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Understanding the Timing Requirements Associated with Workers’ Compensation Claims

May 31, 2016 Brown Moore Workers' Compensation

Since it is logical to assume that employers can only agree to pay workers’ compensation claims when they know that an injury occurred, it is not surprising to learn that submitting a notice of accident to employer is a requirement under the state Workers’ Compensation Act.

Still, submitting a notice is not always feasible within the prescribed legal timelines. Our Charlotte workers’ compensation attorneys want to make sure that workers understand the many exceptions to this rule.

The Timing Rule for Notification Has Built-In Flexibility

The overriding principle for issuing accident notification to an employer essentially states that employees cannot receive workers’ compensation benefits until their employers have been notified of an accident — and that notice must be delivered within 30 days after the occurrence unless there is a reasonable excuse for a delay.

The law goes on to cite exceptions to the notification rules. In addition to circumstances where the employer clearly knows about an accident, there are certainly cases when injuries are too severe to permit timely notification by workers. There can also be circumstances of fraud or deceit of a third person.

Additionally, while 30 days may seem to be a reasonable timeframe for notifying employers of workplace accidents, any injury situation can have a number of unique aspects that can come into play.

The following examples illustrate times when employees can fail to meet the notification timing requirements without losing their rights to compensation:

  • Severe injuries: While it is likely that an employer would know about an employee who sustained severe on-the-job injuries, it is conceivable that a remote worker might sustain such an injury. If the employee worked alone at the time of the accident and was in a coma in the hospital for more than a month with no way to contact the employer, the claim would still be valid whenever it became feasible to issue notification and then file a claim.
  • Delayed onset injuries: A slip on a wet floor or a trip on carpeting may not initially seem like an accident to employees who do not actually fall. Even if they notice muscle soreness immediately after the incident, they may not view it as more than temporary discomfort. It can take more than a month to recognize that they now have chronic back pain or other conditions; however, the treatment for those conditions may qualify for workers’ compensation benefits, if they can provide appropriate evidence of the earlier accident.
  • Workplace-related illnesses: Toxic exposure on the job is a good example of illnesses that can develop over months or even years, while not being immediately identifiable as a workplace injury. Conditions generally qualify for workers’ compensation benefits regardless of the time it takes to discover them and make the workplace connection.

Without Timely Notification, Valid Claims Can Be Unfairly Denied

In most cases, employers and insurance companies clearly understand the accident notification requirements and the exceptions that are also written into the law. Still, as more time extends between the date of the accident and the time they receive a notification, the likelihood of claim denial increases.

Workers who believe they have a valid right to receive workers’ compensation benefits in spite of notification delays should not give up without first seeking a knowledgeable assessment based on the specific details behind their circumstances. It costs nothing to call us at 800-948-0577 or use our convenient online contact form to learn if it makes sense to appeal a decision.