NO. COA03-1688
2. Workers' Compensation-_right to direct medical treatment--acceptance of
compensable claim
The Industrial Commission did not err in a workers' compensation case by failing to find
as a fact that plaintiff did not offer evidence that medical treatment rendered by various doctors
and facilities were necessary to effect a cure, to give relief, or to lessen plaintiff's period of
disability, because: (1) defendant did not accept the claim as compensable and therefore was not
entitled to select or limit plaintiff's physicians or treatment; and (2) while the Industrial
Commission previously required a finding that a plaintiff's chosen physician was reasonably
required to effect a cure or give relief in order for the care to be compensable, the 1991
amendment to N.C.G.S. § 97-25 deleted the language supporting such a requirement.
Walden & Walden, by Daniel S. Walden, for plaintiff-appellee.
Cranfill, Sumner & Hartzog, L.L.P., by W. Scott Fuller, for
Defendant-Appellants.
WYNN, Judge.
Defendants VF Corporation (VF) d/b/a/ The Lee Apparel
Company, Inc. d/b/a/
VF Jeans-Wear Limited Partnership
and
Gallagher Bassett Services, Inc. (GBS)
appeal from an Opinion and
Award of the North Carolina Industrial Commission, contending that: (1) the Industrial Commission's Finding of Fact No. 21, to the
extent it suggests a causal relationship between Craven's back
injury and mental condition, is not supported by competent
evidence; (2) the Industrial Commission's Conclusion of Law No. 3,
insofar as it relates to Craven's
mental condition, is not
supported by competent findings of fact; (3) the Industrial
Commission's Award No. 2, insofar as it relates to Craven's mental
condition, is not supported by the Findings of Fact and Conclusions
of Law; (4) the Industrial Commission erred in failing to find as
a fact that Craven did not offer evidence that the medical
treatment rendered by Drs. Bell and Holthusen, Forsyth Medical
Center, and Maplewood Family Practice was necessary to effect a
cure, to give relief, or to lessen Craven's period of disability;
and (5) the Industrial Commission erred in failing to conclude as
a matter of law that the medical treatment rendered by Drs. Bell
and Holthusen, Forsyth Medical Center, and Maplewood Family
Practice was not necessary
to effect a cure, to give relief, or to
lessen Craven's period of disability
. For the reasons stated
herein, we disagree and affirm the Industrial Commission's Opinion
and Award.
The procedural and factual history of the instant appeal is as
follows:
Craven worked as a jeans inspector at VF in
Winston-Salem, North Carolina, where she was responsible for
identifying and sorting irregular jeans. Craven's job, which she
worked four days per week, ten hours per shift, involved lifting
boxes of jeans weighing up to thirty pounds.
While Craven was
injured once before on the job when a bag of jeans hit her head andneck, she did not file a workers' compensation claim. Craven had
no difficulty performing her duties until 28 March 2000.
The record further shows that when Craven arrived at work on
28 March 2000
, her workstation was a mess.
Boxes of irregular
jeans were everywhere because the employee who usually worked the
shift prior to Craven did not show up to work. Craven reported to
her manager that she needed assistance to process the backlog.
Help was promised but never delivered.
In picking up a box of
jeans from the floor, Craven felt her back pop, then burn. Pain
radiated to her hip and leg and she nearly passed out. At her
break, Craven reported the injury to supervisors.
On 29 March
2000, Craven was incapable of performing the lifting required at
her job. Management arranged for medical care at PrimeCare, VF's
health care provider. PrimeCare returned Craven to light duty work
that could be performed standing or sitting and that involved less
lifting.
On 10 April 2000, Craven visited her family physician, Dr.
Keith Van Zandt, who noted that Craven had no history of back
trouble. Dr. Van Zandt found tenderness and a strain and later
diagnosed Craven with, inter alia, very diffuse tenderness and
muscle tightness in her upper and lower back and fairly marked
spasms[.]
On 12 April 2004, Craven was evaluated by Novant
Health; Craven was ordered to receive physical therapy twice a week
for four weeks.
Craven was seen again by Dr. Van Zandt's office,
put on prescription medication for her condition, and temporarily
taken
out of work. On 15 May 2000, Craven was also seen by Dr.
Greg Holthusen, an orthopedist
for whose services Defendantsrefused to pay. Dr. Holthusen believed Craven to have a musculo-
ligamentous injury.
On 28 May 2000, Craven was treated at the
Forsyth Medical Center for severe spasms in her lower back and
referred to an orthopedist.
Craven was last able to work on 11 May
2000.
In May 2000,
Defendants arranged for Craven to see Dr. Philips
J. Carter, who diagnosed Craven with
back sprain and spinal
stenosis.
Dr. Carter believed Craven's pain to be real and
prescribed medical and physical therapy treatment.
Dr. Carter's
prescriptions were, however, not being followed because the
insurance company wasn't paying for this or that [and was] sending
[Craven] back to keep seeing me without doing my treatment.
Carter believed one of the things that, perhaps, prolonged
[Craven's conditions] was just failure to get her into a good
combination of medicine and therapy. As the Industrial Commission
noted, Dr. Carter wrote on or around 12 July 2000, I have
requested further PT, but the insurance company has failed to do
that. I am not sure why they are willing to pay my bill . . . and
yet are not willing to do the treatment that I recommend.
Indeed
,
on 13 July 2000, VF executed a Form 61 Denial of Workers'
Compensation Claim. Again, on 3 August 2000, in its Response to
Request That Claim Be Assigned For Hearing, VF
denied
the
compensability of Craven's claim.
On 21 June 2000, Dr. Van Zandt noted that Craven was having
increasing [] difficulties as well as chronic pain. Dr. Van Zandt
further noted that Craven was developing signs of depression.
On
27 July 2000, Dr. Van Zandt noted that Craven has had increasingdepressive symptoms largely related to her ongoing back pain.
Moreover, Dr. Carter, Defendants' requested physician, testified
that he believed that it was reasonable for Craven to seek
psychological treatment if she suffered from depression secondary
to her back pain.
Deputy Commissioner W. Bain Jones, Jr. filed an Opinion and
Award on 24 July 2001, concluding that Craven sustained injury due
to a workplace accident, that Craven was entitled to medical
treatment of the injury, and that Craven had failed to prove she
remained disabled from the accident. Craven appealed to the full
Industrial Commission, which found in its Opinion and Award dated
5 August 2002 and filed 29 May 2003, inter alia, that Craven had
indeed remained totally disabled from her accident and was entitled
to temporary total disability benefits. Defendants appealed.
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