Addressing Medical Delays During COVID-19

A hallmark right of employers and insurers who direct an employee’s medical care in a North Carolina workers’ compensation case is the ability to require the worker to attend an Independent Medical Evaluation (IME). Similarly, a worker has the right to seek a second opinion from a physician to which both parties agree. Both these actions often help to move cases toward closure.

The COVID-19 pandemic has caused medical providers – especially those most likely to treat workers’ compensation patients – to stop taking patients, or to move to telemedicine. In many cases, this sudden shift in medical availability is translating into frustrating delays for employers and insurers. While some delays are inevitable, sadly, some workers, looking to prolong their benefits, intentionally take advantage of this unusual situation. Some employees are refusing to switch doctors, participate in telehealth, or select a second opinion doctor…even when it would be painless to do so. To make matters worse, there appears to be no end in sight, given the huge backlog of patients that doctors will face when their practices reopen.

The workers’ compensation attorneys at Anders Newton have been helping their clients navigate the COVID-19 barriers to expedite getting workers healed and back to work. Below are three techniques to consider:

Use Existing Evidence

When it is impossible due to COVID-19 to reach the treating physician to get an opinion on medical status, the Industrial Commission may be open to the creative use of evidence already obtained. For example, if a physician indicated in February that the claimant likely would be released at full duty in April, that opinion could possibly support a Form 24 or final release. When going this route, we recommend documenting all attempts to secure a physical medical visit, as proof that the COVID pandemic prevented technical compliance with the rules. This method is not foolproof; it remains to be seen how generous the Commission will be when addressing these issues, but we are hopeful that the unprecedented nature of our situation will cause the Commission to act with leniency.

Consider Motions to Compel

Unlike many other courts across North Carolina, the Industrial Commission continues to operate remotely at nearly full capacity. It is routinely processing motions, so it is a great practice to use the motion system if needed to force a patient to cooperate with medical treatment or telehealth.

Document Non-Cooperation

Once a malingerer, always a malingerer. If an employee is refusing to cooperate during the pandemic, chances are that the employee will refuse to cooperate for years to come. Even though options during the pandemic may be limited, you may thank yourself later if you documented all the instances of non-cooperation and can use them in a motion down the road.

The workers’ compensation attorneys at Anders Newton are available to answer any questions about the impact of COVID-19 on the handling of workers’ compensation claims. Contact us at 919-516-8400.


Disclaimer: The information on the blog is provided for informational purposes only and does not constitute legal advice. Cases referenced do not represent the law firm’s entire record. Each case is unique and must be evaluated on its own merits. The outcome of a particular case cannot be based on past results.

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