North Carolina Workers' Compensation Lawyer Blog

Pundits and policymakers who debate North Carolina workers’ compensation are abuzz about the latest news out of Canada’s Supreme Court regarding a 16-year old workers’ compensation dispute that followed a deadly mine explosion.

Here is the background.

In 1992, a bitter labor dispute at Yellowknife Giant Mine led to riots. One of the rioting miners, Roger Warren, was so distraught that he planted an explosive in one of the mines and detonated it via a trip wire. The explosion killed nine miners. Although Warren himself was quickly convicted and is now serving a life sentence in prison, his action set off a legal dispute between the widows of the miners killed and organizations that they alleged were indirectly responsible (and thus liable) for Warren’s actions.

The miners’ widows sued the Canadian Auto Workers, Royal Oak Mines, and the security firm that was supposed to protect the site, Pinkerton’s of Canada, as well as the Government of Canada’s Northwest Territories. In a lower court decision, the widows won a payout of $10.7 million in 2004. But the Supreme Court overturned the lower court’s decision, citing the fact that the parties named did not have sufficient control over the actions of Roger Warren and could not have anticipated that he would commit such a destructive act.

How might the Canadian Supreme Court’s rejection of these miner widows’ claims impact North Carolina workers’ compensation legislation?

Peripherally at best. However, the case does raise some interesting points of law that have international implications.

For one, it re-raises the long running debate over the definition of indirect liability. If someone else causes significant damage (that merits, for instance, a North Carolina workers’ compensation claim), and a third party could theoretically be indirectly implicated in the primary agitators’ actions, what is correct legal remedy? Obviously, in the abstract, you simply can’t answer that question. In this case in Canada, the Supreme Court found that parties like Pinkerton’s and the Government of Northwest Territory could not be liable for the actions of the renegade angry miner. But you can certainly find analogous cases in Canada and in the United States, in which a third party can be held significantly liable for damages that a subordinate party causes.

For instance, let’s say a trucking company hires a driver and fails to vet the drivers’ safety record effectively. The driver then goes out and causes a car accident, which causes permanent spinal damage to a passenger in another vehicle. Although the truck driver who caused the accident was primarily responsible, the injured victim could probably make a great case against the truck company itself for providing the dangerous driver with a truck to drive in the first place.

If you or a family member has been involved in any kind of North Carolina workers’ compensation dispute, you may want to speak with a veteran, highly credentialed North Carolina workers’ compensation attorney ASAP to get a better understanding of your rights and strategic possibilities moving forward.

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Yellowknife Giant Mine - original verdict

Widows Lose Appeal

North Carolina workers’ compensation policy experts are keeping a close eye on a developing workers’ comp case out of Connecticut involving police officer Frank Chiafari, who shot and killed a chimpanzee who had ripped the face off of a local Stanford woman last year.

The attack on the woman, Charla Nash, provoked a firestorm of media coverage last February. Officer Chiafari had been called into deal with the emergency attack. He entered the melee and saw the woman’s mutilated face. The chimpanzee then attacked him. He drew his gun and shot it fatally. Traumatized by the incident, Officer Chiafari put in a workers’ compensation claim, which was denied in just five days.

The disgruntled officer recently testified before Connecticut lawmakers about how important it is to provide workers’ compensation to cover therapy for cases like his. The officer claimed that he suffered post traumatic stress disorder from the incident: he hallucinated that he saw women without faces, for instance.

How might officer Chiafari’s testimony impact North Carolina workers’ compensation policy?

At this point, it’s unclear. The chimpanzee shooting case was obviously quite one-of-a-kind. In other cases, in which an officer might be required to shoot a feral animal, for instance, would it be appropriate for the state to have to pay workers’ comp for counseling or therapy? Obviously, if an officer is forced to shoot and kill a human assailant, therapy benefits would no doubt be provided. But when you are dealing with an animal assailant? Should similar standards apply?

If the bill advocated by Officer Chiafari and others passes the Connecticut Legislature, other states may or may not follow suit and pass similar kinds of legislation. However, as we just mentioned, given the odd nature of this case, it seems unlikely that the bill will provoke a rapid state-by-state change in the law. Although when it comes to North Carolina workers’ compensation policy, you never know.

If you or a family member or a friend is having trouble securing workers’ comp benefits, or if you have questions about North Carolina workers’ compensation insurance coverage, please connect ASAP with a knowledgeable NC workers’ comp attorney.

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Charla Nash

Officer Frank Chiafari

Blue chip insurance companies, such as Travelers and Hartford Financial Services Group, heavily lobbied the US government over North Carolina workers’ compensation (among other issues) last year, according to twin reports released on February 9th by the AP.

Travelers spent over $1.6 million in just the fourth quarter last year to lobby Congress, the FDIC, the Federal Reserve, the Treasury, and other government agencies.

Hartford Financial Services Group spent more than $0.5 million in that same period.

In addition to lobbying on behalf of North Carolina workers’ compensation concerns, the insurers also sought favorable treatment with respect to consumer protection issues, global warming issues, and insurance regulation reform.

Travelers also lobbied on bankruptcy, asbestos loss, and coastal wind zone issues. Hartford Financial, meanwhile, lobbied on drywall safety issues, retirement securities and flood insurance, and issues concerning the National Insurance Consumer Protection Act.

What should North Carolina workers’ compensation policymakers take away from these concerted lobbying efforts? Will insurance companies substantially impact policy by throwing around their money and influence? And if so, what might insurance-company-induced changes to law and policy ultimately mean for the workers, employers and physicians who must navigate the North Carolina workers’ compensation system?

The reforms these companies seek are complex and technical. But while it might be tempting to dismiss the proposals as purely self-interested (and thus purely destructive to those who might oppose them), only an in-depth analysis of specific policy proposals can lead to any meaningful insights. And even if a particular proposal does look good (or bad) for employees, for instance, there is no way to really know how it will pan out without seeing a full-scale implementation. After all, the real world tends to change policies substantially; the so-called law of unintended consequences guarantees unpredictable outcomes.

These philosophical considerations notwithstanding, if you or a loved one or friend has specific concerns about your North Carolina workers’ compensation, connect with a qualified and highly credentialed attorney. A free consultation can simplify and improve your long-term outlook.

More Web Resources:

Hartford Financial Services Group

Travelers Insurance

North Carolina Workers' Compensation policymakers have been pouring over the latest report issued by the Workers' Compensation Research Institute (WCRI), a non-partisan and non-for-profit agency that studies workers' comp systems throughout the U.S. and internationally. The Cambridge-based WCRI recently finished a mega survey of 15 states including:

• North Carolina
• California
• Florida
• Illinois
• Indiana
• Iowa
• Louisiana
• Maryland
• Massachusetts
• Michigan
• Minnesota
• Pennsylvania
• Tennessee
• Texas
• Wisconsin

Louisiana demonstrated some of the poorest numbers. LA's costs were more than 35% higher than the average per state costs, and injured employees in Louisiana stayed off of work longer than average - 15 weeks longer, in fact, than the average Michigan worker.

For a summary of the Workers' Compensation Research Institute study findings, visit the WCRI website.

What do the state and national trends imply for NC policy?

It's difficult to extrapolate the results of a single survey - even one as thoroughly and level headedly conducted as the WCRI. Many NC Workers' Comp watchers believe that the raging debate over the healthcare system and jobs recovery act could throw off any analysis. After all, if a federal overhaul the healthcare system pushes through Congress, for instance, this will no doubt radically alter the North Carolina Workers' Compensation insurance landscape, which in turn will impact patient care, employer costs, and so forth.

What does the Workers' Compensation Research Institute study mean for you and your case?

Macroscopic trends in NC Workers' Comp likely won't impact your personal situation. If you do have questions regarding insurance benefits, employer coverage, physician networks, long-term support, or any other subject, get in touch with a quality and battle proven North Carolina Workers' Compensation attorney. Address your concerns now, and get the compensation you deserve to return to work and thrive at your career.

More Web Resources:

Workers' Compensation Research Institute (WCRI)

WRCI study, CompScope™ Benchmarks,10th Edition

A former North Carolina Workers' Compensation insurance agent, Terri Lynn Spence, has been sentenced to four years of supervised probation and a full year of house arrest (under electronic surveillance) for multiple counts of embezzlement, according to North Carolina officials.

North Carolina Insurance Commissioner, Wayne Goodwin, publicized Ms. Spence's sentencing at a news conference. The 34-year-old Emerald Isle resident was ordered to pay more than $46,000 in court fees and restitution to victims of her scheme. All told, 16 different insurance companies and 43 individuals were financially impacted.

Ms. Spence "obtained property by false pretences," according to investigators at the Department of Insurance, who contacted police officers in La Grange to bust the embezzler back in June 2008. Most of the policies embezzled were North Carolina Workers' Compensation policies (along with some homeowners' policies). State officials do not believe that Ms. Spence worked in conjunction with any other entity or syndicate. But her arrest, trial, and sentencing likely have not gone unnoticed by others who would seek to embezzle or otherwise defraud the North Carolina Workers' Compensation system.

If you or a family member has had trouble collecting your North Carolina Workers' Compensation benefits, or if you are having any issues filing paperwork, dealing with your employer, managing negotiations with your insurance company, or talking to your physician or rehabilitation specialist about billing, go over your concerns with a qualified North Carolina Workers' Compensation attorney.

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Terri Lynn Spence

Wayne Goodwin

Does the quality of the CAT Scan used on patients impact treatment outcome and cost? The answer may have significant relevance to North Carolina Workers’ Compensation cases. Consider this argument:

Many CAT Scan technologies in use in hospitals throughout North Carolina were developed in the 1990s and 1980s. When you compare these technologies to emerging CAT Scan equipment (such as the Siemens Somatom Definition Flash), real and potential significant differences emerge. A patient who gets a CAT Scan from an old piece of equipment may receive a fundamentally different diagnosis than a patient who gets analyzed using one of the newer machines!

For instance, on the newer machines, such as the Definition Flash, patients can be scanned in half a heartbeat and need not take beta blockers prior to the scan. These minor differences could be important; when you extrapolate the implications over the entire patient population of United States, we could be looking at potentially millions of dollars a year in patient/doctor savings.

Of course, whenever one does a cost benefit analysis of a new medical technology, we must remember the law of unintended consequence. Adding new machines to hospitals that provide more trustworthy analyses could lead physicians to trust their intuitions less and rely on machines more, for instance. This could lead to doctors ignoring smart intuitions - thus, putting some patients in dange. Furthermore, more accurate imaging technology could lead to more false positives and thus to more unnecessary treatments.

These kinds of concerns must be addressed whenever we debate improvements in North Carolina Workers’ Compensation policy. A policy solution may, at first blush, appear to have no downsides. But the execution of the solution can open a Pandoras Box of problems.

One famous, if peripheral, example of this kind of nasty surprise comes from ecology. In the middle of the 1900s, a Caribbean island was besieged a rat infestation. So the government literally parachuted cats onto the island to eat the rats. But the once the rats were eaten, this severely disrupted the island food chain and created an ecological catastrophe.

To mitigate against the dangers of unforeseen consequences associated with your North Carolina Workers’ Compensation claim, discuss your concerns with quality North Carolina Workers’ Compensation attorneys today.

More Web Resources:

CAT Scan

Siemens Somatom Definition Flash

An intriguing new study published in the January issue of the magazine Spine has critical implications for North Carolina Workers’ Compensation patients. The study, out of Massachusetts’ General Hospital, looked at nearly 1,000 patients with lower back pain and leg pain stemming from herniated discs and sciatica. Some patients underwent surgery to treat back problems. Other patients received non-surgical interventions such as drugs, physical therapy, and exercise plans. The leader of the study, Dr. Steven Atlas, discovered that, while surgery initially yielded better results for patients; after two years, the differences between the surgery patients and non-surgery patients dwindled away - at least for Workers’ Comp patients.

In other words, injured patients who got surgery for sciatica faired equally as well as injured patients who did non-surgical treatment, two years down the road. The implications for treatment of North Carolina Workers’ Compensation patients seem pretty profound. They suggest that surgery may not be the best course for action for some sciatica patients.

Here is one potential explanation of these results: BOTH surgery and non-surgical interventions may not deal effectively enough with fundamental back health problems. Consider: nodules of fibrous tissue (called trigger points) will form at stressed sites in the muscle tissue. These trigger points have been implicated in causing all sorts of soft tissue injuries and repetitive stress problems, from Carpel Tunnel Syndrome to lower back pain. Neither of the two interventions studied effectively located and resolved the trigger points that might have been causing/exacerbating the sciatica. Thus, it makes sense that the treatments would yield similar (less than stellar) results two years out.

It would be interesting to see how the patients studied would have compared with a third cohort of patients who received trigger point therapy and other soft tissue treatments for their backs.

The big point here is that North Carolina Workers’ Compensation patients must keenly research their treatment options. What is in vogue today, medically, may be disproven tomorrow. Thus, it’s important to speak with your physician at length before making any decisions. Informed patients can work more effectively with their doctors and, theoretically, develop more proactive recovery plans.

For assistance with any North Carolina Workers’ Compensation legal questions, get in touch with a qualified and top caliber attorney today for a free, no obligation, and confidential consultation.

More Web Resources:

Dr. Steven Atlas Back Study

Trigger Points and Back Issues

Most first time North Carolina Workers’ Compensation claimants find themselves ovewhelmed by the Byzantine claims process. To make things easier for you, we’ve put together this quick guide to explain the basic players who deal with North Carolina Workers’ Compensation claims and injury management.

1. Employee

This is you. A worker who gets injured while executing a job related duty can be eligible for North Carolina Workers’ Compensation.

2. Employer

Your boss or your company is technically be known as the “employer.” If you work for yourself, and you have Self Employment Workers’ Compensation Insurance, you may be both the employee and the employer. Many employers are required by law to carry North Carolina Workers’ Compensation policies. These policies pay out to injured claimants; thus, the money does not come directly from the employers/company’s pockets. Another technical name for the employer is the “Insured.”

3. Insurance Company

The insurance company issues policies to employers to cover them in the event that an employee (such as you or a co-worker) gets injured on the job and requires money to pay for medical services, rehabilitation, and time off of work. Different states have different laws regarding Workers’ Comp Insurance Coverage. If you have specific questions regarding how North Carolina Workers’ Compensation Insurance companies must behave, speak with a veteran attorney or call the North Carolina Industrial Commission (NCIC).

4. Insurance Broker/Agent

A Broker or Agent acts as a liaison between the Insurance Company and the Employer. A broker typically tries to sell services to employers. The Broker can also act as a consultant and risk benefit analyst for employers.

5. Claims Administrator

A third party administrator, also known as a TPA, manages claims, adjusting them per settlement arrangements. Some insurance companies outsource their work to these independent agencies. TPAs also must act in accordance with North Carolina laws.

6. Doctor/Rehabilitation Specialist

The Physician and/or Rehab Specialist play critical roles in the injury management process. Obviously, if you are hurt on the job, a medical doctor must examine you and attest to your state and degree of injury before you can collect North Carolina Workers’ Compensation benefits.

7. Attorney

A North Carolina Workers’ Compensation Attorney can help you resolve questions you have regarding eligibility, benefits, settlement arrangements, insurance negotiations, and so forth. Most good attorneys will provide free, confidential consultations to answer your questions and concerns. Take advantage of this opportunity to learn more about the lawyer’s services, fee structure, track record, and credentials.

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Third Party Administrator (TPA)

More about parties involved in workers compensation claims

Elevated North Carolina Workers’ Compensation costs concern everyone in the “employment ecosystem” - small business owners, employees, government agencies, insurance companies, and physicians alike. To bring down costs across the board, however, requires a holistic approach to problem solving. In this article, we will speculate about remedies that could be applied throughout this “ecosystem” - at little to no cost to employers, insurers, or employees.

1. Put in place systematic solutions to common workplace ergonomic problems.
How many North Carolina workers’ compensation cases begin at the keyboard? Carpel tunnel syndrome, repetitive stress injuries, and other soft tissue injuries abound in North Carolina - many of them no doubt due to bad workstation ergonomics. An employer can mitigate against risk of repetitive stress injuries by investing in more economic keyboards, for instance, more tailored workstations, and a program of regular breaks and stressing. The cost of such a proactive “war” against repetitive stress injuries would be minimal, and the benefits would no doubt be long lasting. Workers who are not exhausted from keyboarding and other repetitive tasks can work longer hours (thus making up any theoretical costs of ergonomic modifications). Fewer injuries would mean lower North Carolina Workers’ Compensation insurance premiums.

2. Better Alert and Response System to Control North Carolina Workers’ Compensation Fraud.
As the old saying goes, a few bad apples can spoil the bunch. Everyone loses when people cheat the system. But how do you get people the stop cheating? This is the $64,000 question. Better monitoring of claims might be a theoretically good solution, but when you incentivize insurance companies to look for fraud, these companies inevitably will turn up “false positives.” I.e., they will harass people who are legitimately injured - trying to get them to admit that they are not actually hurt. This is obviously terrible, and it results in many tragedies, some of which we have reported on this blog.

A better solution might be to build in a more robust tracking system to make sure that claimants stay honest. In addition, insurance companies and employers must recognize and respect the claimants who are actually hurt and go the extra mile to help them.

3. Involve physicians in more holistic patient care.
The fractured approach to patient healthcare no doubt exacerbates many medical problems. If a patient sees four doctors, chances are that each physician will require separate paperwork, and that the doctors will not communicate with one another about the patient. This needs to change. Implement across the board holistic treatment for injured patients, and we will see much better health care. This is obviously an enormous task. But if we really want to bring down North Carolina Workers’ Compensation costs, we need to start treating patients as whole people -- and not just as carriers of individual symptoms they present with.

4. Better, more thorough and more regular data analysis of North Carolina Workers’ Compensation cases.

Organizations like the North Carolina Industrial Commission (NCIC) and other government agencies do track serious injuries and deaths at NC workplaces. But the amount of data that’s mined and shared about these accidents is extremely small, maybe even negligible, compared with what could be mined. We need to gather much more information - much more detailed analyses of various injuries and incidents. We must be able to share that information not only with government agencies, insurance companies, and fellow employers, but also with employees.
Do this kind of analysis, and we will no doubt be amazed at the kind of improvisations and “band-aid” solutions that emerge.

If you or somebody you love has been hurt or needs help with North Carolina Workers’ Compensation issues, connect with a qualified veteran attorney near you for a confidential consultation.

Here is a brief primer on North Carolina workers’ compensation fraud -- including relevant laws passed by the North Carolina General Assembly as well as information, implications, and a toll-free hotline for fraud investigation.

Laws
In 1994, the state assembly passed the Workers’ Compensation Reform Act, which included statute 97-88.2 (outlining punishments for misrepresentation in a North Carolina workers’ compensation filing) as well as statute 97-88.3 (outlining punishments for healthcare providers who fail to follow the law.)

The following year, the state assembly changed statute 97-88.2 and empowered the North Carolina Industrial Commission (NCIC) to look into fraud violations of the 1994 WCRA.

In 1997, the North Carolina Assembly passed House Bill 618, which further amended two key statutes - 97-88.2 and 97-94 -- to spell out increased penalties for fraud and misrepresentation under the Workers’ Compensation Act.

Today, the NCIC operates a hotline at (888) 891-4895 from Monday through Friday during normal business hours.

Who can be accused of conducting fraud? Parties including but not limited to:
• employees/claimants
• employers/managers
• corporate officers
• administrators of third party services
• insurance adjusters/agents
• lawyers
• providers of healthcare services
• rehabilitation providers

Individuals who commit North Carolina workers’ compensation fraud imperil the whole system. Fraud drains millions of dollars that would otherwise go to claimants with legitimate problems. That being said, not all cases are cut and dried. Some individuals may accidentally commit North Carolina workers’ compensation fraud simply because they fail to fill out paperwork properly or fail to follow bureaucratic protocol. It’s not that they try to cheat the system, in other words; it’s that they do not understand how to operate within it effectively.

This isn’t to say that there are not some bad eggs out there who intentionally game the system. However, if you or a family member has been accused of this crime -- or if you're in need of other kinds of assistance filing or moving forward with your North Carolina workers’ compensation claim -- it may behoove you to connect with a knowledgeable attorney right away to discuss your concerns in confidence. A free consultation with a reputable attorney can put you on a strategic path to maximize your benefits and minimize your hassle.

More Web Resources:

NC Workers’ Compensation Reform Act

More about Workers Comp Fraud in NC

Advocates for North Carolina workers’ compensation benefits rights are closely watching the drama currently unfolding in the US Senate regarding the health care bill. Democrats and Republicans have split entirely along party lines in the Senate -- 60-40. Democrats are poised to use their filibuster-proof margin to plow through a sweeping reform of our national healthcare system. Experts say this bill might have trillion dollar implications for our national economy -- and billion dollar implications for North Carolina’s economy.

So how might this bill impact North Carolina workers’ compensation policy? Given that the bill is currently thousands of pages long and contains so many sweeping changes to the system, it’s difficult to identify the key implications. But speculation abounds. Consider:

1. Massive institutional changes will likely lead to confusion in the short term.
With new rules for insurance companies, employers, and healthcare bureaucrats likely to be put in place, we should expect a certain degree of chaos initially. After all, any time a sweeping piece of legislation gets passed, confusion reigns.

2. The broad political implications might trickle down to impact the debate over North Carolina workers’ compensation coverage.

The 2009 healthcare debate has widened the already gaping schism between the national Republican and Democratic parties. In North Carolina -- a state that President Obama won in 2008 by a small margin -- the political ramifications of the bill’s passage for both Dems and Republicans could be huge. If the two major parties find it more difficult to work congenially with one another following this bill’s passage, this could delay pending legislation regarding North Carolina workers’ compensation, for instance.

3. Many more questions have been raised than answered.
Will this new law ultimately lead to lower premiums and more affordable coverage for small businesses? Will North Carolina workers with preexisting conditions get better coverage and thus recover faster from injuries and illnesses? Will the tremendous cost of the national bill impact the state’s economy indirectly and thus indirectly compel business owners to cut budgets and drop employees to stay competitive? How will companies that provide North Carolina health and workers’ compensation insurance adapt to the changing national environment? Will these companies adhere to the law or find ways to skirt it? Will the new rules strangle them or make them more vigorous and accountable to the public?

With so many different questions up in the air, politicians and policy makers alike are holding their tongues to see what cascading effects this bill might have.

More Web Resources:

Health Care Bill 101

Democrat 60-40 Margin: What It Means

As we’ve discussed in our previous blog posts on North Carolina workers’ compensation costs, our state is at a crossroads. 2010 could be the year in which we turn the economy around and help workers become healthier. Or it could be the year in which our problems get worse, and our employment and disability rates break the back of the state’s economy. Given what's at stake, here are five more potential solutions to our skyrocketing compensation costs.

6. Adapt quickly to the realities of the new healthcare bill.

Assuming that President Obama’s healthcare bill passes through Congress, North Carolinians should expect significant and far reaching changes throughout the healthcare system and general economy. While it’s too early to say what kind of an effect this bill will ultimately have on the job force -- and, indirectly, on North Carolina workers’ compensation benefits -- it’s not too early to prepare. Policymakers from both sides of the aisle should come together to discuss state-specific problems and solutions resulting from this bill.

7. Workers need to get more fresh air.

Numerous independent studies show that indoor air pollution is a growing problem. In some buildings, indoor air pollution can be ten times worse than outdoor air pollution. Toxic molds, particulate matter, dust, debris, and bacteria in ventilation systems can wear down the workforce. Even if an employee doesn’t get specifically sick or hurt from breathing in bad air, he or she can be slowed and prevented from working at optimal capacity. By instituting a program educating people about the benefits of breaks and fresh air, perhaps we can improve respiratory health.

8. More sleep for workers.

As any doctor will tell you, it’s important to get a good night’s rest. Unfortunately, with the state’s economy in shambles and unemployment rates climbing, more and more North Carolinians are sacrificing sleep to work more hours and longer shifts. While this might pay off in the short term, in the long run, it’s bound to have ill effects. Sleep is restorative. Without sleep, we become inattentive, irritable, less able to communicate with our peers and coworkers, and at greater risk for heart disease and obesity.

9. Technological innovations.

We do live in 2010 -- and the technology sector is booming. Improved computer software, ergonomic furniture designs, and other engineering solutions to common workplace problems abound. By implementing these technologies broadly, we can likely cut down on injuries and thus indirectly improve the North Carolina workers’ compensation benefit system.

10. More humor at work.

Coworkers who laugh together and smile at one another not only enjoy their work more but also get into fewer accidents and take fewer sick days. And employers and employees who strive to make the workday more fun see significant benefits -- not just in terms of quality of life but also in terms of bottom line budget numbers.

To discover effective and efficient help with your North Carolina workers’ compensation problems, connect today with an attorney to protect your rights and your benefits.

More Web Resources:

Dangers of Indoor Air Pollution

Importance of Sleep to Workers

With unemployment rising across the nation, and with Congressional leaders growing ever more desperate for a solution to the healthcare mess, the political debate over workers' compensation in North Carolina and elsewhere in the US has reached a fever pitch. Democrats have decried Republican attempts to chip into a homebuyers' tax credit; Republicans have denounced Democratic initiatives as more "tax and spend" government meddling.

According to a recent AP article, around 7,000 Americans every day run out of workers' comp and unemployment benefits. With North Carolina’s unemployment rate already into the double digits – 10.8% according to figures from 9/09 – lawmakers on both sides of the aisle are scrambling to deliver solutions. (The national US unemployment rate is just 0.2% shy of the 10% mark.)

What might proactive legislation mean for North Carolina workers' compensation policy?

Analysts disagree. Some believe that increased federal involvement in extending benefits to the under or unemployed may cause problems for insurance companies and small businesses. Others counter that an infusion of federal capital could only aid the state's teetering economy, by encouraging employers to take risks on new investments and by shoring up leaks in the North Carolina workers' compensation benefits payment system. Insurance companies might also welcome the relief of the financial pressures on them.

Whether or not the White House's proposed policies help or hinder the plight of unemployed workers won’t be known for some time. With so many different variables at play, it can be extraordinarily difficult to isolate the key factors ultimately driving the North Carolina economy.

On a more personal level, if you or someone you love has been struggling with NC workers' comp benefits, it may behoove you to speak with a dedicated, experienced, and compassionate attorney about your problems before you lock into an agreement with your employer and/or the employer’s insurance company.

More Web Resources:

Jobless Benefits To Be Extended, Click on Detroit, Nov 5, 2009

Unemployment Extension Clears Senate, US News and World Report, Nov 4, 2009

On December 3rd, 2008, a construction worker named Hussein Montalovo died when a girder collapsed after temporary supports ("strongbacks") broke while he was in a vulnerable position. Montalovo’s family has reportedly collected some North Carolina workers' compensation benefits from the state’s Industrial Commission, but the family seeks more damages from potentially culpable parties, including two engineering firms, the bridge's contractor, and even the State's Department of Transportation.

Suing for negligence is very different from filing for North Carolina workers' compensation. To prove negligence, you must meet a higher burden of proof. At the same time, if you win a negligence case against an employer, contractor, insurance company, or other entity, you can potentially collect more money to pay medical bills, afford therapies, and mitigate (to some extent) pain suffered.

To more forward with a North Carolina workers' compensation or personal injury claim, it may help to work directly with an experienced attorney. Given the legal complexities – as well as the sheer number of entities that can be involved in disputes such as the case of Montalovo – it’s easy for claimants to experience confusion and make statements that could make it more difficult to prosecute a claim or law suit.

More Web Resources:

Family of construction worker killed in Oak Island bridge collapse suing DOT, StarNewsOnline.com, Oct 23, 2009

Family of construction worker killed in Oak Island bridge collapse suing DOT, Morning Star, Oct 24, 2009

On June 9th, 2009, an explosion at a Slim Jim plant in Garner, North Carolina killed three and injured dozens. A spate of North Carolina workers’ compensation claims were filed in the wake of the disaster, which authorities at the U.S Bureau of Alcohol, Tobacco, Firearms and Explosives now believe was caused by a defect in the natural gas piping system.

The Garner plant rebooted its operations shortly after investigators completed their work there and safety inspections had been performed. That said, the plant was hobbled and could only produce at half its former capacity. Since the Garner plant was the sole manufacturer of Slim Jim products in the U.S., the incident impacted the entire country's dried meat industry.

The burden of paying 750 full time employees as well as North Carolina workers’ compensation benefits for the injured led management to take defensive action. On Friday September 18th, ConAgra announced that the company will slash 321 jobs at the plant. Layoffs will begin in November and will be based on seniority and experience with the company, according to reports. Workers currently receiving benefits will be forced to look to the state to provide their North Carolina workers’ compensation payments.

In addition to these cost saving measures, ConAgra has committed other resources to shoring up the plant, such as outsourcing some of its manufacturing to third parties and paying factory workers per hour worked (as opposed to per a standard forty hour workweek).

ConAgra to cut 321 at Slim Jim plant, Omaha World Tribune, Sept 18, 2009

Slim Jim plant lays off 300 after blast, UPI.com, Sept 17, 2009

More Web Resources:

U.S Bureau of Alcohol, Tobacco, Firearms and Explosives

ConAgra

Experts who study North Carolina workers’ compensation often spend so much time looking at what’s going on in the state (in terms of insurance regulations, laws pertaining to coverage limits and benefit caps, and so forth) that they neglect to pay attention to big news about workers’ compensation in other states. To wit, consider the battle now raging in New Mexico over whether agricultural laborers should qualify for workers’ comp coverage:

According to the AP, a dairy laborer named Joe Griego has teamed up with coworkers to sue New Mexico’s workers’ compensation administration on the grounds that the state fails to protect ranch and farm workers because no mandate exists to compel their employers to offer coverage. (Mr. Griego suffered severe injuries after being savaged by a bull at his ranch. He subsequently discovered that he could not receive workers’ comp benefits, either for his acute injuries or for his long term medical problems.)

Many North Carolina workers’ compensation authorities might be quick to dismiss the relevance of this story -- after all, NC’s regulations regarding workers’ comp coverage for farm workers are entirely different. Moreover, the case of Griego and his fellow claimants is tied up with a greater argument facing New Mexico over how to integrate the state's burgeoning Mexican immigrant community.

But North Carolinians ignore the lessons of this case at their peril. When groups of workers don’t get adequate coverage, lives and families can be torn apart. In addition, lawsuits and other skirmishes can drain resources, create hostilities, drive up insurance costs, and generate bad press for the state. One solution is to push legislators to adopt more uniform, fair, and easily implemented codes -- not only for employers but also for insurance agencies, PEOs, and the like.

NM ag laborers sue for workers' comp coverage, AP, Sept 25, 2009

1. Waiting too long to go to a doctor.

The longer a claimant waits before seeing a physician about his or her North Carolina workers’ compensation injury, the more dubious his or her claim may be perceived to be. After all, an employer or an insurer can always argue that the injury or impairment occurred after the fact (e.g. when the claimant was not at work) and therefore that the claim should not be allowed. Moreover, delaying treatment can result in exacerbation of the underlying problem. For instance, if you suffer a wrist sprain and fail to treat it, the favoring that results from that injury can lead to secondary “downstream” injuries.

2. Failing to read fine print of your North Carolina workers’ compensation benefits agreement.

Insurance companies are cagey. They can stipulate that claimants meet with rehabilitation specialists, job search consultants, and other intermediaries as a condition of receiving benefits. Claimants may also be required to make themselves available at certain hours, check in with agents, and deal with what can be overwhelming logistical requirements. That’s why it’s so important to vet the fine print. Ideally, this process should fall to an experienced North Carolina workers’ compensation attorney.

3. Speaking with an adjuster or other insurance company representative before speaking with a North Carolina workers’ compensation lawyer.

In the wake of your injury or illness, you may want to “get through” the paperwork as quickly as possible, so you can rest and heal. However, comments made to insurance company representatives can jeopardize your potential settlement. Don’t jump the gun.

4. Playing down an injury or illness.

Good employees don’t like to complain. They want to appear tough, persistent, and diligent in the face of adversity. There is something to this philosophy. But if you’ve been seriously or even mildly injured at work and you fail to attend to it, an array of problems can follow. First of all, mild problems can get worse. For instance, carpal tunnel syndrome or thoracic outlet syndrome can cripple people, notwithstanding mild initial symptoms, such as tingling in the fingertips and soreness in the forearms.

5. Conflating workers’ compensation claims with lawsuits.

A lawsuit and a North Carolina workers’ compensation claim are not the same thing. You can file a claim even if your employer did nothing wrong (i.e. wasn’t negligent, careless, et cetera). The burden of proof required to collect a claim is much lower than the burden of proof you'd need to win a lawsuit.

Web Resources

thoracic outlet syndrome

what is a North Carolina workers' compensation "claimant"?

It’s no secret that North Carolina workers’ compensation claims have decreased precipitously over the past three years. In 2006, claims dropped 2%. In 2007, claims dropped another 2%. And in 2008, claims dropped a whopping 4.4% -- on top of those declines. This rapid drop coupled with sobering projections put out by the North Carolina Rate Bureau has inspired insurance companies to request a 9.6% decrease in North Carolina workers’ compensation premiums. Employers in the state and government overseers of benefits programs alike appear pleased with this request. One survey estimates that in-state businesses could save nearly $120 million if the Department of Insurance allows the decrease. The burden of setting the final rate falls to State Commissioner Wayne Goodwin. A spokesperson for the DOI applauded the request, saying “that’s a good thing for businesses in North Carolina.”

An NC state representative, Sherry Melton, also approved. “There isn’t much bad to say," said Rep. Melton, about a decrease in North Carolina’s workers’ compensation rates. Notwithstanding, she argued that the system could be further refined to bring “costs and rates down even lower.”

North Carolina employers currently pay out over $1.4 billion annually in premiums, and both workers and employers alike have complained in the past that these excessively high premiums stunt growth and lead to less effective and efficient care for injured workers. The insurance rate request will not impact all employers in the state. State and Federal government employees, for instance, won’t be impacted, nor will about 25% of small and medium sized businesses that self insure.

Charlotte Observer, Workers' comp rate may fall, September 3, 2009

WRAL, Workers comp insurance rates could drop, September 2, 2009

More Web Resources

North Carolina Rate Bureau

Wayne Goodwin

1. Settling a North Carolina workers’ compensation claim without assessing the true value of that claim.

Even if a claimant has sustained a relatively minor injury, such as soft tissue damage to the pad of the thumb or shin splints from lifting heavy objects, he/she may be ultimately entitled to collect North Carolina workers’ compensation benefits for an entire lifetime. It’s a fact of human psychology that people tend to over-emphasize the difficulties associated with acute injuries and underestimate the difficulties associated with chronic injuries. Thus, particularly when it comes to chromic injuries, claimants tend to undervalue their claims.

2. Thinking that the insurance company is on your side.

Insurance companies are in business for one reason and one only reason only -- to make money. To stay competitive, insurers go through rigorous processes to shave costs and minimize payouts to policyholders. In other words, the insurance company exists in large part to DENY as many claims as it can get away with. This isn’t to say the insurers are malicious. But they are most assuredly NOT working for you (even if individual associates appear sympathetic and helpful.) To that end, if you volunteer information about your condition -- even by saying relatively innocuous things like “I’m feeling better this week” -- your statements can be manipulated, taken out of context, and leveraged against you in the future.

3. Signing an incomplete agreement within the insurance company.

Let’s say the insurance company agrees to settle. If so, the claimant will receive what’s known as an "agreement to pay" from an adjuster. This agreement can be quite complicated, so it’s often in claimants’ interest to have it examined by a competent North Carolina workers’ compensation attorney. Not all of your injuries may be included on the form. For instance, perhaps you hurt your arm AND suffered a finger sprain. If the agreement only stipulates that your arm was injured and you do not correct the form, you may not be able to recoup any costs associated with the treatment of your hand.

4. Even after your claim has been accepted and approved, insurers can still investigate you.

Often North Carolina workers’ compensation claimants feel that they are “in the clear” after settling successfully with insurers. However, this can be a serious mistake. Insurance companies often reserve the right to investigate claims even after they have been processed and paid out, particularly claims for chronic disabilities. Indeed, insurers have gone to incredible lengths to retract, amend, or otherwise renegotiate claims, including, for instance, secretly videotaping claimants.

5. Believing that you can choose from an indefinite number of healthcare providers.

North Carolina workers’ compensation rules limit your choice of providers. An employer or an insurance company may offer you a choice of physicians from a pre-selected list. Once you choose a doctor, it can be very difficult and time consuming to "deselect" that doctor and find someone else… without risking your benefits.

Web Resources

North Carolina Industrial Commission

workers' comp insurance adjuster

Last year, the Durham, North Carolina Police Department adopted the widespread use of the taser – a non-lethal weapon designed for what police technically call “force applications.” The purpose of this program was to encourage suspects to comply with officers without the officers having to brandish lethal force. In a story in the Herald Sun, Durham Officer Lt. John Shelton touted the taser program as a major success for Durham in terms of deterring escalations of confrontations between suspects and officers. One key downstream effect, according to Shelton, has been “lowering cost for workers' compensation claims.” Since city police can use tasers to effectively to contain suspects more effectively, they need not pursue potentially risky maneuvers like high-speed chases through traffic or hand-to-hand combat. As a result, cop injuries are way down this year.

Since the implementation of this taser program, North Carolina workers' compensation claims for local officers have dropped by nearly $0.5 million – from over $650,000 to just over $187,000. Assuming other police departments across the state implement similar programs, if one extrapolates the numbers, NC could see a reduction in North Carolina workers' compensation payouts on the order of several million dollars annually. Not only will the state therefore save money, but also the savings can potentially fund other programs to reduce North Carolina workers' compensation costs. Of course, it remains to be seen whether the taser’s utility in reducing injuries to officers is a long term effect.

The Hearld Sun, Taser use aids police, August 25, 2009

Journal Live, North police use Taser guns every three days, August 18, 2009

More Web Resources

Tasers

Durham, NC

Recent statistics put out by both the US Department Of Labor (DOL) and the Occupational Safety and Health Administration (OSHA) suggest that construction workers are at high risk for suffering on the job injuries that can result in workers' compensation claims, leading some North Carolina workers' compensation policy experts to argue that accidents in this sector may be inflating premiums for employers.

According to DOL figures on 2007 construction work related injuries, there are over 250,000 active construction sites in the country, and around 6 million laborers employed. Each year, more than a thousand workers get killed on site. Many times that number get severely injured or traumatized. Construction work often leads to acute injuries, such as brain damage, spinal injuries, and bone and ligament damage, as well as to repetitive stress injuries and soft tissue damage stemming from overuse of machinery, bad ergonomics, and even improper posture.

OSHA also has sounded the alarm. The agency has found that construction site employers and employees alike routinely violate codes for scaffolding safety, protection against falls, helmet use, training, and general safety around ladders, electrical and open pits.

This news concerns many North Carolina workers' compensation experts because of the anticipated "downstream" effects of these bad practices. When insurance companies pay out large claim amounts to injured construction workers, they must account for that resource drain somehow. Thus, they must raise premiums, cut benefits, or take other actions which can drive employers out of business or imperil the ability of other injured parties to collect on their North Carolina workers' compensation claims.

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DOL

OSHA

5. If you were hurt in a car accident on the way to or from work, can you make a workers' compensation claim?

Answer: Depends on the circumstances. In some cases, it’s easy to make a case. (For instance, a pizza delivery person who gets into an auto accident on the way back from a delivery and suffers spinal cord damage can make a workers' comp claim AND a claim against the driver who hit him.) Given situations like this, employers should keep their North Carolina workers' compensation insurance premiums paid and up to date.

6. Can individuals or employers self-insure for workers' compensation?

Answer: In many cases, yes. Self-employed workers and employers can often self-insure, provided they meet requirements stipulated by NC state law.

7. Can you claim NC workers' compensation benefits even if your employer was not negligent?

Answer: Yes. Many potential claimants never file for workers' comp because, in their minds, their employers didn’t “do anything wrong.” (For instance, if an employee crashed his car on the way to a work related event, the employer can hardly be blamed.) But a workers' comp claim is not the same thing as a personal injury suit. If you've bee hurt at work, you can make a claim regardless of whether anyone was at fault. (That said, however, employees cannot generally sue their employers directly for benefits.)

8. How can you learn more about the North Carolina workers' compensation process?

Answer: The North Carolina Industrial Commission website (www.ic.nc.gov) contains a wealth of information on the subject.

9. Do you need an attorney to collect workers' comp benefits?

Answer: Not necessarily. However, in many cases, employees can get shortchanged. Insurance companies can use legal loopholes and other unsavory tactics to deny payouts to otherwise qualified claimants. In addition, sometimes employers don’t fully cooperate and even retaliate against workers who file claims. To protect yourself and ensure that you get the maximum remuneration for your pain, suffering, and medical bills, it may behoove you to connect with an experienced, aggressive North Carolina workers' compensation attorney.

More Web Resources:

North Carolina Bar Association Pamphlet on Workers' Compensation

NC Workers' Compensation Law

North Carolina Industrial Commission

When most people think of accidents that merit North Carolina workers’ compensation coverage, they think of catastrophes, like the explosion at the North Carolina Slim Jim plant in June 2009. Acute injuries attract ample media coverage. But overuse injuries stemming from chronic ergonomic effects often don't, even though they account for a significant slice of North Carolina workers’ compensation claims.

Overuse injuries, such as repetitive stress injuries (RSI), thoracic outlet syndrome (TOS), carpal tunnel syndrome (CTS), “blackberry” thumb, joint and soft tissue damage, and eye strain often take months or even years to develop. But once an employee suffers chronic damage, he or she may find it very difficult to regain functions, find good care, and get enough North Carolina workers’ compensation benefits to pay for medical costs.

Recovering workers often complain that physicians are too quick to prescribe cortisone injections, non-steroidal anti-inflammatory drugs (NSAIDs), and surgeries. At the same time, many doctors who specialize in treatment of these injuries seem not to pay attention enough to more holistic factors, such as trigger points, poor workstation ergonomics, bad posture, and lack of physical activity and work breaks. That’s why it’s so important for injured North Carolina workers to get the facts about soft tissue injuries and to explore their treatment options thoroughly before paying for expensive interventions or agreeing to surgeries that can have permanent negative consequences if they don’t go precisely as planned.

Third Body Found in Slim Jim Plant Explosion Rubble, FoxNews, June 10, 2009

On the Other "Hand"
Repetitive Overuse Injuries of the Hand & Wrist, Hughston Sports Medicine Foundation

More Web Resources
Ergonomic Tips

Thoracic Outlet Syndrome

Whether you’re an experienced North Carolina workers' compensation insurance adjuster or an NC employee who’s recently been hurt on the job, here are some answers to basic questions you might have about the origins and process of the state’s system.

1. How is workers' compensation different from long term disability?

Answer: Workers' comp benefits pay out for injuries sustained during the course of work. Disability benefits pay out for non-work related injuries. For instance, if you lost your hand in an assembly line accident on the job, you’d file a workers' compensation claim. If, on the other hand, you lost your hand in a non work related context – for instance, while fishing with your family – you would file for disability.

2. Are all companies in the state mandated to carry North Carolina workers' compensation insurance?

Answer: Most are. Exceptions apply, however. If you’re an employer or prospective employer, and you’re not sure whether or not you need to acquire insurance, the North Carolina Industrial Commission can advise you. You might also consider retaining an attorney. After all, employers who fail to carry enough workers' comp insurance can be hit with pretty serious penalties if they’re caught, and their personal assets may even be up for grabs in certain situations.

3. If you were hurt and your employer doesn’t have insurance, what are your options?

Answer: It may be possible to make a claim against the company’s assets or against your employer’s personal assets. You also may have other legal mechanisms available to collect payment. Discuss your matter with an attorney.

4. Can independent contractors collect workers' compensation?

Answer: Independent contractors are not considered employees, according to North Carolina workers' compensation law. This means that, if a contractor gets hurt while on the job, he is generally not entitled to file a claim against the person or entity who hired him. However, depending on the injury, the nature of the work, and the type of working arrangement, in some situations, independent contractors can make a case. For instance, an independent contractor might argue that he should have been designated as employee and thus should be entitled to collect benefits.

More Web Resources

NC's Workers' Compensation Act

Independent Contractor

North Carolina Industrial Commission

Let’s discuss some myths and realities concerning North Carolina workers’ compensation.

Myth #1 -- You must see the doctor that your insurance company (or employer) provides.

Reality – In the event that the first North Carolina workers’ compensation physician who treats you does not meet your needs, you can go back to your insurance company or to your employer to request a change of physician. Legally, you’re allowed to do this at least one time, and your employer/insurance company must compensate you for the visit.

Myth #2 -- If you fail to file for benefits within your employer’s timeline, you won’t get compensation.

Reality: Employers don’t make North Carolina workers’ compensation laws -- the state legislature does. In most cases, you have up to two years following your injury to file a claim.

Myth #3 -- Insurance companies will cooperate if your claim is legitimate.

Reality: Insurance companies are primarily in business to make money. Claims adjusters will likely dig into your claim looking for as many possible reasons to reject it, disqualify it, or erode your settlement amount. In fact, if you discuss your injury with an insurance company representative before speaking with an attorney, you can accidentally imperil your North Carolina workers’ compensation claim -- just by misspeaking or citing the wrong numbers. While insurance companies are not always adversarial, they can be. That’s why it's generally smart to retain an experienced and intuitive legal representative -- someone who’s purely interested in your well-being.

Myth #4 -- Retaining an expensive North Carolina workers’ compensation attorney will chip into your benefits.

Reality: The benefits of working with a knowledgeable, results-oriented attorney in general far outweigh the nominal costs of services. Consider: by simply extracting a few extra percentage points on your settlement, you can usually pay for your attorney’s fees and then some. To settle for a fair amount, it makes sense to work with experts who've delt with similar cases hundreds of times. Exceptions can apply, of course. For instance, if you've closely studied North Carolina workers’ compensation law, perhaps you can negotiate on your own behalf. But even then, you might be advised to retain counsel, since having a proxy negotiate on your behalf gives you extra leverage.

North Carolina Workers’ Compensation Law

NORTH CAROLINA STATE GOVERNMENT
WORKERS' COMPENSATION EMPLOYEE HANDBOOK

More Web Resources

US DOL Statistics on Workers' Comp

NC Industrial Commission

According to a study conducted by the non-partisan Workers’ Compensation Research Institute (WCRI), North Carolina’s workers’ compensation payment per claim costs are significantly higher than average when compared to similar costs in other states. The study, CompScope TM Medical Benchmarks, revealed that North Carolina workers’ compensation payments per claim exceeded the average of a group of 13 states by 13%. State lawmakers have already reacted to the problem by imposing fee schedule changes; these began taking effect in July 2009. Various policy groups have also proposed initiatives to reduce payouts for certain hospital costs, physical medicine, and outpatient services. The Office of State Budget and Management has calculated that the fee schedule changes for 2009 should save the state over $35 million.

What was driving the abnormally high payments per claim in the state?

The CompScope survey points to many culprits. For one, the state has a higher surgery rate than other states surveyed. In addition, both outpatient and inpatient payments per claim and payments to providers are much higher than the median for the states studied. Bear in mind that these figures don’t mean that North Carolina workers’ compensation claimants are necessarily getting more money or a better deal on their medical services. The costs have gone up for almost every party within the healthcare system across the board.

Workers` Compensation Payments Per Claim to North Carolina Hospitals Higher Than Typical of 14 States and Growing, Says WCRI Study, Reuters, Fri Jul 10, 2009

North Carolina: Study finds payments per claim growing rapidly, Risk and Insurance.com, July 30, 2009

More Web Resources

CompScope

Workers’ Compensation Research Institute

Is there a non-profit state agency that can provide unbiased information about North Carolina workers’ compensation benefits, eligibility and rights?

Yes. The North Carolina Industrial Commission (based out of Raleigh) is reachable at (919) 807-2500. You can also contact workers comp info specialists directly toll free at (800) 688-8349 or email someone for assistance at infospec@ic.nc.gov.

If your employer does not report your injury, for whatever reason (e.g. negligence, refusal to assist), is there anything you can do?

Yes. Collect a claim Form 18 or Form 18-B and file it with the NC Industrial Commission within two years of your on the job injury.

Can injured employees get benefits for using chiropractic services?

In some cases, yes. If your employer's insurer allows, you can have up to twenty visits to a designated chiropractor paid for, provided that the services are “medically necessary.” If you require more chiropractic services, the chiropractor needs to contact the employer directly.

If you have been injured at work, what steps should you take immediately?

First of all, tell your employer -- both verbally and in writing. It’s very important that you keep track of all of your correspondence and file it and date it. You should make sure to do this within thirty days of your injury, unless your recuperation has rendered you unable to make such a communication.

In the event that your employer lacks North Carolina workers’ compensation insurance, do you have any recourse to collect benefits?

Yes. First of all, the North Carolina Industrial Commission’s fraud hotline should be notified. You can call toll free at (888) 891-4895 or email a government representative at fraudcomplaint@ic.nc.gov. If you’ve been injured and then you discover that your employer lacks insurance, contact the Commission. You’ll likely have to fill out two forms -- Form 33 and Form 18 -- to attempt to collect benefits.

More Web Resources

North Carolina Industrial Commission

NC Workers Compensation Act

Who is in charge of directing your medical care?

In general, your employer or the employer’s insurance company is in charge of offering and directing your course of treatment. If you don’t like the physician that your employer commends you to, it’s up to you to petition the North Carolina Industrial Commission to compel your employer to find another doctor. Be sure to get any changes in writing prior to receiving treatment, or you may not get reimbursed. In some cases, in which your employer or your employer’s insurance company does not behave fairly, the Commission may mandate certain terms of treatment. In the event that you need emergency medical assistance, obviously you should get it. If your employer or the insurance company subsequently refuses to pay for that treatment, you should contact the NCIC as quickly as possible within reason to discuss your situation.

Is it true that you can’t collect compensation for the first week you’re off of work?

In general, the first seven days you miss work due to your disability will not be covered by so called "Lost Wage Compensation." However, if your disability lasts longer than 21 days, you will be able to start collecting -- just not for days 1 through 7.

Are compensation payments always made weekly?

Under most circumstances. However, the NCIC can in some situations mandate that you get monthly checks instead.

How much money should you expect in terms of benefits?

In general, you should expect two thirds of your weekly wage with a maximum of $816 per week (according to 2009 rules).

Can you continue receiving benefits after you return to your job?

In general, no. Once an employee is able to go back to work, his or her benefits end.

How can you find out your North Carolina Workers’ Compensation claim number and the insurance carrier that your employer uses?

The North Carolina Industrial Commission maintains a statistics hotline at (919) 807-2506 to answer these questions.

What should you do if your employer does not acknowledge or otherwise refuses to honor your claim?

In general, it’s a good idea to connect with a North Carolina workers compensation attorney ASAP. You also should notify the NCIC and all relevant healthcare providers.

More Web Resources

North Carolina Industrial Commission

NC Workers Compensation Act

According to a recent Fitch Ratings report, unexpected underwriting losses in 2008 have challenged the North Carolina workers' compensation insurance industry's financial support structures. The combination of increased competition (which generally leads to reduced rates) and fewer claims filed (which generally leads to higher rates) has thrown many North Carolina workers' compensation insurance companies for a loop. Many NC executives in the industry vividly remember the mid-1990s, when an unusual string of bad luck sent blue-chip companies out of business and upset both the regional and national workers' comp markets. Excessive competition and a sudden, surprising surge in claims drove that particular "perfect storm," which forced companies to make good on policies that they had sold at reduced rates.

What do the latest numbers suggest about how future North Carolina workers' compensation insurance claims will be processed? At this point, it’s too early to say. The North Carolina economy is still struggling to recover from the crippling effects of the national economic downturn. When the economy shrinks, employers take fewer risks and thus expose workers to less vulnerability. This theoretically should drive insurance prices down. At the same time, however, hard-pressed North Carolina entrepreneurs may be tempted to go without insurance or to under-insure to cut costs. This should theoretically drive prices up.

In any event, if you're a North Carolina worker laboring in this environment, you should learn about your employer's workers' compensation policies. If you get hurt on the job and your employer does not have adequate insurance protection, you may not be able to get compensation owed to you – at least without a drawn-out legal fight.

Unprecedented hike in workers’ comp insurance rates is unnecessary, Capitol Weekly, June 18, 2009

WC market faces considerable challenges in '09, group says, Risk & Insurance, June 29, 2009

More Web Resources

Fitch Ratings

Workers' Comp Insurance

The North Carolina Department of Labor is reportedly deep in the process of investigating ten different entities that might be liable for damages in the June 9 explosion at a North Carolina Slim Jim plant that killed three workers and injured many more. The explosion has been regarded one of the most prominent worker safety failures in the state’s recent history and has merited a federal investigation.

Three companies in particular may shortly face a variety of workers’ compensation claims stemming from the accident, according to reports. Jacobs Engineering Group, Southern Industrial Constructors, and Energy Systems Analysts may all be charged with negligence with respect to the failure of the Slim Jim plant’s gas lines. (Investigators believe that a water heater gas pump accidentally allowed gas to leak into the plant’s pump room, setting the stage for the explosion.) Investigators suspect that employee negligence may also have contributed to the leak.

An attorney representing two injured claimants has publicly hinted that Jacobs Engineering Group and Energy Systems Analysts did not have the proper licensing to engineer gas line hookups and that their lack of experience and certification may have precipitated the dangerous conditions that led to the massive explosion. So far, the three aforementioned companies and other potential defendants (including ConAgra) have parsed their public statements carefully. Given the fluid dynamics of this complicated and likely long term North Carolina worker’s compensation case -- as well as the amount of money potentially at stake -- prospective claimants and defendants want to avoid accidental admissions of guilt or other admissions that might compromise their legal leverage.

Third Body Found in Slim Jim Plant Explosion Rubble, FOX News, June 10, 2009

Gas Leak Caused Fatal North Carolina Slim Jim Plant Explosion, Insurance Journal, June 15, 2009

More Web Resources:

Energy Systems Analysts

Southern Industrial Constructors

A workers' compensation case involving a Fine Arts and Ceramics Professor at Virginia Commonwealth University has led to an ongoing debate about building safety at the school and may lead to lawsuits in Virginia, North Carolina, and elsewhere.

Allan Rosenbaum had been working in VCU’s Fine Arts building for years, teaching crafts and ceramics. After inhaling significant quantities of fine silica dust over a period of years, Rosenbaum developed the incurable degenerative disease, silicosis. He brought a claim against VCU via Virginia’s Workers' Compensation Commission and won disability benefits of over $210,000.

University Ignores Red Flags

Rosenbaum’s workers' compensation suit tipped off university officials to the seriousness of the situation in the Fine Arts building. Numerous faculty members have since attested to the fact that the crafts area is -- and has been -- extremely dusty. Plastic sheets at one time covered ventilation screens. During kiln cleanings, massive clouds of silica dust spread out into the halls and propagated through the school’s ventilation system to other classrooms and buildings.

Rosenbaum was first diagnosed with silicosis by a colleague at VCU’s medical department, who warned school administrators of the hazards of continuing to expose faculty and students to large amounts of silica dust. VCU administrators responded by putting up notices about the dust and conducting an internal test of air quality. These tests found that dust levels were likely not dangerous; but critics of the administration retorted that the tests conducted were not accurate.

A North Carolina faculty member who had been working as a visiting professor testified that the Fine Arts building had terrible ventilation throughout his tenure at VCU.

Whether Professor Rosenbaum’s ordeal leads to other workers' compensation claims against VCU for silicosis or other inhalation diseases is anyone’s guess. Since silicosis is a cumulative condition, individuals with the longest-term exposure to dusty conditions have the greatest risk for developing symptoms.

When dealing with workers' compensation cases, injured parties often require strong, experienced legal help to advocate for their rights and get them appropriate compensation.

Professor Sickened by Dust, but VCU Says Facilities are Safe, Richmond Times-Dispatch, June 8, 2009

Suffering for Art, Workers Comp Insider, June 8, 2009

Related Web Resources:

Virginia Commonwealth University

Preventing Silicosis

The June 9, 2009 explosion of a Slim Jim plant in Garner, North Carolina will undoubtedly lead to NC workers' compensation and wrongful death claims and could result in a drawn out court battle between the giant food manufacturer and the victims of the tragic blast.

Facts about the Blast

Investigators still don’t know what caused the 500,000 square foot building to explode Tuesday morning. One report suggests that an unidentified person called ConAgra’s Omaha, Nebraska headquarters over the weekend and threatened to bomb the Garner plant. Authorities are investigating this threat.

All told, 38 people were significantly injured in the blast. Three have died from injuries sustained. Four of the 38 injured survivors are being treated for severe second and third degree burns. Several firefighters at the scene got sick from ammonia fumes. The ConAgra building is still being tested for structural integrity: on-site investigators don’t want to risk getting crushed or injured while researching the source of the blast.

Accidental or Premeditated?

It remains to be seen whether the ConAgra explosion was some kind of mechanical or chemical accident, or whether it was an act of domestic terrorism. The victims of the blast and the families of the victims who were killed will no doubt seek compensation for pain and suffering, injuries, potential wages lost, therapies, and other damages.

While a giant company like ConAgra no doubt carries workers' compensation insurance for contingencies like these, this situation is so much bigger than standard North Carolina workers' compensation cases that the legal wrangling will almost certainly be broader in scope than is typical.

Who Will Pay?

• If the explosion was caused by negligence on ConAgra’s part, then the company and its insurers will likely have to pay out claims.
• If, on the other hand, a defective machine, component, or chemical caused the blast at the NC Slim Jim plant, then other entities will likely be held liable.
• And if it turns out that the incident was indeed an act of terrorism or subterfuge, the claimants’ case would be altered in many regards.

Hundreds of Other Claims?

It’s also significant to note that over 900 people work at the plant. Assuming that the plant will be out of operation for a while, pending the investigation, these employees won’t be able to work and collect paychecks. They, too, may seek compensation for wages missed, considerably complicating this already tangled matter.

2 Dead, 1 Missing after Slim Jim Plant Explosion, June 9, 2009, CNN

Third Body Found in Slim Jim Plant Explosion Rubble, June 10, 2009, FOX News

Related Web Resources:

Slim Jims

Con Agra