North Carolina N.C. Workers' Compensation Notice to Injured Workers and Employers Mandatory
The N.C. Workers' Compensation Notice to Injured Workers and Employers is a North Carolina workers compensation law poster provided for businesses by the North Carolina Department Of Labor. This is a required poster for all North Carolina employers, and any business that fails to post this notification may be subject to penalties or fines.
This is a state labor law enforced by state, North Carolina Workers’ Industrial Commission. It is a mandatory posting affecting all workers and employers within the state. The poster provides information what workers and employers should do in the event of an injury on the job or when one develops an occupational disease out of and in the course of the job. The poster highlights workers’ rights as well as the employers’ responsibilities in the event of injury among other relevant concerns under workers compensation laws. The poster should be correctly posted in a conspicuous place where all employees can see it. Failure to comply with the posting as stated under the law may attract fines and or sanctions.
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).
Get a 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 October 2017!
Get All-In-One Poster NowMore North Carolina Labor Law Posters 7 PDFS
Minimum-Wage.org provides an additional six required and optional North Carolina labor law posters that may be relevant to your business. Be sure to also print and post all required state labor law posters, as well as all of the mandatory federal labor law posters.
North Carolina Poster Name | Poster Type |
---|---|
Required N.C. Workers' Compensation Notice (Spanish) | Workers Compensation Law |
Required N.C. Workers' Compensation Notice to Injured Workers and Employers | Workers Compensation Law |
Required Unemployment Insurance Poster | Unemployment Law |
Required Unemployment Insurance Poster (Spanish) | Unemployment Law |
Required N.C. Labor Laws Poster | General Labor Law Poster |
List of all 7 North Carolina labor law posters
North Carolina Labor Law Poster Sources:
- Original poster PDF URL: http://www.ic.nc.gov/forms/form17.pdf , last updated May 2020
- North Carolina Labor Law Poster Page at http://www.nclabor.com/posters/posters.htm
- North Carolina Department Of Labor at http://www.nclabor.com/index.htm
Labor Poster Disclaimer:
While Minimum-Wage.org does our best to keep our list of North Carolina labor law posters updated and complete, we provide this free resource as-is and cannot be held liable for errors or omissions. If the poster on this page is out-of-date or not working, please send us a message and we will fix it ASAP.