Personal Injury / Wrongful Death / Workers’ Compensation

Personal Injury / Wrongful Death / Workers’ Compensation

Personal Injury

An accident can have a difficult effect on you and your family’s emotional, physical and financial situation. You probably have questions about your injury claim and what rights you have. Hopefully, you are recovering from your injuries.

When you are involved in an accident through the negligence of some other party, you are entitled to assert a claim to pursue certain damages. The negligence of another party is where they have failed to use the reasonable care of a person under those circumstances. Some examples of course are running a stop sign, running a red light, or anything when they violate traffic laws and crash into you.

You may need medical treatment. If you need treatment, we suggest that you go immediately to your family doctor or a doctor that has been recommended to you by friends or family, or at the very least to a hospital or urgent care. Immediate treatment is often necessary to make sure that there are no other severe problems that could develop. It is also important that you keep track of all of the doctors you see, that you obtain copies of all bills from the medical providers, and that you get copies of any prescriptions you might fill.

You are entitled to be compensated for the amount of your reasonable medical expenses, the pain and suffering suffered by you, lost wages or other income, and permanent disabilities if any. These amounts can vary and it is difficult to place a quantitative value on some aspects such as pain and suffering. We will work with you during your case to keep you informed of settlement negotiations.

NOT talking to the insurance adjuster is one of the most important things to remember. Do not sign anything from the insurance company without being fully aware of your legal rights. The insurance adjuster works for the insurance company and will not advise you of all of your rights, the full extent of your potential compensation, or what remedies may be available to you. The insurance company’s representatives will attempt to get you to say something that may hurt your case or take some other action that will lessen the value of your claim. It is therefore very important that you do not talk to any of them without a lawyer’s presence.

Something else to consider is that sometimes car accidents also involve workers’ compensation or social security disability, or may have implications in situations such as child support. You need a full-service law firm to fully protect your interests.

You have probably received a lot of mailings from lawyers. Remember, you need lawyers that will make themselves available to you, at a time and location that is convenient for you. Choose your lawyer carefully. Look for lawyers with a good local reputation, and who exhibit integrity and professionalism. Make sure whomever you choose as a lawyer actually litigates cases and is willing to handle your case from start to finish.

We would welcome the opportunity to speak with you and assist you in this stressful time. Please feel free to call us if you want further information and to schedule a time to meet at a convenient time and location.

The personal injury law practice of Wright, Worley, Pope, Ekster & Moss, PLLC handles injuries and fatal accidents resulting from occurrences such as the following:

* Motor vehicle accidents: auto accidents, truck collisions, motorcycle crashes

* Bicycle / pedestrian accidents

* Premises liability (injuries on personal or commercial property)

* Products liability

* Medical malpractice

* Workplace injuries

* Construction accidents

Workers’ Compensation

Getting hurt on the job can have a difficult effect on you and your family’s emotional, physical and financial situation. You probably have questions about your workers’ compensation claim and what rights you have. Hopefully, you are recovering from your injuries and getting the medical care you need, and you are also receiving the workers’ compensation benefits you are entitled to.

Sometimes a workers’ compensation claim can also involve third party claims against parties at fault or social security disability, or may have implications in situations such as child support. You need a full-service law firm to fully protect your interests. Choose your lawyer carefully. Look for lawyers with a good local reputation, and who exhibit integrity and professionalism. Make sure whomever you choose as a lawyer actually litigates cases and is willing to handle your case from start to finish.

Workers’ compensation insurance carriers often work to find ways to deny or limit legitimate claims. An injured person who is represented by an attorney from the beginning is best able to meet the insurance company’s lawyers and claims adjusters on a level playing field. Further, a prompt evaluation of the circumstances of an injury – on the job or not – by an experienced workers’ compensation lawyer is an important first step toward protecting the rights of the victim and affected family members.

The Workers’ Compensation law practice of Wright, Worley, Pope, Ekster & Moss, PLLC handles on the job injuries and accidents of any sort from specific traumatic incidents, to occupational diseases, to loss of function in vital organs.

Some important notes regarding a workers’ compensation claim:

Workers’ Compensation developed as an alternative to Personal Injury or tort actions. The benefit of Workers’ Compensation is that it is not fault-based. In other words, you do not have to prove any negligence of the employer in order to recover Workers’ Compensation benefits. You simply need to demonstrate that you sustained an injury by accident arising out of and in the course and scope of your employment with your employer. Basically, this means that you were injured while working for your employer doing your job in an ordinary fashion, when some accident or something out of the ordinary occurred. For major bodily injuries, this is quite apparent what it could be. For example, a broken bone or other physically visible injury. For your back, the injury must be related to a specific traumatic incident, that you can describe with detail. For example, lifting boxes or twisting in some way when you feel an immediate pain in your back. There are also occupational diseases, repetitive injuries, and certain mental claims that could also arise and that will be discussed in further detail with you if relevant to your case.

When you are hurt, and a doctor keeps you out of work for over seven days, you are entitled to receive your Temporary Total Disability benefits or TTD. Your first check is generally for two weeks, the first week you are out, and then the second week as well. These benefits are 2/3 of

your average weekly wage. Your average weekly wage is calculated based on your income, but can also include things such as a per diem, travel pay, lodging monies, or other bonuses you might receive. If you have a second job, that may also come into play. It is therefore very important that you provide us with specific details of all of your wages as everything that arises in a Workers’ Compensation case is based upon your average weekly wage. Therefore, the higher your average weekly wage, the more financial benefits you would be entitled to. Each year, a minimum and maximum compensation rate is set by the North Carolina Industrial Commission. Once a proper compensation rate is set, this amount is the same throughout the case…there is not increase for inflation or cost of living.

You are entitled to have medical treatment paid for by the insurance company. If it is an accepted claim, the insurance company can direct your medical treatment within reason. If it is a denied claim, you would have to see your own doctors and pay for them yourself and we would pursue obtaining their reimbursement from your claim. You are entitled to reimbursement for your travel mileage over 20 miles for a medical visit, and we will give you the respective form required for you to submit in order for you to get your mileage. You are also entitled to have your prescriptions paid for. Basically, anything that is medically necessary to effectuate a cure, lessen your period of disability, or provide relief to you should be covered. If the claim is denied, you will not get anything from the employer and we will proceed with a Form 33 Hearing request.

Generally, Workers’ Compensation cases proceed with you getting the treatment you need and receiving your TTD benefits until you reach maximum medical improvement or MMI. At this point, several things can occur. You can possibly go back to work with your employer if they have a position available for you that is within your medical restrictions. If this is not an option, you may have to get a job elsewhere if your employer cannot accommodate your medical restrictions. Getting a job with another employer is the responsibility of the insurance company. In most cases, they must provide you with suitable employment somewhere before they can stop their TTD benefits to you. They could put you through vocational rehabilitation in order to attempt to return you to work. It is important that you attend all doctors’ appointments, particularly those set up by the insurance company so that they do not claim that you are failing to comply with medical treatment. Most likely a nurse case manager will be assigned to your case to oversee your treatment and make recommendations to the insurance company. This nurse case manager is paid by the insurance company, so you must exercise caution when dealing with them, even though they are supposed to be looking out for your best medical interest. If your case goes through vocational rehabilitation, there are specific rules and guidelines that the vocational rehabilitation counselor must follow or they will be removed from your case. This vocational rehabilitation counselor is also paid by the insurance company, so you must exercise caution when dealing with them, even though they are supposed to be looking out for your best interests. It is important that you keep up with the details of every dealing you have with any representative of the insurance company so that our firm is aware of the same.

At some point, a hearing may be needed in your case to resolve issues in dispute. These issues can arise from the compensability of the claim, your average weekly wage, the percentage of your maximum medical improvement, or anything else that might be in dispute. If this occurs, a Form 33 will be filed by our firm on your behalf. This is the form requesting a hearing with the Industrial Commission. The Industrial Commission is the “court system” that handles Workers’ Compensation cases. When a hearing is filed for, the parties must proceed to a mediation.

At the mediation, both sides discuss their position and a settlement is attempted to be reached through what is called a clincher agreement, which would resolve your case permanently. Part of the considerations for settling are the percentage that the insurance company would pay you for a disability rating that you receive to a certain body part. For example, pursuant to the North Carolina General Statutes, a back is worth 300 weeks. If your back was completely disabled you would be entitled to receive 300 weeks times your compensation rate as a lump some payment. This is one alternative to resolving a claim and there are others. If for example your back was only injured 10%, then you would be entitled to receive 30 weeks, which is 10% of 300, times your compensation rate.

Who is Subject to the North Carolina Workers’ Compensation Act?

Not everyone who works in North Carolina is covered. An employee is covered if he or she works for an employer who regularly employs three or more people full or part time, or is an employee of a construction subcontractor, or where the employer has workers’ compensation insurance. An individual who works for the State, a County, or City is covered. An individual who works with or around radiation is covered regardless of the number of employees. With some exception, agricultural workers, residential workers, residential domestic workers, independent contractors, and casual workers are not covered by the Act. Federal, maritime, and railroad workers are covered under other State and Federal laws.

What to Do in the Event of an On-the-Job Injury or Diagnosis of a Job-related Disease or Condition

The employee should immediately report to his or her supervisor any on-the-job injury including the time and date of the injury, the manner in which it occurred, and the nature of the injury. If an employee is informed by a doctor, or believes that he or she has a disease or condition which is related to or caused by the job, that should be immediately reported as well. The employee should request the North Carolina Industrial Commission Form 18 from the employer, or from the Industrial Commission if necessary, fill this form out, and give it to the employer, providing the Industrial Commission with a copy. If this form is not provided, the employee should simply type and sign, or write out, a full report and give it to the employer, keeping a copy, and sending a copy to the North Carolina Industrial Commission.

Most workers’ compensation claims are administered either by the workers’ compensation insurance carrier or, in the case of a self-insured employer, a claims administrator, and they will need copies of these reports