Legal Question in Workers Comp in North Carolina
My husband was injured at work, doing a job he does everyday. His workers compensation claim was denied because he was injured doing his regular duties that must be performed in order to accomplish is job. How can workers comp deny to pay? Is that not what workers comp is for?
2 Answers from Attorneys
No, that is not how it works.
He needs a good work comp lawyer. He will not be able to fix this on his own.
Work comp does not pay for all injuries, but only for injuries that were caused by an "accident." The rule is easier if it is a back or neck injury or a hernia, which only require a "specific traumatic incident." If he has not given them a recorded statement already, he should decline to do so. People often get their cases denied due to their recorded statements.
As Bob, said it is not so simple that you simply get injured and are granted benefits. Your husband needs to consult with an attorney about the facts and circumstances surrounding the incident and also discuss what he hurt. If it is a back injury or hernia, he certainly has an easier road. If it is any other body part, the injury must occur "by accident"--meaning something outside of the normal work routine (think slip, trip, fall, struck with something, etc).
By no means am I saying that the insurance company is right and that your husband does not have a claim. He does need to speak with an experienced attorney though. Many times, you will see the phrase "Attorney and Counselor at Law". I've always taken the "Counselor" part to mean it is my obligation to discuss a claim with a client or potential client, ask pointed questions and then discuss how the law applies to the facts I have learned and do my best to give the client or potential client an understanding of how those things work together to make or break a case.
Consultations for workers' comp claims in NC are free and I would advise that both you and your husband take advantage to sit down to talk to an experienced attorney. At a minimum, you and your husband should walk away with a good understanding about his case, at best, there may be some fact that you have not posted that makes your husband's case a good one to take on. It's a win-win situation for you, don't miss the opportunity.