The Workers’ Compensation Insurance Company Is Telling Me They Do Not Have To Pay For Any Of My Further Medical Treatment, Because They Have Not Paid For Disability Checks Or Medical Treatment In More Than Two Years, Is There Anything I Can Do?

The North Carolina Industrial Commission addressed this issue in Dominguez v. Francisco Dominguez Masonry, Inc. (2022).

In this case the Workers’ Compensation Insurance Company paid for the injured employee’s medical treatment and disability checks due to a workplace injury. However, the last disability check was issued in December 2013 and the last medical bill was paid in June 2015. In August 2017 the Workers’ Compensation Insurance Company contacted the injured employee about a disability check that was not cashed from July 2011. The injured employee requested that this check be re-issued and in September of 2017 the injured employee cashed the re-issued disability check. In 2018 the injured employee request the Workers’ Compensation Insurance Company pay for additional medical treatment due to his injury at work. The Workers’ Compensation Insurance Company denied this request alleging that the injured employee’s entitlement to medical treatment was now time-barred pursuant to N.C. Gen. Stat. 97-25.1, since the last disability check paid was for 2013 and the last medical bill paid was for 2015.

The North Carolina Court of Appeals noted that an injured employee will no longer be entitled to payment for medical treatment if more than two years elapse since the last time the Workers’ Compensation Insurance Company paid for medical treatment or disability checks for the injured employee. This issue before the North Carolina Court of Appeals was whether a “corrective payment” for past owed benefits for the injured employee reset the two-year time period noted per N.C. Gen. Stat. 97-25.1.

The North Carolina Court of Appeals ruled that if the Workers’ Compensation Insurance Company paid for medical treatment or disability checks for the injured employee within the past two years then N.C. Gen. Stat. 97-25.1 would not provide a bar to the injured employee’s entitlement to payments for further medical treatment related to the workplace injury. However, the North Carolina Court of Appeals made clear that the payment for a medical bill or disability check must actually have been made versus the injured employee simply arguing that it was owed by the Workers’ Compensation Insurance Company.

Should you have any questions about this or any of issues involving your work-related injury, please feel free to reach out to one of the Board Certified Workers’ Compensation Specialists at Cardinal Law Partners for a free consultation by calling (833) 444-4127.