WORKERS’ COMPENSATION EMPLOYEE HANDBOOK
North Carolina State GovernmentWORKERS’ COMPENSATION EMPLOYEE HANDBOOKNorth Carolina Office ofState Human ResourcesNovember 2018
Notice to State GovernmentEmployeesthe reporting and administration of workers’Employees have the right to report work-relatedThe North Carolina Industrial Commission (NCIC)injuries and illnesses. Employers are prohibitedmaintains claim records, adjudicates disputes,from discharging or in any manner discriminatingand approves certain awards of benefits inagainst employees for reporting work-relatedaccordance with workers’ compensation law.injuries or illnesses. If an employee is injured oncompensation in their agency/university.their supervisor. If the employee’s injury requiresThis Document Does NotConstitute Legal Advicemedical treatment, the agency/university’sThis document provides general informationprocedures regarding obtaining medicalregarding workers’ compensation law astreatment should be followed.specified in NC General Statutes Chapter 97,the job, the employee should immediately notifythe North Carolina Workers’ CompensationThe NC Office of State Human ResourcesAct. This document instructs employees on(NC OSHR) administers the State Workers’how to report and file a claim and provides anCompensation Program. NC OSHR contractsexplanation of available benefits when theywith a Third Party Administrator (TPA) and otherhave suffered an injury on the job or contractedvendors to provide workers’ compensationan occupational disease. This document alsoclaims services for covered employees in Stateincludes a general explanation of workers’agencies and universities. Each state agency/compensation related rights and duties of theuniversity has a Workers’ Compensationemployee and employer.Administrator (WCA) who is responsible forWHO MAY AN EMPLOYEE CONTACT FOR HELP?If an employee has questions about workers’ compensation coverage or benefits, the employeemay contact their agency/university Workers’ Compensation Administrator (WCA), NC OSHR at(919) 807-4800 or workerscomp@nc.gov, or Third Party Administrator (TPA) claim adjuster atthe phone number specified below.Additional information about workers’ compensation law and benefits is available from the NorthCarolina Industrial Commission (NCIC) website, www.ic.nc.gov, or by calling (919) 807-2501 or1-800-688-8349.Agency/University Name: Division:Agency/University Workers’ Compensation Administrator (WCA):Name:Telephone Number:TPA Claim Adjuster – CorVel Corporation: 1-800-365-5998Adjuster Name:Agency/University Safety OfficerName: Telephone Number:Workers’ Compensation Employee Handbook1
What Employees are Covered?nature occurring regularly or at frequent intervalsThe North Carolina Office of State Humanover a period of time in the employment.Resources (OSHR) workers’ compensationprogram covers all agency and university fulltime, part-time, and temporary State employeesand officers. It also covers all State electedofficials, members of the General Assembly orthose appointed by the Governor to serve on aper diem, part-time or fee basis.What Injuries are Covered?Pursuant to North Carolina workers’compensation law, an “injury by accident” toany body part is covered if it arises out of and inthe course of employment. An “accident” is anunusual or untoward event or interruption in thenormal work routine.There are two exceptions to this general rule:1. Hernia: will be covered if it meets specificstatutory requirements; and2. Back injury: will be covered if the resultof a “specific traumatic incident” whileperforming work assigned i.e., can point tospecific point in time when injury occurredbut an “accident” is not required.An injury that occurs while performing regularjob duties in the usual and customary manner isnot covered.Certain diseases termed “occupationaldiseases” are compensable under the NorthCarolina Workers’ Compensation Act. Anoccupational disease is any disease provento be due to causes and conditions which arecharacteristic of a particular job, but excludingWhat Happens When anEmployee is Injured?State agencies/universities require an employeeto give written notice to their employerthat an injury by accident or diagnosis ofan occupational disease has happened bycompleting one of the following forms:1. The Office of State Human Resources(OSHR) “NC Employee Incident Report”form. This form is part of the OSHR IncidentInvestigation and Reporting Program. Thisform allows the employee to describethe accident and injury(ies). This form isavailable at workerscomp.nc.gov or maybe obtained from the employee’s supervisoror agency/university WCA.2. An agency/university specific incidentreporting form.Injury by accident: The employee shouldimmediately tell their supervisor (or any othersupervisor if unavailable) when an “injury byaccident” or “specific traumatic incident”happens or as soon as possible after it occurs.In any event, the employee should tell theirsupervisor or agency/university Workers’Compensation Administrator (WCA) of theirinjury no later than 30 days after it happens orthe employer may refuse compensation.Occupational disease: An employee shouldgive notice to their supervisor or agency/university WCA of an occupational diseasewhen a competent medical authority first tells anemployee of the nature and work-related causeof the illness.general public is equally exposed outside ofThe employee should complete the formprovided by his or her employer and give it totheir supervisor as soon as possible after thethe employment. Occupational diseases areinjury occurs or occupational disease diagnosisgenerally caused by a series of events of similaris given.all ordinary diseases of life to which theWorkers’ Compensation Employee Handbook2
How Does an Injured EmployeeGet Medical Treatment?State agencies/universities have medicaltreatment procedures for injured employees tofollow such as in-house treatment or referral toa list of authorized local medical providers. Theinjured employee’s supervisor or other agency/university staff should immediately send theemployee to an authorized medical provider forThe TPA processes the FNOL report based uponthe type and severity of injury.The assigned TPA claim adjuster contactsthe employee directly to complete a claiminvestigation and continues communicatingwith the employee throughout the claimadministration process. The employee shouldgive the agency/university WCA or assignedneeded treatment.TPA claim adjuster all requested informationFor referral to external medical providers, theprocessing.in a timely manner to prevent delays in claimemployer generates an initial medical treatmentauthorization form from the Third PartyAdministrator (TPA) web portal, and gives it tothe injured employee to provide to the specifiedinitial medical provider. If the employer doesnot give the employee an authorization form, theinjured employee should tell the medical providerthat their injury happened on the job and billsshould be sent to their employing agency/The agency/university WCA electronically reportsthe employee’s injury to the TPA and an NCIndustrial Commission Form 19, the employer’sreport of injury, is generated. The TPA claimadjuster mails the employee a copy of theNC Industrial Commission Form 19, a blankNC Industrial Commission Form 18, and theadjuster’s contact information. The employeeuniversity.may ensure their workers’ compensation claimIf the agency/university fails to send theIndustrial Commission Form 18 or 18B to the NCis preserved by completing and sending an NCemployee to initial medical treatment, theemployee may go to a medical provider of theirchoice and such treatment will be paid for bythe agency/university. Thereafter, the injuredemployee is responsible for payment for anymedical treatment received for their injury if suchtreatment is not authorized or directed by theirIndustrial Commission within two years from thedate of injury or knowledge of an occupationaldisease.The TPA claim adjuster accepts or deniesliability for the employee’s injury on behalf ofthe agency/university, monitors and processesagency/university or TPA claim adjuster.claims, and pays benefits in accordance withHow Does the TPA ClaimAdjuster Process a Claim?Act. The agency/university and TPA provideThe agency/university WCA completes the FirstNotice of Loss (FNOL) report in the TPA webportal based upon initial information provided bythe employee and supervisor.the North Carolina Workers’ Compensationthe best possible medical care for the injuredemployee to help them reach maximum medicalimprovement (the end of the healing period fortheir work injury) and return to work as soon aspossible.Workers’ Compensation Employee Handbook3
Who Directs and Pays for anInjured Employee’s MedicalTreatment?The employing agency/university directs initialmedical treatment for an injury. Thereafter, theTPA claim adjuster authorizes and directs allmedical treatment related to an injury. Once anauthorized treating physician is established forthe injury, it may only be changed by the TPAclaim adjuster or with NC Industrial Commissionapproval.The employing agency/university pays for theinjured employee’s medical treatment related toa covered injury. Medical treatment as definedby State law includes:1. Medical, surgical, hospital, nursing andrehabilitative services, including, but notlimited to, attendant care services prescribedby a health care provider authorized by theemployer or subsequently by the IndustrialCommission.2. Vocational rehabilitation and medicines, sicktravel and other treatment, including medicaland surgical supplies as may reasonably berequired to effect a cure or give relief andfor such additional time as, in the judgmentof the Industrial Commission, will tend tolessen the period of disability.3. Any original artificial members as mayreasonably be necessary at the end ofthe healing period and the replacement ofsuch artificial members (prosthetics) whenreasonably necessitated by ordinary use ormedical circumstances.Medical bills for injury related treatment arepaid in accordance with the NC IndustrialCommission fee schedule which sets maximumfees for all treatment. It is against state law forany medical provider to accept any fee from aperson for treatment of a workers’ compensationWhat Happens if an Employee’sClaim is Denied?If the employee’s claim is denied, the employeemay appeal the denial by filing written noticewith the NC Industrial Commission includingthe employee’s name, employer’s name, date ofinjury, and nature of injury. This written noticeshould be mailed to:North Carolina Industrial Commission1236 Mail Service CenterRaleigh, NC 27699-1236An injured employee may request a hearing onany issue related to their claim by filing writtennotice or an NC Industrial Commission Form33 with the NC Industrial Commission. TheNC Industrial Commission Form 33 is availableon the North Carolina Industrial Commissionwebsite, www.ic.nc.gov, or by calling (919) 8072501 or 1-800-688-8349.What Workers’ CompensationBenefits Does an InjuredEmployee Receive When Unableto Fully or Partially Return toWork?The injured employee should give all workstatus related documents received from theirauthorized treating physician to their supervisoror the agency/university WCA as soon aspossible after receiving them. A work note fromany other medical provider may not be used tocertify the employee is unable to work due totheir injury.Scenario 1. The injured employee’s authorizedtreating physician issues a written statementcertifying the employee is completely unable towork due to their injury, the employee is eligibleto receive weekly temporary total disability (TTD)compensation after expiration of the seven-daywaiting period.injury other than the fee approved by the NCIndustrial Commission and paid by the employer.Workers’ Compensation Employee Handbook4
An employee’s weekly compensation rate equalsAn employee is expected to return to worksixty-six and two-thirds percent (66 2/3%) ofon the date of injury unless the initial medicalthe employee’s average weekly wages in theprovider states the employee must go home foremployment in which the injury occurred duringthe rest of the day.the past 52 weeks prior to the injury. The weeklycompensation rate is subject to a statutoryIf the employee’s compensable injury resultscompensation rate minimum ( 30.00 per week)in lost time from work other than the dateand maximum amount which is establishedof injury, the employee must go on workers’annually by the North Carolina Industrialcompensation leave and is entitled to receiveCommission in accordance with State law. Theinjured employee’s weekly compensationrate is calculated as of the date of injury andremains the same for the life of the claim.Scenario 2. The injured employee’s authorizedtreating physician issues a written statementcertifying the employee is only able to workwithin certain restrictions (i.e. physicalworkers’ compensation weekly benefits.There is a seven-day waiting period where nocompensation for time lost from work is allowedexcept when the injury results in the inabilityto work for more than 21 days. If the employeeis unable to work for more than 21 days, thenweekly compensation is allowed for the firstseven days.limitations, certain number of hours per day) dueAn injured employee has the following leaveto their injury.options covering the seven-day waiting period(Certain law enforcement officers and publicWhen an employee can perform some workschool employees eligible for salary continuationwithin certain restrictions, the employerbenefits are exempt from the seven-day waitingmay elect to provide such work and only beperiod requirement as described below.):responsible for the payment of temporary partialdisability (TPD) compensation if the employeeOption 1:does not receive the same or greater pre-injuryearned sick or vacation leave during the requiredwages during this period.seven-day waiting period and then go onThe employee may elect to takeworkers’ compensation leave and begin drawingTemporary partial disability (TPD) compensationworkers’ compensation weekly benefits. Noteequals sixty-six and two-thirds percent (66that if the injury results in disability exceeding2/3%) of the difference between the injured21 days no adjustment will be made in the leaveemployee’s weekly earnings while working withused for these workdays.restrictions and prior to the injury.How is Workers’ CompensationLeave Time Handled?Option 2:The employee may elect to go onleave without pay for the required seven-daywaiting period and then begin drawing workers’compensation weekly benefits.The employee is paid for the entire day of injurySupplemental Leave Option: After an employeeand no leave time is charged if the employeebegins receiving weekly workers’ compensationleaves work to get needed medical treatment.benefits (TTD), the employee may supplementWorkers’ Compensation Employee Handbook5
this benefit by using partial sick or vacationFor Public School Employees Injured in anleave earned prior to the injury or illness inEpisode of Violence: Full time employees ofaccordance with a schedule published each yearan educational institution supported by andby the NC Office of State Human Resources.under the control of the State when injured inThis supplemental leave provides an incomean episode of violence as described in G.S.approximately equal to the employee’s pre-injury115-C-338 are entitled to salary continuationtake home pay.for the shortest of the following threeperiods: 1) one year; 2) the continuation ofThe agency/university WCA will give the injuredthe disability; or 3) the lost work time due toemployee an “Employee Use of Leave Optionsthe injury.Election” form to complete when placed onworkers’ compensation leave to documentIn addition to salary continuation, an employeethe employee’s selection of Option 1 or 2 forin these two groups receives all workers’the seven-day waiting period and usage ofcompensation benefits other than weeklysupplemental leave. This election may not becompensation during the salary continuationchanged for the duration of the claim.period. If an employee is unable to workEmployees injured on the job that have returnedfor more than the allowed period of salaryto work who need to attend medical or therapycontinuation, the employee is then entitled to thevisits during regularly scheduled workingsame weekly compensation benefits as all otherhours are not charged leave for time lost fromemployees.work for required treatment. Paid time will belimited to reasonable time for the treatment andAn injured employee’s supervisor is responsibletravel. Any excess time will be charged as sick/for notifying the agency/university WCA whenvacation/bonus leave or leave without pay. Thean employee returns to work after an out ofemployee’s supervisor will approve such leavework period due to the compensable injury. Theas it occurs.agency/university WCA then notifies the TPASalary Continuation Plansadjuster that the employee has returned to work.§143-166.13 receive their full salary for upWhat Happens to an InjuredEmployee’s Benefits While Unableto Work?to two years if their injury is the result of anAn employee unable to work due to ainjury by accident or occupational diseasecompensable injury is placed on workers’“resulting from or arising out of an episodecompensation leave and taken off the State’sFor Certain Law Enforcement Officers:Eligible employees as defined in NCGSof violence, resistance, or due to otherspecial hazards that occur while the eligibleperson is performing official duties”.regular payroll. While in this pay status, NODEDUCTIONS are taken from the employee’sweekly workers’ compensation benefit. If theemployee has payroll deductions made fromregular pay for items such as credit unionloans, etc., it is the employee’s responsibilityWorkers’ Compensation Employee Handbook6
to arrange an alternate payment methodrepresentative will provide writtenwhile on workers’ compensation leave.information regarding how to continueWhile on workers’ compensation leave anparticipation in NC Flex and other agencyemployee is eligible for continuation of thespecific insurance plans to an employeefollowing benefits:who is on workers’ compensation leave. Nomonthly reminders, invoices, or paymentVacation/Sick Leave: While on workers’compensation leave, the employeecontinues to accumulate vacation and sickleave to be credited for use upon return towork. If an employee does not return towork, vacation and sick leave accumulatedduring the first twelve months of workers’compensation leave will be paid in a lumpsum along with other unused vacation/bonuscredit earned prior to the injury at the time ofseparation.Health Insurance: While on workers’compensation leave, the employeecoupons will be sent to employees onworkers’ compensation leave. Employeemust re-enroll in all NC FLEX plans within30 days of returning to work.Salary Upon Return to Work: Uponreinstatement from workers’ compensationleave, the employee’s salary will becomputed based on the last salary plusany legislative increases to which theemployee is entitled. Any performanceincreases which would have been givenhad the employee been at work may alsoremains eligible for State Health Planbe included in the reinstatement salary oremployee’s or dependent/family’s healthreinstatement.injured employee to the State Health PlanLongevity: While on workers’ compensationDependent coverage may be droppedlongevity credit and, if eligible, annualcoverage. Premiums owed for the injuredinsurance must be paid directly by themay be given on any payment date followingto continue health insurance coverage.leave, the employee continues to receiveduring periods of workers’ compensationpayments.or payment coupons will be sent toRetirement Service Credit: While onleave. Employees should contactdoes not receive retirement service credit.leave. No monthly reminders, invoices,employees on workers’ compensationworkers’ compensation leave, the employeetheir agency/university health/benefitsAs a member of the Retirement System, therepresentative to obtain information on howto pay monthly health insurance premiumsemployee may purchase credits for the timeperiod on workers’ compensation leave.while on workers’ compensation leave.Upon request after returning to work, theHealth Plan within 30 days of returning toof the cost and the date by which purchaseEmployee must re-enroll in the StateRetirement System will provide a statementwork.must be made.WCA and/or Human Resources/BenefitsDisability Income Plan of North Carolina:NC Flex Plans: Agency/UniversityWorkers’ Compensation Employee Handbook7
Eligible employees who become temporarilyhowever, the employee’s authorized treatingor permanently disabled and are unablephysician has assigned temporary workto perform their regular work duties mayrestrictions (i.e. physical limitations, workingreceive partial replacement income on ahours, etc.) to the employee. The agency/short-term or long-term basis through theuniversity may provide, if available, modifiedDisability Income Plan of North Carolina. Foror light duty work for the injured employee.detailed information, access the DepartmentThe injured employee is eligible for weeklyof the State Treasurer, Retirementcompensation benefits: TTD (not workingSystems Division handbook at ks/TSERS DisabilityHandbook.pdf or by calling 1-877-627-3287(877-NCSECURE).at all) or TPD (working within restrictions forless than pre-injury wages) during this timeperiod.3. The employee has reached maximummedical improvement (MMI); however, theWhat Happens When an InjuredEmployee Returns to Work?If an injured employee receives a payment fortemporary total disability (TTD) or temporarypartial disability (TPD) after returning to work,the employee should notify their supervisoror agency/university WCA immediately. If anemployee fails to report any payment made inerror, the employee is responsible for repayingthe State for any overpayment made.When an injured employee with a compensableinjury is released to return to work by theirauthorized treating physician, there are threepossible return to work situations:1. The injured employee has or has not reachedmaximum medical improvement (MMI) fortheir work-related injury and is released toreturn to full duty work by their authorizedtreating physician. The injured employeereturns to the original or similar position heldprior to the injury. The injured employee isnot eligible for any weekly compensationbenefits.2. The injured employee has not reachedmaximum medical improvement (MMI);employee’s authorized treating physicianhas assigned permanent work restrictions(i.e. physical limitations, working hours, etc.)to the employee. An injured employee mayreturn to their pre-injury job if the employee’sjob duties are within the assigned permanentwork restrictions or the restrictions can bereasonably accommodated in that position.If an injured employee’s permanentwork restrictions cannot be reasonablyaccommodated in the employee’s pre-injuryjob, the agency/university may offer the injuredemployee another suitable job in the sameagency/university or assist the employee inseeking employment in other State agencies/universities or alternate employers.If the injured employee refuses to return towork before or after reaching maximum medicalimprovement whose duties are within assignedwork restrictions and has been approved bythe authorized treating physician, the employermay seek NC Industrial Commission approvalfor suspension or termination of the employee’sweekly compensation so long as the refusalcontinues.Workers’ Compensation Employee Handbook8
If a job is not available within the injuredto a compensable injury is eligible to receiveemployee’s assigned work restrictions,permanent partial disability (PPD) compensation.an employee continues receiving weeklyThe injured employee’s authorized treatingcompensation (TTD) benefits in accordance withphysician issues percentage of loss ratings toState law until suitable employment is obtainedinjured body parts when an employee reachesor full and final claim settlement.maximum medical improvement.Agencies/universities have Return To WorkThe PPD compensation rate is the same as thePrograms addressing the return to workweekly compensation rate an employee receivessituations described herein. The TPA adjusterwhen completely unable to work (TTD). Theand OSHR work closely with agencies/weekly compensation rate equals sixty-six anduniversities to assist with returning injuredtwo-thirds percent (66 2/3%) of the averageemployees to pre and post maximum medicalweekly wages as of the date of injury. Theimprovement work within assigned restrictions.weekly compensation rate is subject to theWhat Happens When an InjuredEmployee Has PermanentDamage to a Body Part?An injured employee that suffers total orpartial loss of use of a specific body part duestatutory compensation minimum ( 30.00 perweek) and maximum established by the NCIndustrial Commission in accordance with Statelaw. Below is the schedule for payment of totalloss of use of specific body parts.Permanent Partial Disability RateThumb75 weeksFirst or index finger45 weeksSecond or middle finger40 weeksThird or ring finger25 weeksFourth or little finger20 weeksGreat toe35 weeksAny other toe10 weeksHand200 weeksArm240 weeksFoot144 weeksLeg200 weeksEye120 weeksHearing (one ear)70 weeksHearing (both ears)150 weeksBack300 weeksSerious facial or head disfigurementMaximum 20,000Serious body disfigurementMaximum 15,000Loss of or permanent injury to any part of bodynot covered elsewhere in the statueMaximum 20,000Workers’ Compensation Employee Handbook9
The assigned impairment rating of 1%-100%An injured employee must file the NC Industrialis multiplied times the number of weeks toCommission Form 18M within two years of thecalculate the exact number of weeks of PPDlast compensation payment date. Otherwise, it iscompensation owed to the injured employee.time barred.How is a Workers’ CompensationClaim Closed?What Death Benefits areAvailable?Claims are generally closed when the employeeIn the event of an employee’s death resultingreaches maximum medical improvement, returnsto work without restrictions, or the last medicalor disability compensation payment has beenfiling of a completed NC Industrial Commissionthe NC Industrialbenefits are payable to total dependents or nextof kin in accordance with State law. A deathclaim must be filed in writing within two yearspaid. The claim is officially closed with theForm 28B withfrom an injury or occupational disease, deathof the date of death. Effective June 24, 2011,Remember:compensation fordeath is paid forCommission. TheIf an employee has questions about workers’employee receivescompensation coverage or benefits, thesix and two-thirdsa copy of the filedemployee may contact his or her agency/percent (66 2/3%)form.As stated on theNC IndustrialCommission Form28B, an employeeuniveristy Workers’ CompensationAdministrator (WCA), NC OSHR at(919) 807-4800 or workerscomp@nc.gov,or Third Party Administrator (TPA) claimadjuster referenced on Page 1 of this document.500 weeks at sixty-of the employee’saverage weeklywage. If a survivingspouse is unableto support herselfor himself due tophysical or mentalthat has a significantdisability as ofchange of conditionthe date of deathwithin two years andfeels they are entitled to additional compensationfor lost time from work or permanent impairmentto a specific body part related to the injury mustrequest additional compensation in writingdirectly to the NC Industrial Commission withintwo years of the last compensation paymentof the employee, compensation shall continueduring the life of the widow or widower or untilremarriage. Compensation payments due adependent child(ren) are paid for 500 weeks oruntil the child reaches age 18. Funeral expensesare allowed up to 10,000.date. Otherwise, it is time barred.As stated on the NC Industrial CommissionForm 28B, an employee may file a completedNC Industrial Commission Form 18M toobtain approval for lifetime additional medicaltreatment related to their compensable injury.Workers’ Compensation Employee Handbook10
Workers’ Compensation Employee Handbook 5 An employee’s weekly compensation rate equals sixty-six and two-thirds percent (66 2/3%) of the employee’s average weekly wages in the employment in which the injury occurred during the past 52 weeks prior to the injury. The weekly compensation rate is subject to a statutory
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