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Beverly
Eaves Perdue, Governor
Karen B. Smith, BSN, RN, COHN-S |
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Bernadine S. Ballance,
Commissioner Laura K. Mavretic, Commissioner Danny L. McDonald, Commissioner Staci Meyer, Commissioner Christopher Scott, Commissioner Dianne C. Sellers, Commissioner |
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The North Carolina Industrial Commission Medical Rehabilitation Nurses Section employs six registered nurses who are responsible for different geographic segments of the state. They have a vast amount of knowledge in the field of rehabilitation medical management for individuals who have received traumatic injuries as well as facilities or individuals available to provide assistance in the recovery process following injuries. The goal is to assist in recovery through coordination and utilization of professionals, specialized facilities, and community resources in a manner that will help the injured worker advance from disability to ability in a steady, progressive process.
The NCIC Nurses Section services are available to anyone who expresses concern for the care they feel injured workers in North Carolina are or are not receiving. Referrals are received from within the Industrial Commission, physicians, insurance representatives, attorneys, patients themselves or anyone else interested in the treatment for injured workers. The service is sponsored by the State of North Carolina and free to those seeking assistance.
Referral forms are available below. They also may be obtained from the NCIC Website: http://www.ic.nc.gov/ncic/pages/rehab.htm#forms or from the Medical Rehabilitation Nurses Section by telephone at (919) 807-2616, fax at (919) 807-2699, e-mail, or regular mail to the N.C. Industrial Commission, Medical Rehabilitation Nurses Section, 4341 Mail Service Center, Raleigh, NC 27699-4341.
Click here to view the Workers’ Compensation Registry of Rehabilitation Professionals. For details, see former Medical Rehabilitation Nurses Section Director Margaret Dunn’s May 25, 2004 memorandum. (NOTE: This registry will be updated weekly—no later than 5:00 P.M. Friday—with each Friday’s update including all changes received no later than 2:00 P.M. Thursday.)
You may print and fill out the following PDF (Portable Document Format) versions of Industrial Commission forms, and submit them to the commission in lieu of the NCIC’s preprinted forms. To view or print these PDF files, you must download and install a copy of the Adobe® Acrobat® Reader. Click the button below to obtain your FREE copy of Adobe® Acrobat® Reader. (NOTE: Please pay close attention to this software’s installation instructions and licensing agreement.)
Get
your free Adobe® Acrobat® Reader now!
The pertinent forms include:
Form 25C—Authorization for Rehabilitation Professional to Obtain Medical Records of Current Treatment (revised 1/04). Note 1: Please fill out this form completely; sign it; and mail it to the rehabilitation professional named on the form. Note 2: There is also a Spanish version of the Form 25C:
NOTE: A Microsoft® Word Form 25C Document File with Form Fields is now available.
Forma 25C—Permiso al Especialista de Rehabilitación Médica para Obtener Reportes Corrientes del Tratamiento Médico (revisada 6/04). Resumen De Las Reglas Que Rigen El Uso De Los Profesionales De Rehabilitación En Los Casos De Compensación Laboral Para Los Trabajadores Lesionados (revisada 1/09).
Form 25N—Notice
to the Commission of Assignment of Rehabilitation Professional (revised
8/04). Note 1: A Microsoft® Word
Form
25N Document Template is now available. Note 2: Please fill out this
form completely, making sure to include the I.C. Number for
the claim. Please fax the completed and signed Form 25N to (919) 807-2699,
ATTN: Gina Bunn; mail it Medical Rehabilitation Nurses Section,
N.C. Industrial Commission, 4341 Mail Service Center, Raleigh, NC
27699-4341, ATTN: Gina Bunn or convert the Form 25N to a Microsoft Word
or PDF (Portable Document Format) e-mail attachment and e-mail it to
25n@ic.nc.gov.
Medical Rehabilitation Nurses Section Referral Form (revised 1/09). Note 1: A Microsoft® Word Medical Rehabilitation Nurses Section Referral Form Document Template is now available. Note 2: Please fax this completed and signed form to (919) 807-2699, ATTN: Gina Bunn; or mail it to Medical Rehabilitation Nurses Section, N.C. Industrial Commission, 4341 Mail Service Center, Raleigh, NC 27699-4341, ATTN: Gina Bunn.
The N.C. Industrial Commission Rehabilitation Advisory Board functions as a resource for the Industrial Commission, the Rehabilitation Professionals, the medical community, and the parties working for the benefit of the injured workers in North Carolina. For a list of the board’s members, click here (PDF file).
To view or print the N.C. Industrial Commission Rules for Utilization of Rehabilitation Professionals in Workers’ Compensation Claims, click here. Click here to view or print a summary of these rules (revised January 12, 2009). Click here for a Microsoft Word file of the two-page pamphlet version of this summary, suitable for printing, or here for a PDF file of this brochure. There is also a summary of these rules in Spanish: Resumen De Las Reglas Que Rigen El Uso De Los Profesionales De Rehabilitación En Los Casos De Compensación Laboral Para Los Trabajadores Lesionados.
See also Clarification of Role of “Task Assignments” for Rehabilitation Professionals in the Workers’ Compensation System (PDF file of February 22, 2008 N.C. Industrial Commission minutes).
| Staff List | ||
|
Director Karen B. Smith, BSN, RN, COHN-S |
(919) 807-2617 |
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Cindy C. Boyd, RN, BSN, CRRN, CCM, CBIS |
Cindy.Boyd@ic.nc.gov | (919) 807-2617 |
|
Gloria Bullock, RN, CCM |
Gloria.Bullock@ic.nc.gov | (919) 807-2616 |
Judith Clouse, RN, MSN, CCM |
(919) 807-2616 |
|
Emily McKinney, RN, BA, CCM |
(919) 807-2617 |
|
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Linda Vaughan, RN, COHN |
(919) 807-2616 |
|
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Gina Bunn |
Gina.Bunn@ic.nc.gov | (919) 807-2617 |
|
Judy A. Fisher |
Judy.Fisher@ic.nc.gov | (919) 807-2616 |
This list of conferences was last updated on 5 October 2009.
The N.C. Industrial Commission will hold its
14th
Annual North Carolina Workers’ Compensation Educational Conference on
October 7-9, 2009, at the
Raleigh Convention Center in Raleigh, NC. Click here to view a
PDF file of the
2009 conference brochure and here to fill in the interactive PDF files
of the
Conference Registration Form and the
Exhibitor/Sponsorship
Registration Form. Click here to view the
2008 program. For
more information, please telephone Jeanne Bush at the International Workers’
Compensation Foundation office at (386) 677-0041; fax (386)
677-0155; e-mail
iwcf@bellsouth.net; or write the International Workers’ Compensation
Foundation, 570 Memorial Circle, Suite 320, Ormond Beach, FL 32174.
The N.C. Industrial Commission will hold its 80th Annual N.C. Statewide Safety Conference on May 11-14, 2010, at the Joseph S. Koury Convention Center in Greensboro, NC. Click here to view the 2009 N.C. Statewide Safety Conference Program. For additional information, telephone the Industrial Commission Safety Education Section at (919) 807-2603 or e-mail safety@ic.nc.gov.
E-mail Karen B. Smith at Karen.Smith@ic.nc.gov.
This list of links to related web sites was last updated on 8 January 2008.
American Board of Occupational Health Nurses
(ABOHN)—http://www.abohn.org/
Code of Ethics: Could not find on web site or is available to members
only.
American Nurses Association
(ANA)—http://www.nursingworld.org/
Code of Ethics:
http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/EthicsStandards/CodeofEthics.aspx
Association of Rehabilitation Nurses
(ARN)—http://www.rehabnurse.org/
Code of Ethics:
http://www.rehabnurse.org/profresources/pethical.html
Case Management Society of America
(CMSA)http://www.cmsa.org/
Ethics
Statement on Case Management Practice: Could not find on
web site or is available to members only.
Certification of Disability Management
Specialists Commission
(CDMSC)http://www.cdms.org/
Code of Professional
Conduct:
http://www.cdms.org/pages/50ethics.html
Commission for Case Manager Certification
(CCM)http://www.ccmcertification.org/
Philosophy of Case Management :
http://www.ccmcertification.org/pages/13frame_set.html
Commission on Certification of Work
Adjustment and Vocational Evaluation Specialists (CCWAVES)—http://www.ccwaves.org/
Code of Ethics:
http://www.ccwaves.org/aboutus/ethics.html
Commission on Health Care Certification
(CHCC)http://www.cdec1.com/
Code of Ethics:
http://www.chcc1.com/ConstructionEthicsIndex.htm
Commission on Rehabilitation Counselor Certification
(CRC)http://www.crccertification.com/
Code of Professional Ethics:
http://www.crccertification.com/pages/30code.html
International Association of Rehabilitation Professionals
(IARP)http://www.rehabpro.org/iarpindex.html
Codes, Competencies, and Standards:
http://www.rehabpro.org/about-iarp/standards-and-ethics
International Association of Rehabilitation Professionals-Carolinas—http://www.iarp-carolinas.com/Main
Flash Site/index.html
Codes, Competencies, and Standards:
http://www.rehabpro.org/about-iarp/standards-and-ethics
North Carolina Board of Nursinghttp://www.ncbon.com/
Code of Ethics:
http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/EthicsStandards/CodeofEthics.aspx
North Carolina Industrial Commission (NCIC)http://www.ic.nc.gov/
Online Continuing Ed Chronicle™http://www.rncasemanager.com/email_02-2004.html
Orthopaedic Nurses Certification Board
(ONCB)—http://www.oncb.org/
Code of Ethics: Could not find on web site or is available to members
only.
Rehabilitation Professionals of the Carolinas
(RPC)http://www.rpcarolinas.com/
Code of Ethics: Could not find on web site or is available to members
only.
South Carolina Board
of Nursinghttp://www.llr.state.sc.us/POL/Nursing/
Code of Ethics:
http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/EthicsStandards/CodeofEthics.aspx
South Carolina Workers’ Compensation Commission (SCWCC)http://www.wcc.state.sc.us/