Total Incapacity Status After a North Carolina Work Injury

Workers who have suffered profound and permanent work injuries in Statesville should explore the pursuit of a claim for total incapacity Article I, Section 97-29 of the North Carolina Workers’ Compensation Act. lonely.jpg

While there are some limitations, a worker who qualifies for temporary total disability can receive up to 500 weeks of compensation (up to two-thirds of his average weekly wages). That 500-week limitation (which works out to a little less than 10 years) can be extended even further if the employee can prove after the eight-year mark that he or she has had a total loss of wage-earning capacity.

This compensation can bridge the gap until a person is old enough to qualify for Social Security benefits.

Establishing permanent total disability in North Carolina requires one of the following conditions:

  • Loss of both hands, arms, feet, legs, eyes or any of those two;
  • A spinal injury that involves a major paralysis of both legs, arms or trunk;
  • A major brain injury or a closed head injury that results in sensory or motor disturbances, communication disturbances, complex integrated disturbances of cerebral function or neurological disorders;
  • Second- or third-degree burns on 33 percent or more of the body’s total surface.

However, the gray area is in terms of what constitutes temporary total disability. It’s not enough for the worker to prove they are disabled. They must show a strong causation between the occupational incident and the disability.

The recent case of State ex rel. Roxbury v. Indus. Comm’n, reviewed by the Ohio Supreme Court, reveals what can happen when this connection isn’t proven.

The details provided in the court records are somewhat sparse, but we do know the worker was injured at work in late 2004, with her claim of temporary total disability for a lumbar sprain and related injuries awarded soon after.

However, but the summer of 2006, the state’s industrial commission reviewed her case and determined her physical injuries had reached their maximum medical improvement. She did not appeal this decision, but neither did she return to work.

The following year, she filed a motion to add a psychological condition to her claim, requesting temporary total disability on these grounds. She indicated she had not worked since the 2004 injury and was receiving federal disability benefits through the Social Security Administration.

The hearing officer in the case approved her for compensation based on her diagnosis of dysthymic disorder (chronic depression), but refused to indicate the condition as a temporary total disability.

The worker again filed another claim, this time combining the psychological and physical conditions. However, the commission denied this request, finding that she had the ability to perform sedentary work.

She filed yet another claim, this time with evidence from a psychiatrist who determined she was temporarily-totally disabled. While a commission hearing officer sided with her, upon consideration and further review, the request was denied. The commission rejected the doctor’s findings because it was determined she hadn’t reviewed all prior medical evidence before reaching her conclusion. The doctor had indicated that others from her practice had treated the worker, but did not detail that information in the course of her written analysis. Further, the commission determined that the worker had voluntarily abandoned the workforce, and thus her claim of disability was denied.

The state supreme court supported this opinion upon appeal.

Because there is so much at stake with permanent and temporary total disability claims in North Carolina, they should only be trusted to a workers’ compensation attorney with extensive experience.

If you have been injured at work in Statesville, contact the North Carolina Lee Law Offices at 800-887-1965.

Additional Resources:
State ex rel. Roxbury v. Indus. Comm’n, Jan. 15, 2014, Ohio Suprem Court

More Blog Entries
Welder Injuries in North Carolina Often Substantial, Dec. 24, 2014, Statesville Workers’ Compensation Lawyer Blog

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