What is a Functional Capacity Evaluation In A North Carolina Workers’ Compensation Case?

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A Functional Capacity Evaluation (also called a FCE) is a test performed by a physician or other health care professional to determine an injured worker’s ability to perform a job and to determine their limitations after having been injured on the job. Healthcare professionals perform this standardized test to determine the worker’s functional impairment, assess the success of treatment, and to determine their ability to perform at a job in the present or future. However, completing a FCE without being represented by an attorney may put you and your case in a difficult situation.

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What is Form 25N Regarding Worker’s Comp in North Carolina?

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Workers' Compensation Nurse Case Manager | 25NForm 25N is a form used by the North Carolina Industrial Commission regarding the assignment of a Rehabilitation Professional.  This is usually a registered nurse or a licensed professional counselor who must be qualified under the North Carolina Industrial Commission Rehabilitation Rules.  Once the Rehabilitation Professional has been assigned pursuant to Rule IV of the Industrial Commission Rules for Utilization of Rehabilitation Professionals in Workers’ Compensation Claims, the Rehabilitation Professional becomes a “case manager” for the injured worker and coordinates the medical and vocational rehabilitation care provided to the worker.

The Rehabilitation Professional must make independent and professional judgment regarding the plan for the rehabilitation of the injured worker.  The Rehabilitation Professional is not to be influenced by the employer and insurance company or the injured worker and his or her attorney.  The Rehabilitation Professional is not allowed to be a direct care giver for the injured worker but is there to assist and coordinate the care with the treating physicians and other providers.

What Is A Form 25C In A North Carolina Workers’ Compensation Case?

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Father and Daughter Surfing the WebA Form 25C in Workers’ Compensation is an Authorization for Rehabilitation Professional to Obtain Medical Records of Current Treatment.  When you have been injured on a job and you have started your Workers’ Compensation case, you will be assigned to a physician picked by the insurance company representing the company in which you work(ed) for.  At this point you and the doctor will begin treatment to get you improved medically to the maximum potential (your MMI, maximum medical improvement).   If your physician feels like you need to be seen by a specialist in order to reach your MMI then the physician will send written recommendation and authorization for the specialist to treat you.

At this point, this is where a Form 25C comes in to play.  A Form 25C in Workers’ Compensation is an Authorization for Rehabilitation Professional to Obtain Medical Records of Current Treatment and is filed with the North Carolina Industrial Commission.  This gives permission for the treating specialist to obtain your medical records of treatment resulting from your work related injury to assess your current health situation.

What happens if you do not feel like you should have to see a specialist?  If you wish to continue with your case, unfortunately there is not much choice!  Your refusal to sign this form upon the request of the rehabilitation professional can result in being deemed as “noncompliant” with rehabilitation and the North Carolina Industrial Commission can suspend your benefits.  It is very important throughout your Workers’ Compensation case that you comply with all rules and regulations of the North Carolina Industrial Commission.

Like all other facets of the law, Workers’ Compensation is very complicated and best handled by an experienced attorney.  It is strongly advised that if you think you may have a workers’ compensation case that you consult an attorney.

What Is A Form 23 in North Carolina Workers' Compensation?

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Construction Worker Injured at Work in North CarolinaNorth Carolina Industrial Commission Form 23 is the Application to Reinstate Payment of Disability Compensation. The NCIC requires this form to be used when payment from the employer to the employee in a workers’ compensation case has stopped, and the employee wants to reestablish a payment schedule with their employer. The form has two sections; one must be completed by the employee, and the other must be completed by the employer.

In the section to be filled out by the employee, you must record the nature of your original injury and the history of the case so far. This includes payments already received and which forms have been filed to establish original compensation. You must also state the reason you are seeking further payments from your employer.

The section that is to be completed by the employer can be filled out in one of two ways—If the request to reinstate payments is not being contested, then the employer must record the amount of the new payments and the date on which they will resume. If the employer does choose to contest the employee’s request for new payments then they must state their reason on this form. The employer must also provide a contact phone number so that the North Carolina Industrial Commission may conduct and informal phone interview to discuss why they have declined to reinstate payment.

What Is A Form 28 In North Carolina Workers’ Compensation?

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ChecklistA Form 28 in a workers’ compensation case is a Return to Work Form.  This form is usually completed by your employer or their workers’ compensation insurance company and states that under the Workers’ Compensation Act, an employee can return to work.  What it means is that you as the employee have reached your maximum level of improvement medically, and your treating physician has stated you can return back to your old position (or something similar). This form is only if you are okay to return to work like normal, and this is not a trial return to work, it also means that you meet one of the exclusions contained in North Carolina Industrial Commission Rule 404A(7).

What does that mean for you?  This means that since you have been given the “OK” to go back to work, you will no longer receive your disability compensation.  If your doctor is still “iffy” on sending you back to work at 100% of your capacity, you are entitled to return on a trial basis which is not to exceed 9 months; unless you have been released by your doctor for unrestricted work in which your trial return may be limited to only 45 days.  During this trial period, you may be entitled to partial disability compensation if you earn less in wages now than before your injury.  This is only if this is caused by your on-the-job injury.  If this is the case a separate form (Form 28T) must be filled out.

Will the Insurance Company Provide me with Transportation in a Worker’s Comp Claim?

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Yes, the insurance company can provide you with transportation to receive medical care that is approved by the insurance company or the North Carolina Industrial Commission. Usually you must provide your own transportation, but the insurance company will reimburse you the expenses.  However, if your injury makes it difficult to drive to and from your medical treatment then the insurance company may be compelled to provide you with transportation by the Industrial Commission.

Doing Workers' Compensation Research on a ComputerCurrently the North Carolina law requires the worker’s compensation to reimburse you $0.565 per mile as of January 2013. This amount may change as the cost of gasoline changes.  To be reimbursed, your trip must be more than 20 miles round trip. Normally you will not be reimbursed for medication and supplies on a separate trip in which you did not receive medical care.  These medications and supplies must be purchased on the same trip you are receiving your medical care.

Special consideration will be provided to persons that are unable to drive to receive their medical treatments. The worker’s compensation insurance company, on the orders of the Industrial Commission, may provide special transportation for those injured workers, such as a special van for wheel chairs, etc.

In the event you must stay overnight for your medical care, certain expenses are covered.  These are normally hotel rooms up to $45 per day.  You may receive up to $28 per day for food. You can also be reimbursed for parking and cab expense for your medical treatment.  However, you must provide actual receipts as proof of your expenses that will be reimbursed to you.

To be reimbursed for your travel expenses, you must complete, sign, and submit North Carolina Industrial Commission Form 25T and your receipts to the worker’s compensation insurance company for reimbursement. Be sure and keep a copy of the form and your receipts for your own records.