This is one of the official workers' compensation forms for the the state of North Carolina
Wilmington North Carolina Supplemental Agreement for Workers' Compensation
Category:
State:
North Carolina
City:
Wilmington
Control #:
NC-26D-WC
Format:
PDF
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How to fill out North Carolina Supplemental Agreement For Workers' Compensation?
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FAQ
What does a Form 18 do? A Form 18 establishes a legal claim of injury on your behalf if filed within two years of the date of injury or occupational disease, and gives the required written notice to the employer if a copy is submitted to the employer within 30 days of the injury.
Eight Steps to Take When Filing Your N.C. Workers' Compensation Claim Notify your employer of your work-related injury orally and in writing as soon as possible.See a doctor.Describe your work-related injury or illness to the doctor.With 30 days, report the injury to your employer in writing.Follow doctor's orders.
The award is calculated as two-thirds of your average weekly wages multiplied by the appropriate number of weeks in proportion to your impairment rating. For example, the schedule in North Carolina law lists 200 weeks for the total loss of a hand.
Just multiply the injury percentage rating by the employee's compensation rate, and then multiply that result by the number of weeks assigned to the injured body part.
This means the insurance company offers a lump sum of money to an injured worker in return for a full and final settlement of their case. A clincher (or settlement agreement) typically closes the case in full, including all medical treatment and wage replacement benefits.
North Carolina Industrial Commission (NCIC) Form 33 is the Request That Claim Be Assigned for Hearing. This form is used when the two parties, the injured employee and the employer/insurance company, cannot come to an agreement on compensation for the injuries the employee sustained and require a formal hearing.
Under North Carolina law, workers' compensation claims are governed by a two-year statute of limitations. A statute of limitations is the time limit within which you must file your claim. This means that in North Carolina, you must file your workers' compensation claim within 2 years from the date of your injury.
According to the North Carolina Industrial Commission, the maximum weekly payment amount for TTD payments in 2022 is $1,184. Generally, workers receive approximately two-thirds of their weekly pre-injury income in TTD payments. You can receive TTD payments for up to 500 weeks for severe work-related injuries.
A workers' compensation case typically takes about 12 to 14 months when the employee has no lawyer, a permanent disability, and refuses to negotiate. Settlement negotiations might take longer if you have a workers' compensation attorney on your side.