What is Workers’ Compensation
Transcript:
Cindy Speaker: What is workers compensation? That’s our topic on this episode of Main Street Law. My guess is North Caroline Personal Injury Atty. Michael A. DeMayo of the Law Offices of Michael A. DeMayo. So Michael, thanks for being here today.
Michael DeMayo: Always a pleasure.
Cindy Speaker: Well, Michael, what is workers’ compensation?
Michael DeMayo: Workers’ compensation is exactly what it sounds like, it is a scheme, an administrative scheme that covers individuals if they are injured on the job. It’s not liability base, so it doesn’t really matter, there doesn’t have to be an at fault component, it just has to be that someone is employed and working and on the job at the time of the accident. So it’s fairly simple and basic. There are some limitations as to who is covered, but generally, very, very small companies of two employees or less are ones that are not required in our state to have coverage. But for the most part, if you are working and you are injured on the job, you would be entitled to workers’ compensation.
Cindy Speaker: Okay. Well, let me ask you this. Does an injured employee have the option of opting out of the workers’ compensation system and instead suing their employer?
Michael DeMayo: In essence, the answer is no. There is a very, very, very, very small minute exception to the exception, they’re called Woodson’s claims where gross negligence has to be shown on the part of the employer to make a separate third party claim. But in the last four to eight years, the Supreme Court of North Carolina has eviscerated even the Woodson claim somewhat so that they are none existent.
So in essence, the short answer is no. Workers’ compensation as a general rule is your exclusive remedy if you are injured on the job. Now, that is as with regard to the employer. If you are injured on the job and you happen to be in an automobile accident and you are on the job but there is a third party defendant, you do have the potential to make two claims. One is the workers’ comp claim and one is the personal injury claim. But if the only liable defendant potentially in you claim is the employer, workers’ compensation will be your only remedy.
Cindy Speaker: Very good. Now, are there any injuries that are not covered by workers’ compensation?
Michael DeMayo: Generally, no. There are some—generally, workers’ comp covers any injury on the job regardless like I said of liability. There are some exclusions if you are under the influence of alcohol or drugs that is a reason to deny workers’ complementation coverage. Obviously, if it’s not a accident, then you’re not covered under the workers’ compensation scheme. But anything from exposure to repetitive motion, like carpal tunnel, those are all covered. So as a general rule, if you are uncertain about whether or not you have a potential legitimate workers’ commensuration claim, it is generally advisable to consult an inexperienced workers’ comp attorney to give you some advice and some council as to whether or not there is coverage there.
Cindy Speaker: And Michael, if someone wants to speak with you, how can they reach you?
Michael DeMayo: Well, they probably won’t speak to me because we have a team of dedicated professionals of over 84 employees, but we do have an entire department that just as workers’ comp, three attorneys specifically, two that are board certified and what they would do is they would contact our office, they can either call us toll free at (877) 333-1000 or they can go to our website which is www.demayolaw, all one word, D-E-M-A-Y-O-L-A-W dot-com and certainly, we can give them information and/or if we can assist them, get them singed up so we can start working on their case.
Cindy Speaker: Excellent. Michael, thank you so much for your time today.
Michael DeMayo: My pleasure.
Cindy Speaker: This is Cindy Speaker for State Law TV.
What Is Workers’ Compensation?
Video Transcript:
Cindy Speaker: What are my legal rights if I am injured at work? That’s our topic on this episode of Main Street Law. My guest is North Carolina Personal Injury Attorney Michael A. DeMayo of the law offices of Michael A. DeMayo. So Michael thanks for being here.
Michael A. DeMayo: My pleasure as always Cindy.
Cindy Speaker: Well Michael, what are my legal rights if I’m injured at work?
Michael A. DeMayo: Generally, if someone is injured at work, they have rights to what’s called compensation or worker’s compensation. Generally what that entails is they are entitled to get their medical bills paid and if they are out for more than seven days, they’re entitled to get two thirds their salary capped to a maximum amount as far as benefits. As a general rule, if the injury is one where they will resolve their treatment and their injury will resolve, and there’s not going to be any level of permanency or future lost earnings, that’s something that generally is concluded there and often times does not need an attorney.
If on the other hand there’s any kind of permanency, serious injury, toxic exposure, repetitive motion exposure like carpal tunnel, where there’s any kind of surgery or any kind of potential future or present diminution in wages, then it is usually very important that someone hire an experienced worker’s compensation attorney to help them recover, because not only are they entitled to the medical bills and two thirds salary, but oftentimes they are entitled to either a series of payments or a lump sum payment which is usually concluded in a settlement which is also called a clincher.
Cindy Speaker: Okay. Well Michael, walk us through the steps. If someone is injured, what is the first step?
Michael A. DeMayo: Sure. The first step is you have to report an on the job injury as soon as possible. Generally, that same day is recommended, but 30 days usually is kind of a litmus test.
It is the responsibility of the employer to then file what’s called the Form 18, which starts the claim essentially. It opens a worker’s compensation claim. There is a two-year statute of limitations on worker’s comp claim. So if the employer refuses, which is illegal, or is not able for some strange reason to assist in that, then certainly for example our firm could help in filing a Form 18.
As a general rule, you will report the accident and obviously secondarily, get care or treatment. Oftentimes the employer or their insurance company will dictate and delegate where the person is to go for treatment. That is one of the things as worker’s comp that you have to kind of abide by. Worker’s comp is no fault so it doesn’t matter if it was your fault or it wasn’t your fault. You’re still covered as long as you were on the job at the time of the accident. So it’s important that you report it and get treatment. From there, depending on the severity of the injury than often times it is important to seek legal representation from an experienced worker’s compensation attorney.
Cindy Speaker: Michael, tell us about the requirements in obtaining medical care. Do you have to go to a company assigned doctor or can you go to your own doctor?
Michael A. DeMayo: You generally have to abide by under the worker’s compensation scheme. You do have to go to the doctors that the worker’s compensation carrier refers you to. When we get involved for example though, oftentimes, we can send the client to what’s called the second opinion if maybe our doctors disagree with the insurance company doctors.
Someone has to remember that the doctors that are used by the workers compensation insurance carriers are generally ones that are more favorable towards the insurance company and the employer. So their job is to get the person back to work as soon as possible.
Obviously in a perfect world, you’d want an unbiased doctor who would not basically take into account whose paying their bill, but that’s not the world we live in. So as a practical matter, yes. You do have to abide by and go to the doctors they refer and recommend, but with an experienced worker’s compensation attorney, oftentimes, we can recommend different doctors and certainly get a second opinion if there’s any questions about either the level of injury or the necessity of surgery or any future medical needs.
Cindy Speaker: Okay now, what if the company doctor orders me back to work and I don’t feel ready? Do I have any recourse?
Michael A. DeMayo: Again, generally you do have to go back to work. Again, if you have an experienced worker’s comp attorney, a lot of times we are able to get a second opinion where the second opinion says, “Hey! This person can’t return back to work,” and then it is legitimate to stay out.
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It is not appropriate for the person to decide of their own volition that they are not going to go back to work regardless of what the doctor says. If they do that, yes, they will cut off their benefits and they’re in for a decent fight. So you have to work within the rules and the regulations because worker’s comp is regulated by the Industrial Commission and it’s an administrative remedy. But that being said, there are some ways to work within the system that we can utilize to benefit the client or the injured person.
Cindy Speaker: Very good. Well it sounds like a complicated area of the law.
Michael A. DeMayo: Yes. Worker’s compensation is a very detailed, sophisticated area of the law and you should never in my opinion, if you have any type of serious injury, use anyone other than a worker’s compensation attorney who only does that type of work.
In our office, we have three worker’s compensation attorneys, two that are certified Worker’s Compensation Specialist by the North Carolina State Bar which says, they need an even higher standard of regulations and they have taken an exam to show their level of expertise in that particular area. But yes, generally, there’s no reason why anyone should not get an experienced worker’s comp attorney especially if you have a severe injury on the job.
Cindy Speaker: Well Michael, if someone has specific questions, how can they reach you?
Michael A. DeMayo: They can certainly always call us, 24 hours a day, seven days a week, anywhere in the United States at 1-877-333-1000. That’s a very easy number to remember. Or someone would feel more comfortable researching our firm and finding out about our knowledge, experience, and expertise and our track record. They can certainly go to our website at www.demayolaw.com, that’s D-E-M-A-Y-O-L-A-W, and they certainly can get information, they can do what’s called an online inquiry. We even have someone that will come on while their on the web and will ask them if they can help them, it’s called a web chat. So we have a number of different ways where clients can either communicate. Contact us, or at least check us out before they decide to hire us.
Cindy Speaker: Excellent. Well Michael, thank you so much for your time today.
Michael A. DeMayo: My pleasure.
Cindy Speaker: This is Cindy Speaker for State Law TV.
