CAROLYN BOLES,
Plaintiff
v
.
U.S. AIR, INC.,
Defendant
SELF-INSURED
(ALEXIS, INC., Servicing Agent)
Walden & Walden, by Daniel S. Walden and Margaret D. Walden,
for plaintiff-appellee.
Brooks, Stevens & Pope, P.A., by Daniel C. Pope, Jr., and
Kimberley A. D'Arruda, for defendant-appellant.
MARTIN, Judge.
Defendant appeals from an opinion and award of the North
Carolina Industrial Commission (hereinafter "Commission") awarding
plaintiff continuing benefits. Evidence before the Commission
tended to show that plaintiff, Carolyn Boles, was employed by
defendant, U.S. Air, Inc. (now U.S. Airways, Inc.) as a reservation
sales agent (reservationist), providing booking and flight
information to the public by telephone. Her job required her to
sit at a computer keyboard throughout the workday keying in the
necessary information. This work not only physically required her
to use both hands repetitively, but cognitively required
concentration, memory, and attention to detail. On 7 March 1991,plaintiff tripped and fell on a curb outside her office building as
she was going into work. From the fall, plaintiff sustained a back
injury manifested by chronic incapacitating neck, left shoulder,
and left arm pain. Because plaintiff's symptoms did not
significantly improve with conservative treatment (cervical
traction, anti-inflammatory medications, and physical therapy), on
21 May 1992, she was examined by Dr. Curling, a neurosurgeon. Dr.
Curling testified that an MRI revealed a large spur and associated
disk bulge at C5-C6 and that he advised plaintiff to undergo a
cervical discectomy at C5-C6 and an iliac crest interbody fusion at
C5-C6. Dr. Curling performed this surgical procedure on 17 June
1992 and released plaintiff, without restrictions, on 24 September
1992 to return to work at U.S. Air, Inc., starting on half days for
the first two weeks and then working up to whole days.
At the end of September 1992 the Commission approved the
parties' Form 21 "Agreement for Compensation for Disability"
wherein defendant accepted plaintiff's injury by accident resulting
in an "HNP [at] C5-C6." Additionally, the Commission approved
several Form 26 Agreements for temporary total disability of
various weeks (not continuous) in 1991 and 1992. In December 1992,
Dr. Curling found plaintiff at maximum medical improvement (MMI)
and rated her at approximately 10 percent permanent partial
disability and released her from his care. Dr. Curling noted that
plaintiff was having minimal neck discomfort but that plaintiff had
returned to work and doing her usual job without significant
difficulty. On 25 February 1993, the Commission approved theparties' Form 26 "Supplemental Memorandum of Agreement as to
Payment of Compensation" for a 10 percent permanent partial
disability to the back (for 30 weeks of benefits at the rate of
$306.42 per week from 10 December 1992 pursuant to G.S. § 97-31).
On 10 February 1993, plaintiff was again seen by Dr. Curling,
complaining of recurrent pain in the neck and left arm. Dr.
Curling stated in a letter to plaintiff that her pain was caused by
nerve injury and recommended that plaintiff take Elavil for her
recurrent neck and arm pain. On 23 August 1993, plaintiff called
Dr. Curling indicating that she was having problems with depression
and was feeling suicidal and asked that he write a letter giving
her permission to stay out of work for two to three weeks so that
she could get her act together. Dr. Curling recommended that
plaintiff go to the emergency room and undergo a psychiatric
evaluation, contact her family physician, or schedule an
appointment with a psychiatrist as soon as possible.
On 23 September 1993, plaintiff's psychiatrist, Dr. Branham,
diagnosed plaintiff with major depression and wrote, "[a]t the
present time I feel that it would be totally necessary for
[plaintiff] to have the least amount of stress possible and since
work is a major stress on her life I think she should be held out
of work until further notice. Dr. Branham noted that since 7
March 1991, plaintiff had a history of feeling futile, hopeless,
and tearful about her chronic pain. Dr. Branham also noted that
she had problems sleeping, concentration and memory difficulties,
and a loss of interest in daily and family activities. Heprescribed chemotherapeutic intervention with anti-depressant
medication. Following this diagnosis, plaintiff regularly returned
to Dr. Branham for treatment.
On 19 July 1994, Dr. Branham indicated in a letter to
defendant that "[d]ue to depression, the concentration, physical
stamina, memory, and ability to withstand stress have all been
eroded to such a degree that [plaintiff] is unable to work."
During Dr. Branham's 1995 deposition, he stated that plaintiff
could not return to work because of her pain, her memory and
concentration deficits, which he noted were two symptoms of
depression, and her difficulty relating to other people. During
his 1998 deposition, Dr. Branham testified that he had never
considered return to work as a goal, but that plaintiff no longer
suffered from impaired memory or cognitive abilities, nor did she
have difficulty with interpersonal relations. In the 1998
deposition, Dr. Branham testified that he thought that plaintiff
was unable to return to work because she suffers from chronic pain
syndrome and intermittent depression.
On 15 March 1994, plaintiff filed a motion pursuant to G.S. §
97-47, alleging she had a change in condition, and moved for
additional compensation. She alleged that as a result of increased
neck pain and depression, she had been unable to work since 28
September 1993. She also moved, pursuant to G.S. § 97-25, for
approval of further medical treatment by Dr. Branham.
On 28 June 1994, after reviewing the results of a functional
capacity evaluation, Dr. Curling indicated that plaintiff couldreturn to work on a light-demand level. Additionally, Dr. Curling
stated that in his opinion plaintiff was capable of returning to
work as a reservations agent.
Plaintiff was sent by defendant for a second opinion and
psychological testing to clinical psychologist John F. Warren, III.
In September 1994, Dr. Warren tested plaintiff's memory and
concentration using the Wechsler Memory Scale-Revised and found
that her general memory and verbal memory scores fell within the
Superior range. In addition, plaintiff's visual memory,
attention/concentration, and delayed recall index scores fell
within the Average range. From these test results, Dr. Warren
indicated there were no signs of severe memory problems that would
cause plaintiff difficulty in terms of trying to attend to the
affairs of daily living or work. Plaintiff was also administered
the Booklet Category Test (BCT), which is a comprehensive,
cognitive screening test designed to evaluate for the presence of
cerebral dysfunction. Plaintiff performed within the Average range
which suggests "that her non-verbal abstract reasoning and logical
analysis skills are adequate for making most decisions required for
organized planning and practical, everyday living and working
situations." Dr. Warren recommended limited mental health
intervention with goals and plans, as opposed to a more
traditional, open-ended analytic or dynamic mental health
treatment.
In February 1997, Dr. Jones evaluated plaintiff upon
defendant's request that he provide a second opinion to clarifyplaintiff's psychiatric condition, as well as make recommendations
regarding her ability to return to work. At the time of the
evaluation, Dr. Jones felt that plaintiff's depressive disorder was
in remission. Dr. Jones did not find any impairments that would
keep plaintiff from being capable of performing tasks required in
the reservationist position. Dr. Jones opined that treatment with
specific benchmarks would be more appropriate than Dr. Branham's
open-ended treatment program.
During the hearing, plaintiff admitted that she was aware that
Dr. Branham was the only physician that she had seen since 1993 who
is continuing to excuse her from work as a reservationist.
Plaintiff also testified that she did not feel that she was capable
of performing her job as reservationist because she was in so much
pain that it caused her to have impaired memory and cognitive
ability. Plaintiff further testified that she has not attempted to
perform the actual job of reservationist since September 1993.
On 25 January 1995 a deputy commissioner heard plaintiff's
G.S. § 97-47 motion to reopen her claim by reason of a change in
condition for the worse, and her G.S. § 97-25 motion for Commission
approval of Dr. Branham and Dr. Rauck. On 5 May 1995, the deputy
commissioner ruled that plaintiff had sustained a substantial
change for the worse in her condition from the 7 March 1991 back
injury resulting in her becoming totally disabled by the same
injury on 24 September 1993. Plaintiff was awarded compensation at
a rate of $306.42 per week from 24 September 1993 to the scheduled
hearing date and continuing thereafter at the same rate for so longas she remains totally disabled. The deputy commissioner also
ruled that defendant shall pay all reasonable and necessary medical
expenses incurred by plaintiff as a result of her substantial
change of condition, including continued psychiatric treatment
provided by Dr. Branham and any other treatment he may reasonably
recommend that would tend to reduce her chronic incapacitating pain
such as a return to the pain clinic. Neither party appealed from
the deputy commissioner's opinion and award.
On 7 April 1997, defendant filed a Form 24 Application to
Terminate Payment of Compensation, alleging that plaintiff had
unjustifiably refused the employer's offer of suitable employment
(as reservations agent) on 14 March 1997. The matter was heard by
a deputy commissioner who ruled that plaintiff was justified in
refusing the job offer under G.S. § 97-32, that plaintiff remains
totally disabled as a result of her 7 March 1991 compensable injury
and is entitled to continuing compensation under G.S. § 97-29, and
that Dr. Branham remain the treating physician under G.S. § 97-25.
Defendant appealed to the Full Commission which modified and
affirmed the decision of the deputy commissioner and ordered
defendant to continue to pay compensation to plaintiff for
temporary total disability, and to continue to pay for her medical
treatment, including that provided by Dr. Branham. Defendant
appeals.
I.
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