In general, any employer who employs three or more employees must have workers' compensation insurance coverage or qualify as a self-insured employer.

It should be noted that every executive officer selected or appointed and empowered in accordance with the charter and bylaws of a corporation is considered an employee of such corporation.  Therefore, a corporation with two officers and one employee would be required to provide workers’ compensation coverage.

It should also be noted that volunteer executive officers of certain non-profit corporations count as employees for the sole purpose of determining whether coverage is required.

One exception to the three-employee rule is for employment involving the use or presence of radiation, which requires workers’ compensation coverage if one or more employees perform activities that involve the use or presence of radiation.

North Carolina law requires that workers’ compensation coverage be in place to cover certain trucking owner/operators, even if the operator is deemed to be an independent contractor.  If the owner-operator does not have workers’ compensation insurance coverage, the motor carrier must provide the workers’ compensation coverage. The workers’ compensation coverage must be in place regardless of whether the principal contractor, intermediate contractor, or subcontractor regularly employs three or more employees.

A motor carrier employer is not liable for the workplace injuries suffered by an independent contractor who is: 1) individually licensed by the U.S. Department of Transportation and 2) personally operates the vehicle. (N.C. Gen. Stat. § 97-19.1)

No. Occupational accident insurance is a separate form of insurance, and it is not a lawful substitute for workers’ compensation coverage under the North Carolina Workers’ Compensation Act.  Unlike workers’ compensation coverage, occupational accident insurance only covers specific injuries and may pay very limited benefits based upon the insurance contract.  The Industrial Commission does not have jurisdiction over disputes concerning coverage under occupational accident insurance policies.

Yes. A non-insured employer can be reported to the Industrial Commission Criminal Investigations & Employee Classification Division by email at fraudcomplaints@ic.nc.gov or by phone at 888-891-4895.

Pursuant to N.C. Gen. Stat. §97-22, an injured employee shall give the employer written notice of a workplace accident “immediately. . . or as soon thereafter as practicable,” but no later than 30 days after the accident or else compensation may not be payable.   Pursuant to N.C. Gen. Stat. §97-58(b), the report and notice requirements set forth in N.C. Gen. Stat. §97-22 also apply in occupational disease claims (except for cases of asbestosis, silicosis, or lead poisoning), and the 30 days for giving written notice in an occupational disease claim begins to run on the date the employee was advised by competent medical authority that the employee has the occupational disease.

An employee can file a workers’ compensation claim by completing and filing an Industrial Commission Form 18.  There is a two-year statute of limitations that applies to workers’ compensation claims, and employees should carefully review N.C. Gen. Stat. § 97-24(a) regarding this two-year statute of limitations.

For an occupational disease that does not involve lung disease, an employee can file an Industrial Commission Form 18. For an occupational disease involving lung disease, an employee should file a Form 18B instead of a Form 18. The two-year statute of limitations that applies to occupational diseases is set forth in N.C. Gen. Stat. § 97-58(c). For occupational diseases, the claim must be filed within two years after the employee has sustained death, disability, or disablement and has been advised by competent medical authority that the employee has an occupationally related disease.

No. The filing of a Form 19 by an employer or carrier does not constitute the filing of a workers’ compensation claim for the employee.  If the employee wishes to claim workers’ compensation benefits, the employee must file a workers’ compensation claim with the Industrial Commission within the statute of limitations set forth in the relevant statute. (N.C. Gen. Stat. § 97-24(a) or N.C. Gen. Stat. § 97-58(c)).

If your claim is denied by the employer or carrier and you want to pursue obtaining workers’ compensation benefits, you may request a hearing before a Deputy Commissioner by filing a Form 33.

No. You may go to any health care provider of your choice if your claim has been denied. However, even in a denied claim, the employer or carrier is entitled to request that you submit to independent medical examination pursuant to N.C. Gen. Stat. § 97-27(a).

The weekly compensation rate for total disability benefits under the Workers’ Compensation Act is two-thirds of the employee’s “average weekly wage,” as defined in N.C. Gen. Stat. § 97-2(5), subject to a cap.

The cap is called the “maximum weekly compensation rate.” Pursuant to  N.C. Gen. Stat. § 97-29(a) and N.C. Gen. Stat. §97-29)(i), the maximum weekly compensation rate is calculated annually and the new annual rate is effective as of January 1 each year.

The applicable cap on an employee’s weekly benefits for the entirety of the employee’s claim is the maximum weekly compensation rate for the year in which the employee’s injury occurred.

Pursuant to N.C. Gen. Stat. § 97-28, no compensation is due for the first seven days of lost time from work, unless the disability exceeds 21 days. Therefore, the first workers’ compensation disability payment issued to the employee by the employer or carrier will not include any workers’ compensation disability payments for days 1-7.  Payment for days 1-7 will be due only if the employee’s disability has continued beyond 21 days.

After calling the representative of the carrier/administrator to attempt to resolve the issue, you may file a motion or written request pursuant to N.C. Gen. Stat. § 97-18(e) and (g) with the Executive Secretary’s Office for an Order compelling payment of the unpaid benefits and a 10% late payment penalty.  You should attach supporting documentation to your filing.

You can file a Form 24 Response by completing Section B of the Form 24 Application and filing your response with the Executive Secretary’s Office within 17 days of the date that the Form 24 Application was mailed to you.  In your Form 24 Response, you should explain your objection to the Form 24 Application.  If you have any supporting documentation, you should attach that to your Form 24 Response.  You must send a copy of your Form 24 Response contemporaneously to the attorney listed in Section A of the Form 24 Application.  Detailed information about the Form 24 filing requirements and the Form 24 procedure can be found in N.C. Gen. Stat. § 97-18.1 and Rule 11 NCAC 23A .0404.

It depends. Pursuant to N.C. Gen. Stat. § 97-29(b), an employee is not entitled to compensation under N.C. Gen. Stat. § 97-29 beyond 500 weeks from the first date of disability unless the employee has qualified for extended compensation under N.C. Gen. Stat. § 97-29(c).  Therefore, no permission from the Industrial Commission is needed to terminate an employee’s weekly temporary total disability compensation after 500 weeks have passed from the first date of disability, if the employee has not been awarded extended compensation by the Industrial Commission.

Additionally, defendants may terminate temporary total disability compensation without Industrial Commission permission when an employee has returned to work for the same or different employer, subject to the Trial-Return to Work provisions set forth in N.C. Gen. Stat. § 97-32.1 and Rule 11 NCAC 23A .0404A.

Defendants also may terminate temporary total disability compensation without Industrial Commission permission when they timely contest a claim in which benefits were paid pursuant to the “payment without prejudice” provision set forth in N.C. Gen. Stat. § 97-18(d).

If, however, none of the three scenarios above applies, then weekly temporary total disability benefits cannot be stopped without Industrial Commission permission. Permission can be sought by filing a Form 24 Application to Terminate or Suspend Payment of Compensation pursuant to N.C. Gen. Stat. § 97-18.1 and Rule 11 NCAC 23A .0404. It should be noted that only an attorney can file a Form 24 on behalf of an employer or carrier because it is a legal filing.  Adjusters and other employer or insurer representatives who are non-attorneys are not permitted to file a Form 24.

A copy of the Form 24 must be sent contemporaneously to the employee or the employee’s attorney of record, if any, and payments may be stopped only if the Industrial Commission approves the Form 24 Application.

An employee who travels 20 miles or more round trip for authorized medical treatment in a workers’ compensation case is entitled to mileage reimbursement to be paid by the employer or carrier at the IRS standard mileage rate for the year or other time period in which the travel occurred pursuant to Rule 11 NCAC 23J .0101(h). The employee should submit the request for mileage reimbursement to the employer or carrier/administrator on a Form 25T.