In a workers’ comp claim, ‘accident’ is key

On Behalf of | Feb 19, 2020 | Workers' Compensation |

The idea behind workers’ compensation insurance is fairly simple. If you, as an employee, suffer an injury while doing your job, workers’ comp can provide financial support during your treatment and recovery.

It should be simple, yet here in North Carolina, it can be anything but. That’s because of strict rules around a single word: “accident.”

The injury must have been caused by an accident

Workers’ compensation is intended to be a no-fault system, meaning it generally doesn’t matter how you were injured while on the job – only that it happened. The way North Carolina interprets its law, however, makes it much harder for some injured workers to prove they should be receiving benefits.

Why is that? As the News & Observer explained in a recent story, workers’ comp only kicks in if the injury happened as the result of an “accident” at work. A worker will not get workers’ comp if they suffered the injury while doing their normal job duties.

What does this actually mean? The story includes a few examples of workers who were injured on the job, but then denied benefits because they did not meet this “accident” requirement. That includes:

  • A woman that tore her rotator cuff while stocking shelves
  • A stylist that tore her meniscus when she kneeled to help a customer put on a wedding dress
  • A prison officer that tore his rotator cuff while practicing prisoner extraction techniques
  • A machine operator that suffered a tendon tear in one arm while working with tires

According to the state’s Industrial Commission, all of these injuries happened during the course of normal job duties – and therefore, the workers were not able to get workers’ comp benefits.

Planning ahead

North Carolina’s accident requirement for workers’ comp is one of the harshest in the nation. It means workers need to keep something important in mind if injured while on the job.

After you report the injury to your employer, be very careful about how you describe what happened. If you misspeak while talking to a supervisor, or write the wrong word on a reporting form, it could sink your chances to secure workers’ compensation benefits.

Insurance companies will go to great lengths to protect their own profits. Even if a work injury was caused by an accident, they may do everything possible to try to demonstrate otherwise. That can include using your own off-hand remarks against you.