A North Carolina workers’ compensation file can involve an employee, supervisor, employer, insurance carrier or self-insured employer, third-party administrator, medical providers, vocational or rehabilitation participants, and the North Carolina Industrial Commission. A document from one participant does not automatically perform another participant’s filing or decision.

A workers’ compensation role map should show which person or organization created, received, filed, decided, paid, or preserved each record instead of treating the employer, carrier, administrator, and Commission as one actor.

Identify the employee’s records and actions

  • Written employer notice, internal incident report supplied by the employer, Form 18, employer copy, Commission submission, acknowledgment, and claim number
  • Medical history, provider instructions, restrictions, work notes, mileage, expenses, missed time, wage records, and reported changes
  • Statement, authorization, questionnaire, form, agreement, objection, hearing request, appeal record, and delivery proof identified by purpose
  • Correction or supplement linked to the earlier version rather than silently replacing it

Separate the supervisor and employer functions

  • Person receiving the first report, date and method, exact event facts reported, affected body areas, witnesses, and requested response
  • Internal safety or human-resources record, schedule, payroll, job description, training, equipment, worksite, video, and disciplinary or leave record
  • Employer legal name, location, insurance or self-insurance information, carrier or administrator contact, and policy or account identifier
  • Form 19 or electronic first report, employee copy, transmission date, recipient, and any disagreement with its event description

N.C. Gen. Stat. § 97-92 addresses employer injury records and reports to the Commission under stated conditions. The employer’s report and the employee’s Form 18 are different records with different actors and purposes.

Distinguish the carrier, self-insurer, and administrator

  • Entity providing coverage or authorized self-insurance, entity administering the claim, adjuster, claim number, address, and contact information
  • Written acceptance, payment without prejudice, denial, reservation, medical authorization, wage calculation, benefit notice, or other position identified by exact form or letter
  • Payment source, payee, amount, period, benefit type, issued date, received date, stopped or changed status, and stated reason
  • Vendor or contractor role kept separate from authority to make a coverage, medical, payment, or litigation decision

Keep medical-provider records within their clinical role

  • Provider, referral source, authorization, appointment, examination, diagnosis wording, treatment, restriction, work note, rating, and follow-up
  • Clinical opinion attributed to its author and date without treating an adjuster, employer, or legal summary as a medical finding
  • Request for records, response, missing item, correction, billing, and travel record maintained separately
  • Disagreement about authorization, causation, capacity, treatment, or rating recorded as an issue rather than resolved by label

Use the Commission’s current forms and functions

The North Carolina Industrial Commission forms page identifies Form 18 for an employee claim, Form 19 for an employer first report, and separate forms for hearings, return to work, medical compensation, benefit changes, ratings, and other matters. The exact form and instructions in effect should be used for the task at hand.

The Commission’s Claims Administration page explains that the section processes injury reports, claim forms, acceptance or denial, return-to-work, permanent-partial-disability, occupational-disease, death, and closure records, and maintains party and administrator information. Commission processing does not by itself show that every factual or legal issue has been accepted.

Build a role-and-status table

  • Record name and date, creator, sender, recipient, filing or delivery proof, claim number, issue addressed, and current status
  • Person or organization with the next action, source of that authority, due date if verified, completion evidence, and unresolved question
  • Conflicting employer, employee, carrier, provider, and Commission descriptions shown side by side
  • No informal call, payment, appointment, or internal report assumed to replace a required form or resolve the entire claim

The related guide to filing a North Carolina workers’ compensation claim follows the employee notice and Form 18 path through claim status, medical and wage records, disputes, and deadlines. Use the role map to identify who created, received, filed, decided or paid each part of the record.

Rosensteel Fleishman Car Accident & Injury Lawyers provides general information about North Carolina workers’ compensation claims involving several participants and records. The current forms, orders, statutes, and individual file determine the required action.

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