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Frequently Asked Questions About Disability and Workers’ Compensation Claims in North Carolina

Answers from an experienced North Carolina benefits attorney

Disability and workers’ compensation matters have a profound effect on your health and your ability to support your family. To maximize the chance of a positive outcome, it is essential to retain an attorney with significant experience in these complex practice areas. At Mark H. Woltz, Attorney At Law, I am a board-certified workers’ compensation attorney who provides effective legal support in matters before the Social Security Administration and the North Carolina Industrial Commission. If you’ve been hurt and can’t work, you’re bound to have questions. My firm is here to help you obtain the benefits you’re entitled to and provide answers to common questions such as these:

Contact an experienced North Carolina lawyer for a free consultation on a disability or workers’ comp claim

Mark H. Woltz, Attorney At Law represents clients in Durham, Person, Granville and Vance counties in a full range of workers’ compensation and Social Security Disability matters. Please call 919-864-2489 or contact me online to schedule a free initial consultation at my Durham office.

Who is eligible to file for Social Security Disability Insurance (SSDI)?

SSDI is a disability insurance program for people who have been unable to work for at least a year due to a significant medical condition. It is designed to compensate people who have worked steadily but can no longer perform substantial gainful activity. In most cases, this means that an applicant must have worked and paid into the SSDI system for at least five of the previous 10 years.

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What are the differences between SSDI and SSI?

Supplemental Security Income, SSI, is a program created to help people who cannot work and lack the resources to provide for basic needs, such as food, clothing and shelter. It is available to people those who are disabled, blind or elderly but they must lack the ability to otherwise support themselves. It is not an insurance program, so, unlike SSDI, it is not dependent upon the recipient’s work history.

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How do I appeal a Social Security Administration decision?

If you believe that the Social Security Administration has wrongly denied your application for SSDI or SSI benefits, you can appeal. First, a request for reconsideration can be filed. This request can include updated information. Should the decision remain intact, a claimant can present their case in a hearing before an Administrative Law Judge. You can submit evidence, call witnesses and be represented by counsel during the proceeding. Many reversals do occur at this stage. If you do not win after the hearing, you can bring your case to an Appeals Council and even in federal court.

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If I suffer an injury at work, what workers’ compensation benefits can I receive?

Regardless of any fault designation, you should receive certain benefits if you have been injured during the course of your work. Reasonable medical costs and rehabilitation expenses should be covered by your employer’s workers’ compensation insurance. This includes reimbursement for prescription medications and associated expenses, such as the cost of travel to medical appointments. Claimants also receive two-thirds of their weekly wage while they are out of work up to a limit set by the state. In 2017, the weekly limit is $978. You can also arrange to receive a lump-sum settlement from your employer and their insurance company.

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What are common reasons for workers’ compensation claims being denied?

Sometimes, employers and their insurers refuse to accept that an injury justifies workers’ compensation benefits. For instance, a claim might be rejected because your employer alleges that the injury or illness did not occur during the course of your work. Other times, companies seek to prevent or stop workers’ compensation benefits because they allege that the claimant is not following medical instructions. Procedural issues, such a late claim or a failure to inform your employer of your injury within the required timeframe, are also sometimes raised.

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Can I obtain benefits if I am able to work on a limited basis?

If you are able to perform limited work that results in a wage reduction, you can collect partial benefits under North Carolina workers’ compensation law. This compensation can be awarded on a temporary or permanent basis. Temporary workers’ compensation wage reimbursement is adjusted according to your income. For permanent disability, a percentage is assigned to the specific impairment(s), and compensation is reduced by that rate.

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If I have been denied workers’ compensation benefits, can I appeal?

Yes. If your workers’ compensation claim has been denied, you can seek to reverse the denial by filing a Request for Hearing with the North Carolina Industrial Commission. Following that, mandatory mediation occurs. During this process, the parties often reach a mutually acceptable resolution. If not, a hearing occurs before a deputy commissioner. Should you fail to win a reversal there, you can try to have your case reviewed by a panel of commissioners or in court.

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