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North Carolina Free Printable Labor Law Posters Posters North Carolina N.C. Workers' Compensation Notice to Injured Workers and Employers Poster Required

 N.C. Workers' Compensation Notice to Injured Workers and Employers PDF

The N.C. Workers' Compensation Notice to Injured Workers and Employers is a labor law posters poster by the North Carolina Department Of Labor. This is a mandatory posting for all employers in North Carolina, and businesses who fail to comply may be subject to fines or sanctions.

This poster must be posted in a conspicuous place where all employees will see it. This poster describes how employees can qualify for workers' compensation when injured on the job as well as steps employers should take to file a claim and what the employer should do when an employee is injured while working.


NC All-In-One Labor Poster: Instead of printing out dozens of posters, employers can also purchase an all-in-one poster that covers both North Carolina and Federal poster requirements by clicking here .

All employees of this business, except specifically excluded executive officers, suffering work - related 
injuries may be entitled to Workers’ Compensation benefits from the employer or its insurance carrier.  FORM   17   Revised 12/2020  
N.C.  WORKERS’ COMPENSATION NOTICE TO INJURED WORKERS AND EMPLOYERS  
 
IF YOU HAVE A WORK - RELATED INJURY OR AN OCCUPATIONAL DISEASE  
The Employee Should:  • 
Report the injury or occupational disease to the Employer   immediately.  
• 
Give written notice to the Employer with in 30   days.  
• 
File  a  claim  with  the  Industrial  Commission  on  a  Form  18  immediately,  but  no  later  than  2  years  from  injury  date  or  occupatio nal 
disease. Give a copy to the   Employer.  
• 
If  medical  treatment  and  wage  loss  compensation  are  not  promptly  provided,  ca ll  the  insurance  carrier/administrator  or   request  a 
hearing  before  the  Industrial  Commission  using  a  Form  33  Request  for  Hearing.  Commission  forms  are  available  at  website  
www.ic.nc.gov   or by calling the Help   Line.  
• 
Your employer’s workers’ compensation insurance carrier is___________________________________________________________   .  
• 
The insurance policy number  is____________________________________________________________________________________   .  
• 
Your employer’s workers’ compensation insurance policy is valid from___________________ until___________________________   .  
 
For assistance: Call the  Industrial Commission HELP LINE — (800) 688 - 8349.  
The Employer Should:  
• 
Provide all necessary medical services to the   Employee.  
• 
Report the injury to the carrier/administrator and file a Form 19 Report of Injury within 5 days with the Industrial Commissi on, if   the 
Employee misses more than 1 day from work  or   if cumulative medical costs exceed   $4,000.00.  
• 
Give a copy of your completed Form 19 to the Employee along with a copy of a blank Form 18 Notice of   Accident. 
Ensure that compensation is promptly paid as req uired under the Workers’ Compensation   Act.  
 
NORTH CAROLINA INDUSTRIAL COMMISSION 
1235 MAIL SERVICE CENTER  
RALEIGH, NORTH CAROLINA 27699 - 1235  
Website:  www.ic.nc.gov  
 
TO EMPLOYER: THIS FORM MUST BE  PROMINENTLY POSTED IF YOU HAVE WORKERS’ COMPENSATION INSURANCE OR QUALIFY AS SELF - INSURED. (N.C. Gen. Stat. §97 - 93).

Other North Carolina Labor Law Posters 4 PDFS

There are an additional six optional and mandatory North Carolina labor law posters that may be relevant to your business. Be sure to also print all relevant state labor law posters, as well as all mandatory federal labor law posters.


View all 7 North Carolina labor law posters


Get a 2024 North Carolina all-in-one labor law poster

Instead of printing out pages of mandatory North Carolina and Federal labor law posters, you can purchase a professional, laminated all-in-one labor law poster that guarantees compliance with all North Carolina and federal posting requirements. Fully updated for 2024!

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Disclaimer:

While we do our best to keep our list of North Carolina labor law posters up to date and complete, we cannot be held liable for errors or omissions. Is the poster on this page out-of-date or not working? Please let us know and we will fix it ASAP.

** This Document Provided By LaborPosters.org **
Source: http://www.laborposters.org/north-carolina/264-workers-compensation-notice-to-injured-workers-and-employers-poster.htm