If you sustained a serious injury on the job in North Carolina, you may be eligible for more than basic medical treatment. In many cases, workers’ compensation may also cover the cost of in-home care provided by a trained professional or even a trusted family member. This support, called “attendant care,” can be vital during recovery.
Understanding your right to attendant care in workers’ comp cases can be key to receiving the assistance you need. At Mehta & McConnell, PLLC, we help injured workers across Charlotte and throughout North Carolina obtain every benefit they’re entitled to, starting with clear and reliable information.
Legal Basis for Attendant Care in Workers’ Comp Cases in North Carolina
The North Carolina Workers’ Compensation Act allows reimbursement for necessary medical and rehabilitative services, including attendant care, when a treating physician prescribes them as essential for recovery. To meet eligibility, the care must:
- Relate directly to the workplace injury,
- Be prescribed by a medical provider,
- Occur on a consistent and ongoing basis, and
- Be supported with detailed documentation.
Insurance companies often challenge these claims, especially those involving non-professional caregivers. That’s why working with a knowledgeable workers’ compensation attorney is often critical.
Who Can Provide Attendant Care Services?
Although a registered nurse or certified caregiver can perform these services, workers’ compensation caregiver benefits may extend to family members who meet specific standards. These caregivers must deliver care that reflects what a professional would provide.
Relatives such as spouses, parents, or adult children may qualify if:
- A physician prescribes the care;
- The caregiver tracks their services with logs or timesheets; and
- The tasks are medical or rehabilitative in nature, not casual help.
Regardless of who provides the assistance, the key factor is that the care must be both medically necessary and appropriately documented. Ensuring proper records and physician oversight is essential to gaining approval and reimbursement.
How Is Attendant Care Different from Standard Medical Care?
Standard care involves medical treatments, like surgeries or medication, while attendant care addresses basic living needs during recovery. Even though it may not be clinical, attendant care is no less essential to a person’s ability to heal safely and maintain dignity at home.
Additionally, standard treatments are often episodic and facility-based, whereas attendant care typically takes place at home and involves ongoing support. This distinction makes it especially valuable for individuals with long-term or mobility-limiting injuries.
Insurance providers sometimes dispute these claims, arguing that assistance with daily activities is not “medical.” However, with a clear physician order and proper legal advocacy, injured workers can secure these vital benefits.
Eligibility Requirements for Attendant Care Benefits
To receive attendant care under North Carolina workers’ compensation law, an injured worker must:
- Have a valid and accepted workers’ compensation claim,
- Obtain a written prescription from a treating physician specifying the care and its necessity,
- Provide proof that the care contributes to recovery or prevents harm, and
- Maintain detailed records of the services delivered.
Physician input plays a pivotal role. The doctor must clearly outline the care needed and explain why it is crucial to your health or safety.
Additionally, documentation should include:
- Dates and times when care was provided;
- Descriptions of tasks completed during each session; and
- Copies of logs, timesheets, or receipts, especially for reimbursement.
If a family member is offering the care, the services must reflect what a professional caregiver would do, not just routine help from a loved one.
Depending on your medical outlook, in-home attendant services may be temporary or long-term. If your health improves, the services necessary may be reduced. If complications arise, the amount of care may increase with medical approval.
Attendant Care Reimbursement: What You Need to Know
Disputes over attendant care reimbursement are common. Insurance companies may deny, delay, or undervalue a claim without proper documentation or legal support.
To strengthen your request for attendant care reimbursement:
- Maintain accurate logs of all care provided,
- Stay in regular contact with your doctor for updated medical documentation,
- Follow all procedural steps set by the insurer and the Industrial Commission, and
- Speak with a workers’ compensation attorney for guidance and representation.
Even unpaid caregiving by a family member may qualify for reimbursement if it meets the legal criteria. That effort deserves proper recognition.
How Mehta & McConnell Can Help with Attendant Care Claims
Navigating the North Carolina workers’ compensation process can be overwhelming, especially with less common benefits like attendant care. At Mehta & McConnell, we apply decades of combined experience, including years spent representing insurers, to fight for the injured workers we now serve. We know how insurance adjusters think. That insight allows us to help clients secure necessary support and reimbursement, even when insurers initially refuse. We are ready to assist if you need help getting a physician’s referral for attendant care, documenting care services, or appealing a denied claim. Contact Mehta & McConnell Injury Lawyers today to set up a free consultation. Let us help you access the care you need to recover with peace of mind.
Frequently Asked Questions
What Qualifies as Attendant Care Under Workers’ Comp?
Attendant care includes help with daily tasks that an injured person can no longer manage alone due to a work-related condition. These services differ from standard medical treatments and focus on maintaining the individual’s safety, hygiene, and comfort.
Examples of attendant care services include:
- Assistance with bathing, grooming, and dressing;
- Help with mobility and transfers (e.g., from bed to wheelchair);
- Medication reminders;
- Meal preparation and feeding;
- Transportation to medical appointments; and
- Supervision to prevent additional harm or medical issues.
Care may be provided by licensed professionals, trained aides, or family members.
How Many Hours of Attendant Care Can I Receive?
The number of hours approved for in-home attendant services depends on the severity of your condition and the physician’s recommendations. Depending on your needs, the care may involve a few hours weekly or round-the-clock support.
Common scenarios include:
- Short-term part-time assistance following surgery;
- Continuous care for severe conditions like spinal cord injuries; and
- Periodic supervision for individuals with cognitive or neurological impairments.
The North Carolina Industrial Commission reviews attendant care requests based on medical evidence and legal advocacy.
Does Workers’ Compensation Pay for a Family Member to Provide Care?
Yes, workers’ comp in North Carolina may pay a family caregiver if the care meets eligibility criteria and is properly documented. However, reimbursement is not guaranteed.
To receive workers’ compensation caregiver benefits and payment:
- The services must be medically necessary;
- The family member must provide skilled, consistent support beyond typical household help; and
- All duties and hours must be recorded and justified.
The reimbursement amount generally reflects the local market rate for similar services. Approval often depends on the quality of the documentation.
Mehta & McConnell Injury Lawyers
Mehta & McConnell, PLLC was founded in 2021 to represent individuals who are injured at work or due to the negligence of someone else. Both of our attorneys began their careers as defense attorneys representing large corporations and insurance companies, but we now only represent injured individuals.
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