Common Questions Related to the Seven-Day Waiting Period for Workers’ Compensation Claims in North Carolina
Employers and adjusters in North Carolina have encountered the seven-day waiting period requirement when an employee is injured on the job and is out of work. While seemingly clear and straightforward, actual application of the seven-day waiting period to certain occupations or situations can be daunting.
Seven-Day Waiting Period
In North Carolina, the first seven days of disability are not payable to an injured employee unless that injury results in a disability of more than twenty-one days.
N.C. Gen. Stat. §97-28, the statute governing the seven-day waiting period, specifies:
“No compensation, as defined in G.S. 97-2(11), shall be allowed for the first seven calendar days of disability resulting from an injury, except the benefits provided for in G.S. 97-25. Provided however, that in the case the injury results in disability of more than 21 days, the compensation shall be allowed from the date of the disability. Nothing in this section shall prevent an employer from allowing an employee to use paid sick leave, vacation or annual leave, or disability benefits provided directly by the employer during the first seven calendar days of disability.” [emphasis added]
But what if the injured employee is someone who works twenty-four-hour shifts, and what if the days missed are not consecutive? Or, what if the employer continues an employee’s salary, does that count toward the waiting period? Let’s take a deeper dive into these frequently asked questions related to the seven-day waiting period.
What If the Injured Employee Is Someone Who Works Twenty-Four-Hour Shifts?
First, let’s examine the seven-day waiting period for an employee who may work irregular hours or a longer shift. In the situation of an employee who works twenty-four hour shifts fewer days per week rather than the standard work week of five days, the employer and adjuster should be thinking in hours instead days. In this situation, if the twenty-four-hour shift employee misses more than forty hours, then they would be eligible for total indemnity benefits if they missed more than the hourly equivalent of twenty-one days (840 hours).
Likewise, if an employee is disabled for more than twenty-one days because of the work injury, regardless of whether those days are consecutive, the employee is entitled to the waiting period.
What If the Employer Continues to Pay an Employee’s Salary After an Injury?
If an employee misses more than twenty-one days as a result of a work-related injury, the employee would be entitled to the initial seven-day waiting period, but additional payment would not necessarily be owed since salary was continued.
In contrast, if an employee used sick pay for that first week of disability and was later out for more than twenty-one days, the employee would have to be reimbursed – paid weekly indemnity benefits – for that initial period.
When thinking about when the seven-day waiting period begins, employers and adjuster should confirm whether the employee was paid for the date of injury. If the employee was paid, then the waiting period begins the next workday when the employee was scheduled to return to work. If they were not paid for that workday, it begins on the date of injury.
Similarly, if an employee is partially disabled as a result of the work injury, they may still be entitled to the waiting period if unable to work a full work week. In that case, the employer or adjuster would compare the employee’s post-injury reduction in hours. If the employee misses more than the hourly equivalent of twenty-one days, they are entitled to the initial waiting period.
Is There Still A Waiting Period If the Employee is Not Disabled?
Is an employee, who was not disabled but ultimately receives a rating which exceeds three weeks/twenty-one days, entitled to the waiting period? Simply put, yes. If the permanent disability is more than twenty-one days in and of itself or if the permanent disability is more than twenty-one days when added to the period of temporary disability, the employee is entitled to payment for the initial seven-day waiting period.
Practice Tip for Employers and Adjusters
Navigating whether an employee in North Carolina is entitled to the waiting period in certain circumstances can be less than clear for employers and adjusters. It helps to keep accurate records of the employee’s post-injury work schedule and earnings. Be mindful that even with diligent recordkeeping, questions can arise.