North Carolina Workers' Compensation Law: A Practical Guide to Success at Every Stage of a Claim

This Fourth Edition covers recent changes to the NC Workers' Compensation Act and guides practitioners through all stages of a workers' compensation claim.

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North Carolina Workers' Compensation Law: A Practical Guide to Success at Every Stage of a Claim is a must have reference guide for all North Carolina workers' compensation practitioners. This 22-chapter publication addresses recent changes to the North Carolina Workers' Compensation Act and guides practitioners through all stages of a workers' compensation claim.

This workers' compensation manual does not merely recite the statute and case law—it provides in-depth analysis of legal issues and offers practical advice from experienced North Carolina workers' compensation practitioners on a wide range of topics including litigating injury by accident and occupational disease cases, fighting obstacles to appropriate medical compensation, handling death claims and third party actions, defining and proving disability, calculating average weekly wage, and much more.

For this Fourth edition, consider these chapters in conjunction with your own independent research; as we all know, the law is subject to change.

The Executive Secretary, Deputy Commissioners, a Commissioner, and a Court of Appeals Judge also offer their practical tips for successfully litigating a North Carolina workers' compensation claim at every stage, including advice for filing motions with the Office of the Executive Secretary, representing clients in Form 23 and Form 24 proceedings, filing Expedited Medical Motions, litigating a case at the Deputy Commissioner Level, handling an appeal at the Full Commission level, and handling an appeal at the appellate court level.

Lastly, the 740+ page manual includes fingertip access to more than 10 Industrial Commission Forms and 24 sample motions and orders. This publication is edited by Valerie A. Johnson of Copeley Johnson & Groninger, PLLC and Kevin Bunn of Kevin Bunn, Attorney at Law, P.C., both of whom are North Carolina State Bar board certified workers' compensation specialists.

The ISBN for the Third Edition was 9781522123439.

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Table of contents

 Foreword
About the Co-Editors
About the Authors

CHAPTER 1  INTRODUCTION AND HISTORICAL OVERVIEW
1.1.  THE INDUSTRIAL REVOLUTION
1.2.  THE DEVELOPMENT OF WORKERS' COMPENSATION
1.3.  THE WORKERS' COMPENSATION SYSTEM IN THE UNITED STATES
1.4.  WORKERS' COMPENSATION ACTS WERE COMPROMISE LEGISLATION

CHAPTER 2  INDUSTRIAL COMMISSION JURISDICTION IN NORTH CAROLINA
 WORKERS' COMPENSATION CLAIMS

2.1.  INTRODUCTION
2.2.  JURISDICTION OF THE PARTIES
2.3.  JURISDICTION OF THE INJURY
2.4.  APPELLATE JURISDICTION
2.5.  MISCELLANEOUS JURISDICTION
2.6.  CONCLUSION

CHAPTER 3  INJURY BY ACCIDENT
3.1.  OVERVIEW AND HISTORY
3.2.  STATUTORY DEFINITION AND INTERPRETATIONS
3.3.  GENERAL RULE
3.4.  SPECIFIC TRAUMATIC INCIDENTS
3.5.  SUMMARY

CHAPTER 4  INJURIES ARISING OUT OF EMPLOYMENT
4.1.  OVERVIEW AND HISTORY
4.2.  STATUTORY DEFINITION AND INTERPRETATIONS
4.3.  TESTS TO DETERMINE CONNECTION TO WORK
4.4.  CATEGORIES OF INJURIES
4.5.  SUMMARY

CHAPTER 5  IN THE COURSE OF THE EMPLOYMENT
5.1.  INTRODUCTION
5.2.  PREMISES EXCEPTION
5.3.  CONTRACTUAL DUTY EXCEPTION
5.4.  WHEN THE WORKER IS REQUIRED TO USE HER OWN VEHICLE AT WORK
5.5.  SPECIAL ERRAND EXCEPTION
5.6.  DUAL PURPOSE EXCEPTION
5.7.  TRAVELING SALESPERSON EXCEPTION
5.8.  CONCLUSION

CHAPTER 6  PROVING CAUSATION IN WORKERS' COMPENSATION CASES
6.1.  THE STARTING POINT: THE GENERAL PRINCIPLE
6.2.  WHEN THE WORKPLACE ACCIDENT/DISEASE IS NOT THE SOLE CAUSE OF
 DISABILITY
6.3.  UNKNOWN CAUSES
6.4.  CHAIN OF CAUSATION AND INTERVENING CAUSES
6.5.  ISSUES REGARDING PROOF OF CAUSATION

CHAPTER 7  PROVING DISABILITY
7.1.  INTRODUCTION
7.2.  STATUTORY PROVISIONS
7.3.  MEANING, PRESUMPTIONS, AND THE BURDEN OF PROOF
7.4.  STANDARDS FOR PROVING DISABILITY
7.5.  TOTAL DISABILITY
7.6.  PARTIAL DISABILITY
7.7.  2011 AMENDMENTS

CHAPTER 8  OCCUPATIONAL DISEASES
8.1.  INTRODUCTION
8.2.  STATUTORY PROVISIONS
8.3.  LISTED OCCUPATIONAL DISEASES
8.4.  UNLISTED OCCUPATIONAL DISEASES
8.5.  LAST INJURIOUS EXPOSURE
8.6.  STATUTE OF LIMITATIONS
8.7.  PRACTICAL CONSIDERATIONS

CHAPTER 9  MEDICAL COMPENSATION
9.1.  MEDICAL COMPENSATION—AN OVERVIEW
9.2.  MEDICAL COMPENSATION AS DELINEATED BY STATUTE
9.3.  MEDICAL COMPENSATION AS DESCRIBED BY INDUSTRIAL COMMISSION
 RULES
9.4.  MEDICAL COMPENSATION AS DISCERNED BY CASE LAW
9.5.  MEDICAL COMPENSATION AS DEVELOPED BY COUNSEL
9.6.  MEDICAL COMPENSATION—CONCLUSION
9.7.  APPENDIX

CHAPTER 10  VOCATIONAL REHABILITATION AND SUITABLE EMPLOYMENT
10.1.  HISTORICAL OVERVIEW
10.2.  THE VOCATIONAL PROFESSIONAL
10.3.  VOCATIONAL PROCESS
10.4.  JOB SEARCH AND PLACEMENT AND SUITABLE EMPLOYMENT
10.5.  PRACTICE TIPS
10.6.  APPENDIX

CHAPTER 11  ACCESS TO MEDICAL INFORMATION: N.C. Gen. Stat. § 97-25.6
11.1.  INTRODUCTION
11.2.  ACCESS TO MEDICAL RECORDS
11.3.  WRITTEN COMMUNICATION WITH HEALTH CARE PROVIDERS
11.4.  ORAL COMMUNICATIONS
11.5.  COMMUNICATIONS BY/WITH REHABILITATION PROFESSIONALS
11.6.  APPENDIX

CHAPTER 12  AVERAGE WEEKLY WAGE
12.1.  INTRODUCTION
12.2.  CALCULATION OF THE AVERAGE WEEKLY WAGE
12.3.  DETERMINATION OF THE AVERAGE WEEKLY WAGE IN SPECIAL
 CIRCUMSTANCES

CHAPTER 13  CREDITS UNDER THE NORTH CAROLINA WORKERS'
 COMPENSATION ACT

13.1.  CREDITS FOR ALTERNATIVE PLAN PAYMENTS (N.C. GEN. STAT. § 97-42)
13.2.  CREDITS FOR UNEMPLOYMENT COMPENSATION (N.C. GEN. STAT. § 97-42.1)
13.3.  APPENDIX

CHAPTER 14  SETTLEMENT, CLINCHERS, RATINGS AND CHANGE OF CONDITION
14.1.  INTRODUCTION
14.2.  RATINGS
14.3.  SETTLEMENTS
14.4.  SPECIFIC SITUATIONS AND ISSUES
14.5.  PARTING WORDS
14.6.  APPENDIX

CHAPTER 15  DEATH CLAIMS
15.1.  INTRODUCTION
15.2.  TIME LIMIT ON THE OCCURRENCE OF THE DEATH
15.3.  NOTICE AND FILING REQUIREMENTS
15.4.  INDEPENDENT CLAIM THAT ARISES AT DEATH
15.5.  CAUSATION
15.6.  DISTRIBUTION OF BENEFITS
15.7.  BENEFICIARIES: WHOLE DEPENDENTS, PARTIAL DEPENDENTS AND NEXT OF
 KIN
15.8.  ASBESTOSIS OR SILICOSIS CLAIMS
15.9.  WHERE AN EMPLOYEE DIES OF UNRELATED CAUSE BEFORE
 COMPENSATION DUE IS PAID
15.10.  INDUSTRIAL COMMISSION HEARINGS xii
15.11.  ISSUES APPLICABLE TO ATTORNEYS IN DEATH CLAIMS
15.12.  APPENDIX

CHAPTER 16  CONSIDER USING N.C. Gen. Stat. § 97-10.2(j) TO BRING YOUR CLIENT
 CLOSER TO WHOLE

16.1.  INTRODUCTION
16.2.  WHY YOU SHOULD CONSIDER USING THE N.C. GEN. STAT. § 97-10.2(j)
 PROCEDURE
16.3.  WHERE TO FILE A N.C. GEN. STAT. § 97-10.2(j) ACTION
16.4.  ELEMENTS OF PROOF NEEDED FOR A N.C. GEN. STAT. § 97- 10.2(j) ORDER
16.5.  NECESSARY EVIDENCE AT A N.C. GEN. STAT. § 97-10.2(j) HEARING
16.6.  THE ISSUES THE PRESIDING JUDGE IS ALLOWED TO DECIDE
16.7.  DISTRIBUTION OF THE PROCEEDS
16.8.  POSITIVE OUTCOMES OF N.C. GEN. STAT. § 97-10.2(j) PROCEEDINGS
16.9.  DOES THE CLIENT HAVE TO CHOOSE BETWEEN PURSUING HER WORKERS'  COMPENSATION CLAIM AND PURSUING A THIRD PARTY ACTION?
16.10.  INTERPLAY BETWEEN UM/UIM AND WORKERS’ COMPENSATION LIENS
16.11.  WHO ELSE HAS STANDING TO FILE A N.C. GEN. STAT. § 97- 10.2(j) ACTION?
16.12.  CONCLUSION
16.13.  APPENDIX

CHAPTER 17  MOTIONS PRACTICE BEFORE THE OFFICE OF THE EXECUTIVE
 SECRETARY AND FORM 23 AND FORM 24 INFORMAL HEARINGS—A PRACTICAL
 GUIDE

17.1.  INTRODUCTION
17.2.  MOTIONS PRACTICE
17.3.  FORM 23 AND FORM 24 APPLICATIONS
17.4.  CONCLUSION
17.5.  APPENDIX

CHAPTER 18  NORTH CAROLINA INDUSTRIAL COMMISSION EXPEDITED AND
 EMERGENCY MEDICAL MOTIONS

18.1.  OVERVIEW
18.2.  WHEN A MEDICAL MOTION MAY BE FILED
18.3.  PROCEDURE FOR EXPEDITED MEDICAL MOTIONS
18.4.  PROCEDURE FOR EMERGENCY MEDICAL MOTIONS
18.5.  APPELLATE REVIEW OF DECISIONS DEEMED INTERLOCUTORY
18.6.  GENERAL DISCUSSION

CHAPTER 19  PRACTICAL TIPS FOR WORKERS' COMPENSATION HEARINGS
19.1.  SCOPE NOTE
19.2.  INTRODUCTORY INFORMATION
19.3.  THE PRE-HEARING PROCESS
19.4.  DOCKETING AND IMMEDIATE PRE-HEARING PROCESS
19.5.  THE HEARING ITSELF
19.6.  POST-HEARING
19.7.  CONCLUSION

CHAPTER 20  PRACTICE BEFORE THE FULL INDUSTRIAL COMMISSION
20.1.  INTRODUCTION
20.2.  NOTICE OF APPEAL
20.3.  APPEALS TIMELINES AND CLERK'S OFFICE PROCEDURES FOLLOWING
 APPEAL TO THE FULL COMMISSION
20.4.  FORM 44 APPLICATION FOR REVIEW
20.5.  SCOPE OF FULL COMMISSION REVIEW
20.6.  FULL COMMISSION MEDICAL MOTION PROCEDURE
20.7.  EXHIBITS/TRANSCRIPTS
20.8.  MOTIONS OR COMMUNICATIONS AFTER APPEAL IS FILED
20.9.  BRIEFING YOUR CASE BEFORE THE FULL COMMISSION
20.10.  ARGUING YOUR CASE BEFORE THE FULL COMMISSION AND POST-
 DECISION MOTIONS
20.11.  APPEALS TO THE NORTH CAROLINA COURT OF APPEALS
20.12.  REMAND FROM THE APPELLATE COURTS
20.13.  APPENDIX

CHAPTER 21  EFFECTIVE APPELLATE ADVOCACY FOR WORKERS'
 COMPENSATION PRACTITIONERS

21.1.  GENERAL APPELLATE CONSIDERATIONS
21.2.  PREPARING FOR THE APPEAL AT THE COMMISSION STAGE
21.3.  RECORD ON APPEAL
21.4.  THE BRIEF: THE MOST IMPORTANT DOCUMENT OTHER THAN THE OPINION
 & AWARD
21.5.  CORRECTING RULES VIOLATIONS
21.6.  MEDIATION
21.7.  ORAL ARGUMENTS
21.8.  POST-OPINION PROCEEDINGS

CHAPTER 22  MEDICARE AS A SECONDARY PAYER AND WORKERS'
 COMPENSATION SETTLEMENTS

22.1.  INTRODUCTION
22.2.  MEDICARE SECONDARY PAYER ACT (MSPA)
22.3.  CONSIDERATION OF MEDICARE'S INTEREST IN SETTLEMENT EVALUATION
22.4.  FUTURE INTEREST
22.5.  OTHER PROGRAM CONSIDERATIONS
22.6.  CONCLUSION

INDEX