What Injuries Are Covered by Workers’ Compensation in NC?

Understanding workers’ compensation coverage in North Carolina

Workers’ compensation is designed to protect employees who are hurt or become ill because of their job. In North Carolina, most employers with three or more employees must carry workers’ compensation insurance. If you’re injured at work, you generally do not have to prove your employer did anything wrong to receive benefits. In exchange, you typically cannot sue your employer for negligence.

Even so, many people are unsure what injuries actually “count,” especially when symptoms develop over time, the injury happens off-site, or a pre-existing condition is involved. Below is a practical guide to the types of injuries and conditions commonly covered under North Carolina workers’ compensation—and the steps you can take to protect your health and your claim.

The basic rule: injuries and illnesses that “arise out of and in the course of employment”

North Carolina workers’ compensation generally covers an injury by accident and occupational diseases that arise out of and in the course of employment. That legal phrase matters:

• “Arise out of” means there is a causal connection between the job and the injury/condition.
• “In the course of” means it happened while you were doing your job duties (including certain activities reasonably related to work).

Coverage is often straightforward for sudden injuries at the workplace, but it can be more complex for repetitive stress injuries, mental health claims, and illnesses with multiple possible causes.

Common covered injuries: sudden, traumatic workplace accidents

Many workers’ comp claims involve a clear accident with an immediate injury. Examples often covered include:

• Slips, trips, and falls (wet floors, uneven surfaces, ladders, stairs)
• Falls from heights (scaffolding, roofs, loading docks)
• Being struck by objects (falling tools, moving equipment, debris)
• Caught-in/caught-between injuries (machinery, pinch points, conveyors)
• Motor vehicle collisions while working (driving for deliveries, traveling between job sites)
• Workplace explosions, fires, or electrical incidents

Body parts and conditions frequently covered

Workers’ compensation can apply to injuries involving:

• Back and neck injuries (strains, herniated discs)
• Shoulder injuries (rotator cuff tears, labral tears)
• Knee injuries (meniscus tears, ligament injuries)
• Hand and wrist injuries (fractures, tendon injuries)
• Head injuries and concussions
• Eye injuries (foreign objects, chemical exposure)
• Burns and lacerations

If you were performing your job duties and an accident caused the injury, coverage is often available even if you made a mistake—workers’ comp is generally “no-fault.”

Repetitive stress and overuse injuries: when there’s no single “accident”

Not every work injury happens in one moment. Many workers develop pain or limitations over weeks or months. In North Carolina, repetitive trauma claims can be compensable, but they may require stronger medical evidence linking the condition to work.

Examples can include:

• Carpal tunnel syndrome and other repetitive hand/wrist conditions
• Tendonitis (elbow, shoulder, wrist)
• Repetitive lifting injuries to the back
• Bursitis or chronic joint inflammation tied to repetitive tasks

Practical tip: If your symptoms worsened over time, report them as soon as you suspect they’re work-related. Waiting can make it easier for the insurance company to argue the condition is from aging, hobbies, or prior injuries.

Occupational diseases: illnesses caused by workplace exposures

North Carolina law recognizes certain occupational diseases—conditions caused by exposure peculiar to a particular trade or occupation. These cases often involve medical and factual disputes about whether work was the significant cause.

Examples may include:

• Hearing loss from long-term noise exposure
• Respiratory illnesses from dust, fumes, chemicals, or silica
• Skin conditions from chemical exposure (dermatitis)
• Certain infectious diseases when tied closely to job duties (for example, some healthcare-related exposures)
• Repetitive exposure injuries (e.g., chemical sensitivity)

Occupational disease claims can be document-heavy. You may need records of job duties, exposure history, protective equipment use, and medical testing.

Psychological and stress-related injuries: limited but possible

Mental health conditions can be covered in North Carolina, but they are often more challenging than physical injury claims.

Coverage may be possible when:

• A work-related physical injury leads to psychological conditions such as depression, anxiety, or PTSD.
• A traumatic workplace event causes a psychological injury, depending on the facts and medical proof.

Because these claims can be contested, it’s important to seek appropriate treatment and ensure your providers clearly document how the work event or physical injury contributed to the diagnosis.

Aggravation of pre-existing conditions: you can still qualify

A common misconception is: “I had back problems before, so workers’ comp won’t cover me.” In reality, if work aggravates, accelerates, or exacerbates a pre-existing condition, you may still have a valid claim.

Examples include:

• A prior back issue made worse by a lifting incident
• Arthritis aggravated by repetitive kneeling or climbing
• An old shoulder injury re-injured by overhead work

What matters is whether work caused a meaningful worsening or new disability—not just that you had symptoms in the past. Medical documentation is key.

Injuries during travel, off-site work, or work-related errands

Workers’ comp coverage is not limited to injuries inside your employer’s building. You may be covered when you’re doing something for the benefit of your employer, such as:

• Traveling between job sites during the workday
• Making deliveries or service calls
• Attending required training
• Running a work errand at your supervisor’s direction

However, injuries during a normal commute to and from work are often disputed under the “coming and going” rule, with exceptions depending on the circumstances (for example, if you’re traveling as part of your job duties or using a company vehicle for work purposes).

If you were hurt off-site, write down exactly why you were there, who directed you, and how it related to your job.

What workers’ compensation typically does (and does not) pay for

In North Carolina, workers’ compensation benefits commonly include:

• Medical treatment related to the work injury (doctor visits, surgery, physical therapy, prescriptions)
• Wage replacement (typically a portion of your average weekly wage) if you’re taken out of work or placed on restricted duty with reduced earnings
• Permanent impairment compensation in some cases, based on a rating
• Vocational rehabilitation when appropriate

Workers’ comp generally does not provide damages for pain and suffering the way a personal injury lawsuit might. That can feel frustrating, especially when you’re dealing with real pain and disruption. But benefits can still be substantial—and getting proper medical care and wage support can be critical while you recover.

Common reasons insurance companies dispute whether an injury is covered

Even when an injury seems work-related, insurers may challenge coverage by arguing:

• The injury happened outside the course of employment
• The condition is pre-existing or not caused by work
• The injury was not reported promptly
• There is insufficient medical evidence connecting the condition to the job
• The worker was engaged in horseplay or a personal errand
• The claim involves a gray area like repetitive trauma, occupational disease, or mental health

A denial is not the end of the road. Many workers successfully appeal or negotiate disputed claims with the right documentation and advocacy.

Actionable steps to protect your health and your claim

If you think you have a covered work injury or occupational disease, these steps can make a real difference:

1) Report the injury immediately (or as soon as you reasonably can)

Tell a supervisor in writing if possible. Include:

• Date/time and location
• What happened (or when symptoms began)
• Body parts affected
• Names of witnesses

Prompt reporting helps reduce disputes about whether the injury happened at work.

2) Seek medical treatment and follow restrictions

Get evaluated quickly. Be honest and specific about how your job caused or worsened the problem. Then follow the treatment plan and work restrictions. Gaps in care can be used to argue you weren’t truly injured or that something else caused your condition.

3) Keep a simple paper trail

Maintain a folder (digital or paper) with:

• Incident report and written notice to your employer
• Medical visit summaries and work notes
• Mileage and out-of-pocket expenses (if applicable)
• Pay stubs and any reduced-hours documentation
• Communications with the adjuster

4) Be careful with recorded statements and social media

Insurance adjusters may request recorded statements. It’s easy to say something that gets taken out of context, especially when you’re in pain or stressed. Also avoid posting about your activities online while your claim is pending.

5) If you receive a denial or feel pressured to return too soon, get legal guidance

If your claim is denied, delayed, or you’re being pushed back to work without appropriate restrictions, it may be time to speak with a workers’ compensation attorney. A lawyer can help gather medical evidence, address disputes about causation, and ensure the benefits you’re entitled to are properly calculated.

When to talk to a North Carolina workers’ comp attorney

Consider reaching out for help if:

• Your employer or insurer says the injury is not work-related
• You’re diagnosed with an occupational disease or repetitive trauma condition
• You have a pre-existing condition and the insurer is blaming symptoms on the past
• You’re not getting authorized treatment or referrals you need
• You’re out of work and wage benefits are delayed or incorrect
• You’re offered a settlement and aren’t sure what you’re giving up

You don’t have to navigate this alone—especially when you’re trying to heal.

How Vasquez Law Firm can help injured workers in Charlotte

A work injury can affect every part of your life: your health, your paycheck, your family responsibilities, and your peace of mind. At Vasquez Law Firm, we help injured workers in Charlotte and across North Carolina understand what injuries are covered, what benefits may be available, and what to do when an insurance company disputes a claim.

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If you were hurt on the job—or you’re dealing with symptoms you believe are caused by your work—contact Vasquez Law Firm in Charlotte, NC to discuss your situation. We can help you understand whether your injury may be covered under North Carolina workers’ compensation law and what steps to take next. Call today to schedule a confidential consultation.