Workers’ compensation

This one deserves its own section because the instinct to help gets you in trouble.

In North Carolina, the employer or its insurance carrier generally has the right to direct medical treatment for a compensable injury. If you treat and bill outside that channel, you may not be paid, and — worse — a well-meant note taking the patient out of work can complicate their claim rather than support it. The forms are Industrial Commission forms (the Form 25R work status report is the one you’ll see most), and the case is managed by an adjuster and often a nurse case manager who will call your office.

My rule: if the injury is work-related and there’s an open claim, the treating physician of record owns the work notes. I document the visit, treat anything urgent, tell the patient plainly that I am not the authorized treating physician, and send them back to their Human Resource Department. If they’ve been denied care and are stuck, the referral is to the North Carolina Industrial Commission (https://www.ic.nc.gov/) or a workers’ comp attorney, not to a longer letter from me.

So if you notice someone on your schedule “workmen’s comp”, it’s best they be called beforehand and explain that for this particular issue, you are not the treating physician.