Identification Number:
DI 52120 TN 29
Intended Audience:See Transmittal Sheet
Originating Office:ORDP OISP
Title:State Specific Workers Compensation (WC) Procedures
Type:POMS Transmittals
Program:Disability
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part DI – Disability Insurance
Chapter 521 – Workers' Compensation/Public Disability Benefit (WC/PDB) Offset
Subchapter 20 – State Specific Workers' Compensation (WC) Procedures
Transmittal No. 29, 12/20/2018

Audience

PSC: BA, CA, DS, IES, PETE, RECONR, SCPS;
OCO-OEIO: BIES, BTE, CR, CTE, ERE, FCR, PETL, RECONE, RECONR, RECOVR;
OCO-ODO: BTE, CR, CST, CTE, CTE TE, PAS, PETE, PETL, RCOVTA, RECONE, RECOVR;
FO/TSC: CS, CS TII, CS TXVI, CSR, CTE, OA, OS, TA, TSC-CSR;

Originating Component

OISP

Effective Date

Upon Receipt

Background

This is a Quick Action Transmittal. The revision does not change or introduce new policy or procedure. This is a minor update to NC WC POMS to include a reminder to check the available online resources for WC payment information in DI 52140.020.

Summary of Changes

DI 52120.180 North Carolina Workers’ Compensation (WC)

Added third paragraph in Subsection A.

DI 52120.180 North Carolina Workers’ Compensation (WC)

A. North Carolina WC payment provisions

North Carolina WC pays 2/3 of the worker’s average weekly wage up to a State determined maximum. To see the weekly maximum visit: http://www.ic.nc.gov/ncic/pages/maxrates.htm

The individual will receive the payments for the duration of the disability except for Permanent Partial (PP) Disabilities, which have a limit of 300 weeks.

To verify WC payments, check that WC evidence is not already in file. Check the Workers' Compensation (WC) Resource Page in DI 52140.020 since NC is a State that provides SSA with access to its online records. The value of online records can vary from State to State and some development may still be required. However, the sites available usually provide contact information for the employer, WC carrier or the WC attorney, which can jump-start the development process. Also included in the WC resource intranet site is a list of individuals in the PC with online access to those individual State records.

B. North Carolina WC lump sum (LS) awards

1. Appeals and changes

Individuals must appeal North Carolina LS Awards based on the facts of the award within 15 days and appeal based on the laws within 30 days. The North Carolina Commission can review the WC award for up to 2 years from the last WC payment, but only on the grounds of a change in condition.

2. Lump sum processing

Use general procedures for life expectancy cases to prorate and offset.

DI 52150.065A Life Expectancy (LE) Award

NOTE: North Carolina occupational disease lump sum awards for byssinosis often specify a very low weekly rate to be paid over a life expectancy up to age 75 or 76.

C. Cost-of-living adjustments (COLA)

North Carolina does not provide a cost of living increase.

D. Attorney fees

Attorney fees in North Carolina are determined on a case by case basis and approved by the North Carolina Industrial Commission.

E. Retirement insurance benefit (RIB) considerations

North Carolina WC does not offset due to the receipt of RIB.

F. References:

http://www.ic.nc.gov/ - North Carolina Workers' Compensation site

DI 52150.045 - For individual State maximum rates visit

DI 52150.060 - Prorating a WC/PDB Lump Sum Settlement

DI 52150.030 - Considering the RIB Option

DI 52150.050 - Excludable Expenses


DI 52120 TN 29 - State Specific Workers Compensation (WC) Procedures - 12/20/2018