North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 23 - INDUSTRIAL COMMISSION › Subchapter A - WORKERS' COMPENSATION RULES › Section .0600 - CLAIMS ADMINISTRATION AND PROCEDURES › Section 23A .0609A - MEDICAL MOTIONS AND EMERGENCY MEDICAL MOTIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Medical
				  motions brought pursuant to
				  G.S.
				  97-25 and responses thereto shall be brought
				  before either the Office of the Chief Deputy Commissioner or the Executive
				  Secretary and shall be submitted in accordance with Rule .0108 of this
				  Subchapter. For parties to whom the electronic filing requirements of Rule
				  .0108(b) of this Subchapter apply, motions, responses, and notices of appeal
				  shall be submitted under the EDFP category "Medical Motions and Responses." The
				  submitting party shall contemporaneously serve a copy of the filing to the
				  opposing party or opposing party's counsel, if represented.
(b) In addition to any notice of
				  representation contained in a medical motion or response, an attorney who is
				  retained by a party to prosecute or defend a medical motion or appeal before
				  the Commission shall file a notice of representation in accordance with Rule
				  .0108 of this Subchapter and send a copy of the notice to all other counsel and
				  all unrepresented parties involved in the proceeding.
(c) Motions submitted pursuant to
				  G.S.
				  97-25 and requesting medical relief other
				  than emergency relief shall contain the following:
(1) a designation as a "Medical Motion"
				  brought pursuant to
				  G.S.
				  97-25 and a statement directly underneath the
				  case caption clearly indicating the request is for either an administrative
				  ruling by the Executive Secretary or an expedited full evidentiary hearing
				  before a Deputy Commissioner;
(2) a
				  statement of the treatment or relief requested;
(3) a statement of the medical diagnosis of
				  the employee and the name of any health care provider having made a diagnosis
				  or treatment recommendation that is the basis for the motion;
(4) a statement as to whether the claim has
				  been admitted on a Form 60, Employer's Admission of Employee's Right to
				  Compensation, Form 63, Notice to Employee of Payment of Compensation without
				  Prejudice (G.S. 97-18(d)) or
				  Payment of Medical Benefits Only without Prejudice (G.S.
				  97-2(19) & 97-25), Form
				  21, Agreement for Compensation for Disability, or is subject to a prior
				  Commission Opinion and Award or Order finding compensability, with supporting
				  documentation attached;
(5) a
				  statement of the time-sensitive nature of the request, if any;
(6) an explanation of opinions known and in
				  the possession of the movant by any relevant experts, independent medical
				  examiners, and second opinion examiners;
(7) if the motion requests a second opinion
				  examination pursuant to
				  G.S.
				  97-25, the motion shall specify whether the
				  employee has made a prior written request to the defendants for the
				  examination, as well as the date of the request and the date of the denial, if
				  any;
(8) a representation that
				  informal means of resolving the issue have been attempted in good faith, and a
				  statement of the opposing party's position or that there has been a reasonable
				  attempt to contact the opposing party and ascertain its position; and
(9) a proposed Order in Microsoft Word
				  format, in accordance with Rule .0609 of this Section.