Hurricane Helene created unprecedented challenges for the State’s workers’ comp program. Here’s how they stepped up to tackle them. 

In September 2024, Hurricane Helene struck North Carolina with unprecedented fury, becoming the deadliest and most destructive natural disaster in the state’s modern history. With 108 lives lost, eight tornadoes, more than 400 road closures, and damages exceeding nearly $60 billion, the hurricane left widespread devastation across the western part of the state.

For the North Carolina Office of State Human Resources (OSHR), which administers the state’s self-insured workers’ compensation program, the storm created an urgent challenge: ensuring that 265 injured state employees across 25 federally declared disaster counties continued receiving critical medical care, pharmacy access, and wage replacement payments despite collapsed infrastructure and failed communication networks.

“When the images first came through of the devastation, which was beyond anything we would have anticipated, the immediate reaction is, wow, I wish I could do something,” said Cathy Pope, state workers’ compensation manager. “And I was very fortunate, and my office was very fortunate. We were in a position where we could do something.”

Within the disaster zone, which comprised a quarter of the entire state, 69 client locations and 265 open claims were directly impacted. Of those, 175 were indemnity claims requiring wage replacement, and 70 injured employees still received physical checks rather than direct deposit. All faced potential delays and uncertainty at a time when consistent support was more vital than ever.

Tackling the Problem

The State’s response began immediately, aided by fortunate timing. The state workers’ compensation conference occurred within days of Helene’s impact, bringing together OSHR representatives and contracted vendors who didn’t hesitate to drop their conference plans and focus on emergency response.

“Those vendors that were present didn’t hesitate when we asked them to drop what they were doing, what they had planned to do at this conference, and to sit down with us for an all hands on deck emergency response,” Pope said.

OSHR worked with its third-party administrator CorVel and multiple specialized vendors to develop a comprehensive response rooted in cross-functional coordination, proactive outreach, and adaptive care delivery. The goal was clear: ensure no injured worker fell through the cracks due to infrastructure damage or communication breakdowns.

“The State of North Carolina demonstrated extraordinary leadership and resolve in the wake of unimaginable devastation. Their rapid, coordinated response to Hurricane Helene, alongside CorVel and other partners, ensured that injured workers received uninterrupted care and support during the most devastating natural disaster in the state’s modern history,” said Michael Combs, president and CEO, CorVel Corporation.

“Their resilience, innovation, and unwavering commitment to employee well-being are precisely what the Theo Award was created to honor.”

The state’s partners built a custom emergency provider panel tailored to the unique needs of affected areas. Where they normally sought providers within 25 miles, they expanded the radius to 40 miles and even crossed state lines to fill access gaps. This became a moving target as some facilities closed, others became overburdened, and different providers reopened or reached capacity.

“When needed, appointments were rescheduled and treatment was redirected as different facilities became open or some became overwhelmed,” Pope said. “Some of those living in the affected area actually moved out of the area. We still have some that are living outside of the area. And so we had to provide medical care in those new areas.”

Organization: State of North Carolina * Location: North Carolina * Number of Employees: 194,000+ * Category: Government & Public Sector

Simultaneously, the state activated disaster pharmacy overrides allowing emergency medication refills in situations where employees wouldn’t normally be eligible. When pharmacies closed, adjusters worked with employees to locate open alternatives and share that information.

Physical therapy providers quickly determined which facilities in impacted areas were closed and which had capacity for additional patients. They moved swiftly to reschedule treatments and coordinate with adjusters to determine if patients had relocated or needed alternative contact methods. This process continued for months as services were restored, roads reopened, and some closed again for repairs.

Diagnostic radiology facilities faced similar challenges, requiring constant coordination to confirm which facilities could accept patients and reschedule with alternatives as needed. The state also had to ensure durable medical equipment reached patients who might have relocated or whose homes were no longer accessible.

Case managers faced their own challenges, as some employees providing services were also in impacted areas. The biggest obstacle was lack of phone coverage and internet access, forcing some nurse case managers and vocational rehabilitation specialists to relocate to areas with reliable connectivity.

“As a matter of fact, when we met that first day, they had representatives at the conference, and they were still working to confirm whether some of their people were safe and had not been able to reach some of them,” Pope said. “So we were dealing not only with impact on our injured employees, but also the impact on those who provided the services.”

Critical to the response was ensuring indemnity payments weren’t interrupted. Claims adjusters conducted personalized outreach to all 265 affected employees, speaking with each person to confirm their safety and address payment needs. Those receiving paper checks could transition to expedited direct deposit,or arrange alternative mailing addresses.

“During that process, no payments were missed,” Pope said. “And that was critical at a time of need. People don’t need to have to deal with that on top of everything else.”

The state also had to address new injuries occurring during the disaster response. With 69 state locations in the affected area and numerous employees deployed to assist with disaster relief, new claims continued to arise. OSHR worked around communication limitations, allowing agencies to call in claim information when internet systems weren’t accessible.

Throughout the crisis, communication remained structured and intentional. OSHR and its partners established daily check-ins with agencies, coordinated with vendors, and served as a central contact point for stakeholders. Despite numerous logistical challenges, the response focused on tailoring solutions to each worker’s specific needs.

“Even though there were 200 and something claims, for each person, that was very personal and what they needed had to be structured for what was going to meet their needs,” Pope explained.

Success to Build On

The coordinated response preserved workers’ compensation services without disruption during one of the most catastrophic natural disasters in state history. Injured workers continued receiving needed care with minimal delays in treatment scheduling, prescription access, or disability payments. The emergency provider panel ensured medical care remained available across all impacted communities, even in rural or isolated areas.

Of the 175 indemnity claimants affected, 100% maintained access to compensation without payment gaps. Those previously reliant on physical checks successfully transitioned to digital solutions or received custom delivery methods. (Here I would add “if needed” as some elected to continue as they were before.)

Cathy Pope, state workers’ compensation manager, State of North Carolina

The response’s impact extended beyond statistics. Agency leaders and administrators sent testimonials praising the team’s compassion and diligence. The handling of injured workers during the disaster was described as seamless by those who witnessed it firsthand.

The Hurricane Helene experience created a sustainable model for future emergencies. This collaborative disaster response framework, built on manual outreach, agile provider paneling, and customized support, has become core to North Carolina’s crisis management approach. The framework adapts to future storms, power outages, or mass events that disrupt services.

“This experience with Hurricane Helene has created a sustainable model for future emergencies—a collaborative disaster response framework for customizing support for the needs of individuals,” Pope said. “And while we hope never to have anything of that magnitude again, we live on the East Coast. There are going to be emergencies.”

The state’s approach offers lessons for other employers facing crisis management challenges. Pope emphasized the importance of thinking ahead but acting immediately, working with partners to develop responses that fit individual needs rather than just general solutions.

“I think it’s important to have an overall response, but also not lose sight that these are individuals we are dealing with, individuals who are probably in what would be one of the most difficult times of their lives,” she said. “And so whatever first steps we could take to make that easier for them, we needed to take.”

In the face of historic devastation, North Carolina’s collective response protected the well-being of injured workers across the state while creating a blueprint for resilient, compassionate claims management in any crisis. The experience demonstrated that even in the worst circumstances, employee care must remain personal and immediate.

“For those in the impacted areas, what they needed for success at that time was disaster  relief things and for the workers’ comp program to continue working in the worst of times,” Pope said. “We were glad we were able to do that.” &

The Theo Award celebrates its sophomore year, honoring 32 workers’ compensation programs for their excellence and service to workers across the nation. To learn more about the award and amazing qualities each winner possesses, visit here.