A workers compensation claim can become more difficult when the injury report does not clearly explain when, where, and how the accident occurred. This is particularly important with hand, wrist, and finger injuries because pain, weakness, or loss of coordination may develop gradually after the initial event. An insurer may question whether the condition came […]
Medical treatment can end while an injured worker still faces a risk of later surgery, injections, medication, equipment, replacement devices, or other care. North Carolina law has a specific timing rule for additional medical compensation.
Future medical rights should be tracked from the employer’s actual last payment of medical or indemnity compensation, the Commission record, and evidence of a substantial risk that additional injury-related care will be needed.
Calculate the G.S. 97-25.1 period from payment evidence
G.S. 97-25.1 states that the right to medical compensation terminates two years after the employer’s last payment of medical or indemnity compensation unless, before expiration, the worker files an application for additional medical compensation that is later approved or the Commission orders additional medical compensation on its own motion.
- Obtain the carrier’s medical-payment and indemnity-payment ledgers rather than assuming the last treatment date controls
- Match the last claimed payment to an invoice, explanation, check, electronic record, service date, payee, and amount
- Identify returned, voided, reissued, credited, disputed, or late-processed payments that could make the timeline unclear
- Keep the Commission file, accepted conditions, prior awards or agreements, and any existing future-medical language together
Document the substantial risk of future care
The statute directs the Commission to provide for future necessary medical compensation when it determines there is a substantial risk that future care will be needed. The evidence should connect the anticipated care to the compensable injury and explain why the risk is substantial rather than merely possible.
- Current diagnosis, accepted body parts, treatment history, response, maximum-medical-improvement status, and permanent impairment
- Provider recommendations for follow-up, medication, injections, testing, surgery, equipment, replacement, maintenance, or symptom-based return
- Expected frequency, clinical trigger, likely timing, prognosis, alternatives, and consequences if care is unavailable
- Prior conditions, later injuries, nonwork causes, and the medical reasoning connecting future care to the accepted injury
Use the current Form 18M and filing process
The Industrial Commission’s forms directory identifies Form 18M as the employee’s application for additional medical compensation under G.S. 97-25.1. Use the current form, answer each claim and treatment question accurately, attach the supporting provider record, and preserve filing and service confirmation before the calculated deadline.
A submitted application is not the same as an approved order. Track any response, request for more information, hearing or motion, Commission decision, appeal, and the exact conditions or treatment covered by the resulting order.
Continue to request necessary care through the proper channel
G.S. 97-25 addresses medical compensation, provider requests, second opinions, disputes, and Commission orders. A future-medical order does not remove the need to document a later treatment recommendation, authorization request, response, and connection to the covered injury.
Do not confuse an open right with a settlement term
An order preserving future medical compensation, an open accepted claim, a rating agreement, and a full settlement can affect future care differently. Read the actual documents for injury scope, covered treatment, authorization, payment, release, finality, and Commission approval. Do not assume a permanent rating automatically keeps every form of future care open or that every payment closes it.
The related North Carolina impairment-rating guide explains how a permanent rating, scheduled payment, Form 26A, wage-loss evidence, medical rights, and change-of-condition issues differ.
Rosensteel Fleishman Car Accident & Injury Lawyers provides information about consulting a Charlotte workers’ compensation lawyer about future medical benefits or Form 18M. A review should begin before the payment-based period expires.
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