Statutory Limits for Workers' Compensation in North Carolina

Medical and Hospitalization Costs

North Carolina's workers' compensation system caps medical expenses at a maximum of $35,000 per injury, regardless of the actual cost incurred. This limit applies to all medical services, including surgeries, physical therapy, and prescription medications. If a claim exceeds this amount, the employer's workers' comp insurer pays the full amount, and any excess must be covered by the employee's own insurance or out‑of‑pocket payment.

Wage Replacement Benefits

In the event of a temporary disability, employees receive a weekly wage replacement benefit calculated at 60% of the employee's average weekly wage, up to a statutory maximum of $1,200 per week. The benefit is paid for up to 26 weeks, but a second 26‑week period is available if the injury remains disabling beyond the first 26 weeks. After the 52‑week cap, the employee may qualify for a permanent disability award.

Permanent Disability Awards

Permanent disability benefits are determined by a percentage of the employee's permanent loss of earning capacity. The maximum award is limited to 60% of the employee's average weekly wage, with a cap of $45,000 for each injury. For injuries that result in total disability, the cap is $90,000. These figures are adjusted annually by the state to account for inflation.

Death Benefits

When a work‑related fatality occurs, the employee's family receives a death benefit equal to 12 weeks of the deceased's average weekly wage, capped at $1,440 per week. The benefit is paid in a lump sum and can be used to cover funeral expenses, outstanding debts, or ongoing living costs.

Additional Considerations

Employers are required to maintain workers' comp insurance that meets these statutory limits, and they may elect to purchase higher coverage for additional protection. Employees should review their policy details to confirm whether any supplemental benefits are available beyond the statutory caps.