Medical Benefits Available to Injured Workers in NC
WHAT MEDICAL SERVICES MUST NORTH CAROLINA EMPLOYERS PROVIDE?
Under North Carolina workers' compensation law, employers must provide all necessary and appropriate medical, surgical, hospital or other treatment to eligible injured employees. Medical services which must be provided include physical therapy treatment, psychological therapy, chiropractor services, and attended care.
In case of a controversy arising between the employer and employee relative to the continuation of medical, surgical, hospital or other treatment, the Industrial Commission may order further treatment as necessary.
What treatment is appropriate for a particular employee is a matter which may only be decided by the Industrial Commission. The Industrial Commission may order such treatment or rehabilitation procedures that it determines, in its discretion, to be “reasonably necessary to effect a cure or give relief for an injured employee”. So long as there is any evidence to support a decision by the Industrial Commission as to what type of medical care should be provided, the appellate courts will not disturb or interfere with a ruling of the Industrial Commission. Rulings provide that employers must cover:
Life-long medical care. The court has approved a decision by the Industrial Commission requiring the employer to pay the injured worker’s doctor for the cost of preparing a plan for future treatment of the injured worker for the remainder of his life.
Treatment to cure, relieve and prevent. The courts have ruled that the employer not only has an obligation to provide medical treatment which will lessen the period of disability, but must also pay for expenses which are reasonably required to cure or give relief. The court defines the term “relief” to include not only an affirmative improvement towards an injured employee’s health, but also the prevention or mitigation of further decline in that health due to the compensable injury. The court has defined “lessen the period of disability” to mean “lessen the period of time of diminution of earnings”.
Handicapped accessible house. The employer is obligated to provide handicapped accessible housing to the worker when recommended by the doctor. This duty includes the requirement to pay for modification of the claimant’s house to make it handicapped accessible.
Prescriptions and medical supplies. The employer’s obligation for medical services includes the requirement to pay for all medicines, sick travel and medical and surgical supplies. The employer must provide for any artificial limbs as may be reasonably necessary at the end of the healing period and must replace those artificial limbs when reasonably necessitated by ordinary use or medical circumstances.
Health aide - private or personal. The Industrial Commission has approved expenses for attendant care to the injured worker, including attendant care rendered by family members.
Medical travel and lodging. Employees are entitled to reimbursement for sick travel when travel is medically necessary and the round-trip mileage to and from the medical providers is 20 miles or more. The per-mileage rate is set by the commission periodically. Injured workers are entitled to lodging and meals when it is medically necessary for the employee to stay overnight at a location away from home. If an employee does not have a vehicle, the employer must pay the cost of a rental vehicle or the cost of the transportation when medically necessary. Worker is also entitled to reimbursement for the cost of parking.
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