1. Workers' Compensation_interlocutory order_reconsideration_notice
The Industrial Commission was not precluded in a workers' compensation case from
revisiting an earlier order which did not determine all of the issues between the parties; however,
the parties should have had notice that an issue might be reached and should have had an
opportunity to present pertinent evidence.
2. Workers' Compensation_unauthorized treatment_physician's testimony_competent
The fact that a physician is not authorized by the Commission means that the employer
and carrier cannot be required to pay for treatment, but does not render the physician's evidence
incompetent.
3. Workers' Compensation_remand_law of the case
Determinations about an injury which were not appealed by plaintiff became the law of the
case and, although addressed by defendant in its brief on appeal, may not be revisited on a remand
on other grounds.
Wayne W. Martin for plaintiff-appellee.
Orbock, Ruark & Dillard, PC, by Barbara E. Ruark, for
defendants-appellees.
GEER, Judge.
Defendants Carolina Shoe Company and N.C. Insurance Guaranty
Association appeal from an opinion and award of the Industrial
Commission, awarding plaintiff Janet Branch total disability
compensation based on a change of condition under N.C. Gen. Stat.§ 97-47 (2003). On appeal, defendants argue that the Full
Commission was bound by its decision remanding the case for an
evidentiary hearing on specified issues and that the Commission,
therefore, erred when its subsequent opinion and award went beyond
those specified issues. Although we hold that the Full Commission
was not limited by its earlier decision, it was obligated to give
the parties notice and an opportunity to be heard prior to basing
its decision on issues that the parties had no reason to believe
would be addressed. We, therefore, reverse the Commission's
decision and remand for further proceedings to allow the parties an
adequate opportunity to present evidence on the question whether
there was a change of condition under N.C. Gen. Stat. § 97-47.
32. Plaintiff reached maximum medical
improvement no later than 16 September 1997.
She has a permanent impairment rating of 20%
to her left foot.
Based on its findings, the Commission concluded that Branch had
unjustifiably refused to comply with her physicians'
recommendations that she increase her level of activity, including
her work hours, in order to improve. It, therefore, suspended her
eligibility for wage loss compensation as of 16 September 1997.
The Commission also concluded that Branch was not entitled, for the
same reasons, to payment for medical treatment after that date.
The Commission directed that "[i]n order to reinstate
benefits, plaintiff must comply with the following work schedule:
Plaintiff must begin working four hours a day regularly for a
period of two weeks, then increase her daily work schedule by onehour each successive week until she reaches a regular schedule of
eight hours per day." Neither party appealed from this opinion and
award.
One month later, on 5 April 1999, Branch filed a Form 18 that
alleged a "worsening in her pain syndrome from the work related
injury." The nature and extent of this injury was reported to be
"[c]omplex regional pain syndrome involving the predominantly right
lower extremity as well as right upper extremity secondary to work
related injury to the right lower extremity." Plaintiff claimed
her disability started on 6 November 1997.
On 25 September 2000, deputy commissioner Richard B. Ford
filed an order addressing two motions of plaintiff: (1) a motion
to combine plaintiff's original claim (I.C. No. 453005) with her
new claim (I.C. No. 921804) for purposes of hearing, and (2) a
motion to reopen I.C. No. 453005 for change of condition. The
deputy found that Branch had not appealed from the prior opinion
and award and had not complied with it, that the terms and
conditions in I.C. No. 453005 were the law in the case, that there
had been no change of condition with respect to plaintiff's right
foot, and that I.C. No. 921804 sought recovery for an upper
extremity injury occurring on 5 November 1997. He ordered that the
31 December 1997 opinion and award was still in full force and
effect and that I.C. No. 921804 would be set for hearing.
Plaintiff appealed this decision to the Full Commission on 5
October 2000. In an opinion and award filed 20 March 2002, the Full
Commission concluded first that "[p]laintiff is entitled to file a
motion to modify the Commission's Award based on a change of
condition under Section 97-47 and is entitled to present evidence
relevant to this issue." After concluding that the findings of
fact and conclusions of law in the 17 February 2000 opinion and
award were final and could not be relitigated, the Commission
observed that "this fact does not preclude plaintiff from asserting
and presenting relevant evidence on a change of condition under
Section 97-47."
The Commission then concluded that this case differed from the
usual N.C. Gen. Stat. § 97-47 change of condition claim because of
the Commission's prior findings that (1) plaintiff has self-imposed
limitations and failed to comply with her physicians' treatment
plan, (2) the benefits had been suspended, and (3) plaintiff's
upper extremity pain syndrome, as argued in I.C. No. 453005, is not
related to her compensable lower extremity injury. The Commission,
therefore, concluded that evidence that plaintiff's condition had
gotten worse would not "purge the prior finding that plaintiff
failed to accept suitable employment and thereby is not entitled to
benefits under Section 97-32. Therefore, mere evidence that
plaintiff's condition has worsened is not relevant to the issues
before the Commission."
The Commission then remanded to the deputy commissioner for a
hearing on specified issues:
[T]he issues raised by plaintiff's Form 18 in
I.C. No. 921804 and the motion for change ofcondition in I.C. No. 453005 are: (1) whether
plaintiff has complied with her physician's
treatment plan and reasonably sought
employment sufficient to remove the Section
97-32 suspension of benefits; (2) whether
plaintiff has sustained a compensable injury
to her right upper extremity in I.C. No.
921804 that is different from the condition
for which compensation was previously sought
and denied in I.C. No. 435005; and if so, (3)
what benefits, if any, is plaintiff entitled
to receive.
On remand, a hearing took place before deputy commissioner Ronnie
E. Rowell, and the parties took the depositions of Dr. Mark
McManus, Dr. Gary Poehling, and Dr. Hans Hansen. Following the
closing of the record, the deputy commissioner transferred the
matter to the Full Commission.
The Full Commission entered its opinion and award on 6 April
2004. The Commission first observed that the medical depositions
would support findings that plaintiff's complex regional pain
syndrome migrated from her lower extremity to the upper extremity,
that the tag room position exacerbated the upper extremity pain
syndrome and that, as of December 1997, plaintiff was unable to
work in any job due to the complex regional pain syndrome in her
upper and lower extremities. The Commission then found (1) that
plaintiff had presented no evidence that she had made any effort to
seek employment or to comply with the 17 February 1999 opinion and
award, (2) that plaintiff presented no evidence of a new onset of
an occupational disease or new injury in I.C. No. 921804, and (3)
that the issues concerning plaintiff's upper extremity condition
and its relationship to her compensable right foot condition and
the tag room job "have previously been litigated and ruled upon bythe Full Commission. The Full Commission decisions on these issues
were not appealed and therefore are final and binding on the
parties."
The Commission then ruled that the only remaining issue was
whether plaintiff had sustained a change of condition. The
Commission acknowledged that its 20 March 2002 opinion and award
had stated that "mere evidence that plaintiff's condition has
worsened is not relevant to the issues before the Commission," but
found that "the recently submitted uncontroverted medical evidence
in the deposition testimony of Drs. Poehling, Hansen and McManus
shows that plaintiff was not capable of work in any employment
after December 18, 1997 due to the pain syndrome in both upper and
lower extremities." The Commission added that "[t]here is no
medical evidence in the record that since December 1997 plaintiff
was capable of returning to work in any employment or that working
would improve her condition."
Based on these findings, the Commission concluded that
plaintiff's upper extremity condition was not compensable under
either I.C. No. 453005 or I.C. No. 921804. The Commission
concluded, however, that as of 18 December 1997, plaintiff was no
longer capable of work in any employment due to the combination of
her compensable complex regional pain syndrome in her lower
extremity and her non-compensable complex regional pain syndrome in
her upper extremity. Because no medical evidence was presented to
apportion the extent of disability between the compensable
condition and the non-compensable condition, the Commissionconcluded that plaintiff was entitled to a resumption of total
disability compensation after 18 December 1997 "and continuing
until further Order of the Commission."
The Commission also concluded that plaintiff was entitled to
authorized medical treatment related to the compensable right foot
condition, but because Drs. Poehling, McManus, and Hansen were not
authorized treating physicians, plaintiff was not entitled to
payment by defendants of the care provided by those physicians.
The Commission then directed that a Commission nurse be assigned to
manage plaintiff's treatment, to assist the parties in the
designation of an authorized treating physician, and to schedule a
vocational assessment as recommended by Dr. Hansen.
Defendants filed a timely notice of appeal of the Full
Commission's opinion and award. Plaintiff has not appealed any
aspect of the opinion and award.
Id. at 312, 309 S.E.2d at 275. The Court then proceeded to
conclude that the Industrial Commission had no jurisdiction to
consider the plaintiff's claim and that the defendant's motion to
dismiss should have been granted. Id. at 315, 309 S.E.2d at 277.
We read this opinion as holding in part that the Commission must
first decide whether it has jurisdiction prior to reaching themerits. See Bryant v. Hogarth, 127 N.C. App. 79, 83, 488 S.E.2d
269, 271 ("Subject matter jurisdiction is a prerequisite for the
exercise of judicial authority over any case or controversy."),
disc. review denied, 347 N.C. 396, 494 S.E.2d 406 (1997).
We also believe that the Court's reference to a denial of the
rights of the parties concerned the lack of notice and opportunity
to be heard. See Allen v. K-Mart, 137 N.C. App. 298, 304, 528
S.E.2d 60, 64 (2000) ("The opportunity to be heard . . . [is]
tantamount to due process and basic to our justice system. . . .
Therefore, we hold that where the Commission allows a party to
introduce new evidence which becomes the basis for its opinion and
award, it must allow the other party the opportunity to rebut or
discredit that evidence."). The requirement of due process does
not, however, mean that the Commission may not revisit its
interlocutory decisions. Instead, the Commission must, prior to
making its decision, ensure that the parties have notice that an
issue may be reached and an opportunity to present evidence
pertinent to that issue.
In this case, because of the Commission's interlocutory
opinion and award remanding to the deputy commissioner, defendants
had no notice that the Commission would be addressing a change of
condition or plaintiff's inability to comply with the mandated work
schedule until after the Commission filed its 6 April 2004 opinion
and award. Defendants, therefore, had no opportunity to obtain and
present medical evidence on those issues. The Commission then
relied upon this lack of evidence when it found: "There is nomedical evidence in the record that since December 1997 plaintiff
was capable of returning to work in any employment or that working
would improve her condition." Defendants justifiably contend that
they "have now been penalized" by their adherence to the
Commission's prior decisions. Accordingly, we reverse the
Commission's decision and remand for further proceedings to allow
the parties to present evidence on the questions whether plaintiff
experienced a change of condition under N.C. Gen. Stat. § 97-47,
whether plaintiff is capable of working in any employment, and
whether working would improve plaintiff's condition.
[2] Since the issue may arise upon remand, we note that
defendants have argued that the Commission erred in making its
findings by relying upon the testimony of unauthorized physicians,
but cite no authority in support of this position. The fact that
a physician is not authorized by the Commission means that the
employer and carrier cannot be required to pay for treatment by
that physician. See Kanipe v. Lane Upholstery, 141 N.C. App. 620,
627, 540 S.E.2d 785, 789-90 (2000) (Commission could deny claim for
medical expenses if physician not approved by Commission). It does
not render the physician's evidence incompetent. The Commission
did not, therefore, err in relying upon the opinions of Drs.
Poehling, Hansen, and McManus even though they were not authorized
treating physicians of plaintiff.
[3] Defendants have also addressed in their brief the question
of the compensability of plaintiff's upper extremity condition.
The Commission ruled in its 6 April 2004 opinion and award that (1)"[t]he findings and conclusions [in the 17 February 1999 opinion
and award] that plaintiff's upper extremity complaints are not
causally related to the compensable foot injury or to the tag room
position are final and may not be relitigated," and (2)
"[p]laintiff did not sustain an injury by accident or contract a
compensable occupational disease involving her right upper
extremity in I.C. No. 921804." Neither of these determinations has
been appealed by plaintiff, and they are, therefore, the law of the
case and may not be revisited on remand.
Reversed and remanded.
Judges TIMMONS-GOODSON and CALABRIA concur.
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