Typically, if a worker suffers an injury at work and the employer regularly employs three or more employees, the injured worker is entitled to benefits provided in the North Carolina Workers’ Compensation Act. However, there are some exceptions to what would otherwise be a compensable injury.
If an injured worker was injured due to his own intoxication, he or she may not be entitled to benefits. This exception may be nullified in the event the injured worker was provided the intoxicating substance (alcohol or drugs) by the employer or the injured worker’s supervisor. The mere fact that an injured employee was intoxicated may not be enough for the employer to escape liability. The injury to the worker must be proximately caused by (as a result of) the worker’s intoxication.
Another exception to what might otherwise be a compensable injury is when the injured worker intentionally injures or kills himself or another employee.
Under certain circumstances, if an employer fails to comply with any statutory requirement or order of the Industrial Commission, the payments due to an injured worker with a compensable injury who was injured as a result of the willful failure of the employer to follow such regulations may be increased by 10%.
Likewise, if an injured worker has been injured as a result of not following prescribed safety procedures, the benefits due to that worker may be decreased by 10%.
Blood or other medically accepted tests may be used to determine impairment of an injured worker.
In North Carolina, with a few exceptions, any employer who regularly employs three or more employees must have workers’ compensation coverage for the employees. There are exceptions for agriculture, domestic services and certain logging employers. If an employee is injured at work and suffers a compensable injury, the employer or the employer’s workers’ compensation insurance carrier is typically obligated to pay for all medical costs which are authorized by the carrier, as well as all prescriptions and mileage to and from the medical provider, when the round trip exceeds 20 miles. In addition, the injured employee, if excused from work by an authorized treating physician as a result of the compensable injury, is entitled to be paid 2/3 of his or her average weekly wage for the weeks the injured employee is excused from work. The injured worker is not entitled to pay for the first seven days out of work unless he or she is out of work for more than 21 days.
Agricultural employers may be exempt from providing coverage and being subject to the North Carolina Workers’ Compensation Act unless they regularly employ 10 or more nonseasonal workers. Sawmill and logging employers may be exempt from providing coverage and being subject to the North Carolina Workers’ Compensation Act if that operator employs less than 10 employees and saws and logs less than 60 days in any six consecutive months and whose principal business is unrelated to sawmilling or logging.
The medical and weekly pay benefits for an injured worker who suffers a compensable injury are no different for an undocumented worker or for a worker who is not legally employed.