Get 19m Form

Form 18. This is where you begin when you have a claim. This form MUST be filled out completely and submitted to the Industrial Commission when you have been injured on the job. (Note: Please e-mail completed forms to forms@ic.nc.gov.)

North Carolina Industrial Commission Form 22 is the Statement of Days Worked and Earnings of Injured Employee. This form contains a table wherein the hours worked and wages earned over the 52 weeks prior to the employee's injury are recorded.

The North Carolina Workers' Compensation Act requires that all businesses that employ three or more employees, including those operating as corporations, sole proprietorships, limited liability companies and partnerships, obtain workers' compensation insurance or qualify as self-insured employers for purposes of paying ...

Do you need workers' comp in North Carolina if you are self-employed? It's always a good idea to buy workers' comp, even if it's just for yourself. Health insurance providers can deny claims for work-related injuries, which is why even sole proprietors may choose to carry coverage.

Generally speaking, employers and companies in North Carolina are not required to purchase workers' compensation coverage for independent contractors, freelancers and subcontractors.

A "Form 61" is the official North Carolina Industrial Commission form used by insurance companies to DENY workers' compensation claims. If you get a "Form 61" that means that your case is being declined or denied, and no further cash or medical benefits will be provided to you after the date on the Form 61.

Any employee driving for work and using their own personal vehicle for work can claim 65.5 cents per mile, so long as they carefully log each trip and its purpose. The Office of State Budget and Management[1] published a memorandum for 2022 announcing that the state rate refers to the IRS federal rate.

Form 19 - This is the Report of Injury form to be completed by your employer. Form 18 - This is the Injured Worker Notice of Accident Claim form to be completed and filed with the Industrial Commission by you when you have been injured on the job.

Those businesses that employ three or more employees are required to carry workers compensation insurance except agricultural employment with fewer than 10 employees, certain sawmill and logging operations and all domestic employees are exempt.