Healthcare workers dedicate their careers to healing others, but the physical and emotional demands of the profession make them some of the most frequently injured workers in the country. In North Carolina alone, more than 425,000 people work in healthcare — and their injury rates consistently exceed those of workers in construction, manufacturing, and retail.
The healthcare and social assistance sector recorded an injury rate of 3.4 cases per 100 full-time-equivalent workers in 2024 (U.S. Bureau of Labor Statistics), and OSHA has found that healthcare workers are three times more likely to experience workplace injuries than workers in other sectors. Nationally, the industry accounted for 562,500 injuries and illnesses in 2023 alone (U.S. Bureau of Labor Statistics).
If you're a nurse, certified nursing assistant, physician, technician, therapist, or any other healthcare professional in North Carolina who has been injured on the job, understanding your workers' compensation rights — and the special considerations that apply to healthcare workplace injuries — is essential to protecting yourself and your family.
Key Takeaways
- Healthcare workers face higher injury rates than workers in construction, manufacturing, and most other industries, with musculoskeletal injuries from patient handling being the leading cause
- Workplace violence is a serious and often underreported hazard — 75% of the approximately 25,000 workplace assaults in the U.S. each year occur in healthcare settings, and North Carolina has made assaulting a healthcare worker a felony
- North Carolina workers' compensation covers medical expenses, lost wages, and disability benefits for healthcare workers injured on the job, regardless of who was at fault
- Healthcare workers face unique challenges when filing workers' comp claims, including a culture of underreporting, employer pressure, and the complication of receiving treatment from the same healthcare system that employs them
- Consulting a workers' compensation attorney is especially important for healthcare workers, whose claims often involve complex issues like occupational diseases, repetitive injuries, and workplace violence
1. Why Healthcare Workers Face Higher Injury Risks Than Most Professions
The nature of healthcare work creates a combination of physical, biological, and psychological hazards that few other industries can match.
- Physical demands are relentless. Nurses, CNAs, and other patient care workers spend their shifts lifting, transferring, repositioning, and transporting patients — many of whom cannot bear their own weight. According to BLS data, 51% of all injuries among registered nurses result in sprains, strains, or tears, requiring a median of seven days away from work (U.S. Bureau of Labor Statistics).
- Biological hazards are constant. Exposure to infectious diseases — including COVID-19, tuberculosis, MRSA, and bloodborne pathogens like HIV and hepatitis — is an everyday risk. BLS data from 2023-2024 shows that healthcare support occupations had the highest COVID-19 workplace incidence of any occupational group, at 32.4 cases per 10,000 full-time-equivalent workers (U.S. Bureau of Labor Statistics).
- Workplace violence is alarmingly common. OSHA has documented that serious workplace violence incidents are four times more common in healthcare than in private industry on average (OSHA). Healthcare workers make up roughly 10% of the workforce yet account for 48% of all workplace violence injuries.
2. Common Workplace Injuries for Healthcare Workers in North Carolina
Healthcare workers experience a broad range of workplace injuries and illnesses, many of which have specific implications for workers' compensation claims in North Carolina.
Musculoskeletal Injuries and Back Injuries
Musculoskeletal disorders are the number one category of workplace injury for healthcare workers. Patient handling — lifting, transferring, repositioning, and transporting patients — is the activity most frequently associated with injury among nursing staff. These injuries affect the back, shoulders, neck, knees, and hips, and range from acute injuries caused by a single incident (such as catching a falling patient) to chronic conditions that develop gradually over years of repetitive strain.
For healthcare workers who develop musculoskeletal conditions gradually rather than through a single event, the workers' compensation process in North Carolina involves additional considerations, which we'll address below.
Needlestick and Sharps Injuries
Healthcare professionals who handle needles, scalpels, lancets, and other sharp instruments face a constant risk of puncture wounds. The danger isn't the wound itself — it's the potential exposure to bloodborne pathogens including HIV, hepatitis B, and hepatitis C. These injuries require immediate medical evaluation, may necessitate post-exposure prophylaxis, and often involve months of follow-up testing and monitoring.
Slip, Trip, and Fall Injuries
Hospitals, nursing homes, and other healthcare facilities present numerous fall hazards — wet floors, cluttered hallways, equipment cords, and the fast pace of busy clinical environments. BLS data shows that approximately 25% of workplace injuries among healthcare workers are caused by falls and slips, resulting in broken bones, traumatic brain injuries, spinal cord injuries, and soft tissue damage.
Workplace Violence and Patient Assaults
Approximately 75% of the nearly 25,000 workplace assaults in the United States each year occur in healthcare settings. Patients with dementia, psychosis, substance abuse disorders, or acute agitation may strike, kick, bite, or otherwise physically assault caregivers. Emergency department and psychiatric care workers face the highest risk.
North Carolina has recognized this problem through its criminal code — assaulting a healthcare worker has been a felony since 2015, upgraded to a Class D felony in 2019 (punishable by up to 13 years in prison). However, criminal prosecution is separate from your right to workers' compensation. If you are assaulted by a patient while performing your job duties, the resulting injuries are compensable under North Carolina workers' compensation law, regardless of the patient's mental state or intent.
One of the most troubling aspects is dramatic underreporting — research suggests only about 30% of nurse assaults are formally reported. Many healthcare workers have internalized the belief that being hit or kicked by patients is "part of the job." It is not, and these injuries deserve the same protections as any other workplace injury.
Infectious Disease Exposure
Healthcare workers are routinely exposed to communicable diseases in the course of their work. COVID-19 brought this risk into sharp public focus, but the hazard extends far beyond any single virus. Tuberculosis, influenza, MRSA, C. diff, and bloodborne pathogens represent ongoing occupational hazards. When a healthcare worker contracts an illness through workplace exposure, it may qualify as an occupational disease under North Carolina workers' compensation law — though these claims involve additional legal requirements beyond those for a standard traumatic injury.
Repetitive Stress Injuries
The repetitive nature of many healthcare tasks — constant bending, reaching, turning, and manipulating equipment — can lead to conditions like carpal tunnel syndrome, tendonitis, rotator cuff injuries, and chronic low back pain. Nurses who spend years typing at computer stations during charting, performing physical therapy manipulations, or operating surgical equipment may develop these conditions gradually. Like other repetitive injuries, establishing workers' compensation coverage for these conditions requires demonstrating a clear connection between the workplace activities and the resulting condition.
Burnout and Psychological Injuries
Occupational stress, burnout, and psychological trauma are significant hazards for healthcare workers. PTSD from workplace violence, the emotional toll of patient deaths, and chronic understaffing can all seriously impact mental health. In North Carolina, workers' compensation coverage for purely psychological injuries is limited — it typically requires that the condition resulted from an unusual or extraordinary work event rather than general job stress. However, mental health conditions that accompany a physical workplace injury (such as depression or anxiety following a patient assault) may be covered as part of the overall claim.
3. How Workers' Compensation Works for Healthcare Employees in North Carolina
North Carolina's Workers' Compensation Act (NC General Statutes §97.1 et seq.) requires most employers with three or more employees to carry workers' compensation insurance. This includes hospitals, nursing homes, physician practices, home health agencies, and virtually all other healthcare employers in the state. The law provides a no-fault system, meaning you are entitled to benefits regardless of who caused the injury — whether it was your own mistake, a coworker's error, a patient's actions, or an unavoidable accident.
Workers' compensation benefits available to injured healthcare workers in North Carolina include:
- Full medical coverage for all treatment related to the workplace injury — emergency care, surgery, hospitalization, physical therapy, prescriptions, and any other medically necessary treatment
- Temporary total disability benefits — approximately two-thirds of your average weekly wage (subject to a state-mandated maximum) while you are unable to work
- Temporary partial disability benefits — covers a portion of the difference between your pre-injury and post-injury earnings if you return in a reduced capacity
- Permanent partial disability benefits — compensation for lasting impairments, calculated based on the body part affected and degree of impairment
- Vocational rehabilitation services — to help you return to work or transition to a new role if your injury prevents you from performing your previous job
To preserve your right to these benefits, you must report your injury to your employer as soon as possible — and in any event within 30 days of the injury. Your employer should then file Form 19 with their workers' compensation insurance carrier and provide you with Form 18, which you file with the North Carolina Industrial Commission (NC Industrial Commission). Failing to report your injury within 30 days can jeopardize your entire claim, so prompt reporting is critical.
4. Special Considerations for Healthcare Workers' Comp Claims
Healthcare workers face several unique complications in the workers' compensation process that don't typically arise in other industries. Being aware of these issues can help you protect your claim.
Patient Handling Injuries: Proving the "Specific Traumatic Incident"
North Carolina workers' compensation law generally requires that a compensable injury result from a "specific traumatic incident" — a particular event that occurred at a specific time and place. For healthcare workers who are injured in a single, identifiable incident (such as a back injury from catching a falling patient or a needlestick while drawing blood), meeting this standard is usually straightforward.
The challenge arises for healthcare workers whose injuries develop gradually from years of repetitive patient handling. If your back pain didn't start with one dramatic incident but worsened incrementally over months or years, your claim may need to be filed as an occupational disease. North Carolina's occupational disease standards require you to demonstrate that:
- The condition is "characteristic of" and "peculiar to" your occupation
- Your employment significantly contributed to the condition
- The disease is not an "ordinary disease of life"
Meeting these standards requires thorough medical documentation and, often, legal guidance.
Workplace Violence Claims
When a healthcare worker is injured by a patient assault, the resulting injuries are compensable under workers' compensation because they arise out of and in the course of employment. However, workplace violence claims can present complications. The employer or insurer may argue that the assault was not work-related, particularly if it occurred in a parking lot, break room, or other location outside the immediate care area. Thorough documentation of the incident — including witnesses, security footage, and a detailed written account — is essential.
Additionally, healthcare workers injured by workplace violence may have options beyond workers' compensation. If an employer's gross negligence contributed to the assault (such as consistently failing to provide adequate staffing in a high-risk area despite known dangers), additional legal remedies may exist. It's important to note, however, that proving employer gross negligence in North Carolina requires meeting a very high legal standard, and workers' compensation remains the exclusive remedy in most cases.
Infectious Disease and Occupational Disease Claims
When a healthcare worker contracts an illness through workplace exposure, the claim is processed as an occupational disease. North Carolina's requirements are stricter than for standard traumatic injuries. You must demonstrate that:
- The disease was caused by conditions characteristic of your particular employment
- It was not an ordinary disease of life to which the general public is equally exposed
- Your employment was a significant contributing factor
For highly specific exposures — such as a needlestick resulting in hepatitis C or documented contact with a patient with active tuberculosis — establishing the workplace connection is relatively straightforward. For more common illnesses like COVID-19 or influenza, proving workplace-specific exposure (rather than community exposure) can be more challenging and may require detailed evidence of workplace conditions.
The Role of Employer-Directed Medical Care
In North Carolina, the employer or its workers' compensation insurer generally chooses which doctor you see for your workplace injury. For most workers, this is simply an inconvenience. For healthcare workers, it creates a unique problem: you may be directed to receive treatment within the same healthcare system that employs you.
This can raise concerns about conflicts of interest, privacy, and whether the treating physician will provide objective assessments or feel pressure to minimize the severity of your injuries. If you're uncomfortable with this arrangement, you have the right to request a change of physician through the North Carolina Industrial Commission. A workers' compensation attorney can help you navigate this process.
5. Challenges Healthcare Workers Face in Workers' Comp Claims
Beyond the legal complexities, healthcare workers face practical and cultural obstacles that can undermine their claims:
- The culture of toughness. Many nurses, CNAs, and other healthcare professionals have been conditioned to accept injuries as unavoidable. They push through back pain, ignore bruises from patient encounters, and treat their own injuries without reporting them. This mindset is understandable — healthcare workers are caregivers by nature — but failing to report and document injuries can have serious consequences for both your health and your future claim.
- Delayed reporting. Musculoskeletal injuries, repetitive stress conditions, and occupational diseases often develop gradually, making it hard to identify a specific moment when the injury "happened." By the time the condition becomes severe, months or years may have passed since initial symptoms — giving insurers grounds to argue the condition isn't work-related.
- Employer pressure. Healthcare employers facing staffing shortages may discourage injured workers from filing claims or push them to return to work prematurely. Some workers fear that filing a claim will mark them as difficult or unreliable. Remember: you have a legal right to file a workers' compensation claim for a legitimate workplace injury, and your employer cannot legally retaliate against you for doing so.
6. Steps to Take If You're Injured on the Job as a Healthcare Worker
If you've been injured while working in healthcare, taking the right steps early can make a significant difference in the success of your workers' compensation claim.
- Seek immediate medical attention and make sure to tell the treating provider that your injury is work-related. This documentation linking your injury to your employment becomes part of your medical record from the very beginning.
- Report the injury to your supervisor as soon as possible — and follow up with a written report. North Carolina law requires that you report your injury within 30 days, but reporting immediately is always better. Include the date, time, location, what you were doing when the injury occurred, and any witnesses.
- Document everything you can. Take photographs of any visible injuries. Write down a detailed account of what happened while the details are fresh. Save copies of any incident reports you complete. Keep a record of the names of coworkers who witnessed the injury.
- File Form 18 with the North Carolina Industrial Commission. This is the formal notice of your claim. Your employer should also file Form 19 with their insurance carrier. If your employer fails to file or is uncooperative, you can still file Form 18 directly with the Commission.
- Follow your treatment plan and keep all medical appointments. Consistent medical care not only supports your recovery but also creates the documented treatment history that supports your workers' compensation claim.
- Contact a workers' compensation attorney before signing anything from the insurance company. This is especially important if your claim is complex (occupational disease, repetitive injury, workplace violence) or if your employer or their insurer is disputing your claim.
7. Why Healthcare Workers Should Consult a Workers' Compensation Attorney
Healthcare workplace injuries often involve complexities that go beyond a straightforward accident claim. Occupational disease claims require meeting additional legal standards. Repetitive injuries may need to be documented differently than acute injuries. Workplace violence claims may involve questions about where the assault occurred and whether it was truly work-related. And the employer-directed medical care system can create conflicts that are uniquely challenging for healthcare workers.
An experienced workers' compensation attorney understands these nuances and can:
- Ensure your claim is filed correctly and on time
- Gather and present medical evidence that meets North Carolina's legal requirements
- Negotiate with the insurance company on your behalf
- Represent you at hearings before the North Carolina Industrial Commission if your claim is disputed
- Protect you from employer retaliation
Knowing what to look for in a workers' comp lawyer can help you find the right attorney for your situation. The most important thing is to consult with an attorney early in the process — before gaps in documentation or missed deadlines compromise your claim.
8. Frequently Asked Questions
Can I file for workers' compensation if I was injured by a patient?
Yes. Injuries from patient assaults are covered by workers' compensation in North Carolina because they arise out of and in the course of your employment. This is true regardless of the patient's mental state — whether the assault was intentional, the result of dementia, or caused by psychosis or substance use. Report the incident to your employer immediately, document the assault thoroughly, and seek medical attention for your injuries.
Does workers' compensation cover back injuries from years of patient lifting?
It can, but the process is more complex. If your back injury developed gradually from repetitive patient handling rather than from a single traumatic incident, it may be classified as an occupational disease under North Carolina law. This requires proving that the condition is characteristic of your occupation and that your employment was a significant contributing factor. Medical documentation linking your specific job duties to your condition is critical. An experienced workers' compensation attorney can help you build this type of claim.
What if my employer pressures me not to file a workers' comp claim?
North Carolina law prohibits employers from retaliating against employees who file workers' compensation claims. If your employer discourages you from reporting an injury, pressures you to return to work before your doctor clears you, or threatens disciplinary action for filing a claim, these actions may be illegal. Document any such communications and consult with a workers' compensation attorney immediately. You have a legal right to file a claim for a legitimate workplace injury.
Can I choose my own doctor for a workers' compensation injury in North Carolina?
In most cases, the employer or its workers' compensation insurer has the right to direct your medical treatment, including choosing your treating physician. However, you can request a change of physician through the North Carolina Industrial Commission if you are dissatisfied with your care. This is particularly important for healthcare workers who may be directed to receive treatment within the same healthcare system that employs them. An attorney can help you navigate the process of requesting a change of provider.
What benefits are available to healthcare workers under NC workers' compensation?
North Carolina workers' compensation provides several categories of benefits for injured healthcare workers:
- Full coverage of all medical treatment related to the workplace injury
- Temporary total disability benefits (approximately two-thirds of your average weekly wage) while you are unable to work
- Temporary partial disability benefits if you return to work in a reduced capacity
- Permanent partial disability benefits for lasting impairments
- Vocational rehabilitation services to help you return to work or transition to a new role
There are no upfront costs for medical treatment — the employer's workers' compensation insurance covers all authorized medical expenses.
9. You Take Care of Others — Let Us Take Care of You
Healthcare workers give everything they have to their patients, often at significant cost to their own health. When the job you've devoted your career to causes you physical harm, you deserve more than a suggestion to "push through it." You deserve the full workers' compensation benefits that North Carolina law provides — and an advocate who will fight for them.
The Law Offices of Timothy D. Welborn represents injured workers across North Carolina, including the healthcare professionals who keep our communities healthy. Whether you've suffered a back injury from patient handling, been assaulted by a patient, contracted an illness through workplace exposure, or developed a repetitive stress condition, we're here to help you understand your rights and pursue the compensation you need.
Contact us today for a free consultation and let us put our workers' compensation experience to work for you. Your career has been about caring for others — now let someone care about you.
