NORTH CAROLINA INDUSTRIAL COMMISSION

Help Line: (800) 688-8349, (919) 807-2501, or infospec@ic.nc.gov
Fraud and Insurance Compliance Hotline: (888) 891-4895 or fraudcomplaints@ic.nc.gov

For Employers

Information For Employers

Employers Responsibilities

Employer’s Obligation to Carry Workers Compensation Insurance

Please see the Video Resources section below for more information.

Employer's Duties When a Worker is Injured

An employer must immediately report to its Workers’ Compensation insurance carrier any injury or occupational disease, or allegation by an employee of an injury or occupational disease, sustained in the course of employment for which the attention of a physician is needed or actually sought.

If an injury or alleged injury causes the employee to be absent from work for more than one day, or the employee’s medical expenses are greater than $2000.00, the employer or carrier must file with the Industrial Commission a Form 19 “Employer’s Report of Employee’s Injury to the Industrial Commission” within five days of learning of the injury or allegation.

If a Form 19 is filed with the Industrial Commission, the employer or carrier must provide a copy of the Form 19 to the employee, together with a blank Form 18 “Notice of Accident to Employer and Claim of Employee” for use by the employee.

Please see the forms section below for the relevant forms.

See Rule 104 of the Workers’ Compensation Rules of the North Carolina Industrial Commission

Video Resources

Understanding Your Workers' Compensation Obligations

A video presentation on the employer's obligations regarding workers' compensation insurance coverage.

In English:

En Español:

Workers' Compensation Forms

All Employers or Carriers MUST file a Form 19 “Employer’s Report of Employee’s Injury to the Industrial Commission” within five days of learning of any injury or allegation of an injury. Employers should use the following form.

Form 19 for Electronic Submission
This version of the Form 19 allows for filling out and submitting it on-line. You must have Adobe Reader version 7.0 or later and a valid e-mail address to submit this form on-line. Click Here to get the free Adobe Reader.

Standard Form 19 With Instructions
This Form 19 may be downloaded, printed, filled out and mailed into the NC Industrial Commission. Please read the attached instructions for required information and the mailing address.

Form 18 for Electronic Submission

This version of the Form 18 allows for filling out and submitting it on-line. You must have Adobe Reader version 7.0 or later and a valid e-mail address to submit this form on-line. Click Here to get the free Adobe Reader.

Standard Form 18 With Instructions

This Form 18 may be downloaded, printed, filled out and mailed into the NC Industrial Commission. Please read the attached instructions for required information and the mailing address.

Form 18B

This form is used if there is a claim by an Employee, Representative, or Dependent for Lung Disease, Including Asbestosis, Silicosis, and Byssinosis (G.S. §97-53)

Form 18M

This form should be used if an employee wishes to apply for Additional Medical Compensation (G.S. §97-25.1) (Applicable to Injuries by Accident or Occupational Illness on or After July 5, 1994)

Additional Forms

Please click here to visit the Forms page for a complete listing of all the available
NC Industrial Commission Forms

Employees That Have Been Injured At Work

The NC Industrial Commission provides the following instructions to employees that have been injured in the course of their jobs. In the event one of your employees becomes injured, please familiarize yourself with the following procedures and be ready to assist your employee(s).

Employees' First Steps

FIRST - Seek out appropriate medical treatment.

Your employer may have a health care provider on your work site and if consistent with your employer’s instructions present yourself to that health provider if appropriate.

If you do not have access to an on-site health provider, your employer may have instructed you to present yourself to a designated health care office in case of work related injuries. If appropriate to the seriousness of your injury, report to that facility.

If there is no employer onsite or designated off-site health care provider, seek medical care appropriate to your medical needs. Depending on your circumstances, appropriate health care may be obtained from your family doctor or a hospital emergency room.

Second

tell your health care provider that your injury is related to your work and the name of your employer. This information allows the health care provider to bill treatment as a workers’ compensation claim.

Third

As soon as possible, inform an appropriate manager of your employer or the owner of your company that you have experienced a work related accident. If you can personally report your injury, do so. If you are unable to report your injury because of your medical condition, have a family member, friend or health care provider notify your employer of the injury as soon as possible.

Fourth

as soon as practical after the accident, and within thirty days, give written notice to your employer. A simple written statement giving the date of the accident and a brief description of the injury is all that is necessary. If you cannot write the letter, have a friend or family member write it for you and send it to the employer. Keep a copy of the letter for your records.

Fifth

follow your physician’s instructions for medical treatment. The goal of the Workers’ Compensation System in North Carolina is to ensure that you get good health care to restore you as nearly as possible to the health and ability to work that you had prior to your injury.

Following these five simple steps will ensure that your injury is properly reported, you receive appropriate health care quickly and that your employer can initiate workers’ compensation medical benefits.

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