Court of Appeals Rules Attendant Care Services Compensable Without Pre-approval

When workers are severely injured, they may required attendant care, i.e. assistance in the home such as help with household tasks and personal nursing. Workers' compensation can cover the costs of this care, if required, even if it is provided by a family member. In recent years, the Industrial Commission, pursuant to its Fee Schedule, has sometimes said that attendant care provided by family members is not compensable, though, if approval is not obtained beforehand. The North Carolina Court of Appeals hopefully put a stop to such rulings this week.

In Boylan v. Verizon Wireless, the plaintiff had fallen and injured her back at work. After back surgery, she continued to have difficulty maneuvering around her home and suffered frequent falls. She was unable to get into or out of a bathtub by herself, dress herself, prepare her own meals, clean, do yard work, run errands or drive herself to medical appointments. Her daughter moved in and provided live-in care and, later, plaintiff's sister also provided attendant care. After a hearing in 2008, the Commission ruled that plaintiff was disabled, and that defendants had to pay for past and future attendant care.

Defendants appealed, specifically arguing that the Commission's fee schedule required pre-approval for family-member attendant care. The Court rejected the argument and held that the Act (N.C.G.S. 97-90) does not require pre-approval of family-member medical care, and apparently found the Fee Schedule to have no bearing on the question. Therefore, the award for past attendant care services was upheld.

The Court also upheld the Commission's findings that attendant care was medically necessary and in the amount approved by the Commission. On cross-appeal, the Court held that it was the wrong forum for a challenge on plaintiff's attorney fees, and upheld the the Commission's findings that plainiff did not need a life care planner and was not permanently and totally disabled.