North Carolina General Statutes
Article 1 - Workers' Compensation Act.
§ 97-90 - Legal and medical fees to be approved by Commission; misdemeanor to receive fees unapproved by Commission, or to solicit employment in adjusting claims; agreement for fee or compensation.

97-90. Legal and medical fees to be approved by Commission; misdemeanor to receive fees unapproved by Commission, or to solicit employment in adjusting claims; agreement for fee or compensation.
(a) Fees for attorneys and charges of health care providers for medical compensation under this Article shall be subject to the approval of the Commission; but no physician or hospital or other medical facilities shall be entitled to collect fees from an employer or insurance carrier until he has made the reports required by the Commission in connection with the case. Except as provided in G.S. 97-26(g), a request for a specific prior approval to charge shall be submitted to the Commission for each such fee or charge.
(b) Any person (i) who receives any fee, other consideration, or any gratuity on account of services so rendered, unless such consideration or gratuity is approved by the Commission or the court, as provided in subsection (c), or (ii) who makes it a business to solicit employment for a lawyer or for himself in respect of any claim or award for compensation, shall be guilty of a Class 1 misdemeanor.
(c) If an attorney has an agreement for fee or compensation under this Article, he shall file a copy or memorandum thereof with the hearing officer or Commission prior to the conclusion of the hearing. If the agreement is not considered unreasonable, the hearing officer or Commission shall approve it at the time of rendering decision. If the agreement is found to be unreasonable by the hearing officer or Commission, the reasons therefor shall be given and what is considered to be reasonable fee allowed. If within five days after receipt of notice of such fee allowance, the attorney shall file notice of appeal to the full Commission, the full Commission shall hear the matter and determine whether or not the attorney's agreement as to a fee or the fee allowed is unreasonable. If the full Commission is of the opinion that such agreement or fee allowance is unreasonable and so finds, then the attorney may, by filing written notice of appeal within 10 days after receipt of such action by the full Commission, appeal to the senior resident judge of the superior court in the county in which the cause of action arose or in which the claimant resides; and upon such appeal said judge shall consider the matter and determine in his discretion the reasonableness of said agreement or fix the fee and direct an order to the Commission following his determination therein. The Commission shall, within 20 days after receipt of notice of appeal from its action concerning said agreement or allowance, transmit its findings and reasons as to its action concerning such agreement or allowance to the judge of the superior court designated in the notice of appeal. In all other cases where there is no agreement for fee or compensation, the attorney or claimant may, by filing written notice of appeal within five days after receipt of notice of action of the full Commission with respect to attorneys' fees, appeal to the senior resident judge of the superior court of the district of the county in which the cause arose or in which the claimant resides; and upon such appeal said judge shall consider the matter of such fee and determine in his discretion the attorneys' fees to be allowed in the cause. The Commission shall, within 20 days after notice of appeal has been filed, transmit its findings and reasons as to its action concerning such fee or compensation to the judge of the superior court designated in the notice of appeal; provided that the Commission shall in no event have any jurisdiction over any attorneys' fees in any third-party action. In any case in which an attorney appeals to the superior court on the question of attorneys' fees, the appealing attorney shall notify the Commission and the employee of any and all proceedings before the superior court on the appeal, and either or both may appear and be represented at such proceedings.
The Commission, in determining an allowance of attorneys' fees, shall examine the record to determine the services rendered. The factors which may be considered by the Commission in allowing a reasonable fee include, but are not limited to, the time invested, the amount involved, the results achieved, whether the fee is fixed or contingent, the customary fee for similar services, the experience and skill level of the attorney, and the nature of the attorney's services.
In making the allowance of attorneys' fees, the Commission shall, upon its own motion or that of an interested party, set forth findings sufficient to support the amount approved.
The Commission may deny or reduce an attorney's fees upon proof of solicitation of employment in violation of the Rules of Professional Conduct of the North Carolina State Bar.
(d) Provided, that nothing contained in this section shall prevent the collection of such reasonable fees of physicians and charges for hospitalization as may be recovered in an action, or embraced in settlement of a claim, against a third-party tort-feasor as described in G.S. 97-10.2.
(e) A health care provider shall not pursue a private claim against an employee for all or part of the costs of medical treatment provided to the employee by the provider unless the employee's claim or the treatment is finally adjudicated not to be compensable or the employee fails to request a hearing after denial of liability by the employer. Notwithstanding subsequent denial of liability or adjudication that the condition treated was not compensable, the insurer shall be liable as provided in G.S. 97-26 to providers whose services have been authorized by the insurer or employer. The statute of limitations applicable to a provider's claim for payment shall be tolled during the period the compensability of a claim or liability for particular treatment remains an issue in a compensation case.
(f) If a dispute arises between an employee's current and past attorney or attorneys regarding the division of a fee as approved by the Commission pursuant to this section, the Commission shall hear any dispute after the Commission has approved the settlement agreement. The Commission shall give notice to each of the employee's current and past attorneys of record of the total amount of the approved fee prior to determining how the fee shall be divided between those attorneys. An attorney who is an interested party to an action under this subsection shall have the same rights of appeal as outlined in subsection (c) of this section. (1929, c. 120, s. 64; 1955, c. 1026, s. 4; 1959, cc. 1268, 1307; 1973, c. 520, s. 4; 1981, c. 521, s. 4; 1991, c. 703, s. 6; 1993, c. 539, s. 680; 1994, Ex. Sess., c. 24, s. 14(c); 1993 (Reg. Sess., 1994), c. 679, s. 9.1; 2013-278, s. 1; 2017-124, s. 2.)

Structure North Carolina General Statutes

North Carolina General Statutes

Chapter 97 - Workers' Compensation Act

Article 1 - Workers' Compensation Act.

§ 97-1 - Short title.

§ 97-1.1 - References to workmen's compensation.

§ 97-2 - Definitions.

§ 97-3 - Presumption that all employers and employees have come under provisions of Article.

§ 97-5 - Presumption as to contract of service.

§ 97-5.1 - Presumption that taxicab drivers are independent contractors.

§ 97-6 - No special contract can relieve an employer of obligations.

§ 97-7 - State or subdivision and employees thereof.

§ 97-8 - Prior injuries and deaths unaffected.

§ 97-9 - Employer to secure payment of compensation.

§ 97-10.1 - Other rights and remedies against employer excluded.

§ 97-10.2 - Rights under Article not affected by liability of third party; rights and remedies against third parties.

§ 97-10.3 - Minors illegally employed.

§ 97-11 - Employer not relieved of statutory duty.

§ 97-12 - Use of intoxicant or controlled substance; willful neglect; willful disobedience of statutory duty, safety regulation or rule.

§ 97-12.1 - Willful misrepresentation in applying for employment.

§ 97-13 - Exceptions from provisions of Article[Effective until January 1, 2023]

§ 97-17 - Settlements allowed in accordance with Article.

§ 97-18 - Prompt payment of compensation required; installments; payment without prejudice; notice to Commission; penalties.

§ 97-18.1 - Termination or suspension of compensation benefits.

§ 97-19 - Liability of principal contractors; certificate that subcontractor has complied with law; right to recover compensation of those who would have been liable; order of liability.

§ 97-19.1 - Truck, tractor, or truck tractor trailer driver's status as employee or independent contractor.

§ 97-20 - Priority of compensation claims against assets of employer.

§ 97-21 - Claims unassignable and exempt from taxes and debts; agreement of employee to contribute to premium or waive right to compensation void; unlawful deduction by employer.

§ 97-22 - Notice of accident to employer.

§ 97-23 - What notice is to contain; defects no bar; notice personally or by registered letter or certified mail.

§ 97-24 - Right to compensation barred after two years; destruction of records.

§ 97-25 - Medical treatment and supplies.

§ 97-25.1 - Limitation of duration of medical compensation.

§ 97-25.2 - Managed care organizations.

§ 97-25.3 - Preauthorization.

§ 97-25.4 - Utilization guidelines for medical treatment.

§ 97-25.5 - Utilization guidelines for vocational and other rehabilitation.

§ 97-25.6 - Reasonable access to medical information.

§ 97-26 - Fees allowed for medical treatment; malpractice of physician.

§ 97-26.1 - Fees for medical records and reports; expert witnesses; communications with health care providers.

§ 97-26.2 - Reimbursement for prescription drugs, prescribed over-the-counter drugs, and professional pharmaceutical services.

§ 97-27 - Medical examination; facts not privileged; refusal to be examined suspends compensation; other medical opinions; autopsy.

§ 97-28 - Seven-day waiting period; exceptions.

§ 97-29 - Rates and duration of compensation for total incapacity.

§ 97-29.1 - Increase in payments in cases for total and permanent disability occurring prior to July 1, 1973.

§ 97-30 - Partial incapacity.

§ 97-31 - Schedule of injuries; rate and period of compensation.

§ 97-31.1 - Effective date of legislative changes in benefits.

§ 97-32 - Refusal of injured employee to accept suitable employment as suspending compensation.

§ 97-32.1 - Trial return to work.

§ 97-32.2 - Vocational rehabilitation.

§ 97-33 - Prorating in event of earlier disability or injury.

§ 97-34 - Employee receiving an injury when being compensated for former injury.

§ 97-35 - How compensation paid for two injuries; employer liable only for subsequent injury.

§ 97-36 - Accidents taking place outside State; employees receiving compensation from another state.

§ 97-37 - Where injured employee dies before total compensation is paid.

§ 97-38 - Where death results proximately from compensable injury or occupational disease; dependents; burial expenses; compensation to aliens; election by partial dependents.

§ 97-39 - Widow, widower, or child to be conclusively presumed to be dependent; other cases determined upon facts; division of death benefits among those wholly dependent; when division among partially dependent.

§ 97-40 - Commutation and payment of compensation in absence of dependents; "next of kin" defined; commutation and distribution of compensation to partially dependent next of kin; payment in absence of both dependents and next of kin.

§ 97-40.1 - Second Injury Fund.

§ 97-42 - Deduction of payments.

§ 97-42.1 - Credit for unemployment benefits.

§ 97-43 - Commission may prescribe monthly or quarterly payments.

§ 97-44 - Lump sums.

§ 97-45 - Reducing to judgment outstanding liability of insurance carriers withdrawing from State.

§ 97-46 - Lump sum payments to trustee; receipt to discharge employer.

§ 97-47 - Change of condition; modification of award.

§ 97-47.1 - Payment without prejudice; limitations period.

§ 97-48 - Receipts relieving employer; payment to minors; when payment of claims to dependents subsequent in right discharges employer.

§ 97-49 - Benefits of mentally incompetent or minor employees under 18 may be paid to a trustee, etc.

§ 97-50 - Limitation as against minors or mentally incompetent.

§ 97-51 - Joint employment; liabilities.

§ 97-52 - Occupational disease made compensable; "accident" defined.

§ 97-53 - (See editor's note on condition precedent) Occupational diseases enumerated; when due to exposure to chemicals.

§ 97-54 - "Disablement" defined.

§ 97-55 - "Disability" defined.

§ 97-56 - Limitation on compensable diseases.

§ 97-57 - Employer liable.

§ 97-58 - Time limit for filing claims.

§ 97-59 - Employer to pay for treatment.

§ 97-61 - Rewritten as §§ .1 to .7.

§ 97-61.1 - First examination of and report on employee having asbestosis or silicosis.

§ 97-61.2 - Filing of first report; right of hearing; effect of report as testimony.

§ 97-61.3 - Second examination and report.

§ 97-61.4 - Third examination and report.

§ 97-61.5 - Hearing after first examination and report; removal of employee from hazardous occupation; compensation upon removal from hazardous occupation.

§ 97-61.6 - Hearing after third examination and report; compensation for disability and death from asbestosis or silicosis.

§ 97-61.7 - Waiver of right to compensation as alternative to forced change of occupation.

§ 97-62 - "Silicosis" and "asbestosis" defined.

§ 97-63 - Period necessary for employee to be exposed.

§ 97-64 - General provisions of act to control as regards benefits.

§ 97-65 - Reduction of rate where tuberculosis develops.

§ 97-66 - Claim where benefits are discontinued.

§ 97-67 - Postmortem examinations; notice to next of kin and insurance carrier.

§ 97-68 - Controverted medical questions.

§ 97-69 - Examination by advisory medical committee; inspection of medical reports.

§ 97-70 - Report of committee to Industrial Commission.

§ 97-71 - Filing report; right of hearing on report.

§ 97-72 - Appointment of advisory medical committee; terms of office; duties and functions; salaries and expenses.

§ 97-73 - Fees.

§ 97-74 - Expense of hearings taxed as costs in compensation cases; fees collected directed to general fund.

§ 97-77 - North Carolina Industrial Commission created; members appointed by Governor; terms of office; chairman.

§ 97-77.1 - Expired.

§ 97-78 - Salaries and expenses; administrator, executive secretary, deputy commissioners, and other staff assistance; annual report.

§ 97-78.1 - Standards of judicial conduct to apply to commissioners and deputy commissioners.

§ 97-79 - Offices and supplies; deputies with power to subpoena witnesses and to take testimony; meetings; hearings.

§ 97-80 - Rules and regulations; subpoena of witnesses; examination of books and records; depositions; costs.

§ 97-81 - Blank forms and literature; statistics; safety provisions; accident reports; studies and investigations and recommendations to General Assembly; to cooperate with other agencies for prevention of injury.

§ 97-82 - Memorandum of agreement between employer and employee to be submitted to Commission on prescribed forms for approval; direct payment as award.

§ 97-83 - Commission is to make award after hearing.

§ 97-83.1 - Facilities for hearings; security.

§ 97-84 - Determination of disputes by Commission or deputy.

§ 97-85 - Review of award.

§ 97-86 - Award conclusive as to facts; appeal; certified questions of law.

§ 97-86.1 - Payment of award pending appeal in certain cases.

§ 97-86.2 - Interest on awards after hearing.

§ 97-87 - Judgments on awards.

§ 97-88 - Expenses of appeals brought by insurers.

§ 97-88.1 - Attorney's fees at original hearing.

§ 97-88.2 - Penalty for fraud.

§ 97-88.3 - Penalty for health care providers.

§ 97-89 - Commission may appoint qualified physician to make necessary examinations; expenses; fees.

§ 97-90 - Legal and medical fees to be approved by Commission; misdemeanor to receive fees unapproved by Commission, or to solicit employment in adjusting claims; agreement for fee or compensation.

§ 97-90.1 - Insurers that provide employee's health benefit plans, disability income plans, or any other health insurance plans as real parties in interest; reimbursement.

§ 97-91 - Commission to determine all questions.

§ 97-92 - Employer's record and report of accidents; records of Commission not open to public; supplementary report upon termination of disability; penalty for refusal to make report; when insurance carrier liable.

§ 97-93 - Employers required to carry insurance or prove financial ability to pay for benefits; employers required to post notice; self-insured employers regulated by Commissioner of Insurance.

§ 97-94 - Employers required to give proof that they have complied with preceding section; penalty for not keeping liability insured; review; liability for compensation; criminal penalties for failure to secure payment of compensation.

§ 97-95 - Actions against employers failing to effect insurance or qualify as self-insurer.

§ 97-97 - Insurance policies must contain clause that notice to employer is notice to insurer, etc.

§ 97-98 - Policy must contain agreement promptly to pay benefits; continuance of obligation of insurer in event of default.

§ 97-99 - Law written into each insurance policy; form of policy to be approved by Commissioner of Insurance; single catastrophe hazards.

§ 97-100 - Rates for insurance; carrier to make reports for determination of solvency; tax upon premium; wrongful or fraudulent representation of carrier punishable as misdemeanor; notices.

§ 97-101 - Collection of fines and penalties.

§ 97-101.1 - Commission may issue writs of habeas corpus.