§ 97-18, where the employee’s right to compensation is admitted, the first installment of compensation payable becomes due 14 days after the employer has written or actual notice of the injury. If only this portion of the form is completed, then the carrier reserves the right to subsequently deny a claim by filing a Form 61 if only medical benefits have been paid.įinally, according to N.C. The Form also contains a section for accepting a claim for payment of medical benefits only without prejudice. ![]() Practically speaking, this part of the Form 63 is rarely used because it requires a second filing within 90 days. Additionally, if indemnity payments are initiated pursuant to a Form 63, the initial payment to the employee must be accompanied by a copy of the Form 63. An extension of time may be requested, but the extension must be requested prior to the expiration of the initial 90 days. If payments are made past the 90 day deadline, the claim is deemed fully accepted. Note, however, that payments may be made without prejudice only for 90 days from the date of actual notice of the injury-not from the date of filing the Form 63. The proper form to use in this situation is the Form 63. § 97-18 also provides that, if the employer or insurer is uncertain with regard to compensability or liability, compensation may be initiated without prejudice. If the Form 61 does not contain a sufficiently detailed statement in support of the denial, the employee can move the Commission to Order that the employer/insurer do so pursuant to Rule 601 of the Industrial Commission Rules. ![]() The Form 61 must contain a detailed statement of the grounds upon which the right to compensation is denied. The proper form to use in this situation is the Form 61. § 97-18, if the employer or insurer denies the employee’s right to compensation, the Commission should be notified within 14 days after written or actual notice of the injury and advise the employee of its decision. The three relevant forms are: Form 60, Employer’s Admission of Employee’s Right to Compensation Form 61, Denial of Workers’ Compensation Claim and Form 63, Notice to Employee of Payment of Compensation without Prejudice or Payment of Medical Benefits Only without Prejudice.Īccording to N. ![]() Once the employee files a Form 18, the carrier must decide whether to accept or deny the claim. A blank Form 18, Notice of Accident to Employer and Claim of Employee, must also be provided to the employee along with the Form 19. The Form 19 must be sent both to the Industrial Commission and to the employee. The first form that may need to be completed is the Form 19, Employer’s Report of Employee’s Injury to the Industrial Commission. According to Rule 104 of the Workers’ Compensation Rules of the Industrial Commission, a Form 19 must be filed within five days of knowledge or allegation of an injury if it causes the employee to be absent from work for more than one day or if the employee’s medical compensation exceeds the amount periodically established by the Industrial Commission, which is currently $2,000.00. A review of the controlling statutes and rules is helpful in determining what forms should be filed within what deadlines. Of course, initial forms procedure is key in limiting liability and avoiding sanctions. Forms practice in North Carolina is conducted pursuant to a maze of statutes and North Carolina Industrial Commission Rules, which can lead to quite a bit of confusion.
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