The Workers’ Compensation Act is administered by the North Carolina Industrial Commission, a state agency located in Raleigh, North Carolina. The Commission is comprised of six commissioners who are nominated by the Governor and confirmed by the General Assembly. The Governor designates one member of the Commission to serve as Chairman. The Chairman in turn selects deputy commissioners and the Executive Secretary of the Commission.
The North Carolina Industrial Commission administers workers’ compensation claims and also acts as a court in deciding workers’ compensation disputes. The Industrial Commission also administers a mediation program, investigates the insurance status of employers, and provides safety training to employers.
The Industrial Commission operates pursuant to the Workers’ Compensation Act as well as its own administrative rules.
The NC Industrial Commission plays an active role in directing medical benefits in workers’ compensation cases. This includes requests for approval of denied treatment, for a second opinion, 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 makes initial administrative decisions on a number of issues, including access to medical treatment and, in certain cases, the termination of wage replacement benefits. The Executive Secretary also rules on settlement and third party agreements.
Most disputes in workers’ compensation cases are heard initially by a deputy commissioner. This includes disputes over whether a case is subject to the Industrial Commission’s jurisdiction, whether a particular injury is compensable, and whether an employee is due wage replacement benefits and if so in what amount. There are no juries in workers’ compensation hearings.
Appeals from decisions of a deputy commissioner are to a panel of three full commissioners. Appeals from the full commission are to the North Carolina Court of Appeals and then to the North Carolina Supreme Court.
North Carolina workers’ compensation claims must be filed with the North Carolina Industrial Commission. The Commission’s jurisdiction over workers’ compensation claims is neither voluntary nor optional. The settlement of a workers’ compensation claim outside the purview of the Industrial Commission is void, and the parties to such a scheme are subject to sanctions.
As a workers’ compensation attorney in North Carolina I spend many hours each year trying cases before the Industrial Commission, and many more hours working with various Commission officers. A full understanding of the way the Industrial Commission works is critical to the proper handling of a workers’ comp case in NC.