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All opinions are subject to modification and technical correction prior to official publication in the North Carolina Reports and North Carolina Court of Appeals Reports. In the event of discrepancies between the electronic version of an opinion and the print version appearing in the North Carolina Reports and North Carolina Court of Appeals Reports, the latest print version is to be considered authoritative.
DAVID NOBLE WATTS, Employee, Plaintiff, v. BORG WARNER
AUTOMOTIVE, INC., Employer, and LUMBERMENS MUTUAL CASUALTY
COMPANY, Carrier, Defendants
NO. COA04-895
Filed: 21 June 2005
Workers' Compensation-_additional findings of fact required--reasonable excuse--
causation
The Industrial Commission erred in a workers' compensation case by awarding plaintiff
temporary total disability benefits and medical expenses without making adequate findings of
fact on: (1) whether plaintiff had a reasonable excuse and the employer was not prejudiced by
the delay in giving written notice as required by N.C.G.S. § 97-22; and (2) causation of the
injury. Thus, the case is remanded for further findings.
Judge ELMORE concurring.
Judge TYSON dissenting.
Appeal by Defendants from Opinion and Award entered 4 March
2004 by the North Carolina Industrial Commission. Heard in the
Court of Appeals 22 March 2005.
The Law Office of David Gantt, by David Gantt, for plaintiff-
appellee.
Hedrick, Eatman, Gardner & Kincheloe, LLP, by Hope F. Smelcer
and Angela M. Easley, for defendants-appellants.
WYNN, Judge.
The Industrial Commission is required to make findings on
crucial facts upon which the right to compensation depends. Gaines
v. L. D. Swain & Son, Inc., 33 N.C. App. 575, 579, 235 S.E.2d 856,
859 (1977). In this matter, the full Commission made no findings
of fact whether, under the circumstances, Plaintiff had a
reasonable excuse and the employer was not prejudiced for delay in
giving written notice as required by section 97-22 of the NorthCarolina General Statutes. Additionally, the full Commission
failed to make any findings of fact determining causation of the
injury. Accordingly, we remand this case for further findings of
fact.
Plaintiff David Noble Watts filed two workers' compensation
claims alleging that he injured his lower back on 28 October 1999
and 26 May 2000 while lifting turbos. Mr. Watts filed an
additional claim alleging that he injured his cervical spine and
right hand and fingers while building turbos on 16 May 2000.
Following the 28 October 1999 injury, Mr. Watts went to a
chiropractor, Dr. James Dutton, for back pain and did not report
the injury as work-related. Dr. Dutton referred Mr. Watts to Dr.
Stewart Harley, an orthopedic surgeon. On 24 November 1999, Dr.
Harley saw Mr. Watts for lower back pain. Mr. Watts told Dr.
Harley the injury was not a workers' compensation claim.
From 28 October 1999 until he was terminated on 30 April 2001,
Mr. Watts was periodically absent from work and received short-term
disability benefits while recovering from back surgery. During
this period, Mr. Watts never told his supervisor or human resources
that his injury was work-related. Mr. Watts filed four separate
weekly indemnity forms for health benefits with Defendant Borg
Warner Automotive, Inc., and stated in the four forms that the
claims were not the result of a work-related illness or injury.
Borg Warner terminated Mr. Watts on 30 April 2001 for failure to
comply with its absence policy. On 3 July 2001, Mr. Watts completed three separate Form 18s
giving Borg Warner notice of the accident and claim. Borg Warner
denied the claims. The case was heard before Deputy Commissioner
Morgan S. Chapman on 11 July 2002. Deputy Commissioner Chapman
filed an Opinion and Award denying all claims. Mr. Watts appealed
to the full Commission. The full Commission reversed the award
with regard to the 28 October 1999 claim number 152657, and awarded
Mr. Watts temporary total disability benefits from 28 October 1999
through 27 December 1999 and ordered Borg Warner to pay for related
medical expenses and attorney's fees. Borg Warner appealed the
Opinion and Award as it related to claim number 152657.
__________________________________________
On appeal, Borg Warner argues that the full Commission erred
in awarding Mr. Watts temporary total disability benefits and
medical expenses because (1) Mr. Watts's claim was barred by his
failure to timely notify Borg Warner in writing of his injury; and
(2) Mr. Watts did not sustain a compensable injury arising out of
his employment. Because the full Commission failed to make
adequate findings of fact on both issues, we remand this case for
further findings of fact.
The standard of review for this Court in reviewing an appeal
from the full Commission is limited to determining whether any
competent evidence supports the Commission's findings of fact and
whether the findings of fact support the Commission's conclusions
of law. Deese v. Champion Int'l Corp., 352 N.C. 109, 116, 530
S.E.2d 549, 553 (2000). Our review 'goes no further than todetermine whether the record contains any evidence tending to
support the finding.' Adams v. AVX Corp., 349 N.C. 676, 681, 509
S.E.2d 411, 414 (1998) (citation omitted). The full Commission's
findings of fact are conclusive on appeal when supported by
competent evidence, even if there is evidence to support a
contrary finding, Morrison v. Burlington Indus., 304 N.C. 1, 6, 282
S.E.2d 458, 463 (1981), and may be set aside on appeal only when
there is a complete lack of competent evidence to support them[.]
Young v. Hickory Bus. Furniture, 353 N.C. 227, 230, 538 S.E.2d 912,
914 (2000) (citation omitted). Further, all evidence must be taken
in the light most favorable to the plaintiff, and the plaintiff is
entitled to the benefit of every reasonable inference to be drawn
from the evidence. Deese, 352 N.C. at 115, 530 S.E.2d at 553.
Borg Warner argues that the full Commission erred in awarding
Mr. Watts temporary total disability benefits and medical expenses
because Mr. Watts's claim was barred by his failure to timely
notify Borg Warner, in writing, of his injury. Because the full
Commission failed to make adequate findings of fact, we remand for
further findings.
Section 97-22 of the North Carolina General Statutes provides
in pertinent part:
no compensation shall be payable unless such
written notice is given within 30 days after
the occurrence of the accident or death,
unless reasonable excuse is made to the
satisfaction of the Industrial Commission for
not giving such notice and the Commission is
satisfied that the employer has not been
prejudiced thereby.
N.C. Gen. Stat. § 97-22 (2004). Section 97-22 clearly requires
written notice be given by the injured employee to the employer
within thirty days. Pierce v. Autoclave Block Corp., 27 N.C. App.
276, 278, 218 S.E.2d 510, 511 (1975).
Here, both parties agree that Mr. Watts did not give written
notice of injury to his employer until twenty months after the
injury occurred. Since Mr. Watts failed to provide written notice
within the thirty-day time period, (1) he must provide a reasonable
excuse for not giving the written notice, and (2) the employer must
show prejudice for the delay. Id.
Section 97-22 gives the Industrial Commission the discretion
to determine what is or is not a reasonable excuse. N.C. Gen.
Stat. § 97-22 (. . .unless reasonable excuse is made to the
satisfaction of the Industrial Commission . . .) (emphasis added).
This Court has previously indicated that included on the list of
reasonable excuses would be, for example, 'a belief that one's
employer is already cognizant of the accident . . .' or '[w]here
the employee does not reasonably know of the nature, seriousness,
or probable compensable character of his injury and delays
notification only until he reasonably knows . . ..' Jones v.
Lowe's Cos., Inc., 103 N.C. App. 73, 75, 404 S.E.2d 165, 166 (1991)
(quoting Lawton v. County of Durham, 85 N.C. App. 589, 592, 355
S.E.2d 158, 160 (1987)); see also Lakey v. U.S. Airways, Inc., 155
N.C. App. 169, 173, 573 S.E.2d 703, 706 (2002) (reasonable excuse
because employer knew of injury where employee was injured on
employer's aircraft, employer filed an incident report, andemployee saw employer's doctor within the thirty days following the
injury); Peagler v. Tyson Foods, Inc., 138 N.C. App. 593, 603-04,
532 S.E.2d 207, 214 (2000) (reasonable excuse found because
employee did not know nature and character of injury where doctors
originally told him he had a heart attack, not a herniated disk).
The burden is on the employee to show a reasonable excuse.
Jones, 103 N.C. App. at 75, 404 S.E.2d at 166.
In this case, Mr. Watts argues in his brief
(See footnote 1)
that his fear of
retaliation was the reasonable excuse for failing timely to
notify Borg Warner in writing.
(See footnote 2)
However, while the full Commission
made a finding of fact that the late reporting did not prejudice
defendant and plaintiff's failure to timely report the injury is
excused, it failed to make findings of fact to support the
conclusion that the delay was due to a reasonable excuse. Instead, the full Commission made the following conclusion of law
which is not supported by adequate findings of fact:
5. Plaintiff stated that he did not report his
28 October 1999 injury because when he had
filed a previous workers' compensation claim
in 1991, he was moved to a job with more
difficult duties. He believed the employer
was trying to make him quit. He also stated
that he feared losing his job. We find this
to be a reasonable excuse.
While the Industrial Commission is not required to make
specific findings of fact on every issue raised by the evidence, it
is required to make findings on crucial facts upon which the right
to compensation depends. Gaines, 33 N.C. App. at 579, 235 S.E.2d
at 859. Specific findings on crucial issues are necessary if the
reviewing court is to ascertain whether the findings of fact are
supported by competent evidence and whether the findings support
the conclusion of law. Barnes v. O'Berry Ctr., 55 N.C. App. 244,
247, 284 S.E.2d 716, 718 (1981). Where the findings are
insufficient to enable the court to determine the rights of the
parties, the case must be remanded to the Commission for proper
findings of fact. Lawton v. County of Durham, 85 N.C. App. 589,
592, 355 S.E.2d 158, 160 (1987) (citing Hansel v. Sherman Textiles,
304 N.C. 44, 59, 283 S.E.2d 101, 109-10 (1981)).
Whether an employee has shown reasonable excuse depends on the
reasonableness of his conduct under the circumstances. Lawton, 85
N.C. App. at 592, 355 S.E.2d at 160. We hold that in this case,
the full Commission made no findings of fact showing that Mr.Watts feared retaliation if he timely reported his injury. As
such, the full Commission's conclusion that a reasonable excuse
existed under section 97-22 of the North Carolina General Statutes,
is not supported by adequate findings of fact. Lawton, 85 N.C.
App. at 592-93, 355 S.E.2d at 160. Accordingly, this case must be
remanded for additional findings. Additionally, if the full
Commission finds these circumstances constitute a reasonable
excuse, it must then make sufficient findings regarding whether
Borg Warner was prejudiced by the delayed notice.
(See footnote 3)
See Lakey, 155
N.C. App. at 173, 573 S.E.2d at 706; Pierce, 27 N.C. App. at 278,
218 S.E.2d at 511.
Borg Warner also argues that the full Commission erred in
concluding that Mr. Watts sustained a compensable spine injury
arising out of his employment. Because the full Commission failed
to make adequate findings of fact on causation, we must remand this
matter.
The plaintiff in a workers' compensation case bears the burden
of initially proving each and every element of compensability,including causation.
(See footnote 4)
Whitfield v. Lab. Corp. of Am., 158 N.C.
App. 341, 350, 581 S.E.2d 778, 784 (2003); Porter v. Fieldcrest
Cannon, Inc., 133 N.C. App. 23, 28, 514 S.E.2d 517, 521 (1999).
Since the full Commission failed to make any findings of fact
determining causation of the injury, we must remand this case for
sufficient findings of fact on causation. Lawton, 85 N.C. App. at
592, 355 S.E.2d at 160.
Remanded.
Judge TYSON dissents in a separate opinion.
Judge ELMORE concurs in a separate opinion.
ELMORE, Judge concurring.
I concur in the result and reasoning of the majority opinion
on both issues. I write separately in an attempt to guide the
Industrial Commission on section 97-22 upon remand.
At the root of this case is the question of whether
plaintiff's excuse for not reporting an alleged on-the-job injury
within thirty days of its occurrence is reasonable, pursuant to
N.C. Gen. Stat. § 97-22. The Full Commission did not make adequate
findings on this issue, and thus we deem it necessary to remand for
further consideration. This Court has reviewed the reasonable excuse language in
section 97-22 many times.
See, e.g., Lakey v. U.S. Airways, Inc.,
155 N.C. App. 169, 573 S.E.2d 703 (2002); Davis v. Taylor-Wilkes
Helicopter Serv., Inc., 145 N.C. App. 1, 549 S.E.2d 580 (2001);
Peagler v. Tyson Foods, Inc., 138 N.C. App. 593, 532 S.E.2d 207
(2000); Westbrooks v. Bowes, 130 N.C. App. 517, 503 S.E.2d 409
(1998); Jones v. Lowe's Companies, 103 N.C. App. 73, 404 S.E.2d 165
(1991); Lawton v. County
of Durham, 85 N.C. App. 589, 355 S.E.2d
158 (1987); Sanderson v. Northeast Construction Co., 77 N.C. App.
117, 334 S.E.2d 392, (1985); Hill v. Bio-Gro Systems, 73 N.C. App.
112, 326 S.E.2d 72 (1985).
The majority and dissent in this case
highlight a subtle difference in these cases that has not been
precisely addressed: whether reasonable excuse should be read
broadly under the circumstances or strictly construed and limited
to two previously identified circumstances.
In Lawton, this Court remanded the case to the Full Commission
for further findings, but not before interpreting the statutory
language.
While a belief that one's employer is already
cognizant of the accident may serve as
'reasonable excuse' under G.S. 97-22, see Key
v. Woodcraft, Inc., 33 N.C. App. 310, 235
S.E.2d 254 (1977), it is not the only basis
for establishing reasonable excuse. The
question of whether an employee has shown
reasonable excuse depends on thereasonableness of his conduct under the
circumstances. Where the employee does not
reasonably know of the nature, seriousness, or
probable compensable character of his injury
and delays notification only until he
reasonably knows, he has established
'reasonable excuse' as that term is used in
G.S. 97-22. See generally 3 Larson, The Law of
Workmen's Compensation, Section 78.40 (1983).
Though plaintiff testified that he did not
immediately realize the nature and seriousness
of his injury, the Commission made no findings
whether, under the circumstances, that
constituted a reasonable excuse. Accordingly,
this case must be remanded for additional
findings.
Lawton, 85 N.C. App. at 592-593, 355 S.E.2d at 160.
Then, in
Jones, the Court
quoted the language in Lawton, not of
reasonableness under the circumstances, but the more definitive
text as what constitutes a reasonable excuse.
A 'reasonable excuse' has been defined by this
Court to include 'a belief that one's employer
is already cognizant of the accident . . .' or
'[w]here the employee does not reasonably know
of the nature, seriousness, or probable
compensable character of his injury and delays
notification only until he reasonably knows. .
. .'
Jones, 103 N.C. App. at 75, 404 S.E.2d at 166 (internal quotations
noted above). No Court has yet to hold that any circumstance other
than the employer's knowledge of the injury or the employee's lack
thereof is a reasonable excuse.
The dissent argues that these are the only two circumstances
that
warrant a reasonable excuse and plaintiff fails to fall into
either. I write separately to stress the fact that the majority
does not agree with this limited interpretation of reasonable
excuse. Indeed, the majority opinion cites Lawton for the
proposition that [w]hether an employee has shown a reasonable
excuse depends on the reasonableness of his conduct under the
circumstances. Lawton, 85 N.C. App. at 592, 355 S.E.2d at 160.
The fact that no opinion has found a reasonable excuse to encompass
anything other than the two identified in Jones should not limit
the Commission's determination of what is reasonable.
TYSON, Judge dissenting.
The majority holds the Commission failed to make adequate
findings of fact on: (1) a reasonable excuse for plaintiff's
failure to timely notify his employer of an industrial accident;
and (2) whether plaintiff's alleged injuries were caused by the
accident and remands to the Commission for further findings of
fact. Under the facts of and the law applicable to this case,
remand is unnecessary. I vote to reverse and respectfully dissent.
I. Standard of Review
Our review of a Commission's opinion and award [is] limited
to reviewing whether any competent evidence supports the
Commission's findings of fact and whether the findings of fact
support the Commission's conclusions of law. Deese v. Champion
Int'l Corp., 352 N.C. 109, 116, 530 S.E.2d 549, 553 (2000). No
findings of fact support the Commission's conclusions of law. This
Court reviews conclusions of law de novo. Grantham v. R. G. Barry
Corp., 127 N.C. App. 529, 534, 491 S.E.2d 678, 681 (1997), disc.
rev. denied, 347 N.C. 671, 500 S.E.2d 86 (1998).
II. Notice Requirement
The Commission found as fact that [p]laintiff did not report
the injury to his employer within 30 days but concluded as a
matter of law that plaintiff's twenty month delay was justified by
plaintiff's showing a reasonable excuse. The majority agrees
plaintiff failed to provide defendants notice within the required
thirty day time period, but remands the matter for additional
findings of fact whether a reasonable excuse was given. Undisputed
evidence
shows plaintiff failed to notify defendants within the
statutorily required thirty days and failed to offer any
reasonable excuse recognized by any precedent. Remand to the
Commission for further findings of fact is unecessary. The
Commission's opinion and award is affected with an error of law and
should be reversed.
A. Immediate Notice
N.C. Gen. Stat. § 97-22 (2003) states every injured employee
. . . shall immediately on the occurrence of an accident . . . giveor cause to be given to the employer a written notice of the
accident and no compensation shall be payable unless such written
notice is given within 30 days after the occurrence of the
accident. (Emphasis supplied). The purpose of the notice-of-
injury requirement is two-fold. It allows the employer to provide
immediate medical diagnosis and treatment . . . to minimiz[e] the
seriousness of the injury, and . . . [to] facilitate[] the earliest
possible investigation of the circumstances surrounding the
injury. Booker v. Medical Center, 297 N.C. 458, 481, 256 S.E.2d
189, 204 (1979) (N.C. Gen. Stat. § 97-22 inquiries are conducted to
prevent prejudice to the employer by lack of notice by the
employee).
The primary goal of statutory construction is to effectuate
the purpose of the legislature in enacting the statute. Hoffman
v. Great American Alliance Ins. Co., 166 N.C. App. 422, 427, 601
S.E.2d 908, 912 (2004). We are required to interpret notice
requirements in N.C. Gen. Stat. § 97-22 to protect the employer's
right and to require timely notice of injury. See Davis v. Taylor-
Wilkes Helicopter Serv., Inc., 145 N.C. App. 1, 2, 549 S.E.2d 580,
581 (2001)
(Both parties knew of the plaintiff's injury within
thirty days but believed the plaintiff was an independent
contractor when he was, in fact, an employee. The Court found
reasonable excuse and no prejudice in the delay). Cases cited
within Judge Elmore's concurring opinion show either the employer
had actual knowledge of the injury or the plaintiff was unaware a
compensable injury had occurred:
Lakey v. U.S. Airways, Inc., 155N.C. App. 169, 573 S.E.2d 703 (2002)
(The defendant failed to
allege prejudice and the delay of five months for written notice
did not prejudice the defendant. The Court held the defendant had
notice because the plaintiff's incident report was made after the
flight was complete.), disc. rev. denied, 357 N.C. 251, 582 S.E.2d
271 (2003)
;
Westbrooks v. Bowes, 130 N.C. App. 517, 503 S.E.2d 409
(1998) (The defendant conceded immediate notice but contended
prejudice by the surviving spouse's filing of a claim a year late.
The court remanded for a finding of prejudice because the
Commission's award failed to address it.); Hill v. Bio-Gro Systems,
73 N.C. App. 112, 326 S.E.2d 72 (1985) (The employee told his
supervisor about the accident within a week, but had not suffered
any pain and was unaware of his injury. The Court found the
defendant was not prejudiced in the delay.); Sanderson v. Northeast
Construction Co., 77 N.C. App. 117, 334 S.E.2d 392 (1985) (The
employer was on constructive notice because it received a doctor's
bill for plaintiff's injury within a month. The Court found no
prejudice in the delay.); see also Chilton v. School of Medicine,
45 N.C. App. 13, 262 S.E.2d 347 (1980) (The plaintiff was not
barred by failure to notify the employer within thirty days where
school faculty had personal knowledge of the plaintiff's injury as
it happened.).
Here, plaintiff failed to immediately and timely report his
alleged 28 October 1999 injury to defendants until July 2001, more
than twenty months after the accident. No precedent has allowed a
reasonable excuse for a twenty month delay. Under N.C. Gen. Stat.§ 97-22, plaintiff's failure to provide notice immediately on the
occurrence of an accident which caused his alleged injuries bars
his workers' compensation claim.
B. Reasonable Excuse
Plaintiff's failure to timely report the accident places the
burden on him to provide a reasonable excuse for his delay. The
Commission must find and be satisfied that the employer has not
been prejudiced. N.C. Gen. Stat. § 97-22.
The Commission concluded plaintiff's fear[] [of] losing his
job was a reasonable excuse for his unduly delayed notification to
defendants of his injuries. The majority remands to the Full
Commission because the full Commission made no findings of fact
showing that [plaintiff] feared retaliation if he timely reported
his injury and whether this fear was a reasonable excuse. Id.
;
Lawton v. County of Durham, 85 N.C. App. 589, 592-93, 355 S.E.2d
158, 160 (1987)
(The Commission did not address the employee's
allegation that he did not realize the nature and seriousness of
his injury).
Defendants argue plaintiff failed to give and cannot provide
a reasonable excuse for his prejudicial failure to provide written
notice to his employer within thirty days. I agree.
The burden
is on the employee to show a 'reasonable excuse.'
Jones v. Lowe's
Companies, 103 N.C. App. 73, 75, 404 S.E.2d 165, 166 (1991)
(quoting Lawton, 85 N.C. App. at 592, 355 S.E.2d at 160)
(Two
months after the injury, the employee gave oral notice and sought
treatment. Three months after injury, the employee gave writtennotice. The Court found a reasonable excuse because the plaintiff
did not know he was hurt).
All prior cases recognized a
reasonable excuse as either 'a belief that one's employer is
already cognizant of the accident . . .' or '[where] the employee
does not reasonably know of the nature, seriousness, or probable
compensable character of his injury and delays notification only
until he reasonably knows . . . .' Id.
Undisputed facts show
plaintiff cannot justify his failure of notice under either
exception to excuse his noncompliance with the statute.
1. Employer Knew of Injury
The Commission erred in concluding as a matter of law that
plaintiff gave a reasonable excuse for his failure to notify
defendants of the accident. We all agree no findings of fact show
the employer was cognizant of the accident. Id. The Commission
found: (1) plaintiff did not report a work-related injury to
defendant-employer[;] (2) plaintiff did not mention anything
about an injury at work to [the human relations coordinator;] and
(3) when [plaintiff] complet[ed] the forms regarding disability
associated with the neck surgery, he affirmatively checked the
box stating that the condition was not the result of a work-related
illness or injury. (Emphasis added). The Commission's findings
of fact directly conflict with his employer being cognizant of the
accident to excuse plaintiff's failure to timely report. Id.
Plaintiff not only failed to report his accident to defendants
but affirmatively represented his injury was not related to his
employment. Plaintiff cannot meet his burden of proving areasonable excuse existed for his failure to notify his employer of
the accident.
2. Plaintiff was Unaware of Injury
We also all agree the Commission's findings of fact also
cannot support a conclusion that plaintiff was unaware of the
nature, seriousness, or probable compensable character of his
injury. Id. The Commission found plaintiff was injured on 28
October 1999, visited a chiropractor on 1 November 1999, missed
approximately two weeks of work, and was treated by an orthopedic
surgeon. Plaintiff sought treatment from his chiropractor within
four days of his injuries. Plaintiff was obviously aware of his
injuries throughout these visits and knew or should have known of
the nature, seriousness, or probable compensable character of his
injury. Jones, 103 N.C. App. at 75, 404 S.E.2d at 166. Plaintiff
cannot meet his burden of showing a reasonable excuse by not
realizing the seriousness of his injuries. Id. Undisputed facts
also show plaintiff had previously filed a workers' compensation
claim and was aware of his duty to promptly notify his employer.
N.C. Gen. Stat. 97-22 requires that a reasonable excuse is
made to the satisfaction of the Industrial Commission. The
Commission's finding of fact stated, plaintiff's late reporting
did not prejudice defendant[s] and plaintiff's failure to timely
report the injury is excused. The majority correctly holds the
Commission failed to make a finding of fact to support its
conclusion that plaintiff had a reasonable excuse. N.C. Gen.
Stat. § 97-22. Undisputed evidence shows plaintiff cannot provide a
reasonable excuse to the Commission for his failure to timely
notify defendants of his injury. Plaintiff did not give actual
notice to defendants and intentionally misrepresented his accident.
Defendants were not cognizant of the accident and plaintiff was
aware of the nature, seriousness, or probable compensable
character of his injury. See Jones, 103 N.C. App. at 75, 404
S.E.2d at 166.
Plaintiff's actions directly contravene the purpose of the
notice requirement in N.C. Gen. Stat. § 97-22. This Court has
recognized claims by a plaintiff where timely notice was not given,
if the plaintiff was unaware of the serious nature of their injury.
See Peagler v. Tyson Foods, Inc., 138 N.C. App. 593, 532 S.E.2d 207
(2000) (The plaintiff filed a claim after thirty days but showed
reasonable excuse
that doctors mis-diagnosed his injury as a heart
attack when the actual injury
was a herniated disc and
the
plaintiff depended on his wife and doctor to notify the defendant
of his work-related injuries.)
.
Here, plaintiff knew of his injuries, immediately sought
treatment for them, and did not report the accident to his
employer. Plaintiff's actions are easily distinguishable from all
precedents upholding reasonable excuses. Plaintiff claims he
failed to report his injuries for fear[] [of] losing his job.
The purpose of the notice requirement in N.C. Gen. Stat. § 97-22 is
not for the benefit of the employee, but rather to provide actual
notice to the employer. Plaintiff cannot meet his burden to showa reasonable excuse. Jones, 103 N.C. App. at 75, 404 S.E.2d at
166. The Commission's opinion and award should be reversed.
C. Prejudice to Employer
Defendants suffered prejudice as a matter of law
by
plaintiff's delay
regardless of the Commission's conclusion that
plaintiff had a reasonable excuse.
N.C. Gen. Stat. § 97-22 requires both a reasonable excuse
and a showing that the employer has not been prejudiced if notice
of an injury is untimely. If prejudice is shown, [e]mployee's
claim is barred even though he had a reasonable excuse for not
giving notice of the accident within 30 days. Id. at 76, 404
S.E.2d at 167. The purpose of the requirement of notice is to
prevent prejudice toward the employer. The purpose is dual:
First, to enable the employer to provide immediate medical
diagnosis and treatment with a view to minimizing the seriousness
of the injury; and second, to facilitate the earliest possible
investigation of the facts surrounding the injury. Id. at 76-77,
404 S.E.2d at 167; Booker, 297 N.C. at 481, 256 S.E.2d at 204
; see
2B Larson's Workmen's Compensation Law § 78.10, 15-102.
Plaintiff delayed reporting his accident for nearly two years
after it occurred. Without notice, defendant-employer was: (1)
unable to provide plaintiff with immediate medical diagnosis; (2)
unable to provide plaintiff with treatment and could not initiate
the earliest possible investigation of the facts; (3) unable to
interview employees who may have witnessed plaintiff's injuries;
(4) unable to investigate the site where the alleged injuryoccurred; and (5) unable to provide or direct plaintiff's medical
treatment. Jones, 103 N.C. App. at 76-77, 404 S.E.2d at 167.
We all agree that although the Commission is not required to
make findings of fact concerning each question raised by the
evidence, . . . it is required to make specific findings pertaining
to these crucial facts upon which plaintiff's claim rests. Barnes
v. O'Berry Center, 55 N.C. App. 244, 246, 284 S.E.2d 716, 717
(1981).
The Commission's conclusion of law, [d]efendant-employer has
not shown prejudice for plaintiff's late filing of this claim is
unsupported by its findings of fact. The only finding of fact made
by the Commission is plaintiff's late reporting did not prejudice
defendant . . . . This statement is actually a conclusion of law
and does not explain or support the Commission's finding. The
Commission failed to consider each of the factors above. Jones,
103 N.C. App. at 76-77, 404 S.E.2d at 167. If no finding of fact
supports the Commission's conclusion of law, our review is de novo.
Grantham, 127 N.C. App. at 534, 491 S.E.2d at 681. Defendants were
prejudiced by plaintiff's delayed notification as a matter of law.
Jones, 103 N.C. App. at 76, 404 S.E.2d at 167. Remand is
unnecessary where plaintiff cannot offer any recognized reasonable
excuse to overcome prejudice to defendants. The Commission's
opinion and award should be reversed.
III. Causation
Defendants argue the Commission failed to make adequate
findings of fact on causation. We all agree the Commission failed to make adequate findings
of fact on causation, but the majority remands for further
findings of fact. Our Supreme Court has repeatedly held that the
entirety of causation evidence must meet the reasonable degree of
medical certainty standard necessary to establish a causal link
between the plaintiff's accident and their injury. Holley v.
ACTS, Inc., 357 N.C. 228, 234, 581 S.E.2d. 750, 754 (2003); Edmonds
v. Fresenius Med. Care, 165 N.C. App. 811, 600 S.E.2d 501 (2004)
(J. Steelman, dissenting), rev'd per curiam, 359 N.C. 313, 608
S.E.2d 755 (2005)
;
Alexander v. Wal-Mart Stores, Inc., 166 N.C.
App. 563, 603 S.E.2d 552 (2004) (J. Hudson dissenting), rev'd per
curiam,
359 N.C. 403, 610 S.E.2d 374 (2005)
.
Unless a causal connection between employment and injury is
proved, the injury is not compensable. The burden of proving the
causal relationship or connection rests with the claimant. Arp v.
Parkdale Mills, Inc., 150 N.C. App. 266, 274, 563 S.E.2d 62, 68
(2002) (J. Tyson, dissenting), rev'd per curiam, 356 N.C. 657, 576
S.E.2d 326 (2003). The rule of causal relation is 'the very sheet
anchor of the Workmen's Compensation Act,' and has been adhered to
in our decisions, and prevents our Act from being a general health
and insurance benefit act. Id. (quoting Bryan v. First Free Will
Baptist Church, 267 N.C. 111, 115, 147 S.E.2d 633, 635 (1966)).
Although expert testimony as to the possible cause of a
medical condition is admissible[,] . . . it is insufficient to
prove causation, particularly 'when there is additional evidence or
testimony showing the expert's opinion to be a guess or merespeculation.' Edmonds, 165 N.C. App. at 818, 600 S.E.2d at 506
(quoting Holley, 357 N.C. at 233, 581 S.E.2d. at 753).
Although medical certainty is not required, an expert's
'speculation' is insufficient to establish causation. Holley, 357
N.C. at 234, 581 S.E.2d. at 754.
In Alexander, our Supreme Court
held the role of the Court of Appeals is 'limited to reviewing
whether any competent evidence supports the Commission's findings
of fact and whether the findings of fact support the Commission's
conclusions of law.' 166 N.C. App. at 573, 603 S.E.2d at 558
(quoting Deese, 352 N.C. at 116, 530 S.E.2d at 553).
Plaintiff's orthopedic surgeon, Dr. Moody, testified
plaintiff's work injury could have aggravated and caused the onset
of symptoms in the neck and low back or could have been caused by
plaintiff's recreational weight lifting or working on his home.
Plaintiff's family physician, Dr. Kelly, also testified concerning
plaintiff's injuries, I do not think that his whatever happened at
work caused all this . . . . Dr. Kelly later added, I think it
could have, could have aggravated, accelerated or contributed.
This testimony is insufficient to prove causation.
[M]edical experts were asked only whether 'a
particular event or condition could or might
have produced the result in question, not
whether it did produce such result.'
Lockwood v. McCaskill, 262 N.C. 663, 668, 138
S.E.2d 541, 545 (1964) (quoting Stansbury,
North Carolina Evidence § 137, at 332 (2d ed.
1963)). With the adoption of Rule 704 in
1983, experts were allowed to testify more
definitively as to causation. N.C.G.S. §
8C-1, Rule 704. While the could or might
question format circumvented the admissibility
problem, it led to confusion that such
testimony was sufficient to prove causation. See Alva v. Charlotte Mecklenburg Hosp. Auth.,
118 N.C. App. 76, 80-81, 453 S.E.2d 871, 874
(1995) (a case that erroneously relied on
Lockwood an opinion on the admissibility of
expert opinion testimony, to find could or
might testimony sufficient to prove
causation). Although expert testimony as to
the possible cause of a medical condition is
admissible if helpful to the jury, Cherry, 84
N.C. App. at 604-05, 353 S.E.2d at 437, it is
insufficient to prove causation . . . .
Holley, 357 N.C. at 232-33, 581 S.E.2d. at 753 (emphasis supplied).
Plaintiff's physicians testified only to possibility and not
to a medical certainty or that it is more likely plaintiff's
injuries were caused by his accident. Id. at 234, 581 S.E.2d. at
754. Possibility or might testimony is insufficient to prove
causation. Id. The entirety of plaintiff's expert medical
testimony is possibility and speculation and does not meet
plaintiff's burden to show the necessary degree of medical
certainty to prove causation. Id.
Remand for further findings of fact could give plaintiff a
second bite at the apple. Plaintiff fully litigated his claim and
failed to prove causation. The majority perpetuates and encourages
both fraudulent and stale claims against employers by employees who
fail to report injuries for nearly two years and who fail to
establish their injuries were caused by their alleged accident.
The Commission failed to make any findings of fact on the
cause of plaintiff's injuries, but concluded [p]laintiff sustained
an injury by accident arising out of his employment with defendants
as a direct result of the work assigned on or about 28 October
1999. No competent evidence substantiates the required element ofthe accident causing plaintiff's injury. The Commission's
conclusion of law that plaintiff suffered a compensable injury is
not supported by any competent evidence in the record. The
Commission's opinion and award should be reversed.
III. Conclusion
Plaintiff failed to report his injury immediately to
defendants within the statutorily required thirty day requirement
and failed to provide a reasonable excuse for his twenty month
delay. N.C. Gen. Stat. § 97-22 (2003). Defendants were prejudiced
as a matter of law by plaintiff's unduly delayed notification.
The Commission's conclusion of law that plaintiff suffered a
compensable injury is not supported by any competent evidence or
findings of fact. No competent evidence substantiates the required
element of causation. Plaintiff's claim for temporary total
disability compensation should be denied. I vote to reverse the
Commission's opinion and award. I respectfully dissent.
Footnote: 1 We note that Plaintiff-Appellee's brief exceeded the page
limit. N.C. R. App. P. 28(j). Additionally, Plaintiff-
Appellee's
Motion for Waiver of Page Limit to File Plaintiff-
Appellee's Brief
was denied by this Court by Order dated 23
November 2004. Thus, this Court did not consider that part of
Plaintiff's brief that exceeded the allowable page limit.
Footnote: 2 The dissent asserts that Plaintiff cannot provide a
reasonable excuse because
Plaintiff did not give actual notice
to defendants and intentionally misrepresented his accident.
After throughly examining the record and transcripts, we find no
evidence that Plaintiff concealed or intentionally misrepresented
his injury. The record shows that when filling out health
insurance forms for time off work due to his back injury,
Plaintiff did not include that he was hurt at work. However,
while he was filling out the health insurance forms, Plaintiff
informed his supervisor, Myra Butler, of the nature and cause of
his injury by stating
I did say that, you know, I'd hurt my back
lifting the turbochargers last week[.]
Footnote: 3 The dissent asserts that since Plaintiff cannot meet
either of the two previously established
reasonable excuses,
i.e., that the employer had actual notice or that the employee
was unaware of the nature of his injuries, it is unnecessary to
remand this case for further findings of fact. However, section
97-22 of the North Carolina General Statutes does not limit what
constitutes a reasonable excuse, but instead gives the Industrial
Commission discretion to determine if an excuse is reasonable on
an individual basis. N.C. Gen. Stat. § 97-22 (
. . . unless
reasonable excuse is made
to the satisfaction of the Industrial
Commission for not giving such notice . . ..
(emphasis added)).
Footnote: 4 The dissent asserts that
[n]o competent evidence
substantiates the required element of the accident causing
plaintiff's injury[,]
therefore, the Opinion and Award should be
reversed and not remanded. The dissent cites Dr. Bruce Kelly,
Plaintiff's family physician, as testifying that
I do not think
that his whatever happened at work caused all this . . ..
Dr.
Kelly went on to testify that
I think it could have, could have
aggravated, accelerated or contributed.
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