Key Takeaways
- North Carolina requires workers' compensation for employers with 3 or more employees
- The NC Industrial Commission oversees the workers' compensation system
- Workers' compensation provides exclusive remedy for work-related injuries
- Benefits include medical care, disability income, and death benefits
- North Carolina has both private insurance and state fund options
North Carolina Workers' Compensation Insurance
North Carolina has a mandatory workers' compensation system with specific requirements.
Mandatory Coverage
North Carolina requires workers' compensation for most employers:
Coverage Requirements
| Employer Type | Requirement |
|---|---|
| 3+ employees | MANDATORY coverage |
| Fewer than 3 | Generally exempt |
| Domestic workers | Exempt |
| Farm labor | Exempt (10 or fewer employees) |
| Corporate officers | Covered (may elect out) |
Exam Tip: North Carolina requires workers' comp for employers with 3 OR MORE employees. This threshold is lower than some states.
Penalties for Non-Compliance
- Misdemeanor criminal charges
- Fines up to $100 per day
- Personal liability for injuries
- Stop work orders possible
NC Industrial Commission
The NC Industrial Commission oversees workers' compensation:
Industrial Commission Functions
| Function | Description |
|---|---|
| Dispute Resolution | Hear and decide claim disputes |
| Rule Making | Adopt rules and procedures |
| Rate Review | Review and approve rates |
| Compliance | Ensure employer compliance |
| Appeals | Hear appeals from decisions |
Dispute Process
- Claim filed with employer/insurer
- Mediation if dispute arises
- Deputy Commissioner hearing
- Full Commission review
- NC Court of Appeals (final appeal)
Obtaining Coverage
North Carolina employers have options for obtaining coverage:
Coverage Options
| Option | Description |
|---|---|
| Private Insurance | Purchase from licensed insurer |
| Assigned Risk Pool | For employers unable to obtain coverage |
| Self-Insurance | Large employers with IC approval |
| Group Self-Insurance | Qualified employer groups |
Workers' Compensation Benefits
North Carolina workers' comp provides these benefits:
Benefit Types
| Benefit | Description |
|---|---|
| Medical Care | All reasonable and necessary treatment |
| Temporary Total Disability | 66 2/3% of wages (up to state max) |
| Temporary Partial Disability | 66 2/3% of wage difference |
| Permanent Partial Disability | Based on impairment rating |
| Permanent Total Disability | Lifetime benefits for total disability |
| Death Benefits | To dependents |
Waiting Period
- 7-day waiting period before income benefits begin
- If disability exceeds 21 days, waiting period paid retroactively
- Medical benefits begin immediately
Compensation Rates
| Benefit | Rate |
|---|---|
| Income Benefits | 66 2/3% of Average Weekly Wage |
| Maximum Weekly Benefit | Set annually by IC |
| Minimum Weekly Benefit | Set annually by IC |
Exclusive Remedy
Workers' compensation is the exclusive remedy:
What This Means
- Employee cannot sue employer for negligence
- Workers' comp benefits are sole remedy
- Employer protected from tort liability
- Trade-off: guaranteed benefits for no-fault system
Exceptions to Exclusive Remedy
- Intentional torts by employer
- Third-party liability (non-employer)
- Dual capacity doctrine (limited)
Rate Regulation
North Carolina uses the NC Rate Bureau for workers' comp rates:
Rate Bureau Role
- Files rates with NCDOI
- Classification of risks
- Experience rating
- Loss cost development
Experience Modification
- Large employers rated on their own loss experience
- Modification factor adjusts premium
- Good experience = lower premium
- Poor experience = higher premium
How many employees must a North Carolina employer have before workers' compensation is mandatory?
What agency oversees the North Carolina workers' compensation system?
What is the waiting period before income benefits begin in North Carolina workers' comp?