DIANE ATKINS,
Plaintiff,
v
.
KELLY SPRINGFIELD TIRE CO.,
and
THE TRAVELERS INS., CO.,
Defendant.
Kathleen G. Sumner, Attorney for appellant.
Jonathan C. Anders and Jaye E. Bingham, Attorneys for
Appellees.
WYNN, Judge.
Under Lewis v. Craven Reg'l Med. Ctr., 134 N.C. App. 438, 441,
518 S.E.2d 1, 3 (1999), the Industrial Commission's conclusion that
compensation and compromise agreements are fair and just must be
indicated in the approval order [and] must come after a full review
of the medical records filed with the agreement submitted to the
Commission. The claimant in this case argues that the Commission
erred by approving her compensation agreement without reviewing her
medical records. Because the record shows that the Commission
relied only on the Form 25R Physician Evaluation for Permanent
Disability, and not the full and complete medical report as
required under N.C. Gen. Stat. § 97-82(a) (2001), we remand thismatter to the Commission for further consideration.
The underlying facts show that claimant Diane Atkins sustained
a compensable injury to her left arm on 3 November 1995 while
working at Kelly Springfield Tire Company. Based on a 10%
permanent partial disability rating to her left arm made by her
treating physician, Dr. James H. Askins, the parties executed a
Form 21 Agreement for Compensation for Disability for 24 weeks of
permanent partial disability benefits. The Commission approved the
agreement on 19 August 1996 and two days later, the Commission
approved a lump sum award of $11,472 to Ms. Atkins.
For the next three years, Ms. Atkins did not have any pain in
her left arm nor did she receive any medical treatment for her
compensable injury. However, after Ms. Atkins began experiencing
pain in her left wrist in July 1999, she consulted with her former
treating physician, Dr. Askins, who ultimately performed distal
ulnar resection surgery on her hand. In October 1999, Ms. Atkins,
through an attorney, filed a Form 18 Notice of Accident to Employer
along with a request that the claim be assigned for a hearing.
Following a hearing, Deputy Commissioner Amy Pfeiffer declined to
set aside the Form 21 agreement and denied Ms. Atkins claim for
additional benefits; Ms. Atkins appealed to the full Commission.
From the full Commission's affirmance, Ms. Atkins now appeals to
this Court.
The North Carolina Workers' Compensation Act, N.C. Gen. Stat.
§§ 97-1 et seq., does not prevent settlements made by and between
the employee and employer so long as the amount of compensation andthe time and manner of payment are in accordance with the
provisions of this Article. N.C. Gen. Stat. § 97-17. If the
employer and the injured employee reach an agreement regarding
compensation, such agreement, accompanied by a full and complete
medical report, shall be filed with and approved by the Commission;
otherwise such agreement shall be voidable by the employee or his
dependents. N.C. Gen. Stat. § 97-82(a).
In addition to the statutory mandate that the agreement be
accompanied by a full and complete medical report, N.C.
Industrial Comm. R. 501(3) states no agreement will be approved
until all relevant medical, vocational and nursing rehabilitation
reports known to exist in the case have been filed with the
Industrial Commission. While Rule 503(3) does not define the term
relevant medical reports, reading 501(3) in light of N.C. Gen.
Stat. § 97-82(a) leads us to conclude that relevant records include
the full and complete medical records related to the work-related
injury.
In this case, the Form 21 compensation agreement was submitted
for approval with a Form 25R Evaluation for Permanent Disability
stamped with the treating physician's signature.
(See footnote 1)
Therefore, when
the employer sought approval of the Form 21 agreement, no medical
records were submitted to the Commission as required. Thus, theclaimant argued before the full Commission that the Form 21
agreement must be set aside. In response, the full Commission
concluded:
[T]he Commission was presented with a Form 25R
that was stamped with the treating physician's
signature. . . . While perhaps not advisable,
the Commission sometimes approves from
agreements based upon a review of the Form 25R
if the Form 25R is signed by the treating
physician.
We hold that the Commission's substitution of the Form 25R for the
statutory requirement of a full and complete medical report is more
than not advisable; it is statutorily impermissible. Under Lewis,
this Court recognized that the N.C. Gen. Stat. § 97-82(a)
requires the Commission to indicate in its approval order that the
agreement is fair and just; furthermore, the fair and just
determination must come after a full review of the medical records
filed with the Agreement filed with the Commission. Lewis, 134
N.C. App. at 441, 518 S.E.2d at 3 (emphasis added). If the
Commission approves an agreement without conducting the required
inquiry and concluding the agreement is fair and just, the
agreement is subject to being set aside. Id.
In this case, the Commission acknowledges that it substituted
the Form 25R for the statutorily required full and complete
medical reports. Since we hold that this substitution is not
permitted by our legislature, we must remand this matter for
further consideration by the Commission to determine whether the
Form 21 Agreement was fair and just. Id.
On remand, the Commission must determine the fairness andjustness of the agreement from the medical evidence filed with the
agreement at the time it was originally submitted to the Commission
for approval. Id. Since it appears from the record there were
not any medical records submitted to the Commission with the Form
21 agreement for approval in 1995, the Commission is to review all
medical, vocational and rehabilitation records and data related to
the work-related injury existing at the time the Form 21 agreement
was submitted for original approval. In determining whether the
Form 21 agreement was fair and just, the Commission should be
guided by the direction set forth in Lewis: The agreement is fair
and just only if it allows the injured employee to receive the most
favorable disability benefits to which he is entitled. Lewis, 134
N.C. App. at 441, 518 S.E.2d at 3.
Reversed and Remanded.
Judges GREENE and BIGGS concur.
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