Note: The following constitutes the proposed
changes in this Rule. Added language appears in bold italic script, and
proposed deletions are indicated by strikeout. The changes will not go
into effect until further notice by the Industrial Commission.
Rule 404
Termination of Compensation
(1) Payments of compensation undertaken pursuant to an award of the
Industrial Commission shall continue until the terms of the award have been fully
satisfied. provided, however, that In
cases where the award is to pay compensation during disability, there is a rebuttable
presumption that disability continues until the employee returns to work. No application
to terminate or suspend compensation shall be approved without a formal hearing if the
effect of such approval is to set aside the provisions of an award of the Industrial
Commission.
(2) When an employer or carrier/administrator seeks to terminate or
suspend compensation being paid pursuant to N.C. Gen. Stat. § 97-29 for a reason other
than those specified in N.C. Gen. Stat. § 97-18(d), payment without prejudice, or N.C.
Gen. Stat. § 97-18.1(b), trial return to work, the employer or carrier/administrator
shall notify the employee and the employee’s attorney of record, if any, on Form 24
rev., "Application to Stop Payment of Compensation." The employer or
carrier/administrator shall complete the blank space in the "Important Notice to
Employee" portion of Form 24 rev. by inserting a date seventeen
17 days from the date the employer or carrier/administrator deposits the completed Form 24
rev. in the mail to the employee and the employee’s attorney of record, if
any. The original of the Form 24 rev. and the attached documents shall be
sent to the Industrial Commission at the same time a copy of the Form 24 rev.
and attached documents are sent to the employee and the employee’s attorney of
record, if any. The Form 24 rev. shall specify the number of pages of
documents attached which are to be considered by the Industrial Commission. Failure to
specify the number of pages may result in the refusal of the Industrial Commission to
accept the same for filing. If the employee or the employee’s attorney of record, if
any, objects by the date inserted on the employer’s Form 24 rev., or
within such additional reasonable time as the Industrial Commission may allow, the
Industrial Commission shall set the case for an informal hearing, unless waived by
the parties in favor of a formal hearing. A copy of any objection shall be sent,
with any supporting documents, to the employer and carrier/administrator. The term
"carrier/administrator" also includes any successor in interest.
(3) If an employee does not object within the allowed time, the
Industrial Commission shall review the Form 24 rev. and any attached
documentation, and an Administrative Decision and Order may be rendered without an
informal hearing as to whether compensation shall be terminated or suspended, except as
provided in paragraph (6) below. Either party may seek administrative
review of the Administrative Decision and Order as provided by Rule 703. A Deputy
Commission shall conduct a hearing which shall be a hearing de novo. The employer has the
burden of producing evidence on the issue of the employer’s application for
termination or suspension of compensation. The hearing may be scheduled by the Commission
on a peremptory basis.
(4) If the employee timely objects to the Form 24 rev.,
the Industrial Commission shall conduct an informal hearing within twenty-five
25 days of the receipt by the Industrial Commission of the Form 24 rev.,
unless the time is extended for good cause shown. The informal hearing may be by telephone
conference between the Industrial Commission and the parties or their attorneys of record,
if any. When good cause is shown, the informal hearing may be conducted with the parties
or their attorneys of record, if any, personally present with the Industrial Commission in
Raleigh or such other location as is selected by the Industrial Commission. The Industrial
Commission shall make arrangements for the informal hearing with a view towards conducting
the hearing in the most expeditious manner under the circumstances. Except for good cause
shown, the informal hearing shall be no more than thirty 30 minutes, with
each side given ten 10 minutes to present its case and five (5)
minutes for rebuttal. Notwithstanding the above, the employer or carrier/administrator may
waive the right to an informal hearing, and proceed to a formal hearing by filing a
request for hearing on a Form 33.
(5) A decision to terminate, suspend, or continue compensation shall be
made within five days after the completion of the informal hearing. except as
provided in paragraph (6) below. Either party may appeal the Administrative Decision and
Order of the Industrial Commission as provided by Rule 703. Such hearing
shall be peremptorily set and shall not require a Form 33.
(6) In the event the Industrial Commission is unable to reach a decision
after an informal hearing, the Industrial Commission shall issue an order to that
effect which shall be in lieu of a Form 33 and place the case shall
be placed on the formal hearing docket. If additional issues are to be
addressed, and the employer or carrier/administrator shall be
required within thirty 30 days of the date of the Administrative Decision
and Order to file a Form 33 if additional issues are to be addressed, or
to notify the Industrial Commission that a formal hearing is not currently necessary. The
effect of placing the case on the docket shall be the same as if the Form 24 rev.
were denied, and compensation shall continue until such time as the case is decided by a
Commissioner or a Deputy Commissioner following a formal hearing.
(7) Any Administrative Decision and Order shall be mailed to the non-prevailing party by certified mail.
(8) No order issued as a result of an informal Form 24 hearing shall terminate or suspend compensation retroactively to a date preceding the filing date of the filing of the Form 24. Retroactive termination or suspension of compensation to a date preceding the filing of a Form 24 may be ordered as a result of a formal hearing. Additionally, nothing shall impair an employer’s right to seek a credit pursuant to N.C. Gen. Stat. § 97-42.
(9) The Amendments to this Rule are effective March
15, 1995.
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