What Is A Form 28C In A North Carolina Workers’ Compensation Case?

Form 28C in regards to workers’ compensation is entitled “Report of Employer or Carrier/Administrator of Compensation and Medical Compensation Paid Pursuant To a Compromise Settlement Agreement”.  Try saying that three times fast!  A Form 28C is filed after the case has been settled between the client and the employer / insurance company and addresses the issue of when the settlement check(s) will be issued.

Under N.C. Gen. Stat. § 97-18(e), the employer/administrator has 10 days to provide compensation to the plaintiff, although under N.C. Gen. Stat. §97-18(g), an additional 14 days can be granted.  Finally, once the check has been issued/mailed to the claimant, Form 28C is filed with the Industrial Commission that clearly states the date when the settlement check was issued and the total amount.  This is to protect the carrier or administrator from a future lawsuit if the claimant attempts to say they didn’t issue their settlement proceeds within the 24 days.  Again, it’s important to remember that this form is filed with the Industrial Commission after the compromise has been reached by both parties.