§ 97-90. Legal and medical fees to be approved by Commission; misdemeanor to receive fees unapproved by Commission, or to solicit employment in adjusting claims; agreement for fee or compensation. - North Carolina Statutes

§97‑90.  Legal and medical fees to be approved by Commission; misdemeanorto receive fees unapproved by Commission, or to solicit employment in adjustingclaims; agreement for fee or compensation.

(a)        Fees for attorneysand charges of health care providers for medical compensation under thisArticle shall be subject to the approval of the Commission; but no physician orhospital or other medical facilities shall be entitled to collect fees from anemployer or insurance carrier until he has made the reports required by theCommission in connection with the case. Except as provided in G.S. 97‑26(g),a request for a specific prior approval to charge shall be submitted to theCommission for each such fee or charge.

(b)        Any person (i) whoreceives any fee, other consideration, or any gratuity on account of servicesso rendered, unless such consideration or gratuity is approved by theCommission or the court, as provided in subsection (c), or (ii) who makes it abusiness to solicit employment for a lawyer or for himself in respect of anyclaim or award for compensation, shall be guilty of a Class 1 misdemeanor.

(c)        If an attorney hasan agreement for fee or compensation under this Article, he shall file a copyor memorandum thereof with the hearing officer or Commission prior to theconclusion of the hearing. If the agreement is not considered unreasonable, thehearing officer or Commission shall approve it at the time of renderingdecision. If the agreement is found to be unreasonable by the hearing officeror Commission, the reasons therefor shall be given and what is considered to bereasonable fee allowed. If within five days after receipt of notice of such feeallowance, the attorney shall file notice of appeal to the full Commission, thefull Commission shall hear the matter and determine whether or not theattorney's agreement as to a fee or the fee allowed is unreasonable. If thefull Commission is of the opinion that such agreement or fee allowance isunreasonable and so finds, then the attorney may, by filing written notice ofappeal within 10 days after receipt of such action by the full Commission,appeal to the senior resident judge of the superior court in the county inwhich the cause of action arose or in which the claimant resides; and upon suchappeal said judge shall consider the matter and determine in his discretion thereasonableness of said agreement or fix the fee and direct an order to theCommission following his determination therein. The Commission shall, within 20days after receipt of notice of appeal from its action concerning saidagreement or allowance, transmit its findings and reasons as to its actionconcerning such agreement or allowance to the judge of the superior courtdesignated in the notice of appeal. In all other cases where there is noagreement for fee or compensation, the attorney or claimant may, by filingwritten notice of appeal within five days after receipt of notice of action ofthe full Commission with respect to attorneys' fees, appeal to the seniorresident judge of the superior court of the district of the county in which thecause arose or in which the claimant resides; and upon such appeal said judgeshall consider the matter of such fee and determine in his discretion theattorneys' fees to be allowed in the cause. The Commission shall, within 20days after notice of appeal has been filed, transmit its findings and reasonsas to its action concerning such fee or compensation to the judge of thesuperior court designated in the notice of appeal; provided that the Commissionshall in no event have any jurisdiction over any attorneys' fees in any third‑partyaction. In any case in which an attorney appeals to the superior court on thequestion of attorneys' fees, the appealing attorney shall notify the Commissionand the employee of any and all proceedings before the superior court on theappeal, and either or both may appear and be represented at such proceedings.

The Commission, in determiningan allowance of attorneys' fees, shall examine the record to determine the servicesrendered. The factors which may be considered by the Commission in allowing areasonable fee include, but are not limited to, the time invested, the amountinvolved, the results achieved, whether the fee is fixed or contingent, thecustomary fee for similar services, the experience and skill level of theattorney, and the nature of the attorney's services.

In making the allowance ofattorneys' fees, the Commission shall, upon its own motion or that of aninterested party, set forth findings sufficient to support the amount approved.

The Commission may deny orreduce an attorney's fees upon proof of solicitation of employment in violationof the Rules of Professional Conduct of the North Carolina State Bar.

(d)        Provided, thatnothing contained in this section shall prevent the collection of suchreasonable fees of physicians and charges for hospitalization as may berecovered in an action, or embraced in settlement of a claim, against a third‑partytort‑feasor as described in G.S. 97‑10.2.

(e)        A health careprovider shall not pursue a private claim against an employee for all or partof the costs of medical treatment provided to the employee by the providerunless the employee's claim or the treatment is finally adjudicated not to becompensable or the employee fails to request a hearing after denial ofliability by the employer. Notwithstanding subsequent denial of liability oradjudication that the condition treated was not compensable, the insurer shallbe liable as provided in G.S. 97‑26 to providers whose services have beenauthorized by the insurer or employer. The statute of limitations applicable toa provider's claim for payment shall be tolled during the period thecompensability of a claim or liability for particular treatment remains an issuein a compensation case. (1929, c. 120, s. 64; 1955, c. 1026, s. 4; 1959, cc.1268, 1307; 1973, c. 520, s. 4; 1981, c. 521, s. 4; 1991, c. 703, s. 6; 1993,c. 539, s. 680; 1994, Ex. Sess., c. 24, s. 14(c); 1993 (Reg. Sess., 1994), c.679, s. 9.1.)