The North Carolina General Assembly passed a new law that will impact those who are seeking medical treatment after being injured on the job. This was done to strike down the North Carolina Supreme Court's ruling in Wilkes v. City of Greenville. In Wilkes, the Court cited the previous version of this legislation and held “an admission of compensability…entitles an employee to a presumption that additional medical treatment is causally related to his compensable injury.” In other words, this meant that once the claim was accepted on a Form 60 or 63 section 1, the burden of proof shifted to the employer to disprove that the requested medical treatment was not related to the injury.
The new legislation now says that an accepted claim on a Form 60 or 63 section 1 “shall not create a presumption that medical treatment for an injury or condition NOT IDENTIFIED in the form prescribed” by the Commission on a Form 60 and 63 section 1 “is causally related to the compensable injury.” Therefore, if the body part that the injured worker is requesting treatment for is not listed on the Form 60 or 63 section 1, then they bear the burden of proof. This is the case even if the Defendants have been paying for the medical treatment for weeks, months, or years.
If the injured worker has been receiving medical treatment for a body part, directed by Defendants, and it is not listed on the Form 60 or 63 section 1 for an extended period of time and the Defendants deny ongoing care, the injured worker must go through the formal hearing process and prove that the body part is related to the claim. This is not only a reversal of our North Carolina Supreme Court's ruling in Wilkes, but also causes harm to the injured worker if Defendants one day stop providing care—months or years down the road.