We are committed to providing you with the highest level of customer service during your care and recovery from a workplace illness or injury. We welcome your comments. Please fill out this confidential questionnaire and click Submit. Thank you for your feedback and service to the citizens of North Carolina.

Do you consider your injury as minor, medium or severe?

- Minor (including but not limited to laceration not requiring stitches, minor burn, sprain, muscle strain, etc.)

- Medium (including but not limited to laceration requiring stitches, broken bone, muscle or ligament tear, second degree burn, etc.)

- Severe (including but not limited to amputation, loss of eye, in-patient hospitalization, etc.)"

Validating Fields
Submitting Form

NCDOT Workers Compensation Program

MSC 1504 Raleigh, NC 27699-1504

If you have any questions, please call: 1-866-361-1818 (24/7 anonymously)

Version 2, Nov 19, 2019 Approved

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