Mehaffey v. Burger King, 367 N.C. 120

Plaintiff injured left knee at work in 2007, developed reflex sympathetic dystrophy (RSD), required extensive assistance at home; plaintiff’s wife provided attendant care (increasing to ~16 hours/day after Aug 2008).
Medical providers recommended attendant care; Commission nurse consultant and physicians recommended substantial attendant-care hours; plaintiff sought compensation under N.C.G.S. §§ 97-2(19), 97-25.
Industrial Commission awarded retroactive and ongoing compensation to plaintiff’s wife for attendant care despite Section 14 of the Commission’s Medical Fee Schedule requiring preapproval for family-provided practical nursing services.
Court of Appeals reversed, relying on Hatchett v. Hitchcock Corp., which upheld the Fee Schedule preapproval requirement and denied retroactive payment absent prior Commission approval.
North Carolina Supreme Court granted review to decide whether the Commission exceeded statutory authority by treating its Fee Schedule as a bar to retroactive compensation; remanded for findings on whether plaintiff sought Commission approval within a reasonable time.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the Commission may bar retroactive compensation to family caregivers by requiring prior written authorization in its Medical Fee Schedule	Mehaffey: Commission lacks statutory authority to impose a preapproval prerequisite that prevents retroactive payment for family-provided attendant care	Employer/Burger King: Fee Schedule preapproval requirement valid and necessary to control costs; Hatchett controls	The Fee Schedule’s preapproval prerequisite exceeds the Commission’s statutory authority and cannot bar retroactive compensation (reversing Court of Appeals on that point)
Whether plaintiff must obtain Commission approval within a reasonable time to recover medical compensation for services rendered	Mehaffey: Wife’s services are compensable medical care under § 97-2(19) and § 97-25; retroactive recovery appropriate	Defendants: Plaintiff delayed unreasonably in seeking approval such that retroactive recovery can be denied	Court: Plaintiff must seek approval within a reasonable time; because Commission’s findings did not address reasonableness of delay, case remanded for the Commission to make findings on that issue

Hatchett v. Hitchcock Corp., 240 N.C. 591, 83 S.E.2d 539 (1954) (upheld Commission fee-schedule preapproval requirement and denied retroactive payment for family-provided nursing)
Charlotte-Mecklenburg Hosp. Auth. v. N.C. Indus. Comm’n, 336 N.C. 200, 443 S.E.2d 716 (1994) (discussing Act’s trade-off of swift compensation and limited employer liability)
Schofield v. Great Atl. & Pac. Tea Co., 299 N.C. 582, 264 S.E.2d 56 (1980) (requiring Commission approval within a reasonable time after selecting a medical provider for reimbursement)
Forrest v. Pitt Cnty. Bd. of Educ., 100 N.C. App. 119, 394 S.E.2d 659 (1990) (agency rules inconsistent with statute are without effect)
High Rock Lake Partners, LLC v. N.C. DOT, 366 N.C. 315, 735 S.E.2d 300 (2012) (agencies may act only as authorized by the legislature)