North Carolina Industrial Commission Implements New Medical Fee Schedule

In February, the North Carolina Industrial Commission approved a revised medical fees schedule that will save North Carolina’s Workers’ Compensation system about $27 million annually. The new fee schedule is currently going into effect and will continue to be implemented throughout 2017.

The Medical Fees Section of the North Carolina Industrial Commission is responsible for processing medical bills for services provided under a workers’ compensation claim. Medical bills are reviewed and sometimes adjusted before being submitted to the insurance carrier for payment. Under the previous medical fee schedule, certain fees were higher than the national average while other fees were low.

The new fee schedule reflects a compromise between workers’ compensation insurance carriers and medical providers. The new schedule was put into place in order to bring all reimbursement rates closer to the national average, to ensure that injured workers receive a high standard of medical care, and to reimburse health care providers with reasonable fees for their services.

Workers’ Compensation Claims

Workers’ Compensation benefits are guaranteed to an injured employee, regardless of who was responsible for the injury. In exchange for this guarantee of benefits, the injured employee cannot file a lawsuit against his or her employer except in limited circumstances. Workers’ Compensation benefits include medical bills and loss of income during the period when the employee is disabled.

Workers’ Compensation covers workers who are injured because of an accident that arises out of employment during the course of an employee’s employment. In order to receive any workers’ compensation benefits, each of the above elements must be proven. Each Workers’ Compensation claim will be different based on the facts and circumstances that caused the accident that resulted in the injury. An injury arises out of employment when it is the natural and probable consequence of employment and the natural result of the risks inherent to employment. Each industry comes with its own risks for certain types of injuries.

On the other hand, hazards that are common to the general public, outside of employment, may not be considered to arise out of employment and therefore, may not be covered by Workers’ Compensation laws. The conditions or obligations of an employee’s job must put the employee in a position or place where the accident occurred in order for the injury to be covered by Workers’ Compensation benefits.

What Should You Do?

Work place injuries can happen to anyone, and some industries are more dangerous than others. If you are injured on the job, the first thing you must do is seek medical attention. After receiving initial care, it is important to inform your workplace that you have been injured. Many times, there are time limits to file paperwork or else workers’ compensation benefits may be lost. Also, consulting an experienced workers’ compensation attorney may be beneficial to ensure that you are receiving the benefits that you are eligible to receive.

Since workers’ compensation laws vary from state to state, consulting an experienced attorney in your area is important. Even if you have been denied workers’ compensation benefits, legal counsel can help injured workers through the sometimes long and arduous process of obtaining deserved workers’ compensation benefits.