North Carolina Workers’ Compensation Claim Process (2026)

How the North Carolina Workers’ Compensation Process Works

Most employers are required to purchase workers’ compensation insurance in North Carolina. When an employee is injured, they file a claim. If it’s approved, the employee receives medical and wage replacement benefits.

Eligibility and What Qualifies as a Workers’ Comp Claim

If you get injured while working or suffer a job-related illness, you may be able to file for workers’ comp. Common categories of workers’ compensation claims include:

• Acute injuries that happen due to workplace accidents
• Job-related repetitive stress injuries
• Illnesses directly caused by your job

There are some circumstances where you may be denied benefits after a work injury. For instance, if you were drinking, breaking safety rules or engaging in horseplay when you were injured, you may not qualify.

Step-by-Step Filing Process in North Carolina

The NC workers’ compensation claim process includes these steps:

Report the Injury to Your Employer

If you’re injured at work, you should notify your employer right away. Most employees use spoken notification at first. However, within 30 days, you must provide written notification.

If you are unable to send a written notification to your employer, ask a friend or family member to do so on your behalf. If you fail to send a written notification within 30 days, any claim you file will likely be denied.

Seek Medical Attention

If you suffer a life-threatening injury at work, you might be rushed off to the hospital immediately. Even if you aren’t, you should see a medical professional as soon as possible. Be sure to specify that your injury happened at work.

It’s also essential to attend all follow-up appointments and comply with your doctor’s treatment recommendations. If you don’t, the insurance company may not cover your expenses.

Fill Out Form 18

Within two years of your injury, you should file Form 18 (Notice of Accident to Employer and Claim of Employee) and send it to the North Carolina Industrial Commission. If you miss this deadline, you will likely lose any claim to benefits.

Typically, you should receive a decision in 14 days.

Employer Response and Investigations

Your employer must submit a response to the North Carolina Industrial Commission stating whether they accept or deny your claim. If your employer disagrees with your claim, the commission may need to investigate.

Understanding Employer Response Forms

Each state has its own workers’ compensation forms that employers must submit. After you file a claim, your employer may complete and file one of the following:

Form 19

Form 19 (also called a First Report of Injury or FROI form) is the first form that your employer fills out and sends to the NCIC. You will also receive a copy.

Notably, your employer is required to complete and file Form 19 regardless of their position on your claim.

Form 60

If your employer fully accepts your claim, they will file Form 60 (Employer's Admission of Employee's Right to Compensation), and you will start receiving benefits.

Form 61

If your employer disagrees with your claim, they will file Form 61 (Denial of Workers’ Compensation Claim). The form requires them to provide detailed reasoning for their denial.

Form 63

If your employer needs more time to investigate, they may file Form 63 (Notice to Employee of Payment Without Prejudice). This form means that your employer will cover your lost wages and medical bills for up to 90 days as the investigation continues.

Duration of Benefits and Settlement Timeline

Temporary disability benefits may last up to 500 weeks in North Carolina. If you become permanently disabled, you could receive lifetime benefits.

Types of Settlements in North Carolina Workers’ Compensation

Sometimes, your case may be resolved with a workers’ comp settlement, especially when dealing with severe injuries. There are three main types: a settlement of the entire claim, a settlement of only permanent impairment benefits, and a settlement of only temporary disability benefits.

Factors That Affect Case Length and Outcome

Cases involving serious injuries or disputed claims can take longer to resolve. The same can be said for cases where it takes significant time to reach maximum medical improvement (MMI).

If Your Claim Is Denied, Know Your Rights

If your claim is denied, you may submit a request for a hearing. Because a workers’ comp attorney can compile evidence and represent you at the hearing, having legal representation is essential.

Contact a North Carolina Workers’ Compensation Lawyer

The NC workers’ compensation claim process doesn’t always go smoothly. If you’re having issues getting your claim approved, the best thing to do is to contact a workers’ compensation lawyer.

If you’re not sure where to look, let ConsumerShield connect you with a qualified attorney near you. Fill out our contact form for a free case review today.