What is Total and Permanent Disability?

Damon Duncan By Damon Duncan, Board-Certified Specialist Updated June 3, 2026 2 min read
Workers' Compensation

The Short Answer

In North Carolina, total and permanent disability under workers' compensation means you've suffered a catastrophic injury — such as the loss of both hands, both legs, or both eyes — or an injury so severe you can no longer earn wages in any capacity. Under NC General Statute §97-31(17), certain injuries like paraplegia or double amputation automatically qualify, while other severe injuries like traumatic brain injuries may qualify under §97-29(d) if you can prove you're unable to work in any capacity. If your injury qualifies, you're entitled to weekly wage benefits and lifetime medical expense coverage. The burden of proving total and permanent disability falls on you as the injured worker.

EKG PhotographIf you have suffered a workers’ compensation injury, the impact on you and your family can be financially and emotionally devastating.  When the injury results in total and permanent disability, the impact is more profound.  Not only is there the trauma from the injury but there is one less wage earner in the family.

Total and permanent disability is defined by North Carolina General Statute §97-31(17) as “The loss of both hands, or both arms, or both feet, or both legs, or both eyes, or any two thereof, shall constitute total and permanent disability…”  As a result, a paraplegic, quadriplegic or double amputee is automatically determined to be totally and permanently disabled.   An individual with these injuries may return to work and earn wages while still being eligible for total and permanent disability benefits.  For example, an employee who loses both legs in an accident may be able to obtain a job as a clerk or computer programmer that is a more sedentary job.  The injured worker is still entitled to compensation under total and permanent disability.

There are other cases, as outlined in North Carolina General Statute §97-29(d), where an employee may have an injury so severe that the employee is unable to return to work and earn wages in any capacity given the severity of the injury that was sustained.  Often this is the case for a traumatic brain injury or a burn victim.  Although the injury does not comply with the North Carolina Statute §97-31(17), the worker no longer has the capacity to earn a living regardless of the training that is provided.  It is important to note that the employee or plaintiff has the responsibility or burden of proving total and permanent disability.

For an injury determined to be a “total” and “permanent” disability, the injured worker is entitled to weekly benefits and compensation of medical expenses for the rest of his or her life.   The weekly benefits are calculated by

Multiplying          Employee’s Weekly Wage ($862 is maximum weekly wage for 2012)

Times                      66.67%

Times                      52 Weeks

Times                      Anticipated Years Remaining in Employee’s Lifetime

If you or a loved one has been injured in a workers’ compensation accident and suffered a total and permanent disability, contact Duncan Law for a free consultation.

Key Takeaways

  • North Carolina law automatically classifies loss of both hands, arms, feet, legs, or eyes — or any two of these — as total and permanent disability under NC General Statute §97-31(17).
  • Even if you return to work after a qualifying injury, you can still receive total and permanent disability benefits — a double amputee who becomes a clerk, for example, remains fully eligible.
  • Severe injuries like traumatic brain injuries or major burns may qualify under §97-29(d) even without meeting the §97-31(17) criteria, but you must prove you cannot earn wages in any capacity.
  • Weekly benefits are calculated at 66.67% of your average weekly wage, subject to the state maximum, and multiplied across your anticipated remaining lifetime.
  • Qualifying injured workers receive both lifetime weekly wage benefits and coverage of medical expenses for the rest of their lives.
  • The burden of proving total and permanent disability rests entirely on the injured worker or their attorney — it is not automatically granted by the employer or insurer.

Attorney Insight

The mistake I see most often in these cases is injured workers assuming that because their injury is severe, the insurance carrier will simply agree it qualifies as total and permanent disability — they won't. For injuries outside the automatic categories in §97-31(17), like a traumatic brain injury, the insurer will fight hard to show you still have some earning capacity, even in a limited role. Coming in without solid vocational and medical evidence to meet the §97-29(d) burden is the single biggest reason these claims fail. If you're in that fight, you need to build that proof early, not after the insurer has already framed the narrative.

Damon Duncan

About the Author

Damon Duncan

Damon Duncan is a Board Certified consumer bankruptcy attorney at Duncan Law, LLP — helping North Carolina families stop collection calls, protect their property, and get a real fresh start through Chapter 7 and Chapter 13 bankruptcies. He is dedicated to guiding clients through the practical realities of financial recovery, including discharging overwhelming medical debt and halting wage garnishments. Duncan Law has served clients across North Carolina since 1996. In addition to the practice of law, Damon leverages his extensive understanding of debt and asset protection to teach Secured Transactions as a law professor at Elon University School of Law.

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