Does Payment of Attendant Care Require a Prescription?

In Thompson v. Int’l Paper Co., the N.C. Court of Appeals addressed whether attendant care prescriptions needed to be provided in writing.

In Thompson, the plaintiff suffered severe burns as a result of his work accident.  He underwent three major skin graft surgeries at the Burn Center.  His wife took leave from her job as a social worker and stayed with him at the Burn Center to assist with his care.  Plaintiff was discharged from the Burn Center on April 2, 2012.  Plaintiff’s wife continued to assist him when he came home.  Defendants did not pay for any of the care and services she provided to her husband during his recovery.  The parties eventually litigated the attendant care issues in this matter.  Initially, Deputy Commissioner Robert Harris found that the attendant care provided by plaintiff’s wife was reasonable and necessary, and he awarded these benefits.  However, the Full Commission found that Plaintiff did not require attendant services after 12/31/12 and denied attendant care reimbursement after that date.  On appeal, Defendants agreed with the Full Commission’s decision and argued that it was not proper to award attendant care after 12/31/12 because a written prescription is required in order to receive compensation for attendant care services, and Plaintiff did not have a written prescription beyond 12/31/12.

In 2011, N.C. Gen. Stat. §97-2(19) was amended to include more detailed language addressing when attendant care becomes compensable.  N.C. Gen. Stat. §97-2(19) defines medical compensation as services, including attendant care services, “…prescribed by a health care provider authorized by the employer or subsequently by the Commission…”  The Court of Appeals closely examined this statutory provision and determined the statute did not require that a written prescription be issued by a medical provider in order for attendant services to be payable by the employer.  The court reasoned the statute simply requires that attendant care services be “prescribed” by the treating physician.

Practice Point:

You don’t need a written prescription for attendant care to be approved.  You just need the treating physician to prescribe this care.  When there is a potential for attendant care issues, you will want to pay close attention to the medical records to make sure you are aware of the attendant care issues as they arise.  Also, these types of cases often benefit from having a Nurse Case Manager on board to help make sure the attendant care issues are being addressed from the start and continue to be appropriately addressed throughout the claim.