Did you know that our workers’ compensation team handles coverage matters as well? Attorney John Tomei spearheads this effort with the full support of our Insurance Coverage Services team, bringing a wealth of institutional knowledge to the coverage disputes and considerations unique to workers’ compensation policies. Here are some of the issues we see on a regular basis:
We represent private and public sector employers, government entities, insurance carriers and third-party administrators in all aspects of a workers’ compensation claim. Our goal is to provide practical and proactive legal advice; diligently manage accepted claims to reduce liability; employ results-oriented negotiation skills to promptly resolve contested cases, minimize defense costs and achieve finality; and, in those cases which cannot be resolved by compromise settlement, aggressively and effectively defend our clients before the Industrial Commission and in our appellate courts.
We believe in being responsive and providing guidance as a trusted advisor. Our workers’ compensation team can handle any issue that may arise in the workers’ compensation realm and always seek the best resolution for our clients, whether that requires litigation or a quick resolution. We offer a wide variety of continuing education courses and are regularly asked to present for industry events, membership organizations and law schools.
Teague Campbell attorneys have assisted in negotiating and drafting legislative changes to the Workers’ Compensation Act and bring that depth of knowledge to each client and every claim. We have been involved in over 180 workers’ compensation decisions before the North Carolina Court of Appeals and the Supreme Court and are the only North Carolina firm in the National Workers’ Compensation Defense Network. Our workers’ compensation attorneys are also consistently recognized by their peers in North Carolina Super Lawyers and The Best Lawyers in America©, with two current and one former partner receiving Lawyer of the Year designation.
Clients trust our unmatched experience – a combined total of 295 years to be exact.
Defense Counsel Perspective: Five Tips for Preparing for Mediation It remains a popular preference for plaintiffs and plaintiffs’ attorneys to attend mediation virtually despite the default rule at the Commission being in-person mediations. From the defense counsel perspective, virtual mediations…
An employer’s right to direct medical treatment, long recognized as a staple of the Workers’ Compensation Act, is not total. The Court of Appeals’ January 2024 decision in Horsey v. Goodyear Tire & Rubber Co. is a reminder of that…
News from NCIC- New Integrated Case Management System The North Carolina Industrial Commission announced Wednesday, January 31st that its new integrated case management system will go live for external users in late February of 2024. The NCIC website stated that…
Mediation Attendance Update On January 23, 2023, The Supreme Court of North Carolina adopted the Rules for Mediated Settlement Conferences and Other Settlement Procedures in Superior Court Civil Actions, superseding the existing set of rules in its entirety, that went…
On September 22, 2023, the North Carolina General Assembly passed House Bill 259 which amended G.S. § 97-29 (c) of the Workers’ Compensation Act. Specifically, the Amendment clarified the meaning of “total loss of wage-earning capacity” related to a plaintiff’s…
Under the North Carolina Workers’ Compensation Act, there are three conditions antecedent to the right to compensation: (1) that claimant suffered a personal injury by accident; (2) that such injury arose in the course of the employment; and (3) that…
Every few years, a Pleasant claim makes its way to the Court of Appeals and almost always serves as a reminder that the facts must be particularly egregious to warrant such a claim. As a reminder, if an employee is…
Philip A. Baddour was confirmed by the General Assembly to serve a second term as a commissioner. The 28th Annual North Carolina Industrial Commission Workers’ Compensation Educational Conference will be held October 4 through 6, 2023 at the Raleigh Convention…
Prescription medications can be a stumbling block when it comes time to resolve a workers’ compensation claim. Insurance carriers often have preferred vendors they utilize to obtain favorable prescription costs or negotiated agreements with pharmacies, leading to less expensive medical…
The N.C. Court of Appeals recently provided new guidance on calculating the average weekly wage (AWW) in a case involving a summer job for a full time graduate student. Although the case also addressed the admissibility of testimony under Rule…
Amber May appointed as the NCIC’s Chief Operating Office Effective June 1, 2023 The Industrial Commission announced that Amber May will serve as its Chief Operating Officer effective June 1, 2023. May currently serves as the Commission’s General Counsel, having…
One of the hot topics in Workers’ Compensation over the past few years has been entitlement to extended benefits and what standard the courts would apply to determine the same. Most recently, the Court of Appeals issued a decision in…
Amended Full Commission Decision Provides Updated Guidance on Navigating Requests for Second Opinions and Clarifies the Issue of Payment Under the Fee Schedule A long-standing issue under the Workers’ Compensation Act has been second opinions on treatment options under N.C.…
Starting February 20, 2023, the Industrial Commission will begin emailing Report of Mediator fee invoices at the time the mediator is appointed. This new procedure will not impact the fee’s due date but is being introduced in an effort to…
Carolyn J. Thompson Appointed to Serve as Deputy Commissioner Carolyn J. Thompson was appointed to serve as a Deputy Commissioner and her term began on January 2, 2023. Thompson previously served as a District Court judge and then a Resident…
Over the holiday season, the Industrial Commission filed the first couple of Deputy Commissioner decisions for COVID-19 claims. Several decisions have been filed under the N.C. Gen. Stat. § 143-166.1 et seq for death benefits for public safety employees, which…
Teague Campbell attorneys Elizabeth Ligon and Logan Shipman have been featured in LexisNexis’ 2022 Edition of Workers’ Compensation Emerging Issues Analysis. This year’s issue highlights the 50 year anniversary of the National Commission on State Workman’s [sic] Compensation Laws, a Commission…
The 1972 Report of the National Commission on State Workmen’s Compensation Laws and the Elimination of North Carolina’s Cap on Extended Benefits Created in 1929 as a compromise between the state’s employers and its workers, the North Carolina Workers’ Compensation…
Two return to work decisions were recently handed down from the North Carolina Court of Appeals, both of which are helpful in determining how the Court is currently examining disability issues. The first case, Geraldine Cromartie v. Goodyear Tire &…
Revised Guidelines for In-Person Industrial Commission Hearings The Industrial Commission has revised its in-person hearing guidelines to reflect the most recent guidance from the Centers for Disease Control (CDC). In-Person Deputy Commissioner Hearing Guidelines Any person with symptoms of COVID-19…
A trip and fall. Injury by machinery. Exposure to asbestos leading to a diagnosis of mesothelioma. These are life-changing events for employees (and employers) that may lead to a slurry of workers’ compensation claims. When the worst happens to an…
On July 26, 2022, the Full Commission issued another extended benefits decision, Messick v. Walmart Stores, Inc. The panel consisted of Vice-Chair Griffin, Commissioner Taylor and Commissioner Goodman. In this case, the Full Commission awarded the claimant extended benefits. The…
Over the last year, we have seen an uptick in claimant attorneys requesting a second opinion on treatment options under N.C. Gen. Stat. § 97-25(b) and that defendants 1) issue a prepayment for that visit and 2) pay beyond the…
A recent May 2022 decision from the North Carolina Court of Appeals provides a refresher on the “eggshell plaintiff rule” and taking your claimant how you find them. In Kluttz-Ellison v. Noah’s Playloft Preschool, the claimant sustained two separate incidents…
Commissioner Myra Griffin Reappointed Commissioner Myra Griffin was reappointed by Gov. Cooper to serve a second six-year term beginning July 1, 2022. Her reappointment is subject to confirmation by the North Carolina Gen. Assembly and had been approved by the…
When employees in North Carolina sustain injuries by accident arising out of and in the course of their employment with employers, their ensuing workers’ compensation claims are generally compensable. However, what if the injured worker is a subcontractor? And, does…
With many types of benefits available for injured and out of work employees, it can be difficult to remember who is entitled to a credit or offset when an employee is also receiving workers’ compensation benefits. In North Carolina, an…
On May 4, 2022, Commissioners Griffin, Gillen and Phillips affirmed Deputy Commissioner Howell’s August 11, 2021 decision to deny claimant’s request for extended benefits in George E. Tyson, Jr. v. North Carolina Department of Health and Human Services and CCMSI. …
In these challenging economic times, which include inflation and rising costs of workers’ compensation coverage, one way employers can reduce their workers compensation insurance coverage costs is to request the inclusion in their policies of deductible provisions. In addition to…
The North Carolina Court of Appeals issued a new decision concerning medical treatment, and what evidence is necessary to prove causation and establish compensability. In Mahone v. Home Fix Custom Remodeling, the claimant worked for a home remodeling company. On…
Commissioner Myra L. Griffin Reappointed to Serve Second Term at the Full Commission Gov. Roy Cooper reappointed Commissioner Myra L. Griffin to serve a second six-year term as a Commissioner beginning July 1, 2022. Her reappointment is subject to confirmation…
In a recent decision issued by the North Carolina Court of Appeals, Judge Chris Dillion remanded Blackwell v. N.C. Dep’t of Pub. Instruction back to the Full Commission where a claimant’s appeal to convert her weekly benefits to a single,…
In North Carolina, an injured employee may recover damages from both the workers’ compensation carrier as well as a third-party tortfeasor. In accepted claims, where a third-party causes the compensable injury, the workers’ compensation carrier is provided an automatic lien…
Employers and adjusters in North Carolina have encountered the seven-day waiting period requirement when an employee is injured on the job and is out of work. While seemingly clear and straightforward, actual application of the seven-day waiting period to certain…
In North Carolina, most COVID-19-related workers’ compensation cases are rightfully being denied. The thought initially with COVID-19 claims, and still to a degree with the Delta variant, was that while a claimant will have a difficult time establishing a compensable…
The most recent case to analyze futility has been issued by the North Carolina Court of Appeals. The case, Monroe v. MV Transportation, relies heavily on the Griffin v. Absolute Fire Control, Inc. case that came down last year to…
Deputy Commissioner Hearings In person Deputy Commissioner hearings were scheduled to resume effective January 1, 2022, but the return date has now been delayed. In person Deputy Commissioner and Full Commission hearings are currently scheduled to begin March 1, 2022.…
Mary Betts v. North Carolina Department of Health and Human Services – Cherry Hospital On February 1, 2022, the North Carolina Full Commission released a decision in the second extended benefits case since the Reform in 2011. The case was…
The newest version of the “Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide” contains just one change, but this one change was apparently intended to send a strong message to WCMSA industry. According to the new reference guide dated January…
As we have addressed previously, under the SMART Act, the Centers for Medicare & Medicaid Services (CMS) is required to set minimum Section 111 mandatory reporting thresholds for liability, no-fault, and workers’ compensation claims. The reporting threshold also establishes a…
According to an announcement issued by the Centers for Medicare & Medicaid Services (CMS) on December 13, the Provide Accurate Information Directly (PAID) Act was implemented and became live effective December 11, 2021. Up to this point, when claims were…
As part of the employer’s and carrier’s prompt investigation of a claim, NCIC Rule 608 allows the taking of a recorded statement to determine the facts and circumstances surrounding the injury. Rule 608 is broad in scope. It requires the…
On October 7, 2021, Deputy Commissioner Wes Saunders issued an Opinion and Award in Tapper v. Penske Logistics, LLC, awarding the claimant extended benefits. This is the seventh decision on extended benefits that has been issued at the Deputy Commissioner…
Ordinarily, bad faith claims against insurance carriers are brought in the Superior Court in the General Courts of Justice in North Carolina. These claims are based upon the law of contracts and torts. The law provides that there is an…
Getting an injured worker back to work is often the ultimate goal when mitigating exposure. When considering how to best maximize an injured worker’s post-injury earning capacity, employers and adjusters should attempt to collect information regarding an injured worker’s potential…
On September 29, 2021, the Full Commission entered an Opinion and Award in Milton Nobles v. North Carolina DHHS and CCMSI. The Full Commission reversed Deputy Commissioner Harris’ Opinion and Award and denied claimant’s right to extended benefits beyond the 500…
Last Updated: February 2, 2022 The North Carolina Industrial Commission has recently issued decisions in the first round of extended benefits cases, in which claimants are arguing entitlement to temporary total disability benefits past the 500-week cap on benefits. Six…
Before a proposal for a Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) may be voluntarily submitted to the Centers for Medicare & Medicaid Services (CMS) for formal review, the claimant must provide written permission to the submitter by completing a Consent…
While COVID-19 continues to spread, many businesses are working to keep their doors open and stave off another shutdown. As part of that effort, and because of the recent full FDA approval of the Pfizer vaccine, we are seeing a…
26th Annual N.C. Workers’ Compensation Educational Conference Going Virtual The 26th annual North Carolina Workers’ Compensation Educational Conference will now be held virtually October 5 – 8, Tuesday through Friday, from 9 AM to approximately 2 PM each day. The…
A recent unpublished case from the Court of Appeals, Suazo v. Gutierrez-Bojorquez, reiterates the importance of obtaining certificates of insurance and ensuring coverage has not lapsed before allowing subcontractors to begin work on a project. Without proper coverage, general contractors…
Oral Arguments Set for October 4, 2021, in Nay v. Cornerstone Staffing Solutions Plaintiff, Luon Nay, injured his back while working as a temporary employee for Cornerstone. Mr. Nay was performing landscaping work at the time of his back injury…
We saw during March 2020 the great migration for businesses to a mainly, and at times exclusively, work from home model. While businesses have re-opened their offices to their employees, data from the Pew Research Center shows that many Americans…
Co-authored by Shannon Till Poteat, Member, Robinson Gray Stepp & Laffitte, LLC If a claimant in a workers’ compensation claim is a current Medicare beneficiary, the carrier has certain reporting obligations to the Centers for Medicare and Medicaid Services (CMS). …
North Carolina Supreme Court remands Lauziere v. Stanley Martin Communities, LLC, 376 N.C. 789, 854 S.E.2d 579 (2021) to the Full Commission for further findings. In a recent decision issued by the North Carolina Supreme Court, the judges remanded a…
In nearly all instances, when a worker is injured on the job in North Carolina, the North Carolina Industrial Commission has jurisdiction over the claim. One notable exception involves out-of-state employers who do not regularly employ three or more employees…
The Commission has recently issued decisions in the first extended benefits cases, in which plaintiffs are arguing entitlement to benefits past the 500-week cap provided in the 2011 reform. The cases have only been heard at the Deputy Commissioner level…
Wanda Blanche Taylor confirmed by NC General Assembly to Serve as a Commissioner Wanda Blanche Taylor was confirmed by the North Carolina General Assembly to serve as a Commissioner replacing former Commissioner and Chair of the Commission, Charlton Allen. Commissioner…
If a claimant in a workers’ compensation claim is a current Medicare beneficiary, the carrier has certain reporting obligations to the Centers for Medicare and Medicaid Services (CMS). Under Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of…
As we head into the summer season, there is no better time for a refresher on the calculation of average weekly wages for seasonal employees. Definition of a Seasonal Employee A seasonal employee is one whose primary employment is during…
Occupational diseases that attack injured workers’ lungs are often filed with the North Carolina Industrial Commission. The most common lung diseases include: (1) silicosis; (2) asbestosis; (3) byssinosis; and (4) occupational asthma. Silicosis and asbestosis are specifically enumerated in N.C…
The tripartite relationship refers to the relationship between the insurer, the insured, and the attorney arising out of the insurance contract. Each party to the relationship has their own respective duties and roles, which will be discussed in turn. In…
Are all workers who perform services for an employer, including owner, partner, member, or executive officer, covered as “employees” under the North Carolina Workers’ Compensation Act to the extent they may be seeking workers’ compensation benefits? How are those “employees,”…
This is the third and final article in a three-part series discussing different aspects of compensability of COVID-19 workers’ compensation claims in North Carolina, including: Part 1: Are all communicable diseases the same? Does the designation of an epidemic or…
This is the second article in a three-part series discussing different aspects of compensability of COVID-19 workers’ compensation claims in North Carolina, including: Part 1: Are all communicable diseases the same? Does the designation of an epidemic or pandemic change…
A decision has been an issued by the North Carolina Supreme Court in a case that we have been following for quite a few years: Griffin v. Absolute Fire Control, Inc. The Supreme Court affirmed the ruling from the Court…
This is the first article in a three-part series discussing different aspects of compensability of COVID-19 workers’ compensation claims in North Carolina, including: Part 1: Are all communicable diseases the same? Does the designation of an epidemic or pandemic change…
Wanda Blanche Taylor and Adrian A. Phillips appointed to the Full Commission by Gov. Cooper Wanda Taylor has been appointed by Gov. Cooper to the Full Commission. If confirmed by the General Assembly, Attorney Taylor will replace Commissioner Charlton Allen,…
This is the fourth and final article in a four-part series discussing different aspects of workers’ compensation psychological claims in North Carolina, including: Part 1: Psychological Claims Resulting from Physical Injury; Part 2: Non-Physical Injury by Accident Psychological Claims; Part…
This is the third article in a four-part series discussing different aspects of workers’ compensation psychological claims in North Carolina, including: Part 1: Psychological Claims Resulting from Physical Injury; Part 2: Non-Physical Injury by Accident Psychological Claims; Part 3: Non-Physical…
As we have addressed previously, under the SMART Act, the Centers for Medicare & Medicaid Services (CMS) is required to set minimum Section 111 mandatory reporting thresholds for liability, no-fault, and workers’ compensation claims. The reporting threshold also establishes a…
This is the second article in a four-part series discussing different aspects of workers’ compensation psychological claims in North Carolina, including: Part 1: Psychological Claims Resulting from Physical Injury; Part 2: Non-Physical Injury by Accident Psychological Claims; Part 3: Non-Physical…
In the course of handling a workers’ compensation case, an adjuster will have to communicate with the employee’s treating physician to collect valuable medical information relevant to the diagnosis and ability to return to work. As noted in N.C.G.S §…
The day is finally here and your case is settled. But is it really over? Let’s go over some key issues in regards to mutual consent in settlement agreements and make sure. First things first, a settlement agreement is a…
This is the first article in a four-part series discussing different aspects of workers’ compensation psychological claims in North Carolina, including: Part 1: Psychological Claims Resulting from Physical Injury; Part 2: Non-Physical Injury by Accident Psychological Claims; Part 3: Non-Physical…
When the actions of an insured give rise to the need for a carrier to cancel a workers’ compensation policy, it is vitally important for the carrier to be aware of how to effectively cancel the policy under North Carolina…
The Industrial Commission recently passed a number of rule changes which were scheduled to go into effect on two different dates. The first set of rule changes went into effect on December 1, 2020. The rules that went into effect…
As workers’ compensation professionals, we are all too familiar with Medicare Set Asides (MSAs) in settlements. But are we required to include a fully-funded MSA in a compromise settlement? According to the Centers for Medicare & Medicaid Services (CMS), the…
Industrial Commission Policy Update on In-Person Hearings, Mediations, and Other Procedural Directives. The North Carolina Industrial Commission has adopted an Emergency Rule that in turn allows the Industrial Commission to implement Emergency Orders and Directives of the Chief Justice of…
The current state of the law in North Carolina Workers’ Compensation in latent occupational disease claims is in flux right now. Considering current case law, there are often three options for calculating a plaintiff’s average weekly wage, and neither the…
The North Carolina Industrial Commission recently passed a number of rule changes, which will go into effect on two different dates over the next few months. The first effective date is December 1, 2020, and those rule changes are discussed…
The NWCDN, in partnership with the WorkersCompensation.com Center for Education Excellence, has produced a webinar series addressing the most pressing COVID-19 concerns across the nation. The schedule of complimentary webinars and recorded replays can be found here. NWCDN members continue…
Under The North Carolina Workers’ Compensation Act, an injured employee may seek a second opinion from a physician upon which the parties agree. N.C.G.S. § 97-25(b). Likewise, employers may request an Independent Medical Evaluation (IME) of the injured employee. N.C.G.S.…
Are you an employer or insurance carrier with a multi-state or national presence? Do you just want to get a sense of how COVID-19 is affecting workers’ compensation laws in other parts of the country? If so, the National Workers’…
While the North Carolina Industrial Commission has not yet issued any decisions specifically related to COVID-19, there are prior cases that have considered whether a claimant is entitled to indemnity benefits when their disability is the result of economic conditions.…
Brief overview of the legal analysis of COVID-19 workers’ compensation exposure in North Carolina. COVID-19 cases must be handled and analyzed on a case-by-case basis; however, based upon the current statute and case law, it is unlikely that suspected COVID-19…
Gov. Roy Cooper has nominated Wanda Blanche Taylor for a six-year term as a Commissioner to the Full Commission. Ms. Taylor’s appointment is pending confirmation by the North Carolina General Assembly. If confirmed, Ms. Taylor would take the position currently…
The New Year will bring a number of issues to the forefront of workers’ compensation. Though some are familiar, there are a few new issues we anticipate will take center stage in 2020. “Form 63, box 2” In 2019, the…
In Macias v. BSI Associates, Inc. d/b/a Carolina Chimney, No. COA 19-299 (November 5, 2019), a recent unpublished opinion, the Court of Appeals reiterated its adherence to the Hayes doctrine for determining whether an injured worker is an “employee” and…
The North Carolina Industrial Commission recently published its 2019 Annual Report. In addition to the statistical overview of fiscal year 2018-2019, (61,776 workers’ compensation claims filed for the fiscal year), the IC also reported that the long-awaited modern case management…
Our firm has recently started receiving inquiries regarding the possibility of claimants receiving extended benefits beyond the 500 week cap on TTD in G.S. 97-29. In addition, the issue is also now being raised by eligible injured employees. There have…
The North Carolina Court of Appeals recently issued an unpublished decision in the case of Bache v. TIC-Gulf Coast. The opinion highlights issues relevant to personal travel versus business travel. Plaintiff was hired as a heavy equipment operator by Defendant,…
There are two categories of workers’ compensation claims: injury by accident and occupational disease claims. Occupational diseases are contracted over time based on the nature of the employee’s job. Some of the most common examples are hearing loss, respiratory diseases…
The North Carolina Court of Appeals recently released two decisions that impact the state’s exclusive remedy doctrine. Under N.C. Gen. Stat. § 97-10.1, the North Carolina Workers’ Compensation Act provides an exclusive remedy for unintentional work-related injuries. This provision affords…
Teague Campbell attorneys Kyla Block and Melissa Woodard recently received a favorable decision from the Full Commission in a nuanced disability argument. Melissa argued the case before the Full Commission in February 2019 and the Commission’s Opinion and Award was…
The increasing trend of employers to provide on-site medical staff can have numerous benefits for both employees and employers. Due to convenience, employees may be more likely to utilize the on-site medical services, leading to quicker identification of health issues…
Former state representative Ken Goodman has been confirmed as a Commissioner at the Industrial Commission by unanimous vote in the House and Senate of the General Assembly on April 18, 2019. He previously served as a Democratic member of the…
The North Carolina Court of Appeals recently issued a new opinion concerning the coming and going rule. In the case of Wright v. Alltech Wiring & Controls, the Court provided some guidance concerning the contractual duty and traveling salesperson exceptions…
Bruce Hamilton and Heather Baker visiting Kids’ Chance of America at the National Workers’ Compensation & Disability Conference in Las Vegas.
Discussion of workplace harassment reached a fever pitch last Fall when media reports streamed seemingly endless claims against Hollywood moguls and corporate giants alike. The #MeToo movement has added force to the discussion, no doubt leaving employers feeling exposed. Although…
With prescription drug and opioid addiction on the rise in America and an estimated 20 million Americans in need of treatment for drug or alcohol addiction, the prevalence of drug and alcohol use in the workplace is a serious concern…
A recent civil case involving a workers’ compensation claim examines the bounds of third-party beneficiary status in North Carolina. Seguro-Suarez v. Key Risk Insurance Co. began as a workers’ compensation case filed at the North Carolina Industrial Commission. However, the…
Teague Campbell attorney Elizabeth Ligon led a panel on managing multi-jurisdictional issues and their challenges with Elizabeth Bailey of Waffle House and Tom Shaver of Zenith Insurance Company at the NWCDN Regional Conference in New Orleans, LA on July 20,…
Commissioner Myra L. Griffin was confirmed to the Full Commission on June 29, 2018 to fill the unexpired term of former Commissioner Linda Cheatham. Governor Cooper appointed Commissioner Griffin as an emergency appointment to allow her to act as a…
Did you know that, effective June 1, 2018, the Industrial Commission’s Rules were recodified from Title 04 Chapter 10 of the North Carolina Administrative Code to Title 11 Chapter 23 of the Administrative Code? According to the NCIC’s website, all…
Recent rulings from The North Carolina Supreme Court and Court of Appeals have set Workers’ Compensation Defendants somewhat adrift regarding the burdens of proof relating to disability. With this uncertainty, and to counter the testimony historically provided by Plaintiffs seeking…
Every employer has been there before. You hire a new employee and everything is going smoothly, until one day you receive a letter from the North Carolina Department of Revenue compelling you to withhold an amount from your new employee’s…
As the state of North Carolina continues its efforts to combat the opioid crisis, the Rules Review Commission, part of the North Carolina Industrial Commission, approved nine rules regarding opioids, prescriptions, and pain management in workers’ compensation claims that go…
The Court of Appeals recently held that Plaintiff’s lay testimony was insufficient to establish increased risk in an occupational disease claim. In Briggs v. Debbie’s Staffing, Inc., Plaintiff worked as a Ceramic Technician, which required him to work a portion…
The Court of Appeals recently released two decisions that analyzed issues relating to disability – specifically, the burden of proving futility – post-Wilkes v. City of Greenville. In Adame v. Aerotek, an unpublished decision, Plaintiff sustained a low back injury…
Two long-time Deputy Commissioners have recently been nominated by Governor Roy Cooper for appointment to the Full Commission. Deputy Commissioners Robert J. Harris and Myra L. Griffin have both served in their current roles since 2005, adjudicating cases and conducting…
Workers’ compensation employers’ subrogation lien rights have received attention in recent years in the appellate courts. The North Carolina Supreme Court recently issued an opinion in Easter-Rozzelle v. City of Charlotte which clarified the impact of a third party settlement…
Opioid use continues to be a growing crisis in North Carolina and across the country. In an effort to continue to take steps to reduce availability and use of prescription pain killers, the Rules Review Commission, part of the Industrial…
After practicing law in the field of workers’ compensation for eleven years, I decided to return to school. Not business school; not for an LMS or other decorative degree which would typically boost the resume of a partner within a…
Starting on December 31, 2017, the North Carolina Industrial Commission will have a permanent Employee Classification Section charged with investigating and punishing employers who misclassify employees as independent contractors. The Employee Classification Section was initially created through an executive order…
An independent contractor is an individual who generally falls outside of the structure of the Workers’ Compensation Act. Whether a person employed to perform specified work for another is to be regarded as an independent contractor or as an employee…
In Ball v. Bayada Home Health Care, Plaintiff worked for Bayada as a certified nurse’s assistant for nine months before she was transferred to a new location and began working with a single client. As a result of this change,…
The North Carolina Industrial Commission recently announced a stricter policy, which includes increased sanctions for failing to timely file a Form 60, 61 or 63. Pursuant to an October 2, 2017 Memorandum issued by the North Carolina Industrial Commission, effective December 1,…
Industrial Commission Executive Secretary Meredith Henderson announced this week that beginning Monday, September 18, 2017, the Commission will no longer accept motion filings or motion responses from adjusters or insurance carriers. Documents the Commission will no longer accept from adjusters…
Following North Carolina’s July 2017 legislative change to the North Carolina Workers’ Compensation Act, one might have put aside concerns over Wilkes v City of Greenville; resting assured that the slippery slope within NC Workers’ Compensation claims as to compensability…
If you have worked on the defense side of workers’ compensation claims for any period of time, the above headline likely sounds like a work of fiction. While we have all heard of the elaborate measures the NCIC Fraud Investigation…
The North Carolina Court of Appeals left the Industrial Commission scrambling when it issued its September 20, 2016, Opinion in Bentley v. Jonathan Piner Construction, holding the plain language of N.C. Gen. Stat. § 97-84 was violated when the Commission…
As opioid use continues to plague the community, as part of the workers’ compensation system and otherwise, North Carolina is one of many states working to take steps to reduce availability and use of prescription pain killers. Per the North…
On July 20, 2017, Governor Roy Cooper signed House Bill 26 into law. In response to Wilkes v. City of Greenville, HB 26 amends G.S. § 97-82(b) of the Workers’ Compensation Act, specifically addressing the issue of medical presumption in Wilkes. Please reach…
According to the July 10, 2017 version of the Workers’ Compensation Medicare Set-Aside Portal (WCMSAP) User Guide, you may now request a reduction in the amount of a CMS-approved workers’ compensation MSA account if you believe the projected care has…
Although overshadowed by the Wilkes v. City of Greenville opinion issued the same day, the N.C. Supreme Court came to a decision on another workers’ compensation matter last month. While not as significant as Wilkes in terms of future claim…
On June 29, 2017 the North Carolina General Assembly passed House Bill 26 which amends G.S. § 97-82(b) of the Workers’ Compensation Act. As previously discussed, Wilkes v. City of Greenville held that when a claim was accepted as compensable pursuant to…
In addition to creating a medical presumption for accepted claims, the North Carolina Supreme Court’s decision in Wilkes v. City of Greenville has significantly altered the landscape for proving disability. The Court has held that an employee can prove a…
On Friday, June 9, 2017, the North Carolina Supreme Court issued its eagerly anticipated decision in Wilkes v. City of Greenville, in significant part, unanimously affirming the Court of Appeals. Wilkes involves two primary issues. First, whether Johnnie Wilkes failed…
When Plaintiffs are injured at work under circumstances which raise the question of whether the precipitating activity was “in furtherance of” versus “incidental to” the job duties assigned and the employer’s interest, the North Carolina Courts will look closely at…
In recent years, attendant care provided under North Carolina’s Workers’ Compensation Act has gotten quite a bit of attention in the appellate courts and at the General Assembly. In particular, the Court of Appeals’ 2011 decision in Shackleton v. Southern…
In Holmes v. Associate Pipe Line Contractors, Inc., the Court of Appeals determined that post-offer contingencies, such as background checks and drug testing, constitute the “last act” necessary to create a contract of employment. On October 29, 2013, Plaintiff, who…
On April 6, 2017, the North Carolina Workers’ Compensation Opioid Task Force held its first organizational meeting to study and recommend solutions for the problems arising from the intersection of the opioid epidemic and related issues in Worker’s Compensation claims.…
Last winter we examined the Court of Appeals decision in Wilkes v. City of Greenville and its seemingly a radical extension of the Parsons presumption to injuries not initially accepted as part of the claim. The decision Wilkes was appealed…
On May 12, 2007, Plaintiff was working as a tire builder for Defendant-Employer, and sustained injury to her right shoulder. Defendants accepted the right shoulder as compensable. Plaintiff underwent surgery and returned to work. Plaintiff sustained a number of exacerbations…
Thompson v. International Paper Co. On February 23, 2012, Darrell Thompson was involved in an at-work accident and suffered severe burns that covered more than 23% of his body, mostly to his left shoulder and arm. Following the injury, Mr.…
Chairman Charlton Allen has been appointed for a four-year term as chairman through December 30, 2020. Yolanda Stith has been appointed as the newest commissioner. She will serve the remaining two and half years of Andrew Heath’s original term and…
Shawn Patillo suffered a low back injury on February 16, 2011 while working as a press operator for Goodyear Tire and Rubber Co. (“Goodyear”). He was evaluated at the on-site medical clinic and was restricted to “off-standard” work, which meant…
Kelly Lewis worked as a bus operator for Transit Management of Charlotte (“Charlotte Transit”). He suffered an admittedly compensable back injury on June 15, 2009 when the bus he was driving was rear-ended. A Form 25R was completed wherein Mr.…
Under the SMART Act, the Centers for Medicare & Medicaid Services (CMS) is required to set minimum Section 111 mandatory reporting thresholds for liability claims, as well as establish a “safe harbor” regarding conditional payment reimbursements. For liability claims, this…
According to a release issued by the Centers for Medicare and Medicaid Services (CMS) late Thursday, June 9, 2016, CMS is again considering expanding its voluntary Medicare Set-Aside Arrangements (MSA) review process to include liability insurance settlements. Per the official…
If employers or carriers have a statute of limitation defense, this defense should be identified early and analyzed as a potential basis for denying the claim.
Employers and carriers should be careful to discuss with their attorneys what documents are in existence and whether these documents are discoverable.
The North Carolina Supreme Court has granted the City of Greenville’s Petition for Discretionary Review in Wilkes v. City of Greenville.
The decision in Whicker provides a reminder of what the Court will look at when determining whether there is joint or lent employment between two employers.
Governor Pat McCrory announced today that Bill Daughtridge, formerly Secretary of Administration, has been appointed a Commissioner at the North Carolina Industrial Commission.
Parties considering an appeal should remember that the Court of Appeals will not overrule the Industrial Commission’s “findings of fact” unless there is no evidence to support those findings.
Charlton L. Allen Named Chairman of the North Carolina Industrial Commission Governor Pat McCrory has selected Charlton L. Allen to be the next Chairman of the North Carolina Industrial Commission, effective February 1, 2016. Mr. Allen succeeds Andrew T. Heath…
Medicare Issues in Liability and Workers’ Compensation Settlements by Daniel W. Hayes, J.D., M.S.C.C., was written to guide practitioners through their analysis of how to best consider Medicare’s interests when resolving claims involving medical exposure. The book is presented from…
If an employer or carrier becomes aware that a medical provider has recommended attendant care services, they should address the issue without delay…
The Workers’ Compensation Act is to be interpreted broadly to provide injured workers benefits, but this purpose will be limited by the laws enacted by the General Assembly.
This decision re-establishes that an employee’s testimony alone will be enough to carry his or her burden of proving futility.
The decision in Burley seems to establish that, short of a drastic modification of the employment contract, there will be only one location for purposes of jurisdiction.
Changes to Industrial Commission Fees Effective July 1, 2015
Teague Campbell’s Medicare Settlement Solutions recently obtained a favorable MSA approval from CMS in a case where the plaintiff sustained a compensable back injury in 2002.
Partner Bruce Hamilton will provide a legislative update on Workers’ Compensation at the 2015 North Carolina Chamber’s Summit on Manufacturing.
Risk Handling Tips on employee’s responsibility to prove disability
Risk Handling Hints on denying claims due to lack of credibility
Frances Atiapo worked as a truck driver for Goree Logistics, Inc. Goree contracted with Owen Thomas, a freight broker, to transport goods for another company. While driving a load of goods for Goree, Frances Atiapo was injured in a motor…
Asbestosis (or any other occupational disease) does not need to be the only cause of an injured worker’s death in order for a death claim to be compensable.
In Bowden v. Young, the North Carolina Court of Appeals addresses alleged intentional torts in workers’ compensation clams
Risk Managers should know that although “medical compensation” is broadly interpreted in North Carolina, the service requested still must effect a cure, provide relief or lessen the period of the injured worker’s disability.
Medicare isn’t the only entity who can sue you for conditional payments – plaintiffs can too!
Daniel Hayes and Tracey Jones presented at the NAMSAP Regional Meeting held in Orlando on January 29, 2015. Their panel discussion, “Protecting the Client,” covered best practices from both the plaintiff and defense perspectives for tackling Medicare Secondary Payer issues…
Keith Tedder was hired as a temporary delivery driver for A&K Enterprises to fill in for a permanent employee who was scheduled to be out of work for seven weeks. Tedder was paid $625 per week. Tedder had an unrelated…
Refik Ademovic worked as a cab driver for Taxi USA. Ademovic owned his own taxi, kept all of the fares he earned, did not receive a salary, paid a monthly franchise fee, set his own schedule, and was free to…
Charles Clark was a resident of Florida who worked for Summit Contractors Group, Inc., a Florida company doing business in North Carolina. In 2009, Clark was employed as a superintendent to supervise construction of apartment complexes in Greensboro. On August…
The 2015 Workers’ Compensation Section of the North Carolina Bar Association’s Annual Meeting will be held February 5th and 6th in Greensboro and two Teague Campbell partners, Bruce Hamilton & Julia Hooten, will be on hand to present portions of…
We recently learned that the Centers for Medicare and Medicaid Services (“CMS”) withdrew a set of proposed rules which were meant to establish guidelines for liability Medicare Set-Aside considerations. This may not have been so much a function of CMS deciding…
Introduction When resolving a liability claim involving medical treatment, the parties are required by federal law, pursuant to the Medicare Secondary Payer Act (MSP), 42 U.S.C. 1395y(b)(2), to consider Medicare’s interests with regard to the settlement of the medical portion…
NCIC Electronic Document Filing Portal
National Workers’ Compensation Defense Network
Teague Campbell prepared a chapter in “Workers’ Compensation Emerging Issues Analysis”, 2017 edition, analyzing the trends and developments in North Carolina Workers’ Compensation law. The co-editors-in-chief are Thomas A. Robinson of LexisNexis and the National Workers’ Compensation Defense Network (NWCDN). This is an essential tool for attorneys, risk managers, and insurance professionals. It serves as a reference guide to issues and cases as well as a 50 state survey of trends and developments. Purchase a copy here.
Injury by Accident
An interruption of the regular work routine and the introduction of unusual circumstances,such as a slip, trip, fall or other unusual activity likely to result in unexpected consequences.
Specific Traumatic Incident (STI)
Trauma not occurring gradually, but rather as the result of an event during a cognizable time period, causing a back injury or hernia.
Occupational Disease
A condition is a compensable occupational disease if the conditions of the employment were a significant contributing factor to its development and the employee was exposed to an increased risk of contracting it, as opposed to merely aggravating it.
Average Weekly Wage (AWW)
The employee’s average pre-injury earnings in the employment of injury. It is typically calculated on the 52 weeks of earnings priorto the date of the injury. Benefits are paid at 2/3 of the employee’s AWW.
Suitable Employment (Post MMI)
A job the employee is capable of performing while considering physical limitations, education, experience and vocational skills and is located within a 50 mile radius of employee’s residence. (For claims filed on or after June 24, 2011.)
Return to Work
For claims arising prior to June 24, 2011, any job offered to an employee has to be suitable (cannot be make work), regardless of whether employee has reached MMI.
Maximum Weekly Compensation Rates from 1982-2018
2009: $816
2010: $834
2011: $836
2012: $862
2013: $884
2014: $904
2015: $920
2016: $944
2017: $978
2018: $992
PPD is payable under NCGS § 97-31 based on application of the percentage assigned by the physician to the following schedule:
Back: 300 weeks
Arm: 240 weeks
Hand: 200 weeks
Thumb: 75 weeks
Index Finger: 45 weeks
Middle Finger: 40 weeks
Ring Finger: 25 weeks
Little Finger: 20 weeks
Eye: 120 weeks
Leg: 200 weeks
Foot: 144 weeks
Great Toe: 35 weeks
Other Toes: 10 weeks
Hearing Loss (1 ear): 70 weeks
Hearing Loss (both ears): 150 weeks
