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The North Carolina Workers’ Compensation Act is a statute passed by the North Carolina legislature, and administered by the North Carolina Industrial Commission. The Industrial commission is a state government entity that is located in Raleigh, NC, as well as other locations throughout North Carolina. The Industrial Commission comprises six “Commissioners” who are nominated by the Governor of North Carolina and confirmed by the NC General Assembly. One of these Commissioners is designated “Chairman” of the Commission. The Chairman, therefore, occupies an appointed political office, and he or she serves as the Industrial Commission’s “Chief Executive Officer” and “Chief Judicial Officer,” completing a range of tasks in each capacity. Also among the decision makers of the Industrial Commission are a number of “Deputy Commissioners,” an “Executive Secretary,” and numerous “Special Deputy Commissioners.”
The Industrial Commission operates under the Workers’ Compensation Act as well as its own administrative rules. Older references to “Workmen’s Compensation Act,” “Workmen’s Compensation” or “workmen’s compensation” all now refer to “workers’ compensation” and the Workers’ Compensation Act.
The North Carolina Industrial Commission administers workers’ compensation claims in North Carolina and also acts as a court (or “quasi-judicial” agency) in deciding workers’ compensation disputes. The Industrial Commission operates ten sections: Docket, Statistics, Safety Education, Claims, Information Technology, Workers’ Compensation Nurses, Office of the Executive Secretary, Medical Fees, File Center, and Fraud Investigations. The Industrial Commission also administers an alternative dispute resolution (mediation) program, investigates and enforces the insurance status of employers, and provides safety training to employers.
The NC Industrial Commission plays an active role in administering the medical compensation and benefits due to injured workers in North Carolina workman’s comp claims. This includes requests for approval of denied treatment, for second opinion evaluations, and for a change in treating physician. The Industrial Commission’s Medical Fees Section sets reimbursement rates for particular medical services, reviews bills submitted by the parties, and resolves disputes between medical providers and workers’ compensation insurers over medical bills.
The Executive Secretary of the Industrial Commission acts in a quasi-judicial capacity as well, making initial administrative decisions on a number of issues, including access to medical treatment and, in certain cases, the termination or reinstatement of “wage loss” or “wage-replacement” disability benefits (weekly checks). The Executive Secretary also reviews and approves (or disapproves) settlements (compromise settlement agreements, or “clinchers”) between the parties.
Most disputes in workers’ compensation cases in NC are heard initially by a Deputy Commissioner, who serves as judge in workers’ comp cases. This includes disputes over whether a case is subject to the Industrial Commission’s jurisdiction, whether the injuries giving rise to a claim are “compensable” (covered by the North Carolina Workers’ Compensation Act), and whether an employee is due wage loss (disability) benefits and compensation (as well as the dollar-amounts associated with such compensation). In workers’ compensation hearings, the Deputy Commissioner fills the role of both judge and jury in the traditional court system. Appeals from decisions of a particular Deputy Commissioner are made to a panel of “Commissioners” known as the “Full Commission.” Appeals from the Full Commission are made to the North Carolina Court of Appeals, and subsequently to the North Carolina Supreme Court.
Following are links to specific pages on the North Carolina Industrial Commission’s website.
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