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‘Injury By Accident’ Is Harsh Standard In North Carolina Workers’ Compensation Claims

Most people understand workers’ compensation as a benefit they are entitled to if they are injured while doing their jobs. In many states, if an employee gets injured and the injury occurred within the scope of employment, the employee is entitled to workers’ compensation benefits. North Carolina is one of only a few states with a more stringent standard that many say unfairly denies coverage to persons who are injured while working and thus circumvents the purpose of workers’ compensation.  

The Charlotte workers’ compensation attorneys at Price, Petho & Associates, P.L.L.C., understand the frustration that workers can experience when they try to file workers’ compensation claims only to have their claims denied because they were doing their usual jobs when the injury occurred.

History of Injury by Accident in North Carolina

North Carolina’s Workers’ Compensation Act states that an injury ‘shall mean only injury by accident’. The law has been on the books for over 60 years and has remained the standard though it has been challenged many times. An exception to the accident first requirement exists for back injuries that are ‘the direct result of a specific traumatic incident of the work assigned’.

Time and again when trying to determine whether an injury is covered under the statute, courts in North Carolina have dealt with the issue of needing to identify an ‘accident’ that precedes the injury. Their findings through the years include the following:

  • The ‘mere fact of an injury does not establish the fact of an accident’.
  • An accident does not occur if work is being performed in the ‘customary and usual manner’.
  • An accident is an ‘unlooked for and untoward event which is not expected’.
  • Changing ‘the kind and character of work’ can present ‘unusual conditions likely to result in unexpected consequences’.

Accidents have been shown to occur when an employee is doing something different from what he or she would normally be doing when an injury occurs – including a more strenuous version of normal duties.

Application of Injury by Accident in Workers’ Compensation Claims

Unfortunately, the law leaves hanging many unsuspecting injured workers who are unaware that injuries occurring from doing the same job, in the same way, will often not be eligible for benefits.

A recent article in the Raleigh News & Observer features the stories of two women who were injured while performing their usual work duties. One received benefits. The other did not.

Janet Thorne worked at a Durham daycare center. While changing the diaper of a ‘plump infant’, the baby kicked yanking Thorne’s arm across her body and tearing her rotator cuff. Thorne’s claim was initially denied because there had been no accident. However, on appeal, it was determined that the forceful kick by the chubby cherub was ‘unexpected’ and therefore qualified as an accident. 

Deborah Lewis was a Lowe’s employee. She was on a stepladder reaching overhead to grab a 30 lb box of nails. When the box began to slip from her hands she had to maneuver quickly to get the box to another shelf. As she did so, she felt a pop in her shoulder. The injury was a torn rotator cuff that required two surgeries and left her with $30,000 in medical bills and out of work for a year.

Lewis initially won her claim when her action in moving the box was considered ‘an unusual exertion’ and therefore an accident. Lowe’s appealed and the decision was reversed and upheld.

If you have been injured at work and there isn’t an obvious unusual event or circumstance that caused your injury, you may not be able to collect workers’ compensation benefits. It’s important that you talk with a workers’ compensation lawyer before completing the employer forms. The language you use and how you explain what happened can be the difference between getting benefits or getting your claim denied. At Price, Petho & Associates, P.L.L.C., our Charlotte workers’ compensation lawyers know how to help you identify the accident that caused your injury so you can collect benefits. Contact us first by clicking here for a free consultation to discuss your case or call our office today at 704.850.6322.

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