Plain Language of North Carolina Statute Withstands Challenge from Claimant
In North Carolina, a claimant’s right to seek additional medical compensation expires two years after the date of the employer’s last payment of medical or indemnity compensation (absent limited exceptions). N.C. Gen. Stat. § 97-25.1 Recently, the North Carolina Court of Appeals, in Anders v. Universal Leaf N. Am, issued an opinion rejecting a claimant’s attempt to get around this time limitation holding true to the plain language of the statute.
In Anders, the claimant suffered from a compensable accident resulting in bilateral hernias on November 20, 2010. On November 28, 2010, the claimant was terminated for violating his employer’s attendance policy. Shortly following termination, the claimant found alternative employment. The timeline of events in this claim turned out to be critical. The claimant underwent a hernia repair and was released to full duty work effective April 7, 2011. On April 8, 2011, he received his last payment of disability compensation. On January 19, 2012, he received his payment of medical compensation. Over two years later, on January 27, 2014, the claimant requested a hearing asserting entitlement to additional indemnity and medical compensation. The Commission rejected claimant’s argument finding that his current condition was not causally related to the November 2010 injury, that his request for additional medical compensation was time barred, and that he had failed to prove disability. The claimant appealed.
On appeal, the claimant attempted to argue that his claim should not have been time barred. The court disagreed. The last date the claimant received indemnity or medical compensation was on January 19, 2012. The claimant requested additional medical treatment on January 27, 2014. As two years had passed, the court held the claimant was not entitled to additional medical treatment.
The claimant attempted to get around § 97-25.1 by asserting that he was allegedly disabled during the two years preceding his hearing request. The claimant argued his hypothetical disability should have restarted the § 97-25.1 limitation period. Alternatively, he argued that he was entitled to a future permanent partial disability rating that, in his opinion, should extent the § 97-25.1 limitation period. The court rejected the claimant’s argument holding that the plain language of § 97-25.1 refers to actual payments of medical or indemnity benefits as opposed to hypothetical payments that might be awarded in the future. The court also held that the claimant had presented insufficient evidence regarding entitlement to an impairment rating.
Here, the court held that the causation argument was not determinative as it could not overcome the fact that the claimant’s claim was time barred. The court’s decision shows that the interpretation of § 97-25.1 is clear and unambiguous. Absent limited exceptions, if two years passes from the date of last payment of medical or indemnity compensation, claimant’s right to future medical treatment expires. The court held that hypothetical future payments were insufficient to extend this timeline. By doing so, the court avoided imposing a cloud of ambiguity over § 97-25.1 which would create uncertainty for employers and insurers regarding the length of time that they must continue to have medical exposure in certain claims.