News from the NC Industrial Commission - Acknowledgement Letter Revision

By: Melissa P. Woodard

When a Form 18 is filed with the NC Industrial Commission, the Director of Claims Administration sends an acknowledgement letter to the employer, carrier, or administrator instructing them on the timeline to respond to the Form 18.  This letter is used to instruct defendants to file “a Form 60, 61 or 63 to admit, deny, or pay without prejudice” within 30 days to comply with N.C. Gen. Stat. § 97-18(j) and avoid a $400 fine.

After receiving a recently dated letter, we have noticed that the language of the letter has been revised in a significant way.  Defendants are still permitted to file a Form 60, 61, or “63, Section 1 consistent with the requirements of N.C. Gen. Stat. § 97-18(d) and Rule 11 NCAC 23A .0601(a)(3).”   However, the Form 63, Section 2 agreement to pay medical benefits without prejudice is no longer a form of compliance with § 97-18(j)avoid the $400 fine since that option has been specifically left out of the Director’s letter.

Given this new language, we recommend that in any claim in which our clients would like to exercise their statutory ability to pay medical benefits only without accepting the claim, they should still file a Form 63, Section 2, but they should also simultaneously file a Form 61 denying indemnity benefits.

It appears that if only a Form 63, Section 2 is filed, the defendants are subject to the fine.  Likewise, if a Form 63, Section 1 is filed in a claim in which the carrier intends to only pay medical benefits, the Commission will likely treat that as a full acceptance of the claim after the 90-day period has run and will also be able to compel payment of indemnity benefits.

Notably, the Commission has not provided any specific notice of this change on its website or in any other form apart from changing the form letter.  We will continue to update you as this issue develops.