What You Need to Know About Medical Treatment & Wage Replacement
A workplace injury can disrupt more than your daily routine — it can affect your health, your paycheck, and your future. If you’ve been hurt on the job in North Carolina, you may be entitled to workers’ compensation benefits, including medical care and wage replacement. But to get the full benefits you’re owed, it’s important to understand how the system works — and where things can go wrong.
Here’s what every injured worker should know about maximizing their benefits and protecting their rights.
What Medical Treatment Does Workers’ Comp Cover in North Carolina?
Under North Carolina law, workers’ compensation insurance must cover all medical care necessary to effect a cure or give relief to your condition and which is causally related to your work injury, including:
- Emergency treatment
- Doctor’s visits
- Diagnostic tests (like MRIs, CT scans)
- Surgery
- Physical therapy or rehabilitation
- Prescription medications
- Medical equipment (e.g., crutches, braces)
- Prosthetics or home modifications, if applicable
Your employer or their workers’ compensation insurance carrier generally has the right to direct your medical care (see N.C. Gen. Stat. § 97-25). This means they choose the doctor you see. However, you may request a second opinion or treatment from a different physician — but it must be approved through the proper legal channels.
Important Tip:
If you don’t follow the approved treatment process, your medical bills might not be covered. Speaking with an experienced attorney can help ensure your care stays on track — and your bills stay covered.
What Is Wage Replacement (Lost Wages) and How Does It Work?
If your injury prevents you from working, workers’ compensation may provide wage replacement benefits while you recover. These benefits are called Temporary Total Disability (TTD) or Temporary Partial Disability (TPD), depending on your situation.
Temporary Total Disability (TTD)
If you can’t work at all due to your injury for more than 7 consecutive days, you may qualify for TTD benefits, which provide two-thirds (66.66%) of your average weekly wage. It is important to note your inability to work must be supported by medical evidence, such as an out of work note from an authorized physician.
These payments begin after 7 consecutive days, but if you miss more than 21 days, you’re entitled to back pay for that first week.
The maximum weekly benefit is capped each year by the North Carolina Industrial Commission. In 2024, the cap is $1,254.00 per week (NCIC Maximum Weekly Benefits).
Temporary Partial Disability (TPD)
If you can return to work but are making less money due to your injury, you may qualify for TPD benefits. These pay two-thirds of the difference between your pre-injury and post-injury earnings, for up to 500 weeks, which is a cap.
Can I Choose My Own Doctor?
While your employer or their insurance company typically selects your treating physician, you can request approval from the North Carolina Industrial Commission to switch providers. There are also certain rights to second opinions, especially for cases involving permanent impairment ratings.
However, switching providers without permission could risk losing coverage. It’s best to have legal guidance before taking this step.
What About Long-Term or Permanent Injuries?
If your injury results in permanent disability, additional benefits may be available under Permanent Partial Disability (PPD) or Permanent Total Disability (PTD) rules.
PPD benefits are based on a scheduled rating system in North Carolina, outlined in N.C. Gen. Stat. § 97-31. For example, losing a finger, limb, or use of a joint may entitle you to a specific number of weeks of compensation.
PTD benefits may be paid for life in severe cases, such as paralysis, traumatic brain injury, or the loss of multiple limbs. Obtaining benefits beyond the 500 cap applies in limited situations only.
Common Mistakes That Can Cost You Benefits
Workers’ comp benefits aren’t always automatic — and there are several ways your claim can be delayed or denied. Here are a few common missteps to avoid:
- Not reporting your injury promptly (You must report it to your employer as soon as possible, and in writing within 30 days — N.C. Gen. Stat. § 97-22)
- Missing medical appointments or not following your treatment plan
- Returning to work too soon, which can hurt your recovery and claim
- Letting the insurance company dictate everything without question
Injured workers sometimes assume their employer’s insurance company has their best interests at heart. Unfortunately, that’s not always true — and that’s where having an attorney on your side can make all the difference.
Why Legal Help Matters in Workers’ Comp Claims
Workers’ compensation law in North Carolina is complex — and your benefits can be reduced, delayed, or denied without warning. At Shankle Law Firm, we help injured workers navigate every stage of the process, from filing a claim to challenging a denial.
Maggie Shankle is a Board-Certified Workers’ Compensation Specialist who has helped thousands of clients in North Carolina secure the care and compensation they deserve. Whether you’re just getting started or your claim is stuck, we’re here to help.
Talk to the Shankle Law Team Today
If you’ve been injured at work and are unsure if you're receiving everything you’re entitled to — or if you're struggling to get the care or wage replacement you need — call the team at Shankle Law Firm at (704) 370-1212.
We’ll listen, explain your rights, and help you take the next step with confidence.
*Please Note - The content on this website is for informational purposes only and does not constitute legal advice. Viewing this site, using information from it, or communicating with Shankle Law Firm, PA through this site does not create an attorney-client relationship. For legal advice tailored to your situation, please contact us directly at (704) 370-1212.