This post discusses an ’s right to a . If you are receiving for a continue reading to find out how to receive all the you are entitled to under NC .
NC
In North Carolina, the North Carolina Industrial Commission (N.C.I.C.) governs workers' compensation cases. State law provides medical and wage loss (indemnity) benefits for non-fatal injuries and death benefits for fatal injuries. Medical includes and mileage reimbursement for treatment of your . Lost Wage benefits provide monetary due to your inability to earn wages because of your on the job injury. This benefit provides based on the physical impairment of the injured body part as well.
Who gets to control your as the ?
If your is accepted by the insurance company, they have agreed that you have a valid . The 's pays for and controls where the is seen for treatment. If the wants to change to a :
“in order for the Commission to grant an ’s request to change treatment or health care provider, the must show by a preponderance of the evidence that the change is necessary to effect a cure, provide relief, or lessen the period of disability” N.C. Gen. Stat. §97-25 .
An must provide proof for the reason he/she wants to change their in a workers’ case rather than simply making a request to change treating physicians.
The North Carolina Court of Appeals has determined that "treatment provided to injured workers that provides “relief from pain constitutes ‘relief’ as the term is used in N.C. Gen. Stat. §97-25 (See Simon v. Triangle Materials, Inc., 106 N.C. App. 39)."
An example would be the need for spinal injections for back pain. An () who is being paid by the may not suggest, mention or agree with injections because they do not offer them at their office while the 's may offer injections in his/her office to relieve pain.
If the treatment that the 's can offer will "effect a cure, provide relief, or lessen the period of disability," the N.C.I.C. may approve the 's request to see the even if the 's will not. However, you may not be able to choose the medical provider to provide the second opinion.
If your is denied, you can go to any for treatment but be advised that if you do not win your claim in front of the North Carolina Industrial Commission, you will not be reimbursed for your expenses.
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NC law permits an to obtain a 2nd opinion regarding appropriate medical care, such as recommended surgery or course of treatment.
If an desires a second opinion with a of his/her own choice, the may make the request in writing to the . The has 14 days to agree to the ’s written request. If the does not agree to the injured workers’ written request for a second opinion, then the may request the N.C.I.C. to order a second opinion. If the N.C.I.C. grants the request, the must pay for the expense of the requested . N.C. Gen. §Stat. 97-25. If the employer refuses to grant the second opinion, you may be able to pay for your own second opinion, but you will not be compensated for the expense.
You should also be aware that the employer has a right to 2nd opinion as well. The can request that the report to a by a which they have chosen and paid for. If the refuses to see the IME their benefits can be suspended. Even if the employer's workers' compensation insurance company has denied the claim, the employee still has to attend the IME.
However, the can (and should) seek another to determine their percentage of permanent disability if they dispute the percentage arrived at by the IME. N.C. Gen. §Stat. 97-27.
often arise in NC Workers’ cases . If you find yourself wondering what to do about appropriate for your on the job injury or if you need to obtain a second opinion, you should speak with a NC Workers’ Lawyer.
The Bishop Law Firm represents Workers’ clients in Raleigh, Cary, Durham, Rocky Mount, Wilson, Smithfield, Louisburg, Chapel Hill, Roanoke Rapids and surrounding areas in North Carolina. We do not get paid unless you win and we offer free case reviews by phone, (919) 615-3095.
