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NO. COA01-108
NORTH CAROLINA COURT OF APPEALS
Filed: 5 March 2002
SHAWN PATRICK KNIGHT,
Employee, Plaintiff
v
.
WAL-MART STORES, INC.,
Employer;
INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA,
Carrier; Defendants
Appeal by defendants from an Opinion and Award entered 14 July
2000 by the North Carolina Industrial Commission. Heard in the
Court of Appeals 29 November 2001.
Poisson, Poisson, Bower & Clodfelter, by Fred D. Poisson, Jr.,
for plaintiff-appellee.
Young Moore and Henderson, P.A., by Joe S. Austin, Jr. and
Zachary C. Bolen, for defendant-appellants.
HUNTER, Judge.
Wal-Mart Stores, Inc. (Wal-Mart) and the Insurance Company
of the State of Pennsylvania (together defendants) appeal from an
opinion and award entered by the North Carolina Industrial
Commission (the Commission) awarding Shawn Patrick Knight
(plaintiff) disability benefits. We affirm.
The evidence presented at the hearing tended to establish the
following facts. Plaintiff has a history of back injuries,
beginning with an injury at work in August of 1990 which caused him
to experience pain running down his left leg and which resulted in
surgery in 1991 to repair a ruptured disk. In 1993, plaintiff
experienced a minor injury to his back. Plaintiff testified thathis back bothered him occasionally between 1993 and the accident in
1998.
In 1998, plaintiff was employed by Wal-Mart stocking freight
at night, and his job required him, among other tasks, to lift
goods and place them on shelves. On 15 March 1998, plaintiff's
supervisor directed plaintiff to remove some computers from the top
riser. Plaintiff climbed to the top of an eight-foot stepladder,
picked up a computer, and started climbing down. When he reached
the second-to-last rung, the computer started to fall. He
attempted to step down to the last rung, but he missed the rung and
fell to the floor. Plaintiff felt something pop or jerk in his
back as he fell, and he landed on his hip. Plaintiff tried to walk
around but felt pain running down his left leg. He reported the
accident to his supervisor and his supervisor filled out an
accident report. After plaintiff indicated that he might need
medical attention, a co-employee drove him to the hospital. At the
hospital, plaintiff was diagnosed with broad-based disk protrusion.
Plaintiff received some painkillers and then returned to work later
that night.
Plaintiff returned to work on a few occasions during the next
week, including 21 March (for six hours), 22 March (for eight
hours), and 24 March (for eight hours). During this time he
continued to feel pain in his lower back and running down his left
thigh. Following 24 March 1998, plaintiff stopped working due to
pain and discomfort. Dr. Joseph King, an orthopaedic surgeon, first saw plaintiff
on 9 April 1998. Dr. King opined that plaintiff had continued
pain in that left leg radiating all the way down the leg and that
was quite consistent throughout the course of his treatment. Dr.
King opined that the accident at Wal-Mart could have aggravated or
accelerated plaintiff's pre-existing back problems. On 30 April,
Dr. King saw plaintiff again and noted that he continued to suffer
significant pain. Dr. King prescribed a pain medication for
plaintiff at that time.
Plaintiff returned to work on 21 May 1998, during which time
he sat on a stool in the electronics department and did nothing.
Plaintiff testified that this was not a job that any employees
normally perform at Wal-Mart. Tracy Stillwell, the store manager,
provided testimony corroborating these facts. After a while,
plaintiff began to experience significant discomfort and pain in
his lower back and leg from sitting, and as a result of this pain
plaintiff left work after a few hours. After 21 May, Wal-Mart
offered plaintiff a light duty position shelving some returns at
night, and plaintiff tried this work two or three times but was
unable to remain at work due to pain.
Dr. King performed a laminectomy on plaintiff on 22 July
1998. Plaintiff chose to have the surgery, despite the risks,
because he didn't see any alternative to relieving the pain.
However, plaintiff testified that he did not experience any relief
from the surgery. Plaintiff again worked on 7 September (four hours), 3 November
(eight hours), and 4 November (five hours). In January of 1999,
Wal-Mart offered plaintiff light duty work as a sweeper, or
greeter, or stock return person. Plaintiff told Wal-Mart that he
did not feel he was able to return to work due to his pain.
Plaintiff testified that he tried to sweep at home and was only
able to sweep for fifteen to thirty minutes. On other occasions
plaintiff attempted to work as a return clerk, but was unable to
work due to pain in his lower back and left leg.
Dr. King saw plaintiff again on 4 January 1999, at which time
plaintiff was still suffering from pain. At that time, Dr. King
concluded that plaintiff had improved as much as he was likely to
improve. In addition, Dr. King found that plaintiff's left ankle
reflex was not present (which, he explained, means that the nerve
is not functioning properly). Dr. King stated that this finding
suggests objective nerve damage, meaning [s]omething that
[plaintiff] has no control over. He testified that because
plaintiff's reflexes were normal in July of 1998, the finding
further suggests that there may have been some different pressure
on that nerve, and that such pressure upon a nerve is connected to
pain. Dr. King testified that plaintiff's complaints of burning
and pain down into his thigh area, and numbness in his left foot,
are consistent with Dr. King's findings.
On 4 January 1999, and on various other occasions during Dr.
King's treatment of plaintiff, he gave plaintiff return-to-work
slips containing various restrictions on how much weight plaintiffshould lift. Dr. King testified that the purpose of giving
plaintiff return-to-work slips was to help plaintiff return to
gainful employment in order to see whether the pain would prevent
him from working. He also explained that, in his opinion, the
return-to-work slips and the restrictions were unrelated to whether
plaintiff's pain would prevent him from working.
Dr. King further testified that there is no objective medical
reason that plaintiff cannot return to work with certain lifting
restrictions, and that plaintiff's complaints of pain are more
severe than one would normally expect given plaintiff's physical
status. However, Dr. King also testified that the type of injury
plaintiff has can be very painful, that sitting can cause the pain
to become much worse, and that, in his opinion, plaintiff's
complaints of significant pain are genuine.
Dr. King also testified that plaintiff has reached a point of
maximum medical improvement (MMI), and that, although identifying
the date at which plaintiff reached MMI is difficult (because
plaintiff has never shown any improvement since the injury), he
would suggest 4 January 1999 as the date at which he became
convinced that plaintiff would not further improve. In addition,
Dr. King assigned a disability rating of fifteen percent to
plaintiff's back.
At the time of the hearing on 26 January 1999, plaintiff was
experiencing numbness in his left foot, as well as pain in his
lower back and his left leg. Plaintiff was not taking any pain
medication because Dr. King had refused to refill his prescription. Plaintiff testified that although Wal-Mart has paid for plaintiff's
medical bills, prescription bills, and for his visits to Carolina
Bone and Joint, Wal-Mart has never offered plaintiff any vocational
rehabilitation services. Further, plaintiff testified that he has
not pursued vocational rehabilitation because he does not believe
he is fit to return to work.
In its Opinion and Award, the Commission first noted that
[a]t the hearing before the Full Commission, the parties orally
stipulated that compensation awarded herein would terminate as of
11 May 1999, and that compensation after that date shall be
determined by agreement of the parties or by Order of the
Industrial Commission. The Commission then set forth findings of
fact consistent with the facts set forth above, including the
following pertinent findings of fact:
11. Dr. King stated that plaintiff's
pain complaints were consistent with his
injury and that he has no doubt that plaintiff
has been truthful about his pain. Dr. King
further opined that plaintiff's fall off of
the ladder on 16 March 1998, could have
aggravated or accelerated any existing back
pain or back injury that plaintiff may have
had on 16 March 1998.
. . .
14. . . . Having weighed the testimony
of both parties, the Deputy Commissioner gave
more weight to the testimony of plaintiff, and
the Full Commission adopts that determination.
The Commission also entered the following pertinent conclusions of
law:
1. Plaintiff sustained a compensable
injury by accident to his back arising out of
and in the course of his employment withdefendant-employer and as a direct result of a
specific traumatic incident of the work
assigned on 16 March 1998, which aggravated,
exacerbated and/or accelerated an underlying
pre-existing back condition.
. . .
3. Plaintiff is entitled to workers'
compensation benefits in the amount of $149.10
per week beginning 16 March 1998, and
continuing until 11 May 1999. . . .
We note that, although it is not expressly stated in the Opinion
and Award, it is clear from the context that the Commission's award
of compensation was made pursuant to the conclusion that plaintiff
has suffered a total loss of wage-earning capacity pursuant to N.C.
Gen. Stat. § 97-29 (1999).
On appeal, defendants have set forth seventeen assignments of
error in the record. Six of these assignments of error are not set
out in defendants' brief and are, therefore, deemed abandoned. See
N.C.R. App. P. 28(b)(5). Defendants have condensed the remaining
eleven assignments of error into five arguments for our review.
I.
By their first argument, defendants contend that the
Commission's findings of fact do not support its conclusion that
plaintiff is disabled. Defendants essentially contend that,
although there is competent evidence that plaintiff suffers from a
painful physical infirmity, plaintiff has failed to provide
evidence establishing a diminished capacity to earn wages.
Therefore, defendants argue, although the findings may be supported
by the evidence, they are insufficient to support the legal
conclusion of a disability. We disagree. The Industrial Commission's conclusions of law are fully
reviewable by the appellate courts.
Hilliard v. Apex Cabinet Co.,
305 N.C. 593, 595, 290 S.E.2d 682, 684 (1982). 'In order to
obtain compensation under the Workers' Compensation Act, the
claimant has the burden of proving the existence of his disability
and its extent.'
Saums v. Raleigh Community Hospital, 346 N.C.
760, 763, 487 S.E.2d 746, 749 (1997) (quoting
Hendrix v.
Linn-Corriher Corp., 317 N.C. 179, 185, 345 S.E.2d 374, 378
(1986)). Under the Workers' Compensation Act, disability is
defined by a diminished capacity to earn wages, not by physical
infirmity.
Id. at 764, 487 S.E.2d at 750 (citing N.C. Gen. Stat.
§ 97-2(9) (1991)). Thus, the employee has the burden to show
that he is unable to earn the same wages he had earned before the
injury, either in the same employment or in other employment.
Russell v. Lowes Product Distribution, 108 N.C. App. 762, 765, 425
S.E.2d 454, 457 (1993) (citing
Hilliard, 305 N.C. at 595, 290
S.E.2d at 684).
The employee may meet this burden in one of
four ways: (1) the production of medical
evidence that he is physically or mentally, as
a consequence of the work related injury,
incapable of work in any employment; (2) the
production of evidence that he is capable of
some work, but that he has, after a reasonable
effort on his part, been unsuccessful in his
effort to obtain employment; (3) the
production of evidence that he is capable of
some work but that it would be futile because
of preexisting conditions, i.e., age,
inexperience, lack of education, to seek other
employment; or (4) the production of evidence
that he has obtained other employment at a
wage less than that earned prior to the
injury.
Id. (citations omitted). Under the facts in the present case, it
is clear that plaintiff has not attempted to establish disability
by means of the second, third, or fourth methods outlined by this
Court in
Russell. Thus, plaintiff had the burden of producing
medical evidence that he is physically or mentally, as a
consequence of the work related injury, incapable of work in any
employment.
Id. We believe plaintiff has produced such evidence,
and that the Commission's findings of fact, based upon this
evidence, support the conclusion of disability.
In determining if plaintiff has met this burden [of
establishing a loss of wage-earning capacity], the Commission must
consider not only the plaintiff's physical limitations, but also
his testimony as to his pain in determining the extent of
incapacity to work and earn wages such pain might cause.
Webb v.
Power Circuit, Inc., 141 N.C. App. 507, 512, 540 S.E.2d 790, 793
(2000),
cert. denied, 353 N.C. 398, 548 S.E.2d 159 (2001).
Moreover, medical evidence that a plaintiff suffers from genuine
pain as a result of a physical injury, combined with the
plaintiff's own credible testimony that his pain is so severe that
he is unable to work, may be sufficient to support a conclusion of
total disability by the Commission.
See Webb, 141 N.C. App. 507,
540 S.E.2d 790;
Barber v. Going West Transp., Inc., 134 N.C. App.
428, 517 S.E.2d 914 (1999)
; Matthews v. Petroleum Tank Service,
Inc., 108 N.C. App. 259, 423 S.E.2d 532 (1992).
(See footnote 1)
Here, Dr. King testified that plaintiff continues to suffer
from genuine pain due to his back injury. In addition, plaintiff
testified that the pain in his lower back and left leg is so severe
that, not only is he unable to work in any employment, he is often
unable to undertake even simple chores, such as sweeping, for more
than thirty minutes. Such testimony constitutes competent
evidence as to [plaintiff's] ability to work.
Niple v. Seawell
Realty & Insurance Co., 88 N.C. App. 136, 139, 362 S.E.2d 572, 574
(1987),
disc. review denied, 321 N.C. 744, 365 S.E.2d 903 (1988).
The Commission determined that plaintiff's testimony was credible
and accorded this testimony significant weight.
See Matthews, 108
N.C. App. at 264, 423 S.E.2d at 535 (holding that Commission is
sole judge of credibility of witnesses and weight to be given their
testimony, and its determination of these issues is conclusive on
appeal). The Commission entered findings consistent with this
evidence, and these findings, in turn, support the legal conclusion
that plaintiff is disabled. Thus, we reject defendants' first
argument.
II.
By their second argument, defendants contend that the
Commission failed to give adequate consideration to certain
competent evidence tending to show that plaintiff is not disabled.
Specifically, defendants argue that the Commission failed toconsider evidence that plaintiff had not taken any steps to find
employment since the date of injury, and also that plaintiff had,
on certain occasions, declined Wal-Mart's offers to allow plaintiff
to work as a safety-monitor or a greeter. However, because
plaintiff established disability by means of the first method
outlined in Russell (showing that he is incapable of earning wages
in any employment), and not by means of the second method (showing
that he is capable of some work but has been unable to obtain
employment), this evidence was not relevant to the Commission's
ultimate determination.
Defendants also contend that the Commission failed to consider
that Dr. King gave plaintiff return-to-work slips on various
occasions. However, a close reading of Dr. King's testimony
reveals that his reason for giving plaintiff return-to-work slips
was to encourage plaintiff to attempt to return to work in order to
see whether the pain would prevent him from working, and that, in
Dr. King's opinion, his giving plaintiff return-to-work slips did
not represent any medical opinion as to whether plaintiff would be
able to work in spite of his pain. Finally, defendants contend
that the Commission should have considered Dr. King's testimony
that there was no medical reason why plaintiff could not return to
work within the limitations of the lifting restrictions. Again, a
close reading of Dr. King's testimony reveals Dr. King's opinion
that, while plaintiff's objective medical condition may not have
directly prevented him from working within certain restrictions,
plaintiff's subjective pain resulting from his back injury may haveprevented him from working in any capacity. Furthermore, Dr. King
opined, and the Commission found, that plaintiff's complaints of
severe pain are genuine.
The record does not indicate that the Commission failed to
consider the evidence cited by defendants. Rather, it is more
likely that the Commission simply recognized that the evidence
cited by defendants does not necessarily conflict with the
conclusion that plaintiff is incapable of work due to pain. For
this reason, we reject defendants' second argument.
III.
By their third argument, defendants contend that the
Commission erred in finding that plaintiff had not reached the end
of his healing period (also referred to as the point of maximum
medical improvement or MMI) by 4 January 1999. The Commission's
finding states:
12. Dr. King determined that by 4
January 1999, he had exhausted all efforts for
treatment of plaintiff's . . . back condition
which he deemed appropriate, but plaintiff had
not gotten any better anywhere along the
way. On that basis, Dr. King stated that one
could pick any date subsequent to 16 March
1998 as the date plaintiff's condition had
reached a plateau in regard to recovery. For
this reason, no weight is given to Dr. King's
opinion on when plaintiff reached maximum
medical improvement.
Plaintiff had not
reached the end of his healing period on 4
January 1999. However, Dr. King stated that
it was possible that plaintiff may not be able
to return to regular duty. Dr. King further
noted that plaintiff's previous restrictions
to alternate sitting and standing and to lift
no more than five pounds remained appropriate.
(Emphasis added.) Defendants contend that this allegedly erroneous
finding is significant because, had the Commission found that
plaintiff
had reached MMI by 4 January 1999, it could not have
concluded that plaintiff was entitled to disability benefits after
January 4, 1999. We disagree because we believe the concept of
MMI is not relevant under these circumstances.
An employee seeking indemnity benefits pursuant to the
Workers' Compensation Act has, at the outset, two very general
options.
(See footnote 2)
First, an employee may seek indemnity benefits by
showing that the employee has suffered a loss of wage-earning
capacity pursuant to N.C. Gen. Stat. § 97-29 or N.C. Gen. Stat. §
97-30 (1999).
See N.C. Gen. Stat. § 97-2(9) (1999) (disability
is defined as an incapacity because of injury to earn the wages
which the employee was receiving at the time of injury in the same
or any other employment). A loss of wage-earning capacity may
either be total, in which case the employee is entitled to benefits
pursuant to N.C. Gen. Stat. § 97-29, or partial, in which case the
employee is entitled to benefits pursuant to N.C. Gen. Stat. § 97-
30.
See Gupton v. Builders Transport, 320 N.C. 38, 42, 357 S.E.2d
674, 678 (1987). If the loss of wage-earning capacity is total,
the employee is entitled to receive benefits for as long as the
total loss of wage-earning capacity lasts with no limitation as to
duration.
See N.C. Gen. Stat. § 97-29;
Vernon v. Steven L. MabeBuilders, 336 N.C. 425, 434, 444 S.E.2d 191, 195 (1994). If the
loss of wage-earning capacity is partial, the employee is entitled
to receive benefits for as long as the partial loss of wage-earning
capacity lasts, up to a maximum of 300 weeks.
See N.C. Gen. Stat.
§ 97-30. In either case, the focus is upon the employee's loss of
wage-earning capacity.
Furthermore, once an employee initially establishes a loss of
wage-earning capacity, a presumption of ongoing or continuing
disability arises, and the burden shifts to the employer to show
that the employee is capable of earning wages.
See Brown v. S & N
Communications, Inc., 124 N.C. App. 320, 329, 477 S.E.2d 197, 202
(1996);
Kennedy v. Duke Univ. Med. Center, 101 N.C. App. 24, 33,
398 S.E.2d 677, 682 (1990). Finally, as to claims involving a loss
of wage-earning capacity, it is important to recognize that,
although the Act does not define the terms temporary or
permanent,
see Gamble v. Borden, Inc., 45 N.C. App. 506, 508, 263
S.E.2d 280, 281 (1980), an incapacity to earn wages (whether total
under N.C. Gen. Stat. § 97-29 or partial under N.C. Gen. Stat. §
97-30) is often further categorized as either temporary or
permanent.
See, e.g., Watts v. Brewer, 243 N.C. 422, 423, 90
S.E.2d 764, 766 (1956).
The second option available to an employee seeking indemnity
benefits is to show that the employee has a specific physical
impairment that falls under the schedule set forth in N.C. Gen.
Stat. § 97-31 (1999), regardless of whether the employee has, infact, suffered a loss of wage-earning capacity.
(See footnote 3)
In order to
receive scheduled benefits pursuant to N.C. Gen. Stat. § 97-31, an
employee with a physical impairment that falls under the schedule
need not establish a loss of wage-earning capacity because
disability is presumed from the fact of the injury itself.
See,
e.g., Watts v. Brewer, 243 N.C. 422, 424, 90 S.E.2d 764, 767 (1956)
(holding that the phrase shall be deemed to continue in N.C. Gen.
Stat. § 97-31 means that an employee with an injury listed under
N.C. Gen. Stat. § 97-31 is presumed to be disabled regardless of
any actual loss of wage-earning capacity).
N.C. Gen. Stat. § 97-31 establishes a specific framework for
claims falling under that section. It provides that compensation
for a scheduled physical impairment is available during two
specific periods of time: (1) during the healing period of the
injury; and (2) for an additional, statutorily-prescribed period of
time (referred to herein as the statutory period), which begins
when the healing period ends and runs for the specific number of
weeks set forth in the statute for each type of impairment.
However, it is important to recognize that, to the extent that N.C.
Gen. Stat. § 97-31 allows for compensation for disability during
the healing period, it does not actually create an additional
statutory basis for recovery beyond that found in N.C. Gen. Stat.§ 97-29 and § 97-30. The reason that this language -- allowing for
compensation for disability during the healing period -- is
included in N.C. Gen. Stat. § 97-31 is simply to clarify that an
employee who has suffered a physical impairment listed under N.C.
Gen. Stat. § 97-31, and who, in addition, suffers a partial or
total loss of wage-earning capacity during the healing period for
that impairment, may (1) receive compensation pursuant to N.C. Gen.
Stat. § 97-29 or § 97-30 during the healing period and (2)
thereafter receive scheduled benefits provided in N.C. Gen. Stat.
§ 97-31 for the employee's specific physical impairment (regardless
of any loss of wage-earning capacity).
See Watkins v. Motor Lines,
279 N.C. 132, 136, 181 S.E.2d 588, 591 (1971)
(citing
Rice v. Panel
Co., 199 N.C. 154, 154 S.E. 69, (1930)).
For example, an employee who loses a thumb in a work-related
accident, and who is unable to work during a seven-week healing
period, and who then returns to work earning the employee's pre-
injury wages, is entitled to seek the following compensation.
First, prior to reaching the end of the healing period, the
employee may seek compensation for a loss of wage-earning capacity
under N.C. Gen. Stat. § 97-29 or § 97-30. Second, once the
healing period ends, the employee may seek compensation for the
employee's specific physical impairment pursuant to N.C. Gen. Stat.
§ 97-31(1) for a duration of seventy-five weeks.
See Watts, 243
N.C. 422, 90 S.E.2d 764; N.C. Gen. Stat. § 97-31(1).
Understanding this framework established by N.C. Gen. Stat. §
97-31 (contemplating a healing period followed by a statutoryperiod of time corresponding to the specific physical injury) is
crucial to understanding the primary legal significance of MMI.
Because N.C. Gen. Stat. § 97-31 allows an employee to receive
scheduled benefits for a specific physical impairment only once
the healing period ends, the question naturally arises: how is
it determined when the healing period ends? This Court has
answered the question by holding that the healing period in N.C.
Gen. Stat. § 97-31 ends at the point when the injury has
stabilized, referred to as the point of maximum medical
improvement (or maximum improvement or maximum recovery).
See, e.g., Crawley v. Southern Devices, Inc., 31 N.C. App. 284,
288, 229 S.E.2d 325, 328-29 (1976),
disc. review denied, 292 N.C.
467, 234 S.E.2d 2 (1977);
see also Carpenter v. Industrial Piping
Co., 73 N.C. App. 309, 311, 326 S.E.2d 328, 330 (1985). Thus,
before an employee may receive scheduled benefits pursuant to N.C.
Gen. Stat. § 97-31, it must be established that the employee has
reached the point of MMI with regard to the employee's specific
physical impairment and, therefore, that the healing period has
ended and the employee's physical impairment has become permanent.
Once this is established, an employee may receive benefits for the
specific physical impairment for the statutory period set forth in
N.C. Gen. Stat. § 97-31 that corresponds to that impairment.
It is also important to bear in mind that neither N.C. Gen.
Stat. § 97-29 nor N.C. Gen. Stat. § 97-30 contemplates a framework
similar to that established by N.C. Gen. Stat. § 97-31 (involving
a healing period followed by a statutory period). Under N.C.Gen. Stat. § 97-29 or § 97-30, the analysis is much more simple:
as noted above, an employee may receive compensation once the
employee has established a total or partial loss of wage-earning
capacity, and the employee may receive such compensation for as
long as the loss of wage-earning capacity continues, for a maximum
of 300 weeks in cases of partial loss of wage-earning capacity.
There is a great deal of confusion regarding what
significance, if any, the concept of MMI has within the context of
a loss of wage-earning capacity pursuant to either N.C. Gen. Stat.
§ 97-29 or § 97-30, and this confusion has produced two lines of
case law exemplified recently in two opinions simultaneously issued
by this Court.
See Anderson v. Gulistan Carpet, Inc., 144 N.C.
App. 661, 670-71, 550 S.E.2d 237, 243-44 (2001) (holding that an
employee may not receive temporary total disability benefits after
the employee has reached MMI);
Russos v. Wheaton Indus., 145 N.C.
App. 164, 167-68, 551 S.E.2d 456, 459 (2001) (holding that the
Industrial Commission did not err in awarding the plaintiff ongoing
temporary total disability benefits after she had reached MMI),
disc. review denied, ___ N.C. ___, ___ S.E.2d ___ (2001).
Until such time as either our legislature or our Supreme Court
directly addresses and resolves the confusion in this area, it is
incumbent upon this Court to attempt to clarify the law. Thus, we
have carefully and thoroughly reviewed the Workers' Compensation
Act and the case law, including our Supreme Court's recent denialof a petition for discretionary review in
Russos.
(See footnote 4)
We have
concluded that the primary significance of the concept of MMI is to
delineate a crucial point in time
only within the context of a
claim for scheduled benefits under N.C. Gen. Stat. § 97-31, and
that the concept of MMI does not have any direct bearing upon an
employee's right to continue to receive temporary disability
benefits once the employee has established a loss of wage-earning
capacity pursuant to N.C. Gen. Stat. § 97-29 or § 97-30.
It should first be noted that compensation received during
the healing period under N.C. Gen. Stat. § 97-31 is sometimes
referred to as compensation for temporary disability, and
compensation received during the statutory period under N.C. Gen.
Stat. § 97-31 is sometimes referred to as compensation for
permanent disability.
See, e.g., Crawley, 31 N.C. App. at 288,
229 S.E.2d at 328. Thus, in
Carpenter, where the plaintiff sought
benefits based upon a specific physical impairment listed under
N.C. Gen. Stat. § 97-31, this Court stated: Plaintiff seeks to
recover under G.S. 97-31. That section provides for compensation of
temporary disability during the healing period of the injury and
for permanent disability at the end of the healing period, whenmaximum recovery has been achieved.
Carpenter, 73 N.C. App. at
311, 326 S.E.2d at 329.
Although these statements in
Carpenter were clearly made
within the specific context of an employee seeking to recover
pursuant to N.C. Gen. Stat. § 97-31
, this Court in
Franklin v.
Broyhill Furniture Industries, 123 N.C. App. 200, 472 S.E.2d 382,
cert. denied, 344 N.C. 629, 477 S.E.2d 39 (1996), appears to have
interpreted
Carpenter as holding that
all temporary disability
benefits (even those awarded under N.C. Gen. Stat. § 97-29 or § 97-
30) may only be received during the healing period (or prior to
reaching MMI), and that after reaching MMI, an employee may only
receive permanent benefits:
Temporary total disability is payable
only during the healing period. The
healing period ends when an employee reaches
maximum medical improvement. Only when an
employee has reached maximum medical
improvement does the question of her
entitlement to permanent disability arise.
Once an employee has reached her maximum
medical improvement, she may establish
permanent incapacity pursuant to either
section 97-29, -30, or -31.
. . . .
In this case, the Commission determined,
and plaintiff does not dispute, that plaintiff
reached maximum medical improvement on 4
January 1993.
Thus, it was improper to award
the plaintiff temporary total disability after
this date.
Id. at 204-05, 206, 472 S.E.2d at 385, 386 (citations omitted)
(emphasis added). In other words, the Court appears to have
applied the framework established by N.C. Gen. Stat. § 97-31(wherein MMI marks the end of the healing period) to benefits
received under N.C. Gen. Stat. § 97-29 and § 97-30. Based upon
this construction of the law, the Court in
Franklin held that the
only options available to the plaintiff after reaching MMI were
benefits for (1)
permanent total disability under N.C. Gen. Stat.
§ 97-29, (2)
permanent partial disability under N.C. Gen. Stat. §
97-30, or (3) scheduled benefits under N.C. Gen. Stat. § 97-31.
Id. at 206-07, 472 S.E.2d at 387.
Franklin appears to hold that MMI serves to delineate the
point in time when temporary disability ends and permanent
disability begins,
even within the context of a loss of wage-
earning capacity established pursuant to N.C. Gen. Stat. § 97-29 or
§ 97-30. In fact, it has become increasingly common for parties to
argue precisely such a proposition to this Court, expressly relying
upon
Franklin. However, to the extent that
Franklin states that an
employee may not receive temporary total disability benefits under
N.C. Gen. Stat. § 97-29 after the employee reaches MMI, such
holding is inconsistent with
Carpenter and the Workers'
Compensation Act, and also conflicts with prior case law.
See,
e.g., Watson v. Winston-Salem Transit Authority, 92 N.C. App. 473,
475, 374 S.E.2d 483, 485 (1988) ([w]e hold that the Industrial
Commission erred in finding that because plaintiff reached maximum
medical improvement she was not entitled to additional temporary
total disability payments).
Perhaps more significantly,
Franklin seems to imply (and, in
fact, defendants here argue) that, in general, once an employerestablishes that an employee has reached MMI, (1) any presumption
of ongoing temporary disability established pursuant to N.C. Gen.
Stat. § 97-29 or § 97-30 is thereby rebutted, (2) the burden of
proof shifts back to the employee, and (3) the employee may only
receive disability benefits if the employee establishes the
existence of a permanent disability.
See, e.g., Anderson, 144
N.C. App. at 670, 550 S.E.2d at 243-44 (where this Court, in a case
involving a total loss of wage-earning capacity, interpreted
Franklin in precisely this way).
In fact, as established by case law both prior to
Franklin and
since
Franklin, the concept of MMI does not have any direct bearing
upon an employee's right to continue to receive temporary
disability benefits (or upon an employee's presumption of ongoing
disability) once the employee has established a loss of wage-
earning capacity pursuant to N.C. Gen. Stat. § 97-29 or § 97-30.
See Watson, 92 N.C. App. at 476, 374 S.E.2d at 485 ([t]he maximum
medical improvement finding is
solely the prerequisite to
determination of the amount of any permanent disability for
purposes of G.S. 97-31 (emphasis added));
Russos, 145 N.C. App. at
167-68, 551 S.E.2d at 459 (holding that finding of MMI does not
rebut presumption of ongoing disability, and that cases holding to
the contrary, such as
Franklin, are not supported by case law). An
employee who establishes a total or partial loss of wage-earning
capacity pursuant to N.C. Gen. Stat. § 97-29 or § 97-30 is entitled
to continue to receive benefits for as long as the loss of wage-
earning capacity continues (up to a maximum of 300 weeks forpartial disability), regardless of whether the employee's
physical
injury has reached a point of maximum medical improvement or not.
The primary significance of the concept of MMI (or maximum
improvement or maximum recovery) is to delineate when the
healing period ends and the statutory period begins in cases
involving an employee who may be entitled to benefits for a
physical impairment listed in N.C. Gen. Stat. § 97-31. In other
words, MMI represents the first point in time at which the employee
may elect,
if the employee so chooses, to receive scheduled
benefits for a specific physical impairment under N.C. Gen. Stat.
§ 97-31 (without regard to any loss of wage-earning capacity).
MMI
does not represent the point in time at which a loss of wage-
earning capacity under N.C. Gen. Stat. § 97-29 or § 97-30
automatically converts from temporary to permanent.
(See footnote 5)
In the present case, even assuming
arguendo that defendants
are correct that Dr. King's testimony clearly established that
plaintiff had reached MMI prior to the hearing, and that,
therefore, the evidence does not support the Commission's findingthat plaintiff had not reached MMI as of the hearing, we find such
error to be immaterial at this time.
See Vaughn v. Dept. of Human
Resources, 37 N.C. App. 86, 90, 245 S.E.2d 892, 894 (1978) (to
warrant reversal, an error made by the Industrial Commission must
be material and prejudicial),
affirmed, 296 N.C. 683, 252 S.E.2d
792 (1979). Plaintiff has established a total loss of wage-earning
capacity pursuant to N.C. Gen. Stat. § 97-29. He has not sought
scheduled benefits pursuant to N.C. Gen. Stat. § 97-31, nor has he
sought to establish that his total loss of wage-earning capacity is
permanent.
(See footnote 6)
He is, therefore, entitled to an ongoing award of
disability benefits equal to two-thirds of his average weekly
wages for as long as he remains totally disabled.
Lackey v. R. L.
Stowe Mills, 106 N.C. App. 658, 663, 418 S.E.2d 517, 520,
disc.
review denied, 332 N.C. 345, 421 S.E.2d 150 (1992). At this point
in time, it matters not whether plaintiff has reached MMI.
(See footnote 7)
Because any error as to whether plaintiff has reached maximum
medical improvement is immaterial at this time, we need not address
whether the Commission erred in finding that plaintiff had not
reached MMI.
IV.
In its Opinion and Award, the Commission entered the following
finding of fact, pertinent to defendants' fourth argument:
9. After the remedial surgery,
plaintiff's psychological condition became
unstable and he attempted to withdraw from his
pain medications too quickly causing him to
become physically and psychologically ill.
Consequently, plaintiff entered a
detoxification unit for three days.
By their fourth argument, defendants contend that they should not
bear the cost of plaintiff's detoxification program because the
finding of fact above is not supported by any medical evidence.
However, the record reveals that defendants' assignment of error
actually contends that this finding of fact is not based upon any
competent evidence (whether medical or otherwise).
The finding in question is supported by competent evidence.
Plaintiff testified: that Dr. King initially prescribed heavy
narcotic pain medication over a period of about six months; that
when plaintiff ran out of the medication, Dr. King decided not to
prescribe a refill because he believed plaintiff was taking too
much of it; that plaintiff abruptly discontinued taking the pain
medication and experienced some withdrawal symptoms; and that, as
a result, plaintiff entered a detoxification program in Hamlet,
North Carolina. This testimony is competent evidence that supports
the Commission's finding of fact, and we reject defendants' fourth
argument.
V.
Lastly, defendants argue that the Commission erred in failing
to award defendants a credit for having advanced plaintiff's share
of the mediator's fee against the compensation due plaintiff.
Prior to the hearing in this case, the parties stipulated that
defendants had paid the mediator's fee of $375.00 in full, thereby
advancing plaintiff's share of $187.50. Rule 7(c) of the Rules for
Mediated Settlement and Neutral Evaluation Conferences of the North
Carolina Industrial Commission provides that, [u]nless otherwise
. . . ordered by the Commission, all parties must pay equal shares
of the mediator's fee. In such situations, the defendant is
required to pay the plaintiff's share, as well as its own, and the
defendant shall be reimbursed for the plaintiff's share when the
case is concluded from benefits that may be determined to be due to
the plaintiff. R. Mediated Settlement Confs. Of N.C. Indus.
Comm'n 7(c), 2002 Ann. R. N.C. 794, 795.
Here, at the conclusion of its Opinion and Award, the
Commission entered the following order: Defendants shall pay the
costs. Thus, pursuant to the authority vested in the Commission
by Rule 7(c), the Commission apparently concluded that the costs of
the mediated settlement conference should not be apportioned as set
forth in Rule 7(c), and further that plaintiff should not be
obligated to share in the payment of such costs. We hold that the
Commission did not err in entering this order, and we, therefore,
reject defendants' final argument.
For the reasons set forth herein, we affirm.
Affirmed. Judge McGEE concurs.
Judge BRYANT dissents in part.
============================
BRYANT, Judge, dissenting in part.
I dissent from the portion of the majority opinion relating to
whether the concept of MMI is material to Issue # 3. That issue
on appeal is whether, once the employee has established loss of
wage earning capacity pursuant to N.C. Gen. Stat. § 97-29 or N.C.
Gen. Stat. § 97-30, employee may continue to receive temporary
total disability after having reached maximum medical improvement.
In two prior decisions of this court, we addressed this issue. In
Anderson v. Gulistan Carpet, Inc., 144 N.C. App. 661 (2001) , a
panel of this Court answered that issue, no; however, in another
opinion filed on the same day as Anderson, a different panel in
Russos v. Wheaton Industries, 145 N.C. App. 164, 551 S.E.2d 456,
disc. review denied, ___ N.C. ___, ___ S.E.2d ___ (2001) answered,
yes. No appeal was taken by the parties from the Anderson
decision; and, our Supreme Court declined to grant discretionary
review of the Russos decision.
Manifestly, a conflict of panels on this Court requires a
decision from our Supreme Court. N.C. Gen. Stat. § 7A-30(2).
Accordingly, I dissent from the majority decision for the reasons
stated in Anderson and thereby afford the defendants the
opportunity to appeal this issue directly to the Supreme Court to
obtain a definitive opinion.
Footnote: 1 We note that this case involves an initial determination of
disability pursuant to N.C. Gen. Stat. § 97-29, and should
therefore be distinguished from our opinion in
Shingleton v.Kobacker Group, ___ N.C. App. ___, ___ S.E.2d ___ (No. COA01-232
filed 19 February 2002), which involves a plaintiff seeking to
establish a change in condition pursuant to N.C. Gen. Stat. §
97-47 (1999).
Footnote: 2 These two options are, of course, not exhaustive, since
there are a few additional categories of other specific benefits
available to particular claimants; examples include claims for
death benefits, claims due to asbestosis and silicosis, and claims
for hearing loss.
Footnote: 3 We note that in cases where an employee has a specific
physical impairment that falls under N.C. Gen. Stat. § 97-31, and
is also able to show a loss of wage-earning capacity (whether
partial or total), the employee may elect to seek benefits under
whichever statutory section will provide the more favorable remedy.
See Whitley v. Columbia Lumber Mfg. Co., 318 N.C. 89, 348 S.E.2d
336 (1986);
Gupton, 320 N.C. 38, 357 S.E.2d 674.
Footnote: 4 We have also considered the import of our Sup
reme Court's
per curiam opinion in
Neal v. Carolina Mgmt., 350 N.C. 63, 510
S.E.2d 375 (1999), reversing this Court's majority opinion
and
adopting the dissenting opinion in
Neal v. Carolina Management, 130
N.C. App. 228, 502 S.E.2d 424 (1998). We interpret the dissenting
opinion, and therefore the Supreme Court's
per curiam opinion, as
standing for the narrow proposition that maximum medical
improvement, by definition, means that the employee's healing
period has ended.
Id. at 235, 502 S.E.2d at 429.
Footnote: 5 The confusion in this area is not surpr
ising given that
compensation received during the healing period under § 97-31 is
sometimes referred to as compensation for temporary disability,
and compensation received during the statutory period under § 97-31
is sometimes referred to as compensation for permanent
disability.
See, e.g., Carpenter, 73 N.C. App. at 311, 326 S.E.2d
at 329. Such terminology tends to obscure the crucial distinction
between the healing period/statutory period framework under N.C.
Gen. Stat. § 97-31 (where MMI signifies a point in time when an
employee's
physical impairment becomes permanent) and the
temporary/permanent framework under § 97-29 and § 97-30 (where the
permanency of an employee's
wage-earning capacity is necessarily
determined by more than merely an assessment of the status of the
employee's physical impairment).
Footnote: 6 We do not address the role that MMI might play where an
employee receiving benefits under § 97-29 or § 97-30 seeks to
establish that the employee's loss of wage-earning capacity is
permanent.
Footnote: 7 At some later point in time, plaintiff may seek to recover
benefits for a specific physical impairment under N.C. Gen. Stat.
§ 97-31, in which case the question of whether he has reached MMI
would be relevant. Also, at some later point in time, plaintiff
may seek to establish that his loss of wage-earning capacity is
permanent, in which case the question of whether he has reached MMI
may be relevant.
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