Disability vs Workers' Comp

Welcome to The Law Offices of John M. McCabe! We are your experienced guides in navigating the complex worlds of Disability Insurance and Workers' Compensation in Raleigh, North Carolina. Our commitment is to fight for your rights and ensure you get the benefits you deserve.

What is Disability Insurance?

Disability Insurance (DI) is designed to replace a portion of your income if you become disabled and are unable to work due to a non-work-related illness or injury. DI typically requires policyholders to meet specific criteria defined in their insurance policy, and the benefits can last for a defined period or until retirement age.

What is Workers' Compensation?

Workers' Compensation is a form of insurance providing wage replacement and medical benefits to employees injured in the course of employment. It applies regardless of who is at fault for the injury or illness. The benefits usually continue until the worker can return to work or are declared permanently disabled.

Disability Vs. Workers' Comp

Disability benefits and workers' compensation are two different types of programs designed to assist individuals who are unable to work due to injury or illness. Here are some key differences between the two:

1. Eligibility Based on Cause:

Workers' Compensation

This is a state-mandated program that provides benefits to employees who suffer work-related injuries or illnesses. The cause of the injury or illness must be directly related to the job.

Disability Benefits

These are federal benefits provided by the Social Security Administration (SSA) through programs like Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). They cover individuals who are unable to work due to a disability, regardless of whether the disability is work-related or not.

2. Benefit Amount

Workers' Compensation

The benefits typically cover all of an injured worker's medical bills related to the injury or illness. They also provide disability payments, usually a portion of the worker's regular wage, for the period that the worker is unable to return to work.

Disability Benefits

SSDI payments are based on the worker's previous earnings record in jobs covered by Social Security, while SSI payments are based on financial need.

3. Duration of Benefits

Workers' Compensation

The benefits continue until the worker can return to work or it's determined that the worker's medical condition will not improve further, at which point they might qualify for permanent disability benefits.

Disability Benefits

Benefits generally continue for as long as the individual remains disabled, subject to regular reviews to check if the person's medical condition has improved.

4. Program Administration

Workers' Compensation

It's a state-run program, and rules, eligibility criteria, and benefit levels can vary from state to state.

Disability Benefits

The SSDI and SSI programs are run by the federal government, specifically the SSA, and have standard rules and regulations applicable across all states.

5. Requirement to Prove Disability

Workers' Compensation

You need to prove that your injury or illness is work-related but don't need to prove total disability.

Disability Benefits

The SSA has a strict definition of disability. You must be unable to engage in any substantial gainful activity due to a medically determinable physical or mental impairment that is expected to last at least 12 months or result in death.

Can You Receive Both Disability and Workers' Comp?

In some situations, you might be eligible for both Disability Insurance and Workers' Compensation. This typically occurs when a work-related injury results in a long-term or permanent disability that exceeds the benefits provided by Workers' Compensation. Consult with our Raleigh workers' compensation lawyers to understand your options better.

Common Accidents That Qualify for Workers' Compensation and/or Disability in Raleigh

Workers' compensation is designed to provide benefits to employees who are injured or become ill as a direct result of their work. The exact rules can vary by state, but generally, most work-related injuries and illnesses will qualify for workers' compensation. In Raleigh, North Carolina, examples of workplace accidents that could potentially qualify for workers' compensation might include:

Slip and Fall Accidents

Slip and fall accidents are one of the most common types of workplace injuries. They can occur in any type of work environment, from office buildings to construction sites.

Overexertion or Repetitive Strain Injuries

If an employee gets hurt because of heavy lifting, pushing, or pulling, it could qualify. Similarly, repetitive strain injuries, such as carpal tunnel syndrome from constant computer work, may also be covered.

Workplace Violence

Injuries that result from fights or other forms of violence in the workplace can qualify for workers' comp.

Accidents Involving Machinery or Equipment

This could include accidents involving tools, machinery, or vehicles used in the course of employment.

Exposure to Harmful Substances or Environments

If an employee becomes ill or injured due to exposure to chemicals, asbestos, extreme temperatures, or dangerous noise levels, they may be entitled to workers' compensation.

Falls from Height

In jobs that require working from ladders, roofs, or scaffolding, injuries from falls are common and generally covered.

Injuries During Work-related Travel

If an injury occurs while an employee is traveling for work-related activities (not including commuting), it could qualify for compensation.

Occupational Diseases

Some professions have higher risk for certain diseases. For example, lung disease in jobs with exposure to harmful airborne substances.

How To File a Workers' Compensation Claim in Raleigh

Filing a workers' compensation claim in Raleigh, North Carolina involves several steps. Here is a general guideline:

Seek Immediate Medical Attention

If you're injured at work, your health should be your first priority. Depending on the severity of your injury, you may need to go to the emergency room or see a doctor as soon as possible.

Notify Your Employer

Notify your employer of the incident as soon as possible. This notification should be in writing, and you should keep a copy for your records. Under North Carolina law, you have 30 days from the date of the injury (or from the date you were first aware of a work-related illness) to inform your employer.

File a Claim with the North Carolina Industrial Commission

You should complete and file a Form 18, which is a notice of accident to employer and claim of employee, with the North Carolina Industrial Commission (NCIC). This form is available on the NCIC's website. The form requires information about you, your employer, the details of the accident and your injuries. After you have completed the form, you need to provide a copy to your employer and keep a copy for your records. This form should be filed within two years of the date of injury or occupational disease diagnosis.

Follow All Medical Advice

Attend all medical appointments and follow the treatment plan prescribed by your healthcare provider. Failing to do so could jeopardize your claim.

Cooperate with the Insurance Company

Once you have filed your claim, your employer's workers' compensation insurance company should contact you. They will ask you for information about your claim. Be honest and straightforward with them, but avoid giving more information than necessary.

Understand Your Rights

If your claim is denied, or if you are not receiving the benefits you believe you are entitled to, you may wish to consider hiring a workers' compensation attorney to help with your case.

How a Wokers' Compensation Lawyer Can Help

A workers' compensation lawyer can be of immense help when dealing with a workers' compensation claim, especially in complex situations or when disputes arise. Here are some of the ways a workers' compensation lawyer can assist:

Understanding and Explaining Rights and Obligations

The workers' compensation process can be complex and confusing. A lawyer can help you understand the laws applicable to your case, explain your rights and obligations, and guide you through the entire process.

Preparing and Filing Necessary Documentation

There are numerous forms and documents that need to be properly completed and filed within certain deadlines when dealing with a workers' compensation claim. A lawyer can ensure that these are all completed correctly, improving the chances of a successful claim.

Negotiating with the Insurance Company

Insurance companies may try to settle for less than what you may be entitled to. A workers' compensation lawyer can negotiate on your behalf to try to secure the best possible settlement.

Representing You at Hearings and Trials

If your claim is denied or disputed, it may need to go to a hearing or even a trial. A lawyer can represent you in these proceedings, presenting your case in the most compelling way.

Challenging a Denied Claim

If your claim has been denied, a workers' compensation lawyer can help you appeal the decision, gather necessary evidence and represent you during the appeal process.

Helping with Related Issues

In some cases, a workplace injury or illness may also give rise to other legal issues, such as potential Social Security Disability benefits, personal injury claims, or even employment law issues. A Raleigh workers' comp lawyer can help you navigate these related matters.

Contact The Law Offices of John M. McCabe

If you're not sure whether you need disability, workers' compensation, or both contact our lawyes today. Consultations are always FREE and we are here to help.

FAQs

Here are some frequently asked questions about disability benefits and workers' compensation:

1. Can I receive both workers' compensation and disability benefits at the same time?

Yes, it's possible to receive both workers' compensation and Social Security disability benefits at the same time, but the total amount of the benefits you receive can't exceed 80% of your average current earnings before you became disabled. If it does, the Social Security Administration (SSA) may reduce your disability benefits.

2. Are the benefits for workers' comp and disability the same?

No, the benefits can differ significantly. Workers' comp benefits may cover medical expenses related to the injury or illness, rehabilitation costs, and a portion of your lost wages. Disability benefits, on the other hand, provide monthly cash payments based on your lifetime average earnings covered by Social Security.

3. What happens to my workers' compensation if I become permanently disabled?

If you become permanently disabled due to a work-related injury or illness, you may be eligible for permanent disability benefits under workers' compensation. The exact amount can vary depending on the extent of your disability and the state in which you live.

4. What's the difference between short-term and long-term disability insurance and workers' comp?

Short-term and long-term disability insurance are typically provided by employers or purchased individually and cover a percentage of your income if you can't work due to a non-work-related illness or injury. Short-term disability is typically used for temporary disabilities, while long-term disability is used for longer-lasting disabilities. Workers' comp, on the other hand, applies specifically to work-related injuries and illnesses.

5. Do I have to pay taxes on my workers' comp or disability benefits?

Workers' compensation benefits are generally not taxable at the state or federal level. Social Security disability benefits, on the other hand, may be taxable if your total income is above a certain threshold.