A decision without a published opinion is authority only in the case in which such decision is rendered and should not be cited in any other case in any court for any other purpose, nor should any court consider any such decision for any purpose except in
the case in which such decision is rendered. See Rule of Appellate Procedure 30 (e)(3).
NO. COA01-568
NORTH CAROLINA COURT OF APPEALS
Filed: 6 August 2002
DAVID WARD,
Employee,
Plaintiff,
v
.
North Carolina
FLOORS PERFECT, Industrial Commission
Employer; I.C. File No. 816964
PENN NATIONAL INSURANCE,
Carrier,
Defendants.
Appeal by plaintiff from opinion and award filed 8 February
2001 by the North Carolina Industrial Commission. Heard in the
Court of Appeals 18 February 2002.
Law Offices of George W. Lennon, by George W. Lennon and
Michael W. Ballance, for plaintiff appellant.
Young Moore and Henderson, P.A., by Dawn Dillon Raynor and
Zachary C. Bolen for defendant appellees.
McCULLOUGH, Judge.
This case arises out of a workers' compensation claim filed by
plaintiff David J. Ward. On appeal, plaintiff seeks review of the
Industrial Commission's opinion and award ordering defendants
Floors Perfect (the employer) and Penn National Insurance (the
insurance carrier) to pay plaintiff reasonable medical expenses and
partial compensation. The relevant facts are as follows: In 1997,
plaintiff was self-employed and operated Floors Perfect, a floorcovering business. Plaintiff did much of the actual installation
himself, working eight hours a day, six hours of which he spent on
his knees. On 27 August 1997, plaintiff filed a workers'
compensation claim alleging that, over time, he developed bilateral
patellofemoral pain (damage to the knees) as a result of his
occupation. Plaintiff's Form 33, dated 3 February 1998, requested
compensation at a rate of $532.00 per week for the days of work he
missed, beginning 13 January 1997; payment of all medical expenses
and treatment; payment for permanent partial disability as required
by law; and payment for training in a new occupation. The Form 33
also requested a hearing before a Deputy Commissioner of the North
Carolina Industrial Commission.
On 5 February 1998, Mr. Joe Griggs, a claims representative
for the insurance carrier filed a Form 61 denying plaintiff's
claim. Mr. Griggs' letter stated that, Upon investigation, your
claim does not meet the statutory requirements for accidental
injury under General Statute 97-2. Medical expenses to this date
will be paid. On 14 April 1998, defendants Floors Perfect and
Penn National Insurance filed a Form 33R in response to plaintiff's
request for a hearing. Defendants maintained that [o]ur
investigation reveals that plaintiff did not sustain an injury by
accident as defined by the Act and his injuries are not the result
of an occupational disease.
On 26 June 1998, plaintiff's case was heard by Deputy
Commissioner Kim L. Cramer in Raleigh, North Carolina. Deputy
Commissioner Cramer found that plaintiff was 41 years old and wasattending community college in hopes of transferring to a four-year
university and going on to law school. Since 1994, plaintiff owned
and operated Floors Perfect, a business installing carpet, vinyl
tile, and linoleum. Plaintiff did the floor installation himself
and spent approximately six hours per day on his knees. Plaintiff
had ten to fifteen years' experience in flooring work prior to
opening Floors Perfect. When plaintiff suffered an unrelated back
injury in September 1997, he stayed out of work until February 1998
and contracted out all his labor.
According to Deputy Commissioner Cramer, plaintiff did not
sustain a specific injury on 27 August 1997; instead, he had been
experiencing trouble with both his knees for several weeks prior to
that date. On 27 August, plaintiff went to WakeMed's emergency
room and told the staff he worked as a flooring installer and had
experienced knee pain for about two months. He was advised to
consult an orthopedic specialist. On 13 January 1998, plaintiff
saw orthopedic surgeon Dr. George Callaway. Plaintiff related that
he had experienced increasing knee pain for the past one to two
years. Dr. Callaway took X-rays, which showed full range of motion
on both knees, stable planes, and no effusion. Other tests ruled
out any cartilage or ligament tears, though Dr. Callaway did notice
crepitus, a crunching noise behind the kneecaps. After
diagnosing plaintiff with bilateral patellofemoral pain (anterior
knee pain), Dr. Callaway gave plaintiff a prescription for an anti-
inflammatory drug, Daypro, and sent plaintiff to physical therapy.
Plaintiff did not take the Daypro, nor did he participate in
physical therapy. Plaintiff went to his first physical therapy
session and informed the therapist he did heavy lifting at work and
was not interested in doing further exercise. Despite plaintiff's
references to work, however, he was actually out of work during
January and February 1998 due to his unrelated back injury. On 24
February 1998, plaintiff saw Dr. Callaway and told him he had taken
Daypro before and it was not helpful. Upon examination, Dr.
Callaway again found full range of motion, stable planes and no
effusion. He advised plaintiff to continue physical therapy and
cleared plaintiff to return to work, with the restriction of no
kneeling. Until he was deposed, Dr. Callaway believed plaintiff
was following through with the physical therapy recommendations.
Plaintiff sought no further medical treatment for his knees
until he visited Dr. Callaway nearly a year later, on 18 February
1999. On that date, Dr. Callaway recommended an MRI. The MRI
showed the cartilage on the back of the plaintiff's kneecap was
defective and there was a small cartilage tear on the lateral
tibial plateau (permanent damages Dr. Callaway believed were caused
by plaintiff's work), as well as a small medial meniscus tear
(which Dr. Callaway believed was unrelated to plaintiff's work).
Dr. Callaway advised plaintiff that the only other possible
treatment was arthroscopy of the right knee and an MRI of the left
knee. Otherwise, Dr. Callaway noted, as of plaintiff's last visit
on 27 July 1999, he was at maximum medical improvement, with a 5%
permanent impairment to his right knee and a 2½% permanentimpairment to his left knee.
Plaintiff continued working but did not resume installation of
flooring after September 1997. Despite this fact, plaintiff's knee
condition remained the same. On 29 April 1998, a physical capacity
evaluation revealed plaintiff could frequently lift and carry up to
fifty pounds, could bend at the waist, and handle materials with
his upper extremities; his only permanent restriction was no
kneeling. By the summer of 1998, plaintiff stopped working and
entered community college. Upon making her findings of fact, Deputy
Commissioner Cramer made the following conclusions of law:
1. As a result of his employment,
Plaintiff has developed bilateral
patellofemoral pain, a condition which is due
to causes and conditions peculiar to his
employment, and which is not a condition to
which the general public is equally exposed
and which is therefore compensable as an
occupational disease pursuant to N.C. Gen.
Stat. § 97-53(13).
2. Defendants are responsible for
payment of all medical expenses incurred for
Plaintiff's treatment of his bilateral
patellofemoral pain. N.C. Gen. Stat. § 97-
2(19), 97-25.
3. The Plaintiff has not suffered any
loss of his wage earning capacity as a result
of his bilateral patellofemoral pain. As
Plaintiff voluntarily removed himself from the
labor market to pursue his education, the
evidence fails to establish any periods of
time for which he would be entitled to
benefits for either partial or total
disability. N.C. Gen. Stat. § 97-29.
4. Plaintiff has reached maximum
medical improvement from his bilateral
patellofemoral pain and has sustained a five
percent permanent impairment to his right leg
and a two and one-half percent permanent impairment to his left leg for which he is
entitled to compensation pursuant to N.C. Gen.
Stat. § 97-31(15).
Defendants were ordered to pay plaintiff's medical expenses, as
well as $512.00 per week for fifteen weeks, beginning 27 July 1999,
as compensation for the permanent impairment ratings of his knees.
Deputy Commissioner Cramer determined a reasonable attorney's fee
of twenty-five percent of the compensation due plaintiff was
approved for his counsel, and defendants were also required to pay
the costs of the action. Plaintiff appealed to the Full
Commission.
By opinion and award filed 8 February 2001, the Full
Commission concluded plaintiff did not show good grounds for
reconsidering the evidence or receiving further evidence. The Full
Commission entered its own findings of fact and conclusions of law
affirming Deputy Commissioner Cramer's decision. Plaintiff again
appealed.
On appeal, plaintiff argues the Full Commission erred by (I)
misapplying the burden of proof and failing to find he was
temporarily totally disabled; (II) reaching an unsupported
conclusion of law that he had reached maximum medical improvement;
(III) failing to make findings of fact regarding his actual wage
earning capacity; (IV) failing to award him retraining and failing
to award disability payments during retraining; and (V) failing to
properly address plaintiff's motion for sanctions. For the reasons
set forth herein, we disagree with plaintiff's contentions and
affirm the decision of the Full Commission.
Burden of Proof
By his first assignment of error, plaintiff argues the Full
Commission misapplied the burden of proof and incorrectly concluded
he failed to prove he was disabled and voluntarily removed himself
from the job market to attend school full time. We do not agree.
In reviewing an award of the Industrial Commission, [t]he
reviewing court's inquiry is limited to two issues: whether the
Commission's findings of fact are supported by competent evidence
and whether the Commission's conclusions of law are justified by
its findings of fact. Hendrix v. Linn-Corriher Corp., 317 N.C.
179, 186, 345 S.E.2d 374, 379 (1986). 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. Id. at 185, 345 S.E.2d at 378. The Workers' Compensation
Act defines a disability as
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.
N.C. Gen. Stat. § 97-2(9) (2001). The term 'disability' as used
under the Workers' Compensation Act refers to the diminished
capacity to earn wages and not to physical infirmity. Priddy v.
Cone Mills Corp., 58 N.C. App. 720, 721, 294 S.E.2d 743, 744
(1982).
[I]n order to support a conclusion of
disability, the Commission must find: (1) that
plaintiff was incapable after his injury of
earning the same wages he had earned before
his injury in the same employment, (2) that
plaintiff was incapable after his injury of
earning the same wages he had earned beforehis injury in any other employment, and (3)
that this individual's incapacity to earn was
caused by plaintiff's injury.
Hilliard v. Apex Cabinet Co., 305 N.C. 593, 595, 290 S.E.2d 682,
683 (1982). An employee may meet the burden in one of the
following 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.
Russell v. Lowes Product Distribution, 108 N.C. App. 762, 765, 425
S.E.2d 454, 457 (1993) (citations omitted). Once the employee
presents substantial evidence of his incapacity to earn wages, the
employer must come forward with evidence to show not only that
suitable jobs are available, but also that the plaintiff is capable
of getting one, taking into account both physical and vocational
limitations. Kennedy v. Duke Univ. Med. Center, 101 N.C. App. 24,
33, 398 S.E.2d 677, 682 (1990); Barber v. Going West Transp., Inc.,
134 N.C. App. 428, 435, 517 S.E.2d 914, 920 (1999). With these
principles in mind, we turn to the case at hand.
Plaintiff contends he met his burden of proving disability.
He points to the testimony of Dr. Callaway, who stated plaintiff
was totally disabled from work as a flooring installer and waspermanently restricted from this type of work in the future.
Plaintiff also contends he showed he was incapable after his injury
of earning the same wages he had earned before his injury in the
same employment, because of his age and lack of education. See
Hilliard, 305 N.C. 593, 290 S.E.2d 682; and Russell, 108 N.C. App.
762, 425 S.E.2d 454. Plaintiff also believes he successfully
conveyed the futility of his search for employment -- and his need
for further schooling -- because someone with a high school
equivalency degree could not earn the same money in another field,
and he maintains he was unable to work in flooring anymore, per Dr.
Callaway's instructions. Plaintiff stated he made over $50,000.00
in 1997 before his injury. He also testified that [t]here's no
way that I could find a job without some type of education, in my
own belief, that would allow me to make a comparable salary as to
what I was doing before.
Plaintiff argues the burden should have then shifted to
defendants to demonstrate the existence of a suitable job
plaintiff could have obtained, considering his limitations. See
Kennedy, 101 N.C. App. at 33, 398 S.E.2d at 682. Plaintiff notes
defendants did not present any evidence before the Full Commission,
and believes they could not meet their burden of showing that
plaintiff retained his pre-injury wage-earning capacity because
there was no evidence of suitable employment for him. Plaintiff
argues defendants should have looked for suitable jobs for him,
taking into account his aptitudes, capabilities, and vocational
future. Moreover, plaintiff contends the Full Commission erred inconcluding that he voluntarily removed himself from the job market
to pursue his educational aspirations. Plaintiff states he went to
school because he could not earn pre-injury wages. He compares his
situation to a voluntary retirement and notes this Court has held
that the Full Commission cannot deny benefits to an injured worker
when the worker chooses to attend school rather than take an
unsuitable job offered by the employer. See Dixon v. City of
Durham, 128 N.C. App. 501, 495 S.E.2d 380, disc. review denied, 348
N.C. 496, 510 S.E.2d 381 (1998).
Plaintiff's arguments hinge on his belief that he met his
burden of showing disability so that the burden shifted to
defendants to demonstrate the existence of a suitable job that
plaintiff could have obtained, given his particular situation.
Plaintiff relies heavily on Russell to argue that the Full
Commission applied an incomplete legal standard in determining
whether plaintiff met his burden of proving disability. We do not
find these arguments persuasive.
Defendants argue, and we agree, that plaintiff never met his
burden of showing disability and the burden did not shift to
defendants to prove the availability of suitable jobs for which
plaintiff was qualified. The Full Commission found that:
15. Plaintiff has failed to prove by the
greater weight that he is incapable of work in
any employment or that he is capable of some
work but has been unsuccessful after making
reasonable efforts to locate employment. In
fact, plaintiff, without reasonable efforts to
locate employment, voluntarily removed himself
from the job market and chose to enter
community college in the summer of 1998. Plaintiff has not demonstrated that he is
incapable of earning wages due to his knee
condition.
This finding of fact was well supported by the evidence of record.
None of plaintiff's doctors opined that plaintiff could not work,
and plaintiff presented no medical evidence that he was unable to
work due to his knee injury. Despite this fact, plaintiff admitted
he had not sought any employment. Though Dr. Callaway took
plaintiff out of work for two weeks in January 1998, he
subsequently released plaintiff to work with only a no kneeling
restriction. Plaintiff was still able to lift and carry objects
weighing up to 50 pounds using his upper extremities, to climb, and
to work at unrestricted heights. Despite plaintiff's intelligence,
experience in numerous fields, and years of successfully operating
his floor installation business, he characterized a job search as
futile. The Full Commission rejected plaintiff's position, and
concluded plaintiff failed to show a loss of wage-earning capacity.
The facts found by the Commission are conclusive upon appeal
to this Court when they are supported by competent evidence, even
when there is evidence to support contrary findings. Pittman v.
International Paper Co., 132 N.C. App. 151, 156, 510 S.E.2d 705,
709, aff'd, 351 N.C. 42, 519 S.E.2d 524 (1999). Upon review, we
conclude the evidence supported the Commission's findings of fact,
which in turn supported the conclusions of law. The Full
Commission concluded plaintiff developed a compensable occupational
disease, but also concluded plaintiff had not suffered a loss in
wage-earning capacity since he failed to prove by the greaterweight of the evidence that he was unable to work or was
unsuccessful in seeking work. The evidence that plaintiff
voluntarily left work to attend school full time obviated the need
for defendants to show that suitable jobs were available to
plaintiff.
Plaintiff's first assignment of error is overruled.
Maximum Medical Improvement
By his second assignment of error, plaintiff contends the Full
Commission erred in concluding he reached maximum medical
improvement because there was no evidence to support that
conclusion. We disagree.
The Full Commission found that as of plaintiff's last visit
on July 27, 1999 with Dr. Callaway, plaintiff was at maximum
medical improvement[.] This finding of fact was supported by
competent evidence in the form of Dr. Callaway's deposition
testimony. During the deposition, Dr. Callaway was asked whether
plaintiff had reached maximum medical improvement. Dr. Callaway
responded, I think that if he chooses to go without an
arthroscopy of the knee, then he'll likely, in the near future, be
at maximum medical improvement. The record indicates plaintiff
decided to forego the arthroscopy; thus, according to Dr. Callaway,
plaintiff achieved maximum medical improvement on 27 July 1999.
Dr. Callaway's assignment of permanent disability ratings to
plaintiff's knees further supports the Full Commission's finding
that plaintiff reached maximum medical improvement. A finding of
maximum medical improvement is simply the prerequisite to adetermination of the amount of any permanent disability under N.C.
Gen. Stat. § 97-31. Silver v. Roberts Welding Contractors, 117
N.C. App. 707, 711, 453 S.E.2d 216, 219 (1995). Dr. Callaway first
had to conclude plaintiff reached maximum medical improvement
before he could assign permanent disability ratings to plaintiff's
knees. Based on our review, we conclude the Full Commission's
finding that plaintiff had reached maximum medical improvement was
supported by competent evidence of record. Plaintiff's second
assignment of error is overruled.
Wage-Earning Capacity
By his third assignment of error, plaintiff contends the Full
Commission erred by not making any findings of fact regarding his
actual wage-earning capacity. We do not agree.
In order to secure an award under G.S.
97-30, the claimant has the burden of proving
(1) that the injury resulted from accident
arising out of and in the course of his
employment; (2) that there resulted from that
injury a loss of earning capacity
(disability); and (3) that he must prove the
extent of that disability.
Gaddy v. Kern, 17 N.C. App. 680, 683, 195 S.E.2d 141, 143, cert.
denied, 283 N.C. 585, 197 S.E.2d 873 (1973). In cases involving
determinations of disability, the Full Commission is required to
make specific findings of fact as to a plaintiff's wage-earning
capacity. McLean v. Eaton Corp., 125 N.C. App. 391, 394, 481
S.E.2d 289, 291 (1997). Plaintiff argues the Full Commission's
failure to make such findings amounted to a de facto deprivation of
his right to choose a wage loss claim under N.C. Gen. Stat. § 97-30(2001). Plaintiff maintains that, under § 97-30, he could have
chosen to receive payments based on the difference in his wage-
earning capacity, or to receive a simple payment for his permanent
partial disability rating (here, $512.00 per week for 15 weeks).
See Gupton v. Builders Transport, 320 N.C. 38, 43, 357 S.E.2d 674,
678 (1987). Defendants contend, and we agree, that there has been
no de facto deprivation of plaintiff's right to choose a wage loss
claim under § 97-30 because he did not prove there was any change
in his ability to earn wages as a result of his knee injury.
Without such proof there is no authority upon which to make an
award even though permanent physical injury may have been
suffered. Gaddy, 17 N.C. App. at 683, 195 S.E.2d at 143.
Plaintiff's third assignment of error is overruled.
Retraining Expenses and Disability Benefits
By his fourth assignment of error, plaintiff contends
defendants should have paid his retraining expenses and provided
disability benefits during the period of retraining. We disagree.
N.C. Gen. Stat. § 97-2(19) explains that rehabilitative
services are meant to lessen the period of disability[.]
Plaintiff contends retraining expenses fall within the scope of
such rehabilitative services. See Sanhueza v. Liberty Steel
Erectors, 122 N.C. App. 603, 607, 471 S.E.2d 92, 95 (1996), disc.
review denied, 345 N.C. 347, 483 S.E.2d 177 (1997). Plaintiff
maintains the Industrial Commission's Rehabilitation Rules also
allow retraining expenses to be payable to him.
In the present case, the Full Commission concluded plaintifffailed to prove he was disabled. Since there was no period of
disability, defendants maintain they should not be required to pay
for plaintiff's education. Plaintiff testified he went back to
school to qualify for a job that would compensate him at his pre-
injury wage. However, we note plaintiff did not present testimony
from any vocational professional stating that retraining was
necessary in his situation. Instead, the record indicates that Dr.
Callaway released plaintiff to go back to work with only a no
kneeling restriction, that plaintiff was experienced in various
fields of work, that plaintiff was intelligent and articulate, and
that plaintiff made no efforts to find a job.
Q. Since September 9, 1997, have you sought
employment in any other position?
A. No, I have not. . . .
Q. Mr. Ward, you're an intelligent man.
You're very articulate. You obviously
have some business acumen. You ran your
own business. Isn't it true that you
could walk out the door right now and go
look for a job and probably find
something within the week?
A. Sure. Anybody can [go] down at
(unintelligible) and get a job at $5.00
an hour.
Q. But in this job economy, isn't it true
that you could find something
significantly better than that?
A. No, it's not.
Q. No, it's not? But you haven't tried;
have you?
A. No.
As we have already upheld the Full Commission's conclusion that
plaintiff failed to prove he was disabled (and likewise failed to
prove a corresponding period of disability), the issue of whether
defendants should be required to pay for retraining is moot.
Plaintiff's argument fails, and his fourth assignment of error is
overruled.
Sanctions
By his final assignment of error, plaintiff asserts the Full
Commission erred in failing to address his motion for sanctions,
which was raised in his Form 44 Application for Review. In support
of this assignment of error, plaintiff contends defendants failed
to properly investigate his claim and erred again by denying his
claim. Plaintiff contends these actions were unreasonable under
N.C. Gen. Stat. §§ 97-88.1 and 58-63-15(11) (2001) and warrant
sanctions. We disagree.
The Full Commission has a duty to make specific findings of
fact and conclusions of law with respect to each issue raised by
the evidence, and upon which plaintiff's right to compensation
depends.
Slatton v. Metro Air Conditioning, 117 N.C. App. 226,
231, 450 S.E.2d 550, 553 (1994). Plaintiff correctly points out
that [w]hether a defendant had reasonable ground to bring a
hearing is a matter reviewable by this Court
de novo.
Ruggery v.
N.C. Dep't of Correction, 135 N.C. App. 270, 273-74, 520 S.E.2d 77,
80 (1999). Thus, we turn to the statutory provisions cited by
plaintiff.
N.C. Gen. Stat. § 97-88.1 states: If the Industrial Commission shall
determine that any hearing has been brought,
prosecuted, or defended without reasonable
ground, it may assess the whole cost of the
proceedings including reasonable fees for
defendant's attorney or plaintiff's attorney
upon the party who has brought or defended
them.
N.C. Gen. Stat. § 58-63-15(11) defines unfair claim settlement
practices as follows:
d. Refusing to pay claims without conducting
a reasonable investigation based upon all
available information;
* * * *
f. Not attempting in good faith to
effectuate prompt, fair and equitable
settlements of claims in which liability
has become reasonably clear[.]
Plaintiff argues defendants violated these provisions of the
General Statutes by continually stonewalling and requesting
incorrect, unreasonable applications of the law, and should be
punished accordingly. Plaintiff also points out that defendants
presented no lay witnesses, medical opinions, or vocational expert
evidence that plaintiff was capable of earning the same wage as he
did prior to his knee injury.
Defendants, on the other hand, correctly point out that, when
determining whether attorney's fees should be awarded under N.C.
Gen. Stat. § 97-88.1, [t]he test is not whether the defense
prevails, but whether it is based in reason rather than in
stubborn, unfounded litigiousness. Sparks v. Mountain Breeze
Restaurant, 55 N.C. App. 663, 665, 286 S.E.2d 575, 576 (1982).
Defendants' position was sustained by the Full Commission, and itwas plaintiff who appealed the opinions and awards of Deputy
Commissioner Cramer and the Full Commission. After reviewing the
record below, it appears defendants were simply defending against
plaintiff's claim and did not act in a stubborn or unfounded
manner; rather, defendants' attorneys acted as zealous advocates
for their clients. As for plaintiff's contention that the Full
Commission failed to make required findings of fact, we note that,
in order for the Full Commission to award attorney's fees, it would
have had to make findings of fact that defendants' decision to
defend the lawsuit was based on stubborn, unfounded litigiousness.
The evidence does not support such findings of fact. Accordingly,
plaintiff's final assignment of error is overruled.
After careful examination of the record and the arguments
presented by the parties, the decision of the Full Commission
denying plaintiff's claim is
Affirmed.
Chief Judge EAGLES and Judge BIGGS concur.
Report per Rule 30(e).
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