Our Charlotte work injury attorneys can attest to the fact that a common reason for denial of workplace injury claims involves employee status. At times, North Carolina employers or their insurance companies reject claims on the grounds that the workers in question were not bona fide employees.
In fact, state law makes Workers’ Compensation benefits available to many workers who sustain on-the-job injuries. Injured workers should not accept claim denials of this type without understanding the law.
Workers’ Compensation in This State Does Not Discriminate Against Most Workers
According to the Workers’ Compensation Act, workplace injury coverage must be in effect (with some exceptions) for the state, public and private organizations that employ at least three employees. Additionally, the term, employee refers to just about anyone who performs work for an employer, including the following:
- Full- or part-time employees
- Apprentices
- Unlawfully-employed workers (including undocumented workers and minors)
The law contains certain distinct exceptions to these rules, however, with a common reason for claims denial pertaining to “casual employees.”
Understanding Casual Employment
Not everyone who works at a workplace is engaged in the company’s actual business. This is a major point in the definition of a casual employee, but the definition is open to interpretation in some cases. For example, people who are called in twice a year to wash the windows of an office building probably fit the definition. On the other hand, a part-time worker who comes in daily to clean up manufacturing residue is more likely a part-time employee or a contract worker.
While it is understandable that injured employees typically accept the reasoning of insurance companies when their claims are denied, this can be a costly assumption.
Injured Workers Should Not Automatically Accept Claim Denials
Most individuals trust their employers to look out for their interests, even if they work on a part-time or temporary basis. However, Workers’ Compensation claims decisions are generally made by claims adjusters who work for insurance companies. While adjusters have extensive experience in looking into the details behind these claims, they also have experience looking out for the bottom lines of the insurance companies that employ them.
This is not to say that claims adjusters are interested in keeping claimants from receiving the benefits that are due to them. Still, when subjective interpretation plays a role in a claim, they often make decisions in favor of the insurance company.
In some cases, claimants can see significantly different results when they seek legal assistance after a workers’ compensation claim denial. Call us at 800-948-0577 or use our convenient online contact form for help in pursuing any benefits that may be due to you.