Whether to file a Form 24 Application is a decision based on the specific facts of each case.  Once the decision is made to file a Form 24 Application, it is vital to properly prepare the Form 24 Application to ensure the best chance of success – which is securing Industrial Commission approval to terminate or suspend TTD benefits.  This blog post will address strategy for properly – and completely – preparing the Form 24 Application.

My two earlier posts in this series address 1) When it is appropriate to terminate TTD benefits without obtaining Industrial Commission approval; and 2) When filing a Form 24 application is appropriate.)

Successfully Preparing a Form 24 Application

  1. Use the latest version of the Form 24 Application – Available here on the North Carolina Industrial Commission website.
  2. Fill out the Form 24 Application COMPLETELY:

(a)  Fill out the entire top section, including Industrial Commission number and carrier code;

(b)  Fill in the correct date by which the injured employee must respond: 17 days from the date defendants file the Form 24 Application;

(c)  Fill out the entire Section A on the Form 24 Application;

(d)  Specify the grounds for the filing;

(e)  At the top of Page 2, enter the employee’s correct address – defendants serve the injured employee directly, with a copy to his/her attorney;

(f)  Enter the correct number of pages of all supporting documentation; and

(g)  Sign and date – provide defendants’ telephone number, including extension, so that defendants may be reached for the telephonic hearing.

  1.  Be sure to be specific.

(a)  Identify WHY defendants are moving to terminate or suspend TTD benefits;

(b)  Include the supporting documentation, e.g., medical records, work notes, job description, physician approval of the job, and job offer letter;

(c)  Identify whether defendants are moving to terminate OR suspend compensation; for example, a full duty work release would be a termination and an unjustified refusal to return to suitable employment would be a suspension; and

(d)  Provide as much information and support as possible to show the Industrial Commission that stopping TTD benefits is appropriate right now.

Pursuant to N.C. Gen. Stat. § 97-18.1 and Rule 404 of the Workers’ Compensation Rules of the North Carolina Industrial Commission, an injured employee has 17 days in which to respond to defendants’ Form 24 Application.

If the injured employee does not timely object, the Industrial Commission shall review the Form 24 Application and may make a decision without an informal telephonic hearing.

If the injured employee timely objects to defendants’ Form 24 Application, the Industrial Commission will set the case for a telephonic hearing before a Special Deputy Commissioner within 25 days of receipt of defendants’ Form 24 Application.  The Special Deputy Commissioner shall make a decision on the Form 24 Application within 5 days after completion of the informal hearing.

An employer’s chances of prevailing on a Form 24 Application depend on the specific facts of each case.  If you have claim-specific questions, please contact me directly at (919) 863-8846 or jjones@cshlaw.com.