North Carolina Workers' Compensation Insurance
Workers' comp protects your employees by covering the cost of medical care for work-related injuries or illnesses.
In addition to reimbursing medical bills, workers' comp can cover lost wages, disability benefits, and more.
Read on to find everything you need to know about workers' compensation laws in North Carolina.
Is Workers' Comp Required in North Carolina?
Workers' comp is required for most North Carolina businesses that employ three or more people.
For that, you can thank the North Carolina Industrial Commission. In 1929, the Commission passed the North Carolina Workers' Compensation Act (NCWCA) stating that all businesses with three or more employees—both part-time and full-time—must have workers' compensation coverage. That law still holds true today.
You're also required to provide coverage, no matter how many employees you have, if your business involves radiation.
Companies that don't have comp coverage can face strict penalties, including fines and even criminal prosecution.
Who Is Exempt from Workers' Comp?
So, what are the exceptions? These business owners and workers don't typically don't require coverage:
- Sole proprietors
- LLC members
- Business partners
- Corporate officers
- Workers employed by the federal government
- Railroad workers, if covered by federal policies
- Domestic workers
- Farm laborers, if the farm employs 9 or fewer employees
- Workers who sell agricultural products on a commission-based salary
- Casual employees
Note that: Sole proprietorships, LLCs, and corporations still need workers' comp for their employees–if they have three or more of them.
How Does Workers' Comp Work in North Carolina?
When an employee sustains a workplace injury or illness, they can receive compensation for medical treatment, lost wages and other benefits by reporting the issue to their employer within 30 days and filing a claim with the Industrial Commission using Form 18.
In filing their claim, employees must be able to demonstrate three things:
- They work for the employer under whom they're filing
- The injury or illness was caused by their job
- The injury or illness resulted in losses
The employer must also file Form 19 and send a copy to the employee.
Workers' compensation insurance covers injuries and illnesses like:
- Sprains, breaks, and fractures, such as a broken arm or sprained wrist
- Cuts or tears requiring stitches
- Concussions
- Injuries that worsen pre-existing conditions, such as back strain
- Repetitive stress injuries, such as carpal tunnel
- Occupational diseases from exposure to chemicals or other hazards
In North Carolina and other states, most insurance companies have a list of preferred healthcare providers for employees to choose from.
If an employee would like to see a provider outside of that list and be compensated for any related medical bills, they may need to get special permission from the insurance carrier.
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North Carolina Workers' Compensation Benefits
Injured workers may be able to receive a number of benefits based on the extent of their illness or injury. Here's some more information about the main types of benefits they may be entitled to.
- Medical benefits cover the cost of physician visits, chiropractic treatment, physical therapy, prescriptions, hospital stays, and more.
- Income benefits cover an employee's lost wages, usually in the amount of two-thirds of their average weekly wage, up to the state maximum.
- Disability benefits help support an employee suffering from lasting impairment, such as a debilitating back or leg injury. These can include benefits for permanent partial disability and temporary total disability.
- Death benefits cover the cost of funeral expenses (up to $10,000) and lost wages (two-thirds of the employee's average weekly wage up to the state max, paid for at least 500 weeks or until one of the children turns 18). These are paid to the employee's dependents, typically the spouse and children of the deceased.
How Can Businesses Save Money on Workers' Comp?
To save money on workers' comp, businesses may opt for pay-as-you-go coverage. As opposed to traditional comp, pay-as-you-go insurance coverage comes with lower premiums and minimal audit fees.
Hourly's pay-as-you-go model helps small businesses make payments in real-time based on their actual payroll numbers rather than an estimate.
Not only does this improve your cash flow, it means that at the end of the financial year, you won't get hit by a nasty audit bill since your payroll numbers are actual, not estimated.
Talk to your insurance carrier today to get started with Hourly.
FAQs
How much can an employee get on workers' comp in N.C.?
In 2023, an employee on workers' comp in N.C. can receive up to $1,254 per week. This number is set by the state and typically changes every year.
How long does it take to get a workers' comp settlement in N.C.?
The state will typically notify an employee of their benefits within 14 days, and payments start as soon as the claim is approved.
Sometimes, an injured employee may choose to settle their claim and receive a lump sum, which they can then use to pay for medical expenses and other fees as they see fit.
When this happens, the employer is no longer held responsible for any additional costs that may come up in the future. Workers' compensation cases typically take 12-15 weeks to settle.
How long can you be on workers' comp in N.C.?
While it varies depending on the case, an employee can typically receive workers' compensation benefits for up to 500 weeks or until they're able to return to work.
If the employee is permanently disabled, they may be able to receive benefits even after their recovery, and in some cases, for the rest of their lifetime.
What is the coming and going rule in North Carolina workers' compensation?
If an employee gets into an accident on their way to work, can they file for workers' comp? Not according to the going and coming rule.
This rule states that employers are not responsible for any accidents that occur while commuting, and as a result, workers' comp does not cover any resulting medical bills or other expenses.
How long does an employee have to file a workers' compensation claim in N.C.?
The statute of limitations on workers' comp claims is two years from the date of injury or, in the case of an occupational disease, two years from when the employee first experiences symptoms. But there are other deadlines you should be aware of as well:
- An employee must report an injury to their employer within 30 days.
- The employer must file Form 19 and send a copy to the employee within 5 days of learning about the injury.
- The employee must file Form 18 within five days of reporting their injury to the employer.
How much does workers' comp cost in North Carolina?
The cost of workers' comp insurance depends on several factors, including:
- Payroll and number of employees
- Job type and risk factor*
- Claims history
Based on the risk level associated with your employee's duties, you'll be assigned class codes, which will affect your premium rates.
It goes without saying that businesses with more employees and higher risk levels, such as airlines or construction companies, will pay more than small businesses with low-risk jobs, such as law firms or therapy practices.
How do I find an authorized healthcare provider?
Employees can contact the N.C. Industrial Commission for a referral to an authorized healthcare provider, either by calling (919) 807-2616 or sending a letter to N.C. Industrial Commission, 4340 Mail Service Center, Raleigh, N.C. 27699-4340.
Easy, Inexpensive N.C. Workers' Compensation
Getting comp coverage for your employees can be expensive and time-consuming. At Hourly, we make it easy and affordable with pay-as-you-go coverage and premiums based on your actual, real-time payroll figures.
Get in touch with us to see how you can get started today with lower workers' compensation rates.
