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Opt-Out Workers' Comp Plans


Posted on Oct 21, 2015

workers comp restrictionsIn a few states outside of North Carolina, lawmakers have started an opt-out workers' compensation system. This system allows employers to opt-out of obtaining workers' compensation as long as they create their own injured preparedness plan. These employers are responsible for fund management, policies, and other details associated with responding to a work injury claim. When employers develop their own plan, they define and include restrictions, non-compensable conditions, and could impose rules about who can accompany the injured worker to medical treatments.

As of this writing, North Carolina does not allow employers to opt out of workers' comp insurance and replace coverage with their own plan. Every employer with three or more employees must maintain workers' comp insurance in North Carolina, however, some employers violate this regulation. Our workers' comp lawyers in Raleigh explain more about what to do if an injured employee learns their employer does not have workers' comp. In recent years, officials started new databases and monitoring systems to help catch negligent employers.

A few more ways North Carolina differs from states that have opt-out comp plans:

  1. Other states with opt-out programs might have strict deadlines for reporting injuries. A worker who fails to report their injury by the end of their shift could forfeit all benefits. Some other employers impose 24-hour rules. Some injuries take time to manifest so a worker might not realize the extent of their injuries before the deadline. In North Carolina, however, workers have 30 days to submit written notice of their injury to the employer. Some conditions have extended limitations, for example, workers who might experience prolonged exposure to toxic substances could develop an illness over a longer period of time. A workers' comp lawyer can explain more.
  2. Other states might require a manager or other staff member to accompany the injured worker on all doctor appointments. North Carolina does not impose this, however, injured workers cannot choose their medical provider.
  3. Other states could exclude coverage for certain injuries or illnesses. North Carolina workers, as long as their condition resulted or worsened during the course and scope of their work, could be eligible for benefits - even if the condition was in some way their own fault.

 

Our Raleigh workers' comp lawyer wrote a book explaining mistakes employees make, ways to maximize compensation, and other important details about our state's system. The book is available at no charge to individuals who were hurt at work. Click the order form on the right side of this page to receive a free copy.

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