Short Answer

In North Carolina, you don’t need the adjuster’s permission to get medical lien paperwork. Your attorney can request itemized bills and lien statements directly from medical providers under state lien laws, and can separately request a workers’ compensation lien statement from the carrier. If an adjuster is unresponsive, escalate in writing, contact providers directly with a HIPAA release, and use formal tools (like subpoenas in a filed case) if needed.

Understanding the Problem

In North Carolina, how do I get the medical lien paperwork so my personal injury/workers’ compensation matter can resolve when the workers’ compensation adjuster hasn’t replied? Your attorney now has the claim number and the adjuster’s contact, but you still need lien documentation to move forward.

Apply the Law

North Carolina recognizes two common lien categories in these situations: (1) medical provider liens on injury recoveries and (2) a workers’ compensation carrier’s statutory lien if there is a third‑party recovery. Medical providers obtain lien rights by giving notice and, when asked, supplying an itemized statement of charges. The attorney must address valid liens before distributing settlement funds. In a third‑party case with workers’ compensation benefits paid, the carrier has a lien and will issue a lien statement showing indemnity and medical payments; a court can allocate or adjust that lien in the right circumstances. Government payers like Medicare and Medicaid have separate repayment rights that must also be resolved, often on their own timelines.

Key Requirements

• Provider itemization on request: Medical providers must furnish an itemized bill upon request for their lien to be enforceable.
• Attorney fee priority and pro rata sharing: After attorney fees, valid provider liens share pro rata from remaining funds, subject to statutory limits.
• No recording needed: Medical liens are statutory; no county filing or recording is required to be effective.
• Workers’ compensation lien letter: The comp carrier may assert a lien on a third‑party recovery and should provide an itemized payment ledger upon written request.
• Government payers: Medicare and Medicaid must be repaid under their own statutes; request their statements directly.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical provider lien) - Creates liens for medical services related to the injury and requires itemized bills on request.
• North Carolina Gen. Stat. § 44-50 (Enforcement and disbursement) - Addresses payment order, attorney fee priority, and pro rata sharing among lienholders.
• North Carolina Gen. Stat. § 97-10.2 (Workers’ compensation lien in third‑party cases) - Gives the carrier a lien on third‑party recoveries and allows court allocation.
• North Carolina Gen. Stat. § 108A-57 (Medicaid reimbursement) - Governs state Medicaid repayment from liability recoveries.

Analysis

Apply the Rule to the Facts: Because the adjuster hasn’t replied, your attorney should not wait on the insurer to produce medical lien paperwork. Under North Carolina law, the firm can send HIPAA-compliant requests directly to each provider for an itemized bill and lien statement; providers must supply itemization to preserve their lien. For the workers’ compensation lien, the attorney can send a written demand to the comp carrier for an updated ledger of indemnity and medical payments and escalate to a supervisor if needed.

Process & Timing

1. Who files: Your attorney. Where: Requests go to each medical provider’s records/billing office and to the workers’ compensation carrier. What: A written request with a HIPAA release, asking for an itemized statement and lien amount (for providers) and a payment ledger (for the comp carrier). When: Send now; request a written response within 10–14 business days.
2. Follow up if no response: Re‑send by certified mail or secure portal, copy the adjuster’s supervisor, and keep a contact log. If a lawsuit is filed, issue a subpoena duces tecum for records. Timeframes vary by provider; expect 2–4 weeks in many cases.
3. Finalize: Verify all lien amounts (including Medicare/Medicaid if applicable), confirm any reductions, and disburse settlement funds consistent with statute. If the workers’ compensation carrier and your attorney cannot agree on the lien in a third‑party case, ask Superior Court to determine allocation.

Exceptions & Pitfalls

• Don’t rely solely on the adjuster: Provider liens do not depend on insurer cooperation; contact providers directly with a HIPAA release.
• Government payers: Medicare and Medicaid have separate repayment processes; request their statements early to avoid delays.
• Missing itemization: If a provider refuses to itemize, note that its lien isn’t enforceable until itemization is furnished; keep written proof of your requests.
• Workers’ comp lien disputes: If the carrier won’t provide a ledger or you disagree on amount, the court can allocate the lien in a third‑party case.
• Notice and documentation: Use certified mail or secure portals, track deadlines, and keep a complete paper trail for disbursement and any court review.

Talk to a Personal Injury Attorney

If you're dealing with stalled lien paperwork and an unresponsive adjuster, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at [919-341-7055].

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.