MARTHA FALLS CLARK, Employee, Plaintiff; v. THE SANGER CLINIC,
P.A., Employer; ITT HARTFORD INSURANCE CO., Carrier; Defendants
No. COA00-153
TIMMONS-GOODSON, Judge.
Martha Falls Clark (plaintiff) appeals from an opinion and award of the North Carolina
Industrial Commission ordering plaintiff's former employer, the Sanger Clinic (defendant-
employer), and its insurance carrier, ITT Hartford Insurance Company, (collectively,
defendants) to pay plaintiff permanent total disability compensation at the rate of $442.00 per
week continuing for the remainder of her life. Plaintiff's position is that her rate of
compensation should increase annually with the maximum benefit calculated in accordance with
section 97-29 of the North Carolina General Statutes. For the reasons that follow, we conclude
that the rate and duration of the compensation as awarded by the Commission comports with the
provisions of section 97-29. The facts relevant to the issues raised on appeal are
summarized as follows: Plaintiff, a registered nurse, began working for defendant-employer in
1977 as the Director of the Pacemaker Clinic, a position usually held by a physician. In her
capacity as director, plaintiff assumed responsibility for thousands of pacemaker and fibrillator
patients. Her duties included tending to the patients' wounds, monitoring their medication, and
programming their devices. Plaintiff typically worked fourteen to eighteen hours per day, and
she was on-call seven days per week, twenty-four hours per day. At the time of her injury,
plaintiff earned an average weekly wage that entitled her to the maximum compensation rate for
the year 1993. Plaintiff was forty-eight years old when her claim for disability benefits was
heard.
Plaintiff was injured on 16 April 1993 while pushing a cart transporting 600 to 800
pounds of equipment into an elevator. The wheel of the cart became wedged in the threshold of
the elevator, and in her attempt to dislodge the wheel, plaintiff suffered an admittedly
compensable injury to her back. Plaintiff subsequently underwent an extensive course of
treatment, the specifics of which are not pertinent to this appeal. Then, in February 1994,
plaintiff's treating physician recommended that she pursue a formal weight loss program to
improve her condition by alleviating some of the pressure on her back. For treatment of her
weight problem, plaintiff visited Dr. Carol Jean Smith of the Bariatric Medical Center in
Asheville, North Carolina. Dr. Smith referred plaintiff to Dr. Martin Fischer for gastric bypass
surgery, which he performed on 8 January 1998 at St. Luke's Hospital in Tryon, North Carolina.
Following the procedure, plaintiff developed a blood infection and pulmonary abnormalities.
She was, therefore, transferred to Memorial Mission Hospital in Asheville, where she received
emergency medical attention. Because plaintiff's condition proved to be beyond the expertise of
her attending physicians at Memorial Mission, she was again transferred to North Carolina
Baptist Hospital in Winston-Salem. There, she remained until her discharge on 29 June 1998.
Plaintiff requested a hearing before the Commission on 14 November 1996, alleging that
she was entitled to payment of attorneys fees and yearly increases in compensation based on the
maximum calculated under section 97-29 of the General Statutes. Plaintiff's claim was heard,
and the deputy commissioner awarded her permanent total disability compensation at the rate of
$442.00 per week continuing for the remainder of her life. Plaintiff appealed this decision to
the Full Commission and moved, pursuant to section 97-25 of the General Statutes, for
authorization of the additional medical treatment provided in connection with her stomach
reduction surgery and the resulting complications. The Full Commission conducted a review andentered an opinion and award denying plaintif
f's motion for authorization and affirming the
ruling of the deputy commissioner. From the decision of the Full Commission, plaintiff now
appeals.
Plaintiff's leading argument is that the rate at which she is compensated should increase
each year with the maximum weekly benefit computed under section 97-29 of our General
Statutes. Plaintiff takes the position that the current practice of the Industrial Commission--to
establish a permanent compensation rate for disabled workers based on the date of their injury--is
an erroneous application of the statute. Further, plaintiff contends that the existing practice is
inconsistent with the spirit and purpose of the Workers' Compensation Act, which is to protect
the injured worker.
[1]At the outset, we consider whether plaintiff has properly preserved the right to
challenge her rate of compensation. The record reveals that the parties executed a Form 21
Agreement for Compensation, pursuant to which defendants undertook to compensate plaintiff at
a rate of $442.00 per week, beginning [5 June 1995] and continuing for necessary weeks. The
Commission approved the agreement on 23 January 1996, at which time the agreement became
binding on the parties and assumed the force and effect of a ruling by the Commission.
See
Pruitt v. Publishing Co., 289 N.C. 254, 258, 221 S.E.2d 355, 358 (1976) (acknowledging that a
Form 21 Agreement as approved by the Commission becomes an award enforceable, if
necessary, by a court decree). Thereupon, neither party was in a position to challenge any
provision of the agreement, unless it [was] made to appear to the satisfaction of the Commission
'that there [had] been error due to fraud, misrepresentation, undue influence or mutual mistake.'
Id. at 259, 221 S.E.2d at 358 (N.C. Gen. Stat. § 97-17 (1972)
).
According to the record, plaintiff entered into the Form 21 Agreement, thereby accepting
a weekly rate of compensation at $442.00, on 11 July 1995, more than two years after her 16
April 1993 injury. In the interim between the injury date and the date of the agreement, the
maximum weekly benefit was re-computed under section 97-29 of the General Statutes three
times. Yet, nowhere in the agreement is there a provision that plaintiff's compensation be
adjusted upward to reflect the maximum rate determined annually. Rather, it appears that
plaintiff first asserted a right to yearly increases on 14 November 1996, when she filed a request
for a hearing on her claim.
Furthermore, at no time during these proceedings has plaintiff sought to have the Form 21
Agreement set aside. Neither has she demonstrated 'error due to fraud, misrepresentation,
undue influence or mutual mistake.'
See id. (quoting N.C. Gen. Stat. § 97-17 (1972))
.
Therefore, plaintiff remains bound by the agreement and, due to her conduct, has waived any
right to challenge the compensation received thereunder. Nevertheless, because plaintiff raises
an issue of first impression, we exercise our discretion pursuant to Rule 2 of the North Carolina
Rules of Appellate Procedure and consider the merits of plaintiff's argument.
See N.C.R. App.
P. 2 (permitting this Court, on its own initiative, to suspend requirements or provisions of
Appellate Rules). Thus, we turn to the issue presented, which involves the interpretation of
section 97-29 of the General Statutes.
[2]It is well recognized that the goal of statutory construction is to give effect to the
intent of the Legislature,
Austin v. Continental General Tire, 141 N.C. App. 397, 540 S.E.2d 824
(2000), and to this end, the courts must refer primarily to the language of the enactment itself.
State ex rel. Utilities Commission v. Public Staff, 309 N.C. 195,
306 S.E.2d 435 (1983). A statute that '
is free from ambiguity, explicit in terms and
plain of meaning' must be enforced as written, without resort to judicial construction.
Andrews
v. Nu-Woods, Inc., 299 N.C. 723, 726, 264 S.E.2d 99, 101 (1980) (alteration in original)(quoting
School Commissioners v. Alderman, 158 N.C. 191, 196, 73 S.E. 905, 907 (1912)).
'[S]ignificance and effect should, if possible, . . . be accorded every part of the act, including
every section, paragraph, sentence or clause, phrase, and word.'
Hall v. Simmons, 329 N.C.
779, 784, 407 S.E.2d 816, 818 (1991) (quoting
State v. Williams, 286 N.C. 422, 432, 212 S.E.2d
113, 120 (1975)). In pertinent part, section 97-29 of the General Statutes provides as follows:
Except as hereinafter otherwise provided, where the
incapacity for work resulting from the injury is total, the employer
shall pay or cause to be paid, as hereinafter provided, to the injured
employee during such total disability a weekly compensation equal
to sixty-six and two-thirds percent (66.%) of his average weekly
wages, but not more than the amount established annually to be
effective October 1 as provided herein, nor less than thirty dollars
($30.00) per week.
In cases of total and permanent disability, compensation,
including medical compensation, shall be paid for by the employer
during the lifetime of the injured employee. . . .
. . . .
Notwithstanding any other provision of this Article, on July
1 of each year, a maximum weekly benefit amount shall be
computed. The amount of this maximum weekly benefit shall be
derived by obtaining the average weekly insured wage in
accordance with G.S. 96-8(22), by multiplying such average
weekly insured wage by 1.10, and by rounding such figure to its
nearest multiple of two dollars ($2.00), and this said maximum
weekly benefit shall be applicable to all injuries and claims arising
on and after January 1 following such computation. Such
maximum weekly benefit shall apply to all provisions of this
Chapter and shall be adjusted July 1 and effective January 1 of
each year as herein provided.
N.C. Gen. Stat. § 97-29 (1999). The average weekly insured wage used to compute the
maximum weekly benefit is:
the quotient obtained by dividing the total of the wages, as defined
in G.S. 96-8(12) and (13), reported by all insured employers by the
monthly average in insured employment under this Chapter during
the immediately preceding calender year and further dividing the
quotient obtained by 52 to obtain a weekly rate. (For this
computation the data as released annually in the Employment
Security Commission's publication North Carolina Insured
Employment and Wage Payment shall be used.) The quotient
thus obtained shall be deemed to be the average weekly wage for
such year.
N.C. Gen. Stat. § 96-8(22) (1999).
Plaintiff argues that an ambiguity exists concerning the clause of section 97-29 stating
that said maximum weekly benefit shall be applicable to all injuries and claims arising on and
after January 1 following such computation. N.C. Gen. Stat. § 97-29. Plaintiff concedes that
the language could naturally be read to mean that all claims arising on or after January 1 will be
limited by the maximum rate effective for that year. Plaintiff, nonetheless, offers the following
as a reasonable alternate construction:
[T]he limiting clause should be read as an attempt [by the
legislature] to dispel any confusion that cases arising on or after
July 1 do not obtain the benefit of the new rate calculated as of that
date. Instead, the date of application of the new rate, though
adjusted on July l, is January 1 of the subsequent year.
When determining the meaning of a provision, however, the courts assume that the legislature
inserted every part of a provision for a purpose and that no part is redundant.
Hall, 329 N.C. at
784, 407 S.E.2d at 818. Plaintiff's latter interpretation of the limiting language departs from this
presumption, in that the legislature inserted the following provision, effectively disposing of any
confusion regarding the effective date of the new rate: Such maximum weekly benefit shall
apply to all provisions of this Chapter and shall be adjusted July 1 and effective January 1 of each
year as herein provided. N.C. Gen. Stat. § 97-29. Accordingly, we reject plaintiff's argument
that the limiting language of section 97-29 is ambiguous. Instead, we conclude that section 97-
29 is clear and explicit on its face, compelling its enforcement as written.
See Nu-Woods, 299
N.C. at 726, 264 S.E.2d at 101.
As previously noted, section 97-29 expressly limits application of the newly derived
maximum weekly benefit to all injuries and claims
arising on and after January 1 following
such computation.
Id. (emphasis added). Our courts have said that '[n]othing else appearing,
the Legislature is presumed to have used the words of a statute to convey their natural and
ordinary meaning.'
Perkins v. Arkansas Trucking Servs., Inc., 351 N.C. 634, 638, 528 S.E.2d
902, 904 (2000) (quoting
In re McLean Trucking Co., 281 N.C. 242, 252, 188 S.E.2d 452, 458
(1972)). Absent a contextual definition, the courts may infer the ordinary meaning of a word
from its dictionary definition.
Id.
In view of the dictionary definitions of arise, we understand the term arising, as it is
used in the limiting clause of section 97-29, to mean originating, resulting, or proceeding.
See Black's Law Dictionary 102-03 (7
th ed. 1999);
The American Heritage Dictionary 45 (3
rd ed.
1994). In the instant case, plaintiff sustained the compensable injury on 16 April 1993; thus,
both her injury and her workers' compensation claim originated or arose after 1 January 1993.
Consequently, the maximum weekly benefit calculated 1 July 1992, which amount became
effective 1 January 1993, is the rate applicable to plaintiff's claim. Moreover, under the express
language of the statute, the maximum benefit calculated 1 July 1993 to take effect 1 January
1994 does not apply to plaintiff's claim, since the claim did not originate or arise on or after 1
January 1994.
Plaintiff, however, would have us rewrite the statute to provide that the maximum weekly
benefit calculated 1 July shall be applicable to all injuries and claims
existing and arising on and
after January 1 following such computation. This we cannot and will not do. Accordingly, we
hold that pursuant to the terms of section 97-29 of the General Statutes, plaintiff is not entitled to
yearly increases commensurate with the maximum rate calculated
per annum. Hence, the
Commission was correct in concluding that [p]laintiff [was] entitled to weekly compensation at
the maximum compensation rate for the year 1993 at the rate of $442.00 and continuing for the
remainder of her life.
[3]Nevertheless, plaintiff maintains that section 97-29 as applied violates the Due
Process and Equal Protection Clauses of the United States and North Carolina Constitutions.
Plaintiff asserts that failing to adjust a disabled employee's compensation rate to equal the
maximum weekly benefit computed annually infringes on what she describes as one's
fundamental right to enjoy[] the fruits of one's labor. Plaintiff additionally contends that the
practice of fixing a claimant's maximum compensation rate based on the year of injury treats
workers injured in later years more favorably than those injured in earlier years.
We initially point out that plaintiff's argument is flawed, insofar as it is based on the
premise that the maximum weekly benefit will invariably increase every year. Generally
speaking, the trend has been for the rate to increase from year to year. However, in a failing
economy, the average weekly wage would likely drop, and so too would the maximum weekly
benefit calculated under section 97-29.
As to the constitutionality of section 97-29, we note that the United States Supreme Court
developed a two-tiered test for determining whether a statute violates substantive due process:
[I]f the right infringed upon is a fundamental right, then the law
will be viewed with strict scrutiny and the party seeking to apply
the law must demonstrate a compelling state interest for the law to
survive a constitutional attack; if the right infringed upon is not afundamental right, then the party applying the law need only
demonstrate that the statute is rationally related to a legitimate state
interest.
Dixon v. Peters, 63 N.C. App. 592, 598, 306 S.E.2d 477, 481 (1983). A similar test is employed
where the statute is challenged as violating the Equal Protection Clauses of the state and federal
constitutions:
[A] statute is subjected to the highest level of review, or strict
scrutiny, only when the classification impermissibly interferes
with the exercise of a fundamental right or operates to the peculiar
disadvantage of a suspect class. For a statute to survive this level
of constitutional review, the government must demonstrate that the
classification created by the statute is necessary to promote a
compelling government interest.
Where a statutory classification does not burden the
exercise of a fundamental right or operate to the peculiar
disadvantage of a suspect class, the government need only show
the classification in the challenged statute has some rational basis.
A statutory classification survives this analysis if it bears some
rational relationship to a conceivable legitimate interest of
government. Statutes subjected to this level of scrutiny come
before the Court with a presumption of validity.
In re Assessment of Taxes Against Village Publishing Corp., 312 N.C. 211, 221, 322 S.E.2d 155,
162 (1984) (citations omitted). To prevail against reasonable scrutiny, the legislation at issue
'need not be the best resolution of a particular problem.'
American Nat'l Ins. Co. v. Ingram,
63 N.C. App. 38, 47, 303 S.E.2d 649, 654 (1983) (quoting
Prudential Property and Casualty Co.
v. Ins. Commission, et al., 534 F. Supp. 571, 576 (C.D.S.C. 1982),
aff'd, 699 F.2d 690 (4
th Cir.
1983)). Even if the legislation is seriously flawed and result[s] in substantial inequality, it will
be upheld if it is reasonably related to a permissible state objective.
Id. (quoting
Prudential, 534
F. Supp. at 576).
The statute at issue here, section 97-29 of the General Statutes, neither burdens a suspect
class, nor affects a fundamental right. It is a purely economic regulation. As such, the provision
need only satisfy the rational basis level of scrutiny to withstand both the due process and equal
protection challenges.
Per our earlier discussion, under section 97-29, the maximum weekly benefit is computed
1 July and is applied to all injuries and claims arising on or after 1 January of the following year.
We conclude that limiting applicability of the maximum rate based on the year of injury enables
insurance providers to project future exposure and calculate premiums accordingly. As
defendants persuasively argue,
Because [the maximum weekly benefit] is tied to the
economic condition of the workers in this State, it is difficult to
predict what the maximum compensation rate will be in [future
years]. . . . The current system allows carriers and employers to
assess their worse [sic] case scenario for the coming year in July of
the current year.
Thus, the application of section 97-29 appears to bear a rational relationship to a legitimate state
interest. Accordingly, we hold that section 97-29 of the General Statutes is not constitutionally
infirm.
[4]Plaintiff further contends that section 97-29 violates the Americans with Disabilities
Act (ADA), 42 U.S.C. § 12101,
et seq. (1994). Plaintiff's assignment of error in the record on
appeal, however, fails to include any reference to the ADA.
See N.C.R. App. P. 10(c)(1)
(requiring assignments of error in the record on appeal to state plainly, concisely and withoutargumentation the legal basis upon whi
ch error is assigned.) Therefore, we conclude that this
argument is not properly before us and decline to address its merits. Moreover, in light of the
preceding analysis concerning the construction of section 97-29, we summarily overrule
plaintiff's alternative claim that she is at least entitled to receive the maximum rate as of the date
the Commission determined her to be totally disabled.
[5]As a final matter, plaintiff argues that the Commission abused its discretion in
denying her motion, pursuant to section 97-25 of the General Statutes, for approval of the
additional medical providers and treatment related to her stomach reduction surgery and the
resulting complications.
Section 97-25 of the General Statutes pertinently provides that:
In case of a controversy arising between the employer and
employee relative to the continuance of medical, surgical, hospital,
or other treatment, the Industrial Commission may order such
further treatments as may in the discretion of the Commission be
necessary.
The Commission may at any time upon the request of an
employee order a change of treatment and designate other
treatment suggested by the injured employee subject to the
approval of the Commission, and in such a case the expense
thereof shall be borne by the employer upon the same terms and
conditions as hereinbefore provided in this section for medical and
surgical treatment and attendance.
N.C. Gen. Stat. § 97-25 (1999). Whether to authorize supplemental medical treatment under
section 97-25 is a matter firmly within the Commission's discretion.
Franklin v. Broyhill
Furniture Industries, 123 N.C. App. 200, 207, 472 S.E.2d 382, 387 (1996). A discretionary
ruling will be upheld on appeal, provided that the decision was reasonable and was not whimsical
or ill-considered.
Carrier v. Starnes, 120 N.C. App. 513, 520, 463 S.E.2d 393, 397 (1995).
In the present case, the Commission denied authorization of the medical treatment related
to plaintiff's stomach reduction procedure without stating any reason for its ruling. Absent
findings of fact or some other clear indication of the basis upon which the Commission denied
the request, we cannot determine whether the decision was an appropriate exercise of the
Commission's discretion. Therefore, we reverse the order denying plaintiff's motion under
section 97-25 of the General Statutes and remand this matter for entry of an order setting forth
findings of fact revealing the basis of the Commission's ruling.
In sum, the opinion and award of the North Carolina Industrial Commission is affirmed in
part, reversed in part, and remanded for further appropriate action.
Affirmed in part, reversed in part, and remanded.
Judges MARTIN and THOMAS concur.
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