Workers' Compensation Program
The State Government Workers' Compensation Program is administered and managed by the Office of State Human Resources. The purpose of the program is to ensure that all eligible employees who experience a work-related injury or illness receive appropriate medical care and equitable benefits as provided under the Workers' Compensation Act and the State Human Resources Policy.
The State is a self-insured employer and has contracted with a Third Party Administrator (TPA) to handle the workers' compensation claims of most employees. The TPA is responsible for all compensation and medical bill payments through a workers' compensation fund established by State agencies and universities and administered by the Office of the State Controller, in cooperation with the Office of State Human Resources.
Employees are our state's most valuable resource. We want to keep our employees safe and make sure that they get the treatment they deserve if they are injured on the job.
All state employees are encouraged to find and report hazardous working conditions so that we can all prevent workplace injuries from occurring!
Employees are encouraged to read the Workers' Compensation Employee Handbook. This resource is designed to provide all state employees with an understanding of the benefits and coverage available by the state.
Workers' Compensation Administrators
There are a great many resources available for WCAs to effectively manage their agency's workers' compensation program.
The North Carolina General Assembly provided for transfer of specific unused funds in S.L. 2005-241 Section 30.10(a) and (c), the FY 2015-2016 state budget for, “closure of workers’ compensation claims”. The Office of State Budget Management (OSBM) has directed the Office of State Human Resources (OSHR) to establish a process for the timely distribution of these funds totaling approximately $4.38 million.
A fillable form has been created for agencies that would like to be considered for the use of some of these funds. Applications will be considered on a first-come, first-served basis. Applications may be submitted beginning July 1, 2016. Settlement Reserve Funds will be allocated for use in individual claim settlements until fully exhausted.
ACCIDENT: An unlooked for and untoward event which is not expected or designed by the injured employee; a result produced by a fortuitous cause. An accident results in an interruption in the normal work routine caused by the accident.
COMPENSATION: The monetary relief for loss of wages due to work related injury; also, payment for disability ratings given when disabling injuries occur. Types of compensation paid to employees covered by the Act are:
- Compensation for disability dependent upon extent of injury.
- Compensation in stipulated amounts for loss of some part of the body.
- Compensation for death.
- Compensation for bodily disfigurement.
DISABILITY: Incapacity because of an accidental injury to earn wages which the employee was receiving at the time of the injury in the same or any other employment. The types of disability are:
- Permanent Partial Disability - Any injury which results in the complete loss or loss of use of any member or part of the body. A disability rating, stated in percentage, is given by the treating physician when the employee has reached maximum medical improvement.
- Permanent Total Disability - Any injury other than death which results in the complete and permanent total incapacity of the employee from following any gainful occupation.
- Temporary Partial Disability - Any injury or disability which renders the employee able to work but at a lesser rate of earnings than that of his average weekly wage of his occupation at the time of the accident.
- Temporary Total Disability - Any disability which renders the injured employee unable to perform a regularly established job on one or more calendar days following the day of injury.
FIRST AID TREATMENT: One-time treatment and subsequent observation of minor scratches, cuts, burns, splinters, etc., which do not ordinarily require medical care.
INJURY: Injury and personal injury shall mean only those injuries caused by accident arising out of and in the course of the employment. With respect to back injuries and hernias, however, injury shall mean those which arise out of and in the course of the work assigned resulting directly from a specific traumatic incident.
LOST WORKDAY: Any day for which the employee is unable to earn or is not paid a full day's wage as a result of the injury or illness. These days are counted on a calendar basis and are used to determine when an employee may begin to draw compensation.
MEDICAL-ONLY CLAIMS: Those claims which have medical cost that does not exceed $2,000.00 and there is one day or less of time lost from work. These claims are accumulated by the agency and totals are submitted to the Industrial Commission once a year.