Short Answer

Yes—denial is not the end. In North Carolina, you can still recover workers’ compensation medical benefits and wage loss if you prove your injury was work-related and you meet the notice and filing deadlines. You ask the North Carolina Industrial Commission to decide the dispute and, if you win, the insurer must pay covered medical bills and wage benefits. If the injury is not covered by workers’ comp, you may have a separate negligence claim against a non-employer.

Understanding the Problem

You want to know if you can still get medical bills and lost wages paid after your employer’s insurer denied your North Carolina workers’ comp claim, saying the injury wasn’t work-related. The decision point is whether the injury qualifies for workers’ compensation so the Industrial Commission can order benefits. This article explains what you must prove, where to file, and the timelines that apply.

Apply the Law

Under North Carolina law, a denied claim can still result in benefits if you show an injury by accident that arose out of and in the course of employment, that your medical treatment and disability were caused by that injury, and that you met the notice and filing requirements. Contested claims are decided by the North Carolina Industrial Commission. Key timelines include giving prompt notice to the employer and filing your claim with the Commission within two years of the injury.

Key Requirements

• Compensable injury: An unexpected event or accident that occurred while you were doing your job or on work-related travel.
• Causation: Medical care and any inability to work must be caused by the work injury; unrelated conditions are not covered.
• Timely notice and filing: Tell your employer promptly (generally within 30 days) and file a claim with the Industrial Commission within two years.
• Disability/wage loss: Show you could not earn your pre-injury wages because of the work injury and related medical restrictions.
• Alternative path if not compensable: If the injury isn’t covered by workers’ comp (for example, it wasn’t work-related), you may pursue a separate negligence claim against a non-employer who caused the hazard; workers’ comp does not bar that.

What the Statutes Say

• N.C. Gen. Stat. § 97-2 (Definitions) - Defines covered employees and “injury by accident.”
• N.C. Gen. Stat. § 97-25 (Medical compensation) - Requires employers to furnish medical treatment for compensable injuries.
• N.C. Gen. Stat. § 97-29 (Total incapacity) - Provides wage-replacement benefits when injury prevents work.
• N.C. Gen. Stat. § 97-24 (Time limitations) - Sets the deadline to file a claim with the Industrial Commission.

Analysis

Apply the Rule to the Facts: Your ability to recover workers’ comp benefits turns on whether the airport fall happened in the course of your employment (for example, while traveling for work) and whether your back care and wage loss stem from that accident. If so, the Commission can order the insurer to pay related medical bills and wage benefits, even after a denial. The unrelated arm fracture would not be covered unless it was caused by the work injury. Loss of union protections does not control; disability must be tied to medical restrictions from the compensable injury.

Process & Timing

1. Who files: The injured worker. Where: North Carolina Industrial Commission. What: File Form 18 (if not already) to preserve the claim and Form 33 to request a hearing on the denial. When: File Form 18 within two years from the date of injury; file Form 33 once the claim is denied and you need a hearing.
2. After filing Form 33, the case is usually ordered to mediated settlement. If unresolved, a Deputy Commissioner conducts a hearing. Expect several months before a hearing, and timelines can vary.
3. The Deputy Commissioner issues an Opinion and Award. If you prevail, the insurer must pay approved medical bills and wage benefits. Either side may appeal to the Full Commission. Many cases also resolve by Commission-approved settlement.

Exceptions & Pitfalls

• Work connection: Injuries during purely personal errands or ordinary commuting are generally not covered; travel for work often is.
• Notice missteps: Delayed notice to the employer can jeopardize the claim; give written notice promptly and keep proof.
• Intervening causes: A new, unrelated injury (like a separate arm fracture) is not covered and can complicate causation; focus documentation on what the work injury caused.
• Medical proof: Wage benefits require medical evidence of restrictions and how they affect earning capacity; gaps in treatment should be explained.
• Third-party claims: If a non-employer caused the hazard (e.g., airport maintenance), you may bring a negligence claim; coordinate carefully because workers’ comp may have a lien on third-party recoveries if the comp claim is later established.

Talk to a Personal Injury Attorney

If you're dealing with a denied workers’ comp claim and mounting medical bills or lost wages, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at 919-341-7055.

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.