Mehaffey v. Burger King

Summary

The North Carolina Supreme Court held that the Industrial Commission exceeded its statutory authority by using its Medical Fee Schedule to bar retroactive compensation for attendant care provided by an immediate family member without prior Commission approval. The court reversed the Court of Appeals on that issue but remanded for findings on whether the employee sought approval within a reasonable time. A partial dissent argued that the Commission's longstanding preapproval requirement was authorized and consistent with the Workers' Compensation Act.

Holdings

1. The Industrial Commission lacked statutory authority to require that attendant care provided by an immediate family member could not be compensated unless the provider obtained Commission approval before rendering the care. The Medical Fee Schedule provision imposing that prerequisite was therefore without effect.
2. Plaintiff was not automatically entitled to reimbursement for past attendant care. An injured worker must obtain Commission approval within a reasonable time after selecting a medical provider, and reimbursement may be denied if approval was not timely sought.
3. Hatchett's statutory basis no longer existed after the 1994 rewrite of N.C.G.S. § 97-26, which removed the language making employer liability depend on treatment being ordered by the Commission.

Questions Presented

1. Whether the North Carolina Industrial Commission's Medical Fee Schedule could prohibit compensation for attendant care provided by an immediate family member before the Commission approved the services.
2. Whether plaintiff was entitled to reimbursement for past attendant care without findings addressing whether he sought Commission approval within a reasonable time after selecting a medical provider.
3. Whether Hatchett v. Hitchcock Corp. controlled after the 1994 amendment to N.C.G.S. § 97-26.

Disposition

reversed_and_remanded