argue (based on the information we have) for return-to-work related benefits, i.e., monetary value beyond the value of the disability rating. If you are having problems working upon your return to work, you would likely benefit from assistance from an attorney in helping obtain a viable second opinion, at which time some work restrictions may be assigned and/or a higher disability rating may potentially be assigned. The insurance company and the employer do not necessarily have an incentive to fire somebody who has an attorney because if there is a genuine return-to-work issue in the case, the lack of employment could potentially, but not always, require payment of additional benefits. To give a more specific response, an attorney would need to determine your current work status, how work is going, how you are doing physically, etc.

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Answered on 3/02/07, 11:08 am
MIchael Lewis Lewis & Daggett, Attorneys at Law
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Re: work comp

If you have returned to your pre-injury job with your pre-injury employer at the same wages as before your injury, then the employer and its insurance carrier generally only has to pay additional benefits under the Workers' Compensation Act for permanent partial disability. This is the 25% disability rating you received. You are entitled to a second opinion on your disability rating, but you may not want to pursue a second opinion if the present rating is fair and accurate. The disability rating is an issue that can be very complicated. We can not guide you on that issue based on the limited information you have provided. In general, once you receive compensation for your permanent partial disability rating, your claim is open for two years during which you may re-open your claim for further compensation for a change of condition and you are entitled to get additional medical coverage during those two years. You must file a separate claim with the Industrial Commission if you want to have your medicals extended beyond the initial two year time period."

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Answered on 3/02/07, 11:10 am

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