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You Can Get Compensation for a Caregiver After a Job-Related Injury

WILL WORKERS’ COMP IN NC PAY FOR A CAREGIVER?

Workers’ Compensation in North Carolina will pay for a caregiver for a disabled worker under certain circumstances. Known as attendant care services, workers’ comp will pay if it is necessary for a caregiver to help individuals disabled from a work-related injury or illness perform the tasks of daily living that their disability keeps them from doing for themselves. Examples of these tasks include cooking, feeding, bathing, shopping, doing laundry, taking medication, and cleaning. Attendant care can be reimbursed for the amount of time necessary, ranging from a few hours a day up to 24-hour care, depending on the individual’s need and seriousness of the injuries.

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Are You Eligible to Get Attendant Care Coverage Under Workers’ Compensation?

ATTENDANT CARE CLAIMS

While workers’ comp in NC is supposed to pay for a caregiver, this does not always happen. Insurance companies that are out for profit are extremely reluctant to pay for this assistance, especially for attendant care provided by family members. They will not voluntarily tell you about these services and will often find reasons to deny claims.

Fortunately, if you have been injured on the job and require attendant care, the Charlotte workers’ comp lawyers at the Sumwalt Anderson law firm can help you get the benefits you deserve. We know the law and what you are entitled to. We can make sure the application process is done correctly and in a timely manner. Are there caregiver benefits due to you for past services? Our attorneys can immediately get to work negotiating to reverse an initial refusal to pay attendant care benefits and start correcting any mistakes and miscommunications. We offer a free consultation to discuss the circumstances of your case and determine the best way to proceed, so call us today at (704) 377-3770 to get started.

What is Workers’ Compensation Coverage for Attendant Care?

MANY INJURED WORKERS AND THEIR FAMILIES DON’T KNOW THIS COVERAGE IS AVAILABLE

Workers’ comp attendant care is compensation that is available when workplace injuries cause a worker to lose the ability to perform activities of daily living, need assistance in doing so, or are too sick to be left alone. The workers’ comp insurance company providing benefits must either provide coverage that pays for professional caregivers or compensate family members who are giving the necessary assistance. Even if caregivers are performing theses duties out of love and commitment, they may qualify to be paid for doing so.

Examples of conditions requiring attendant care include:

  • Neck and spinal cord injuries and paralysis
  • Cognitive impairments caused by a traumatic brain injury
  • Motor difficulties from injuries
  • Loss of limbs
  • Degenerative conditions like lung disease from toxic chemical exposure.

When you begin to understand how attendant care coverage applies to workers’ compensation benefits, you also get the answer to the question, “Will workers’ comp in NC pay for a caregiver?” The answer is “yes.”

WHAT IS THE COMPENSATION RATE FOR ATTENDANT CARE IN NORTH CAROLINA?

The amount of compensation for attendant care will depend on the level of care prescribed and the going rate for attendant care services in the disabled worker’s area. For example, if the average cost of attendant care in North Carolina is $20 per hour, then the insurance should pay that amount to both professionals and family members who are providing attendant care. If the caregiver is a family member, the amount paid is not related to the amount the person earned previously from a job they left to provide the care to a loved one.

How Does Workers’ Compensation Cover Caregiver Benefits?

MANY INJURED WORKERS AND THEIR FAMILIES ARE UNAWARE OF CAREGIVER COVERAGE

North Carolina workers’ comp insurance is intended to provide attendant caregiver benefits along with medical, rehabilitation, and income benefits for workplace-related injuries. Yet, injured workers and their families often are not familiar with the benefits they are entitled to or how to go about getting them. Attendant care is a benefit that many people will not even know about, unless they work with a workers’ comp lawyer who can help them receive this compensation.

Since premiums and costs go up when benefits are paid out, employers and insurers are not going to volunteer information about attendant care. In addition, the rules and procedures for getting attendant care through workers’ comp are complicated. Making mistakes in filing your claim or saying or doing the wrong thing can result in your claim being denied. This is why an experienced attorney is your best option to ensure that you get all the benefits available to you, including coverage that pays for caregiver costs.

Attendant Care Benefits Can Apply to Family Members Providing Care

To help you get attendant care benefits, our workers’ comp lawyers at Sumwalt Anderson can determine whether help from family caregivers are eligible for workers’ comp benefits. Family caregivers, whether a spouse, child, or other relative or friend, often want to be helpful. They don’t consider the possibility of being compensated for lost income, even though some may have to leave their jobs because of the demands of providing care.

Our attorneys can also tell you when a spouse can receive payment through workers’ compensation benefits when they are a caregiver. There can be a loss of income when one spouse becomes the caregiver for the other. This need for care may mean there is no one to support the family, and financial resources can be quickly depleted. Even if a caregiver was not previously employed, they are still entitled to fair payment through workers’ comp.

How Our Attorneys Can Get You the Attendant Care Benefits You Deserve

The team at Sumwalt Anderson has experience with, and knowledge of, the workers’ compensation system in North Carolina that you need. Our attorneys understand all the potential ways you can be compensated and will help you get all that you are entitled to, including benefits covering costs of a caregiver.  When you work with us, we can ensure that you are fully informed of all options available to you for coverage relating to attendant care. We will:

  • Make sure you know about attendant care and why you are entitled to receive it.
  • Ensure that all forms are filled out correctly to receive attendant care in a timely manner in accordance with North Carolina law.
  • Obtain statements from physicians and therapists regarding why attendant care help is necessary.
  • Ensure that caregivers keep detailed records that specifically state what services are being performed, why, and the date, time and hours services were rendered.
  • Negotiate with insurance companies for a fair settlement that includes attendant care.
  • Represent you at any hearings before the North Carolina Industrial Commission.
  • Prepare your case and argue on your behalf if a claim goes to trial.
  • Handle any appeals.

Frequently Asked Questions About Attendant Care and Workers’ Comp in North Carolina

  • What is the best way to get the cost of attendant care covered by the insurance company?

    The best way best way to get your care covered is to document your need for care as recommended by the appropriate medical professional. The experienced attorneys at Sumwalt Anderson are on your side to fight for your rights and all the benefits you deserve.

  • Is it preferable to have a licensed healthcare professional provide the care?

    This would depend on the situation, the type of care needed, and the availability of professionals or family members who could provide the care. In some situations, a licensed professional may be desirable, but in other situations, such as when an individual has suffered a traumatic brain injury or is resistant to having outside people in their home, family members may be a better choice.

  • What evidence would I need to support a claim for attendant care?

    Evidence to support your claim may include physicians’ prescriptions; assessments from physicians, physical or occupational therapists, nurses, or other life care experts; hospital reports; and testimony from the injured employee and family members regarding the extent and type of care necessary.

  • What if the employer or their insurer refuses to pay for necessary attendant care services?

    If the employer or insurer refuses to pay, even after negotiations, our attorneys can request a hearing in front of the North Carolina Industrial Commission, the state agency responsible for enforcing and administering the workers’ compensation laws. If the decision is unfavorable, it can be further appealed to the appellate courts.

  • Can I get compensated for previous caregiving services?

    If you are a family member who has provided caregiving in the past and never received compensation, you may be able to get retroactive compensation for the services you provided. In the case of Mehaffey v. Burger King 749 S.E.2d 252 (2013), our attorney, Mark Sumwalt, litigated the issue of attendant care in a workers’ compensation case for an injured worker whose wife had provided necessary attendant care services for two years and was seeking retroactive payment. While the North Carolina Industrial Commission awarded an amount of $12.50 per hour for the past care provided, this was successfully challenged by the insurance company at the Court of Appeals on the grounds that the injured worker did not receive pre-approval for the attendant care services provided by his wife. On appeal, the Supreme Court reversed the lower court’s decision and ruled that a family member is entitled to compensation for the care provided to an injured employee without the requirement for pre-approval by the Industrial Commission. The significance of this decision is that workers’ compensation carriers are liable for attendant care compensation when the doctor recommends it, not when the carrier finally authorizes it or the Industrial Commission approves it.

  • Can my employer fire me if I was injured at work?

    Your employer cannot retaliate against you for filing a workers’ compensation claim. However, they may still terminate you for other reasons. If you are concerned that you have been wrongfully terminated from your job, or that you might be, please contact us.

  • My injury has affected my marriage or relationship, can I do anything about that?

    The North Carolina Workers’ Compensation Act does not provide a mechanism for spouses to recover damages for losses they experience as a result of a worker’s injury. However, in some cases, a spouse, family, or household member may be eligible to receive payment for care they are providing to an injured worker, when that care has been ordered by a doctor. If you think this may apply in your case, you should contact one of our attorneys to discuss benefits that may have been overlooked in your claim.

  • What is attendant care?

    In cases where the injured worker can no longer do basic things for himself of herself (e.g. prepare food, get dressed, move about their home without stand-by assistance, etc.), a doctor may order attendant care or supervision for a certain amount of time per day. Sometimes this care is provided through an outside home health agency and sometimes it is provided by family or household members. If this has been ordered in your case, or you think you need this care, we can assist you in obtaining that care either through an outside agency or obtaining payment for that care for your family or household member. We have litigated the issue of attendant care extensively in our appellate courts.

Get Help in Obtaining Caregiver Coverage from Your NC Workers’ Compensation Claim

OUR ATTORNEYS CAN HELP YOU GET BENEFITS FOR ATTENDANT CARE PROVIDED IN THE PAST

Obtaining compensation for attendant care provided by family members in the past is extremely difficult, if not impossible, for a disabled worker and their family to do on their own. Fortunately, the workers’ comp lawyers at the Sumwalt Anderson Law Firm have a long track record of successfully pursuing claims for past-due attendant care compensation owed to family members. We also negotiate on-going attendant care benefits to provide a safe environment for our clients and their families. Our experienced attorneys can also help with the many issues that may come up in a workers’ comp case that require legal assistance to ensure that you get the compensation you deserve.

$2.7
million

Recovered on behalf of a gentleman (plaintiff/client) who was working as a vinyl window installer on a metal ladder when the ladder struck a live electrical wire. Learn more.

$2.7
million

Recovered negotiated on the behalf of our client who was rendered a paraplegic due to a spinal fracture after falling from a roof in the course and scope of his employment as a construction worker. Learn more.

$2.5
million

Recovered for a construction worker from Texas who suffered a catastrophic spinal cord injury following a fall from a roof while working on a job site in Charlotte, NC. Learn more.

$2.4
million

Recovered on behalf of our client who sustained a spinal cord injury in the course and scope of his employment as a production worker in a manufacturing plant. Learn more.

$2.3
million

Recovered on behalf of the gentlemen (plaintiff/client) who sustained an injury when he slipped and fell on an icy ramp during his employment. Learn more.

$2.1
million

Recovered on behalf of a client who was injured in the course and scope of her employment as a nurse when attacked by a patient. Learn more.

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    Charlotte NC Law Firm

    Why Our Team at Sumwalt Anderson Is Your Best Choice

    Whether it is helping to collect benefits for being out of work, permanent injury, medical treatment, or attendant care, our attorneys have the knowledge and experience to guide you throughout the entire process of your worker’s compensation claim. We have helped injured workers navigate the workers’ compensation system for over 75 years.

    If you are the caregiver of a loved one who was injured at work and you are not being compensated, or you are a disabled worker who needs help, we can file a claim for compensation with the workers’ comp insurer right away. Let us take care of all the paperwork, deadlines, documentation, legal requirements and appeals to get you the compensation you and your family deserve, so you can focus on recovery and the needs of your loved one. Call the team at Sumwalt Anderson Law Firm today at (704) 377-3770.