Importance of a Change in Condition in a NC Workers’ Comp Case

The purpose of North Carolina workers’ compensation is to support employees while they recover from workplace injuries or illnesses. The goal is for the worker to get better and return to work. Most do return to work, but others have disabling conditions and are unable to return to work. 

Some injured workers who are receiving workers’ compensation see their condition change for the worse. This becomes an issue if their workers’ compensation claim has been settled but they need further medical treatment.

If an injured worker’s NC workers’ comp benefits need to be adjusted because of a change in condition, the employee may find their employer and/or employer’s insurer reluctant to increase payments. The worker may need a knowledgeable Raleigh workers’ compensation lawyer to reopen the workers’ compensation case and present medical evidence of a change in condition to justify an increase in workers’ comp benefits. 

In the Raleigh area, the workers’ compensation attorneys of Younce, Vtipil, Baznik & Banks, P.A. can help you seek an adjustment of benefits based on a change in your medical condition. We can work to ensure that workers’ comp continues to pay for your medical care and replace lost wages and that your disability rating accurately reflects your condition.

Understanding ‘Maximum Medical Improvement’ and ‘Permanent Partial Disability’

Workers’ compensation benefits may be terminated once the doctor determines that a patient has reached “maximum medical improvement.” This is the point at which the worker has recovered as much as they can be expected to through medical care.

When the worker’s doctor declares the patient has reached maximum medical improvement, or MMI, the worker is either released to return to work and benefits end, or they are assigned a Permanent Partial Disability (PPD) rating or a Permanent Total Disability (PTD) rating. The rating reflects the severity or type of disability.

A worker with a PPD may return to their old job with accommodations for their disability or may take a different job. If the worker must take a job that pays less than he or she earned before being injured, workers’ compensation should pay wage replacement benefits to make up a portion of the lost wages. There are also specific scheduled payments for certain specific types injuries, such as the loss of the use of an arm or leg.

A totally disabled worker would receive benefits based on their PTD rating.

Reaching maximum medical improvement and receiving a PPD rating typically establishes whatever ongoing benefits or lump sum settlement the worker will receive and closes a workers’ comp claim. But, if the worker’s medical condition changes, these benefits may no longer be proper and, if that’s so, they must be adjusted.

How a Change in Condition Affects Your NC Workers’ Comp Claim

Let’s consider a back injury, perhaps the most common cause of missed workdays among American workers. You could injure your back in a workplace accident, such as in a fall, or a bad back could be a cumulative injury caused by years of lifting, bending, stress and strain while on the job.

A back injury may be treated with anything from bed rest and pain relievers to surgery and physical rehabilitation. But back injuries can be degenerative, meaning they may grow worse over time, and back surgery can easily fail to achieve significant pain relief.

If you are out of work with a job-related back injury or any occupational injury, you could face a change in your medical condition and a need to adjust your workers’ comp benefits, even after receiving a disability rating.

North Carolina’s workers’ compensation law gives you only a limited amount of time after the last time workers’ comp has paid a medical bill for you to claim a change in condition and seek additional workers’ compensation benefits. A change of condition claim would require medical evidence that demonstrates substantial worsening of the original occupational injury for which benefits were paid.

When considering a request to modify workers’ comp benefits, the Industrial Commission may increase, reduce or terminate the benefits being provided to an injured worker. Our attorneys can review your circumstances and offer guidance about whether a petition for a change of condition is in order in your case. 

You would need to be ready to rebut any allegations that you did something to exacerbate the injury or to re-injure yourself, which an employer or insurer might try to claim to avoid paying additional benefits.

Conversely, if your condition gets better and you are no longer disabled, you must report this to your employer or the N.C. Industrial Commission, which administers workers’ compensation programs. 

How a NC Workers’ Compensation Attorney Can Help

The workers’ compensation attorneys of Younce, Vtipil, Baznik & Banks, P.A. can help you file for a change in your workers’ compensation benefits based on a change in your medical condition. We can handle all of the paperwork and ensure that your filing meets deadlines and other requirements of the N.C. Industrial Commission. We can serve as your legal counsel and advocate if your claim has advanced to the appeals process.

While workers’ comp rules require you to see the doctor assigned to your claim, you can also see another doctor for a second opinion. If needed, our firm can refer you to physicians in the Raleigh area who we consult with and who understand what information the Industrial Commission will consider about a claimant’s medical condition. 

The North Carolina workers’ compensation system is extremely complex. Most injured workers are not fully aware of their rights or how to enforce them, but they face attorneys for their employer and the workers’ comp insurer who work the system every day.

Let the lawyers of Younce, Vtipil, Baznik & Banks, P.A., protect your benefits and deal with the insurance company if there is a change in your medical condition that warrants an adjustment to your workers’ compensation claim or settlement. Phone us at 919-661-9000 or contact us online to get started with a free initial consultation about your case. 

 

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North Carolina Restricts COVID-19 Liability

As Congress debated a COVID-19 relief package at the end of 2020, you may have heard that a sticking point was the Senate leader’s insistence on providing liability protection to ensure that businesses could not be sued if customers or employees contracted COVID-19 from exposure to the virus on their premises. What was less well-publicized is the fact that as of September 1, 2020, more than a dozen states had passed legislation of their own, shielding businesses from COVID lawsuits.

North Carolina is one of those states. In 2020, the North Carolina General Assembly adopted a bill that provides that in a claim for compensation due to contraction of COVID-19, the defendant is not liable for “any act or omission that does not amount to gross negligence, willful or wanton conduct, or intentional wrongdoing.” Gov. Roy Cooper signed the bill into law. The governor also signed a subsequent bill that granted the owners and operators of community pools the same immunity from COVID-19 liability.

In other words, the burden of proof for showing that you should be compensated for contracting the coronavirus at a business, government agency, or nonprofit is higher than simply proving someone was negligent.

Deciding what constitutes “gross negligence, willful or wanton conduct, or intentional wrongdoing” will be up to courts and juries. According to the North Carolina Pattern Jury Instructions, an act is willful if the defendant intentionally fails to carry out some duty imposed by law which is necessary to protect the safety of the person to which it is owed. An act is wanton if the defendant acts in conscious or reckless disregard for the rights and safety of others. This means that if a business has willfully violated closure orders or curfews, a claim may be successful.

At Younce, Vtipil, Baznik & Banks, P.A., our personal injury lawyers are reviewing possible COVID-19 coronavirus injury claim cases and seeking compensation for our clients, when appropriate. Phone us at 919-661-9000 or contact us online for a free initial consultation if you think you may have a claim.

What is Limited Immunity from COVID-19 Transmission?

The primary COVID-19 limited immunity statute spells out who and what it applies to. The law says “no person shall be liable” except as we describe above, and defines “person” as:

• An individual
• Corporation
• Nonprofit corporation
• Business trust
• Estate
• Trust
• Partnership
• Limited liability company (LLC)
• Sole proprietorship
• Association
• Joint venture
• Government
• Governmental subdivision, agency, or instrumentality
• Public corporation
• Or any other legal entity.

The clause in the second law covers community pools, defined as “a privately owned community swimming pool, including a swimming pool owned or operated by a multiunit apartment complex, homeowners association, or condominium unit owners association.”

The immunity is granted for claims filed up to 180 days after North Carolina’s state of emergency order regarding coronavirus protections is lifted. Unfortunately, as of this writing, there are no concrete plans for when this order may be rescinded.

Some politicians and business lobbyists have pushed for blanket immunity, which would eliminate the possibility of any claim based on the transmission of COVID-19. But this ignores the plight of those sickened because of others’ bad actions and, some argue, weakens incentives for businesses to maintain a safe workplace. On the other extreme, some have argued there should be no immunity, which ignores the potential impact of legal costs on businesses already struggling through the pandemic and insurers facing billions in COVID claims.

North Carolina’s law falls somewhere in the middle, allowing that in some cases it is correct to hold a “person” accountable for disregarding the danger of allowing COVID-19 to spread.

North Carolina’s law also states specifically that COVID-19 immunity does not extend to workers’ compensation claims.

Can I File for Workers’ Compensation if I Get COVID on the Job?

If you believe you contracted COVID-19 from an exposure that occurred while you were at work or otherwise on the job, you should seek workers’ compensation. If your employer disputes your claim, you should also contact an experienced North Carolina workers’ compensation attorney. We believe many employers and their insurers will fight COVID-related workers’ compensation claims filed by workers outside of occupations at the highest risk for COVID exposure.

Workers’ compensation pays for medical care and a portion of lost wages if an employee cannot work because of an illness contracted during the performance of their job duties. Workers’ compensation covers all medical costs, including hospitalization, medications, rehabilitation, and more.

In a workers’ compensation claim, the employee needs to provide evidence that:

• He or she contracted the illness from exposure at a job site or while performing assigned job duties, and
• Because of their job, the employee is at greater risk than the general public for contracting the condition. Because COVID-19 is a pandemic, it will be important to be able to overcome the potential allegation that your COVID exposure likely occurred outside of your job.

North Carolina workers’ compensation laws cite some specific occupational diseases contracted from chemical exposures, which do not require evidence of exposure greater than the general public’s.

The Occupational Safety and Health Administration (OSHA) has divided job types into four exposure risk levels: very high, high, medium and lower risk. Most American workers will likely fall in the lower exposure risk or medium exposure risk levels, OSHA says.

Jobs with a very high or high potential for exposure are held by healthcare and medical laboratory workers and funeral home workers.

The medium exposure risk is found in jobs that require frequent/close contact with people who may be infected, but who are not suspected of having COVID-19. Workers in this category include:

• Those who may have frequent contact with international travelers.
• Those who may have contact with the general public in schools, high population density work environments, and some high-volume retail settings.

Those with a low risk include:

• Remote workers
• Office workers without frequent close contact with coworkers, customers or the public.
• Manufacturing and industrial facility workers without frequent close contact with coworkers, customers or the public.
• Healthcare workers providing only telemedicine services.
• Long-distance truck drivers.

Many ill and injured workers lose important rights and benefits because they delay seeking the help of a workers’ compensation attorney. Don’t wait. Contact Younce, Vtipil, Baznik & Banks in Raleigh, NC, today. The initial consultation about whether you have a valid case is free.

The post North Carolina Restricts COVID-19 Liability appeared first on .

from Younce, Vtipil & Baznik, P.A. https://www.attorneync.com/blog/north-carolina-restricts-covid-19-liability/
via https://www.attorneync.com