The Coronavirus pandemic is causing record job loss across North Carolina. Some dismissed employees may be workers’ compensation claimants who had returned to work under restrictions. When they get their pink slip, they may incorrectly turn to the workers’ compensation system hoping for an automatic reinstatement of benefits. Attention adjusters! Do not automatically begin paying disability benefits before considering the following guidelines:
Determine the Cause of the Layoff
Would the layoff have occurred but for the work injury? If so, then temporary total or temporary partial disability (TTD or TPD) benefits should not be reinstated automatically. For example, if the discontinuation in employment is due to poor economic conditions stemming from Coronavirus or an unjustified failure to report to work, the reason for termination is unrelated to the injury and the automatic resumption of workers’ compensation benefits usually is not appropriate. Because the denial of benefits depends on the reason for termination, adjusters should request from the employer a detailed, written explanation documenting the termination and everyone involved in the termination decision.
Document Any Change in Benefits
In some cases, employers may lay off only those employees who are working light-duty or are under restrictions because they are less productive than full-duty workers. Those cases should be treated differently. If the layoff would not have occurred but for the work-related injury or disability, (and the reasons are clearly documented), then benefits probably should be paid automatically via Form 62, Notice of Reinstatement or Modification of Compensation. Because the Coronavirus pandemic is unprecedented and is leading to unusual new rules and policies, the best practice when using a Form 62 for this purpose is to include all relevant information on the Form.
Require Claimant to Prove Disability
Even if the layoff is entirely unrelated to the injury or disability such that benefits should not start automatically, claimants still may pursue a claim for benefits. However, unless the IC has already awarded benefits through an Opinion and Award, employees usually have the burden of proving disability. A claimant who was working in some capacity but thereafter lost his job in the financial crisis must produce evidence that he has made a reasonable effort to obtain other employment but has been unsuccessful. Most claimants satisfy this burden by producing a log of job applications and interviews.
Other Recommendations
Even when workers’ compensation benefits are not available, North Carolina workers’ compensation adjusters and claims managers can nonetheless provide laid-off claimants with helpful resources to get them through an unexpected employment loss due to the Coronavirus pandemic:
- Apply for NC Unemployment Benefits at NC Division of Employment Security
- Find financial help in NC at Work First Family Assistance
- Learn job-seeking tips at NCDHHS Job Seekers Toolkit
- Find free employment services for people with disabilities at Disability Rights NC
Together we will navigate these unprecedented waters and help those in need find the resources to which they are entitled. As always, please contact Anders Newton at 919-516-8400 with questions or concerns.
Disclaimer: The information on the blog is provided for informational purposes only and does not constitute legal advice. Cases referenced do not represent the law firm’s entire record. Each case is unique and must be evaluated on its own merits. The outcome of a particular case cannot be based on past results.