Workers’ Compensation

The State Government Workers’ Compensation Program is administered by the Office of State Human Resources. The purpose of the program is to ensure that all eligible employees who experience a work related injury or illness receive appropriate medical care and equitable benefits as provided under the Workers’ Compensation Act and the Workers’ Compensation section of the State Personnel Policy. Refer to the Workers’ Compensation Employee Handbook for more information.

What To Do if an Employee Gets Hurt at Work

First Steps

In the event of a life-threatening emergency, immediately call 911

Injuries resulting in fatality, amputation, loss of eye or hospitalization require immediate notification to:

Environmental Health and Safety, EHS
Ogaga Tebehaevu, otebeha@ncsu.edu
919-513-0988
919-515-7915

Workers Compensation Administrator (WCA)
Kathleen Segura, workerscomp@ncsu.edu
919-515-5445

In the event of a non-life-threatening emergency:

Report the incident to your Supervisor – ALL Incidents should be reported immediately and all forms be completed and submitted no matter the level of significance.

Supervisor Responsibility

Provide completed Supervisor’s Medical Treatment Authorization Form to the injured employee to present to an Authorized Medical Facility for care.
Provide the Employee Statement and Use of Leave Options forms to the employee to complete.
Investigate the incident to obtain the facts, identify and mitigate hazards, preserve evidence, identify responsible parties & witnesses.
Secure and review for accuracy the completed Employee Statement and Use of Leave Options from the employee.
Complete Supervisor First Report of Incident.
Submit the Supervisor First Report of Incident, Employee Statement & Use of Leave Options Form to accidentreport@ncsu.edu and workerscomp@ncsu.edu as soon as they are completed, within 24 hours of the incident.
Maintain an open line of communication with your injured employee.
Explore opportunities to provide modified duty work.

Employee Responsibility

Report the incident to your supervisor immediately.
Obtain care as directed by your supervisor from an authorized medical provider.
Return the Supervisor Medical Authorization form to your supervisor with your work status.
Complete and submit the Employee Statement and Use of Leave Options forms to your supervisor.
Maintain an open line of communication with your supervisor.
Cooperate with NCSU/TPA, CorVel investigation.

Hospital or Emergency Care: For treatment relating to a worker’s compensation injury, direct the provider to bill CorVel, the third-party administrator and/or contact the Workers Compensation Administrator.

Wage Replacement and Continuation of Benefits

When an employee is placed on leave due to a compensable workers’ compensation claim, wage replacement will be issued by CorVel, the TPA. While in this pay status, NO DEDUCTIONS are taken from the employee’s weekly workers’ compensation benefit. If the employee has payroll deductions made from regular pay for items such as health insurance or credit union loans, etc., it is the employee’s responsibility to satisfy these obligations while on workers’ compensation leave.

Important: Once an employee has been released by the authorized treating physician to return to work, he/she is obligated to accept any suitable employment provided that is in keeping with the employee’s capability. Refusal to accept suitable employment may result in termination of compensation and may result in dismissal.

Bottom Line

The sooner an incident is reported, the sooner an injured employee may obtain care and any potential hazard may be addressed to prevent injury to others.

Assistance and resources may be found on the Faculty and Staff Assistance Program page.

Authorized Medical Facilities

Initial Care

Supervisors are to direct an injured employee located in the Raleigh area to an authorized treating physician at the following locations:

WakeMed Urgent Care
601 Oberlin Drive
Raleigh, NC 27605
Phone: 919-789-4322
Next Care Urgent Care
1110 Kildaire Farm Road
Cary, NC 27511
Phone: 919-481-0277

Employees who work at locations outside of the Raleigh area should be directed to seek care at:

The closest urgent care or
Emergency room (if injury is life threatening)

Follow Up Care

CorVel, the third-party administrator, is responsible for authorizing & directing follow-up care with a specialized physician for compensable injuries.

Treatment not authorized by the CorVel adjuster may be denied.

IMPORTANT

Medical Bills: It is imperative that providers are directed to send their request for payment to CorVel, the third-party administrator.

CorVel Corporation | Charlotte Office
P.O. Box 6966 | Portland, OR 97228
704-941-2800

The provider may also contact the WCA at (919) 515-2151 if claim information is needed.

Frequently Asked Questions

The North Carolina Office of State Human Resources (OSHR) workers’ compensation program covers all agency and university fulltime, part-time, and temporary State employees and officers who sustain injury arising out of and in the course and scope of their employment. It also covers all State elected officials, members of the General Assembly or those appointed by the Governor to serve on a per diem, part-time or fee basis. Refer to the Workers’ Compensation Employee Handbook for more information.

A third-party administrator (TPA) contracted by the State of NC, handles the individual workers’ compensation cases for the University system. The TPA currently responsible for handling workers’ compensation claims is CorVel.

The TPA is responsible for accepting or denying liability for the State and is also responsible for monitoring and processing the claims. Additionally, the TPA is responsible for paying medical benefits and compensation in accordance with the North Carolina Workers’ Compensation Act. The University and the TPA try to provide the best possible medical care for injured employees to help them reach maximum medical improvement and return to work as soon as possible.

When an employee is placed on leave due to a compensable workers’ compensation claim wage replacement will be issued by CorVel, the TPA. While in this pay status, NO DEDUCTIONS are taken from the employee’s weekly workers’ compensation benefit. If the employee has payroll deductions made from regular pay for items such as health insurance or credit union loans, etc., it is the employee’s responsibility to satisfy these obligations while on workers’ compensation leave.

Note: Medical bills for injury related treatment are paid in accordance with the NC Industrial Commission fee schedule which sets maximum fees for all treatment unless otherwise agreed to by employer. It is against State law for any medical provider to accept any fee from the injured employee for treatment of a workers’ compensation injury.

Also: Payment of medical bills is not an indication of the University’s acceptance of liability for the claim. If you receive a bill from the medical facility, please contact the facility to make sure they are billing CorVel correctly. You may contact the WCA assistance, workerscomp@ncsu.edu.

Notice: An employee may ensure their workers’ compensation claim is preserved by completing and sending an NC Industrial Commission Form 18 or 18B to the NC Industrial Commission within two years from the date of injury or knowledge of an occupational disease or may be time barred. Notice of injury or occupational disease shall be given to the employer immediately after the accident or as soon as possible within 30 days .

In the event of denial: If an employee disagrees with a claim denial, the employee is entitled to request a hearing by submitting a Form 33. For Industrial Commission assistance, call (800) 688- 8349 or contact https://www.ic.nc.gov/

For treatment relating to a worker’s compensation injury, all treatment must be directed and authorized by the TPA, CorVel. Treatment not directed and authorized by CorVel may be denied.

The CorVel claim adjuster authorizes and directs all medical treatment related to an injury.

If further assistance is needed, an employee should consult with the WC Administrator to facilitate health care with a specialist.

Process all injury-related prescriptions through CorVel’s pharmacy program. The use of this program will waive any co-pay or cost to the claimant. For assistance with claims processing, please contact the CorVel Pharmacy Department at 800-563-8438.

Please use the BIN, PCN, and RxGroup number below to process an online/electronic claim to CorVel. The Member ID is the injured worker’s 9 digit social security number plus 8 digit date of injury (XXXXXXXXXMMDDYYYY).

First Fill Only

Bin: 004336
PCN: ADV RX
Group: RXFF
Member ID: SSN + Date of Injury

Participating Pharmacies

Below is a sample listing of some of the over 67,000 participating pharmacies nationwide in the CorVel network. If none are nearby, please call (800) 563-8438 for assistance with locating a participating pharmacy near you.

Carlie C’s Pharmacy
Costco Pharmacy
CVS Pharmacy
Food Lion Pharmacy
Harris Teeter Pharmacy
Ingles Pharmacy
Publix Pharmacy
Realo Discount Drugs
Sam’s Club Pharmacy
Target Pharmacy
Walgreens Pharmacy
Walmart Pharmacy

In the instance of a minor injury, an employee may not immediately wish to seek formal medical treatment.

The Supervisor should offer the employee a WORKERS’ COMPENSATION REFUSAL OF TREATMENT (94RT).

The Supervisor should complete the Provider section with an Urgent Care Facility which the employee should report if the employee later decides to seek care.

The Supervisor should also inform the employee that if they later seek care to provide the Supervisor with the treatment information and a work status form.

The Supervisor should provide any and all documents to Workers Compensation.