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Frequently Asked Questions
Frequently asked questions about Workers' Compensation;

What do I do if my check is late? You should call the insurance carrier and ask if your check was mailed and when. Two common reasons that checks are late 1) the mail is late 2) it has "fallen off the diary". The insurance carriers program their computers to print checks out according to an automatic diary for a certain number of weeks. When that number of weeks is over, the check falls off the diary which must be reset for additional weeks if checks continue to be due. Your call will remind the adjuster to reset the check diary.

How often are compensation payments made? Weekly.

At what rate of pay? 66 2/3% of the weekly wage not to exceed a maximum rate which is adjusted annually by the North Carolina Industrial Commission.

When will the first payment be made? The first check is due on the 14th day after the injury. No compensation is due for the first seven days of lost time unless you are out of work over 21 days. Then a check is sent out for the first week.

Who is required to provide workers' compensation coverage? With certain exceptions, any employer who employs three or more employees or whose employees work in the presence of radiation is required to have workers' compensation coverage. Even if your employer does not regularly employ three or more people, your employer may have voluntarily purchased workers' compensation insurance.

How and when should an employee report an injury? You should report all injuries to the employer, in writing, immediately.

What should be done if the employer fails or refuses to report an injury? The employee should file a claim (Form 18) as soon as possible with the North Carolina Industrial Commission.

How long is the employee eligible for wage loss benefits? Until the employee is able to return to work or released to return with no restrictions by the doctor.

How do I know if my claim has been denied? When a claim is denied, the employer and insurance carrier must promptly notify the Industrial Commission, claimant, his attorney, and all known health care providers of the reason for the denial. The letter of denial must detail the exact reason for the denial of the claim.

What should I do if my claim is denied? You may request a hearing before the Industrial Commission by submitting Form 33 (Request for Hearing), or by writing a letter stating that request.

 
Frequently asked questions about Social Security Disability Claims;

What is the Social Security hearing like? The hearings are fairly informal. The only people likely to be there are the judge, a court reporter, you and your representative. In some cases, the Administrative Law Judge has a medical doctor or vocational expert present to testify at the hearing. There is no jury, no spectators and no attorney for Social Security.

What is the definition of disability used by Social Security? The "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months."

How long after becoming disabled do I wait to file for benefits? You can file the same day you become disabled.

Do I have to wait until I don't have any money in the bank before I can apply for Social Security disability benefits? No. There is no reason to wait to file the claim.

Can I file for Social Security disability while on sick leave from my employer? Yes.

Do you have to be permanently disabled to get Social Security disability benefits? No. You have to be disabled or expected to be disabled for at least a year or have a condition that is expected to result in death.

How do I apply for disability benefits? Go to your local Social Security office and apply in person. Be prepared to wait several hours before you actually meet with a claims representative who will take your application. You can also apply online and over the telephone.

What factors does Social Security consider when deciding whether or not I am disabled? They consider your age, your education, your work experience and your medical conditions. You will have to prove you cannot do any of the work you've done in the past fifteen years or any other work that exists in significant numbers in the nation's economy. 

What do I do if Social Security denies my claim for disability benefits? Only about 40% of claims are approved at the initial level. Unless you have already returned to work, you should file an appeal.

Do I have to have a lawyer to represent me in my disability claim?  No. You can represent yourself, but statistics show that claimants who are represented are more likely to win their cases than those who are not.

When should I hire a lawyer? Any time during the process. Do not  wait until a hearing is scheduled.

How is a lawyer paid?  In most cases, most lawyers charge a contingent fee which is the lesser of $5300 or 25% percent of your back benefits. A contingent fee means that if your claim is denied, no attorney's fees are owed. Any attorney fee in a Social Security case must be approved by the Social Security Administration.

How long will it take for my claim to be decided? That is a difficult question to answer.  You can expect that, if you have to go to a hearing, your case will take about a year and half from when you first apply to be resolved.  Sometimes the wait is longer; sometimes shorter.  Most of the reasons why cases take so long to be decided have nothing to do with you or your attorney.  They have everything to do with Social Security's workload and the inefficiency of a large bureaucracy.

 
Frequently asked questions about Personal Injury;

Should I hire an attorney? If you have been seriously injured or are unsure as to the outcome of your injury, then an experienced personal injury attorney should always be consulted before you give any statements or sign any papers of any kind and as soon after your injury as possible.

How much time do I have to decide whether to settle or start a lawsuit? The time you have to take action depends on the person or accident that caused your accidental injury. In North Carolina, the following time limitations apply:

  • Injury generally - 3 years
  • Claims against city/county/school employee - 120 days
  • Claims against state employed physicians - 180 days
  • Claims under a fire insurance policy - 1 year
What is my claim worth? A claim is valued and usually settled based on an estimate of what is fair and reasonable compensation given the severity of your injuries and the effects of the accident on your life. In addition to medical expenses and wage loss, you are entitled to compensation for pain, suffering, and loss of enjoyment of life.

Which insurance policies will cover my costs after an accident? Most automobile, homeowners and commercial liability policies contain "medical payments" coverage for medical expenses after an accident without regard to fault. This coverage in auto policies applies to your insured family members and vehicle passengers, while homeowners and commercial policies cover only your visitors to the premises. Injuries caused by uninsured drivers are compensated by your own "uninsured motorist" coverage.

How will my claim be settled? If the person responsible for your injury has insurance, an adjuster will gather and verify the necessary information about the accident. If the insurance company makes you an offer that you and your attorney find acceptable, then the claim process is over. If no acceptable offer is made, than you may file a lawsuit.

When will my claim be settled? About 95% of injury claims are settled before a trial through informal discussion, mediation or pretrial conferences. You can not know in advance which claims will require a jury trial but once a claim is put in suit, it typically takes six to 18 months to resolve.

Should I do an investigation of the facts of the accident on my own? No. An experienced investigator knows the important steps to take and the best way to gather the important information. Your activities as "investigator" will be characterized later by an insurance company adjuster or attorney as proof that you were determined to make a claim no matter how serious the injury turned out to be. Also, a professional investigator can testify about interviews and other results of his investigation.