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. The Workers' Compensation Employee Handbook is designed to provide all state employees with an understanding of the benefits and coverage available by the state.
The Workers' Compensation law provides medical benefits and disability compensation including a weekly compensation benefit for time lost. The weekly benefit is equal to 66 2/3% of the employee's average weekly earnings up to a maximum established by the Industrial Commission each year. When an employee is injured, he/she must go on workers' compensation leave and receive workers' compensation weekly benefits after the waiting period required by statute (G.S. 97-28).
All North Carolina State Government employees are covered under the State Government Workers' Compensation Program. This includes all agency and university employees and officers. It also includes all State elected officials, members of the General Assembly, or those appointed by the Governor to serve on a per diem, part-time or fee basis. It covers full-time employees, part-time employees, and temporary employees.
The law provides medical and disability compensation including a weekly compensation benefit for time lost from work which is 66 2/3% of the employee's average weekly wage up to a maximum established annually by the North Carolina Industrial Commission. There is a seven calendar day waiting period where no compensation for lost time will be allowed. During this time, employees may elect to go on leave without pay or use any sick or vacation leave accrued prior to the injury. An explanation of leave options and continuation of other benefits may be found in the Workers' Compensation Leave section of the State Human Resources Policy.
Agencies are responsible for administering their own programs, including funding medical treatment and compensation for loss of wages for employees experiencing a work related injury or occupational illness. A Third Party Administrator (TPA) contracted by the state, handles the individual workers' compensation cases for the University System, the Judicial Branch, the Legislative Branch, all agencies under the Executive Branch, and several Boards and Commissions. The TPA currently responsible for handling those workers' compensation claims is CorVel, which has offices located in Charlotte and Raleigh.
The supervisor has the responsibility of ensuring that the employee receives medical treatment immediately and notifying the agency Workers' Compensation Administrator, or designee, as soon as possible in order to begin the process of administering the claim. The supervisor should be aware of where to direct the employee for medical treatment (unless it is a life-threatening emergency). The agency Workers' Compensation Administrator will provide the name of the selected physician from the Preferred Provider Network listing, unless the agency utilizes an in-house medical treatment facility.
The following are the primary responsibilities typically carried out by the agency Workers' Compensation Administrator:
- Administer an effective and efficient Workers' Compensation program.
- Effectively communicate Workers' Compensation policy and procedures to all employees.
- Facilitate good employee relations with respect to Workers' Compensation claims.
- Maintain a thorough working knowledge of the Workers' Compensation Act and Industrial Commission rules, regulations, and procedures.
- Assure that injury notices are received from supervisors in a timely manner.
- Assure reimbursement of funds to the Workers' Compensation Fund on a monthly basis.
- Ensure completion of Form 19s, or other appropriate/required forms, and forward to the third party administrator, where applicable.
- Coordinate Workers' Compensation claims accident investigations with the Safety Officer and third party administrator.
- Coordinate pay, including benefits, for all employees that are involved in a Workers' Compensation claim.
- Participate in clincher agreements.
- Develop and administer an effective return-to-work program.
- Coordinate agency/university participation of Industrial Commission hearings when necessary.
- Assure accurate salary continuation of employees involved in Workers' Compensation cases, where applicable.