The employer is normally responsible for any medical expense your doctor feels will make you better. This normally includes prescriptions, medical supplies, TENS units, crutches, braces, physical therapy and any other expenses you would not have incurred but for your injury. These expenses are payable by the employer until the case is settled. While you have a general right to choose your own doctor for treatment, the insurance company retains certain rights to pre-authorize medical treatment. You should never go to a doctor without obtaining insurance pre-authorization. You should also never let an insurance company force their doctors on you without your approval. A rehabilitation nurse assigned by the insurance company does NOT have the right to be in your exam room with the doctor.
In N.C., the employer is responsible for paying you only 66 2/3% of your gross average wages, up to a maximum that changes each year. This “temporary total” payment (TTD) continues, for a maximum of 500 weeks, until: 1. Your doctor releases you and/or assigns you a permanent partial or permanent total disability rating, OR 2. You are able to return to work, OR 3. The IC approves a “cut-off” of benefits.
These payments do not start until you have missed at least one (1) continuous week of work. Once you have missed a full month, that first week is paid.
Permanent Partial Disability
When a doctor releases you from his/her care, a permanent disability rating will often be assigned to your injured body part. A rating means that you will never be 100% healthy in that body part. Whether you can return to work depends on the severity of your injury and how that injury affects your ability to handle the physical demands of your work. The IC uses your rating and the N.C. law to determine how much money you are entitled to receive for you injury. The law requires that the rating and TTD compensation amount be used to determine this benefit. If you are only partially disabled but your employer won’t take you back, you may have a claim under the Americans with Disabilities Act. Call the EEOC at 1-800-872-3362 to report a claim.
Permanent Total Disability
If you will never return to any type of work because of your injury, the IC can award benefits up to 500 weeks. These benefits can include payment of 66 2/3% of lost wages (PTD) for 500 weeks plus future medical bills. You may want to consult a vocational rehabilitation expert on whether you have any other job options based on your physical/mental condition. You may also want to apply for Social Security Disability or other retirement benefits that may be available to you. Since some benefits are offset or deducted because you receive WC benefits, you should consult your lawyer to minimize these deductions.
If you are able to return to work making less wages than before your accident, the IC can award 66 2/3% difference between your pre and post gross accident wage up to 500 weeks.
Each WC case is different. Other benefits for unusual injuries, scarring, disfigurement may be available depending on the facts of your claim.
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