Short Answer

In North Carolina, you usually need documentation that ties each ongoing visit and prescription to the injury (causation) and shows the charges were actually paid or are still owed (amount). Keep itemized bills and pharmacy records, proof of payment or balances due, and medical records that show the diagnosis, symptoms, and treatment plan for the same injury over time. Also ask your treating provider for a short narrative that explains why continued visits and medications are medically necessary and related to the injury.

Understanding the Problem

If you are pursuing a North Carolina personal injury claim and you are still seeing a doctor monthly, what should you keep so you can show those ongoing visits and prescriptions are for the same injury—especially when your insurance changed and you are now paying more out of pocket?

Apply the Law

In a North Carolina injury claim, ongoing medical and medication expenses are part of damages only if you can connect them to the injury (not just to your general health) and show the amounts you paid or still owe. North Carolina law also draws a practical line between (1) proving the amount of the charges and that they were reasonably necessary, and (2) proving the charges were necessary because of the defendant’s conduct (causation). In settlement discussions, insurance adjusters and defense counsel typically look for the same proof you would need if the case later had to be proven in court.

For medical and pharmacy charges, North Carolina allows an injured person to testify about the amount paid or required to be paid in full satisfaction of those charges, as long as records of the charges accompany that testimony. The law can also create a rebuttable presumption about reasonableness of the satisfaction amount, and a permissive presumption that charged services were reasonably necessary—while still requiring separate proof that the treatment was necessary because of the injury at issue.

Key Requirements

• Clear link to the injury (causation): Records should show the same injury diagnosis/complaints and explain why the ongoing care and medications are for that injury rather than an unrelated condition.
• Itemized charges for each visit and prescription: Keep statements that identify the provider/pharmacy, date of service/fill, and what was provided (not just a lump-sum balance).
• Proof of what you paid or still owe: Save receipts, account ledgers, “patient responsibility” statements, and balance-due notices showing the amount paid or required to be paid in full satisfaction.
• Medical necessity support: Notes should reflect ongoing symptoms, objective findings when available, and a treatment plan that explains why continued visits/medications are appropriate.
• Consistency over time: Documentation should show continuity (same body part/complaints, same course of treatment) and explain changes (new medication, increased frequency, referrals).
• Insurance and coverage change records: Keep EOBs/denial letters and plan change notices to show why your out-of-pocket share increased (this does not prove causation, but it explains the billing shift).

What the Statutes Say

• N.C. Gen. Stat. § 8-58.1 (Medical and pharmaceutical charges; injured party testimony) - Allows an injured person to testify to amounts paid or required to be paid (with records), creates a rebuttable presumption about reasonableness of the satisfaction amount, and notes that necessity and causation are separate issues.
• N.C. Gen. Stat. § 8-44.1 (Hospital medical records) - Addresses how hospital medical records may be received as evidence if otherwise admissible, including through proper tender/certification procedures.

Analysis

Apply the Rule to the Facts: Because settlement discussions are underway and your back condition is worsening, the key is to create a clean paper trail that (1) shows each monthly visit and each medication is for the same injury-related back condition, and (2) shows what you actually paid or are obligated to pay now that insurance coverage changed. Your documentation should make it easy to match each date of service to a medical record entry (why it was needed) and to a bill/pharmacy record (what it cost and what you paid/owe). If the records only show “back pain” without tying it to the injury event, that is where a short treating-provider narrative can help connect the dots.

Process & Timing

1. Who gathers: You and your attorney. Where: From each treating provider’s medical records department and each pharmacy (and your insurer’s member portal for EOBs). What: Itemized statements, account ledgers, pharmacy printouts, EOBs/denials, and the relevant office visit notes for each month. When: Start now and update monthly; don’t wait until the week before a demand package or mediation.
2. Build a monthly “one-page packet”: For each month, keep (a) the visit note or after-visit summary showing the injury-related diagnosis/complaints and plan, (b) the bill showing the date of service and charges, and (c) proof of payment or balance due. Do the same for each prescription fill (pharmacy record + receipt + any prior authorization/denial paperwork).
3. Request a treating-provider narrative if needed: If the connection is likely to be challenged (for example, preexisting back issues or a gap in treatment), ask your attorney to request a short narrative/report that explains ongoing causation and medical necessity and addresses why the current treatment is tied to the injury.

Exceptions & Pitfalls

• “Reasonable/necessary” is not the same as “caused by the injury”: Even if a charge looks medically appropriate, the other side may still argue it is for a degenerative condition or a new problem. Make sure the records (or a narrative) address why the injury is the reason for the ongoing care.
• Gaps in treatment: Long breaks between visits can invite arguments that the condition resolved or that something else caused the flare-up. If there was a gap, document why (insurance change, inability to get appointments, etc.) and make sure the provider notes reflect the history accurately.
• Unitemized balances: A single “amount due” statement without dates and services is weaker. Ask for itemized statements and an account ledger that shows payments, adjustments, and remaining balances.
• Pharmacy documentation problems: Save the pharmacy printout showing the medication name, dosage, quantity, prescriber, and fill date. If you switch pharmacies, get a complete fill history from both.
• Mixing unrelated care: If a visit covers multiple issues, ask for records that clearly show what portion of the visit and prescriptions relate to the injury.
• Out-of-pocket increases without context: An insurance change explains why you pay more, but it does not prove the treatment is injury-related. Pair EOBs/denials with medical notes tying the treatment to the injury.

Conclusion

To prove ongoing monthly doctor visits and medication expenses are related to your injury in North Carolina, keep records that show both causation and the amounts paid or still owed: injury-focused medical notes (diagnosis, symptoms, treatment plan), itemized bills and pharmacy records by date, and proof of payment or balances due. If the link could be disputed, the most practical next step is to have your attorney request a short treating-provider narrative tying the ongoing care to the injury.

Talk to a Personal Injury Attorney

If you're dealing with ongoing treatment and rising out-of-pocket medical and prescription costs while an injury claim is being negotiated, an attorney can help you identify the right records to collect, spot causation issues early, and present your expenses in a clear, settlement-ready format. Reach out today. Call [CONTACT NUMBER].

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.