North Carolina requires all businesses to have workers comp for employees, with only a few exceptions.
Workers comp insurance typically pays medical bills and a portion of lost wages for a worker who's injured while doing a job-related task. Work injuries that can be covered by workers comp range from foot joint pain to broken bones to stress and anxiety.
North Carolina workers compensation law outlines many details on the limits of workers comp payment, who can be exempt from coverage and who must be covered. Below are many of the specifics contained in the workers comp law in North Carolina. The North Carolina Industrial Commission also has a page with helpful information for employers.
Who must be covered by workers comp in North Carolina
Can any employees opt out of North Carolina workers compensation with a waiver?
Yes - corporate officers and sole proprietors can.
Is self-insurance for workers comp allowed in North Carolina?
Yes, for individual employers, groups of employers and political subdivisions. Political subdivisions in North Carolina are typically the state or a city, county, special district, school district or public agency.
By self-insuring, a business assumes responsibility for paying their own workers comp claims. A self-insured company typically hires a claims service company to handle claims administration and other services.
Are there exclusions for:
Small employers? Yes, for employers who employ fewer than three workers.
Agricultural employers? Yes, farm laborers are excluded when fewer than 10 full-time, non-seasonal farm laborers are regularly employed by the same employer.
Domestic employers? Yes, excludes domestic servants and their employees.
Independent contractors? Yes.
Casual employees? Yes.
Volunteers? Yes, officers and volunteers of non-profit corporations may be excluded, provided they receive no compensation (other than reasonable expense reimbursement) for their service to the non-profit corporation.
Professional athletes? No.
North Carolina workers comp medical benefits
Is there a North Carolina workers comp fee schedule?
Yes.
Fee schedules define payments for surgery, radiology, hospital services, chiropractic care, ambulance service, prescription drugs and other medical services for an injured worker.
Are there limits on medical treatment?
Yes.
Medical treatments must be reasonably related to compensable injury. Medical utilization review is authorized by statute. Chiropractic treatment is initially limited in the number of visits. Certain in-patient services can invoke pre-authorization requirements..
Who makes the initial choice of treating physician?
The employer has the right to direct medical treatment, subject to the commissioner's right to order treatment. In emergencies, the employee may select a medical care provider, subject to the subsequent approval of the North Carolina Industrial Commission. The employee may seek a change in health care provider subject to the North Carolina Industrial Commission approval.
Disability payments for workers compensation insurance in North Carolina
Workers comp typically pays an employee some of their salary when they can't work because of a work-related injury. State laws define the limits on the disability payment length and amount, based on both temporary and permanent disability.
How are temporary total disability (TTD) payments calculated?
66 2/3% of the employee's pre-injury weekly wage, subject to a minimum and maximum.
Weekly minimum: $30
Weekly maximum: $944
Maximum length of TDD benefits: Benefit limits have been changed to 500 weeks and can be extended by the North Carolina Industrial Commission if the employee has sustained a total loss wage-earning capacity.
How are permanent total disability (PTD) payments calculated?
66 ⅔% of the employee's pre-injury wage, subject to a minimum and maximum.
Weekly minimum: $30
Weekly maximum: $944
Are there cost of living increases for PTD payments? No.
Maximum length of PTD benefits: Benefit limits have been changed to 500 weeks and can be extended by the North Carolina Industrial Commission if the employee has sustained a total loss wage-earning capacity.
How are permanent partial disability (PPD) payments calculated?
66 ⅔% of the employee's pre-injury wage, subject to a minimum and maximum.
Weekly minimum: $30 for scheduled injuries.
Weekly maximum: $944 for scheduled injuries.
Fatality benefits under North Carolina workers compensation law
Maximum burial benefit: $10,000
Dependency benefits, weekly minimum / maximum: $30/$944
When do children's dependency benefits end? 500 weeks or at age 18, whichever is longer.
Other injuries covered by North Carolina workers compensation
Mental stress with no physical injury? Yes.
Cumulative trauma (such as injuries caused by repeated exposure or repetitive motion)? Yes.
Occupational hearing loss? Yes.
Disfigurement? Yes.
Source: Workers Compensation Research Institute, May 2016 report