What We Do

The Mediation Section educates the Commission’s stakeholders concerning mediation rules and procedures, orders and enforces the mediation deadlines set forth in the Commission’s mediation rules, processes Industrial Commission mediation forms, and sends invoices for Report of Mediator fees. The Mediation Section’s Dispute Resolution Coordinator rules on all mediation-related motions.

Mediation Forms

• MSC1 Consent Order for Mediated Settlement Conference
• MSC2 Petition for Order Referring Case to Mediated Settlement Conference
• MSC3 Order for Mediated Settlement Conference
• MSC4 Designation of Mediator
• MSC5 Report of Mediator
• MSC6 Mediator's Declaration of Interest and Qualifications
• MSC7 Report of Evaluator
• MSC8 Mediated Settlement Agreement
• MSC8 Mediated Settlement Agreement (Spanish)
• MSC9 Mediated Settlement Agreement - Alternative Form
• MSC9 Mediated Settlement Agreement - Alternative Form (Spanish)

If you have questions about these forms, please email mediation@ic.nc.gov.

Mediator Databases

The Industrial Commission keeps a database of certified mediators who have given their contact information to the Industrial Commission.  Some of the mediators in the database are on the Industrial Commission’s “appointed list,” meaning that they can be appointed by the Industrial Commission’s Dispute Resolution Coordinator to mediate a case if the parties fail to choose a mediator by the deadline.  The mediators who are on the appointed list have a checkmark next to their name. The NCIC Mediator Database is available on the NCIC Online Services Center under 'Public Databases'.

DRC Mediator Database

The North Carolina Dispute Resolution Commission also provides a database of certified mediators. If you cannot find a mediator on the Industrial Commission's mediator database, you are encouraged to check the Dispute Resolution Commission's database.

Report of Mediator Fee Payment Due No Later Than 30 Days from Date of Invoice

Pursuant to Rule 11 NCAC 23E .0203(a)(2), an employer or their insurance carrier is required to pay the $200 Report of Mediator fee in full upon receipt of an invoice from the Industrial Commission. Ensuring timely payment of Report of Mediator fees is an important element of the mediation process and is essential to the Commission’s ability to fund its operations.

To provide clarity on the payment due date while giving employers and carriers adequate time to pay the invoiced fee, the Industrial Commission now allows employers and carriers 30 days from the invoice date within which to pay the invoice and avoid a statutory late payment penalty and interest. (Previously, the Commission had set the payment due date as 7 days from the deadline for completing mediation or 7 days from the date mediation was completed, whichever was earlier. However, the Commission has determined that pairing the payment due date with a future event that could be rescheduled is not optimal for the Commission or its stakeholders).

As a reminder, the Industrial Commission emails Report of Mediator fee invoices at the time the mediator is appointed. The Report of Mediator invoice is sent to defense counsel by email shortly after the Appointment of Mediator Order is emailed. Upon receipt of the Report of Mediator invoice, the $200 fee can be paid online via credit card (MasterCard or Visa) or e-Check. A link for online payment is provided in the email. The $200 fee also may be paid by paper check mailed to the Commission, but parties are strongly encouraged to pay online via credit card or e-Check.

Report of Mediator Form Filing Requirements

In all Industrial Commission cases either: (1) ordered into mediation; or (2) made subject to the mediation program by the parties choosing to mediate voluntarily, the designated mediator is required to file a Form MSC5 Report of Mediator.

The Form MSC5 Report of Mediator must be filed not only when reporting that a mediated settlement conference was held and completed, but also to report that a mediated settlement conference was not held or was held but not completed by the mediation deadline.

A mediator is required to file the Form MSC5 Report of Mediator within seven (7) days of the expiration of the deadline to mediate the case, or within seven (7) days of completion of the mediation conference if that date is earlier.

Promptly filing the Form MSC5 Report of Mediator is crucial so that the Industrial Commission can properly docket matters, timely invoice fees that are essential to funding its operations, and accurately obtain statistical data for the evaluation of its mediation program.

Motions to Dispense with Mediation for Certain Expedited Hearing Requests

Extensions of Time to Complete Mediation: Filing Tips

The Industrial Commission’s electronic filing portal includes three document types related to requests for an extension of time to complete mediation. Depending on the document type, a proposed order may not be needed:

• Stipulated Extension of Time to Mediate: If all parties agree to an extension of time to mediate, any named party may use this document type. A proposed order is not required.
• Notice of Scheduled Mediation: If all parties agree to an extension of time to mediate, the mediator may use this document type. A proposed order is not required.
• Motion for Extension of Time to Mediate: If a party does not agree to an extension of time to mediate, or if a party’s position is unknown, any named party may file this document type. Because this filing is a motion, a proposed order is required.

Mediation Section Contacts