Hot Topics in 2024
By Lindsay Underwood, Group Chair, Skidmore Law Group
Throughout 2024 the workers' compensation landscape continued to evolve. For employers, insurers, and legal professionals alike, staying informed about these changes is critical to navigating claims effectively, minimizing risk, and reducing overall claim exposure.
Work from Home Injuries and Compensability
The move towards remote work continues to create new questions and issues regarding the possible compensability of work from home injuries. In order to prove a work from home injury is compensable, a Plaintiff must still show that they sustained 1) an injury by accident, that 2) arose out of and, 3) in the course and scope of their employment.
The main concern regarding the compensability of these claims is determining whether the Plaintiff was actually furthering the interests of their employer at the time of the injury. To defend these claims, investigation is extremely important. We recommend taking thorough recorded statements and initiating a prompt claim review. In order to mitigate risk, it may be necessary to prepare a more detailed job description for a remote employee to limit job duties, physical limitations, and specific work hours. Additionally, many employers issue directive for a work from home set-up to include instructions on keeping a clear work space, utilization of ergonomic tools and desk accessories, and specifications regarding work area, all of which can help mitigate risk. It is also important to consider possible breaktime injuries and deviations from the employment.
Form 60, 61, 63 in compliance with G.S. 97-18 (j)
The recently issued North Carolina Industrial Commission Annual Report demonstrated that carriers are still having difficulty complying with NCGS 97-18(j). When the Claims Administration Section processes a Form 18, it sends a letter to the insurer, third-party administrator, or self-insured employer advising that it has 30 days to file a Form 60, 61, or 63. If defendants fail to submit an appropriate filing within 30 days following receipt of notice that a Form 18 was filed, the Claims Administration Section will enter an Order directing defendants to file a Form 60, 61, or 63, and to pay a sanction in the amount of $400.00. Failure to comply with this Order within 30 days results in the imposition of further sanctions, including assessment of an additional $200 penalty.
During the 2023-24 fiscal year, there were 15,486 Form 18s filed. Only 8,890 claims, just over half, were compliant with the 97-18(j) filing. There are still 3,755 claims not in compliance from the fiscal year.
A quick way to avoid a sanction (as well as additional penalty) is to pay close attention to the filing date, and ensure that a Form 60, Form 63, or Form 61 is filed in a timely manner. If there are questions concerning compensability, but not enough evidence to support a Form 61, we always recommend filing a Form 63 to allow some additional time for investigation of the claim. Additionally, if a sanction was assessed in error, you can contact the Claims Administration Section for further investigation. In many cases, assuming the sanction was an error, the Order will be rescinded.
Remote Mediations
We continue to get client questions about the current status of mediations and attendance either in person or remotely. The default rule is that mediations will take place in person, at a location agreeable to the parties and the mediator. However, if all parties agree to conduct the mediation remotely, they are permitted to do so pursuant to the Rules for Mediated Settlement Conferences and Other Settlement Procedures in Superior Court Civil Actions which were updated on June 18, 2024, and codified by the Supreme Court’s Office of Administrative Counsel.
Every mediator may also designate in the Mediator Information Directory that he or she will only conduct conferences using remote technology. If the parties do not agree on an attendance method and the designated mediator is designated as “remote only,” then the conference shall be conducted using remote technology. If the mediator is not designated as “remote only,” then the conference shall be conducted in person.