JOHN WILLIAMS,
Employee,
Plaintiff,
v
.
North Carolina
Industrial Commission
I.C. File No. 041688
COLONY TIRE CORPORATION,
Employer,
MICHIGAN MUTUAL INSURANCE COMPANY,
Carrier,
Defendants.
Law Offices of George W. Lennon, by George W. Lennon for
plaintiff.
Cranfill, Sumner & Hartzog, LLP, by J. Gregory Newton and
Meredith T. Black for defendants.
LEVINSON, Judge.
Plaintiff (John Williams) appeals from an award and opinion of
the North Carolina Industrial Commission concluding plaintiff
suffered a compensable back injury. Defendants (Colony Tire Corp.
and Michigan Mutual Insurance Co.) also appeal. We affirm.
The evidence presented in the record to the Full Commission
may be summarized as follows:
In the spring of 2000 plaintiff (John Williams) was employed
by defendant Colony Tire Co. as a truck tire changer. By thespring of 2000, plaintiff had worked intermittently as a tire
changer for Colony Tire for ten years. Plaintiff's duties included
lifting truck tires weighing up to 125 pounds. In mid-April 2000
plaintiff was assaulted by a co-worker. The co-worker approached
plaintiff from behind, lifted him off the ground by his neck, and
threw him to the concrete floor. Plaintiff landed on his back.
Following this incident, plaintiff returned to work for a few
weeks. Sometime thereafter, plaintiff began experiencing
increasingly severe pain in his lower back. He stopped working on
8 May 2000 and sought medical treatment. Plaintiff did not return
to work at Colony Tire, and his employment with Colony Tire was
terminated 1 July 2000. On 12 September 2000 plaintiff returned to
work as a tire changer for a different company, White's Tire
Service. Plaintiff worked intermittently for White's Tire Service
and for various other employers until October 2001.
Plaintiff was treated by a chiropractor and various doctors
during an eighteen month period for a number of different
complaints, including lower back pain. He was treated by Dr. Mark
Jensen, a chiropractor; and Drs. Hardy, Rosenblum, Bloem, Rand, and
Nelson, all medical doctors of varying specialities. In November
2001, Dr. Leonard Nelson surgically fused portions of plaintiff's
spine. On 29 August 2002, Dr. Nelson released plaintiff from care
at maximum medical improvement with a 30% permanent partial
disability rating to his back.
Plaintiff filed a Form 18, dated 21 August 2000, initiating
his claim against defendants for benefits pursuant to the WorkersCompensation Act alleging an injury to his back, neck and arm. No
Form 21 or Form 60 agreement appears in the record. Plaintiff's
claim was denied by defendants. On 31 December 2002 a deputy
commissioner issued an opinion and award denying plaintiff's claim.
Plaintiff's claim was reviewed by the Full Commission on 2 June
2003.
In an opinion and award entered 13 October 2003, the Full
Commission found as fact:
1. Plaintiff was 45 years old at the time of the
hearing before the Deputy Commissioner. He
worked intermittently as a truck tire changer
over the course of a ten-year period for
defendant-employer at its service center in
Rocky Mount. Plaintiff was most recently
hired by defendant-employer in October 1999.
Plaintiff worked as a truck tire changer until
8 May 2000, at which time he left his
employment with defendant-employer due to back
pain and never returned to work there.
2. In his capacity as a truck tire changer,
plaintiff was required to perform various
duties. These included making roadside
service calls, mounting and dismounting tires
in the truck tire shop at defendant-employer's
service facility, and various other inventory
and cleaning duties. The truck tires that
plaintiff was required to lift weighed up to
125 pounds. During the course of his
employment with defendant-employer, plaintiff
obtained a certification as a truck tire
changer.
3. At some point in Spring 2000, plaintiff was
involved in an altercation with another co-
worker, Johnnie King. On that morning,
plaintiff was loading tires onto the back of a
truck as part of his regular duties in the
truck tire shop. As plaintiff walked to the
rear of the shop, Johnnie King, a supervisor
in defendant-employer's car tire shop, asked
plaintiff to dismount and balance the tires onan ambulance that Mr. King had just backed
into the rear of the truck tire shop. The
tires had not been balanced properly by some
employees in the car tire shop. Plaintiff
refused to do so as he was not certified nor
allowed by his direct supervisor, Randy Smith,
to do this type of work. When plaintiff
refused to comply with Mr. King's demand, Mr.
King threatened to whoop [plaintiff's] butt.
Following the exchange, plaintiff started to
walk away and Mr. King came up behind him.
Plaintiff turned back towards Mr. King and Mr.
King grabbed plaintiff by the throat and
picked him up in the air. Plaintiff was
unable to breathe and he began kicking Mr.
King. Mr. King threw plaintiff to the
concrete floor where plaintiff landed flat on
his back.
4. After the attack, plaintiff reported the
altercation to Jeff Foster, the manager on
duty at the time, and later that day to
Randall Smith, the service manager. According
to plaintiff, the store's secretary was also
present when he reported the incident to Jeff
Foster. Plaintiff did not report having any
injuries as a result of this incident at that
time. After reporting the incident, plaintiff
left the store to calm down. He returned
after a few hours and worked the remainder of
his shift.
. . . .
7. Based upon the greater weight of the evidence,
the Full Commission finds that the incident
between Mr. King and plaintiff occurred in
mid-April, between 14 April and 18 April[,]
2000.
8. After mid-April 2000, plaintiff continued to
perform his normal duties as a truck tire
changer. During the weeks following the
incident at work, plaintiff was sore and had
increasing pain in his neck and back.
Plaintiff testified that he reported his pain
to his supervisor, Randall Smith, on several
occasions, and that Mr. Smith gave him pain
pills and encouraged him to return to work.
Plaintiff continued to work because he had
to. Mr. Smith testified that plaintiff did
not appear to have any physical problems or bein any physical pain during this time and did
not complain of any back pain; however, the
Full Commission finds plaintiff's testimony to
be more credible than that of Mr. Smith.
9. Mr. Smith also testified that on the morning
of Friday, 5 May 2000, plaintiff requested and
got permission to be off that afternoon in
order to get a head start on remodeling a
bathroom in his home. This work included
replacing the flooring, tile, and fixtures in
the bathroom. Plaintiff testified that he did
leave work early on 5 May 2000, but the
purpose was to take his son to the hospital
for an appointment. Plaintiff specifically
denied having done any remodeling work. The
Full Commission finds plaintiff's testimony in
this regard to be more credible than that of
Mr. Smith.
10. On Monday, 8 May 2000, plaintiff reported to
work with severe back pain. Mr. Smith
recommended that plaintiff seek medical
treatment if he needed to do so.
11. Plaintiff sought treatment with chiropractor
Dr. Mark Jensen at Hammer Chiropractic that
same day. Plaintiff complained of neck, arm,
mid back, and low back pain as well as
headaches. Plaintiff noted on the initial
report that he was injured at work. Plaintiff
related his injuries to his normal duties as a
truck tire changer and specifically to the
fact that he was required to lift heavy tires
all day long. Plaintiff did not relate his
injuries, and specifically his back pain, to
his previous altercation with Mr. King when he
saw Dr. Jensen on 8 May 2000, but he did
report an increase in pain over the last
couple of weeks causing difficulty in
performing his work duties. Dr. Jensen's
examination revealed a decrease in plaintiff's
range of motion in his neck and low back. He
also found segmental dysfunction with pinched
nerves and some neuritis, and misalignment at
C2, C5, L5 and both iliums. Dr. Jensen opined
that plaintiff's condition was not consistent
with degenerative changes.
12. Dr. Jensen recommended conservative treatment
modalities for plaintiff's symptoms, but
plaintiff sought a second opinion. Dr. Jensenobtained an appointment for plaintiff with Dr.
Nelson T. Macedo, a neurological surgeon. Dr.
Jensen gave plaintiff an out-of-work note for
8 May 2000 through 10 May 2000, and provided
plaintiff with a note which stated his opinion
that the heavy lifting required by plaintiff's
employment with defendant-employer was the
cause of plaintiff's strain and neurological
problems.
13. Shortly after 8 May 2000, plaintiff attempted
to file a written claim for his back injury
with defendant-employer. Mr. Smith and Sarah
Joyner attempted to take an Injury
Investigative Report. After a few questions,
plaintiff indicated that he wanted to take the
paperwork home to complete. Plaintiff
returned those documents to defendant-employer
a couple of weeks later. Plaintiff noted on
the report that the accident occurred when he
was thrown on a concrete floor by a co-worker,
Johnny King, and due to heavy lifting by
himself.
14. Plaintiff did not return to work for
defendant-employer after 8 May 2000.
Plaintiff initially kept in contact with
defendant-employer about his back condition
and his ability to work. Defendant-employer
offered to assist plaintiff in applying for
short-term disability benefits, but plaintiff
never followed up on doing so. Eventually,
plaintiff was officially removed from
defendant-employer's payroll on 1 July 2000.
15. Plaintiff did not work from 8 May 2000 until
approximately 12 September 2000, at which time
he returned to work at White's Tire Service as
a tire changer. Plaintiff worked off and on
for White's Tire Service until early January
2001. Plaintiff also worked intermittently
for other employers, both during and after his
employment with White's Tire, earning various
wages. These included jobs as a sales clerk
at a few convenience stores and a job as a
backhoe operator for Turner Plumbing.
Plaintiff worked until 11 October 2001.
16. After his visit with Dr. Jensen, plaintiff
treated with several physicians and medical
providers for his complaints of low back and
bilateral leg pain over the course of theensuing months. This included treatment with
Dr. Ira M. Hardy at Center for Scoliosis and
Spinal Surgery, Dr. Shepard Rosenblum at
Boice-Willis Clinic, P.A., Dr. J. Th. Bloem at
Bloem Orthopaedic Center, and Dr. Tom S. Rand
at Wilson Orthopaedic Surgery and Neurology
Center.
17. Under the direction of Dr. Hardy, MRIs were
taken of plaintiff's cervical, thoracic and
lumbar spine regions on 16 August 2000. Dr.
Hardy reviewed the films and found no evidence
of instability. Plaintiff's MRIs were normal,
with some degenerative changes at the facet
joints at L4-L5 and a small central disk bulge
at L5-S1, with no evidence of nerve root
compression. Dr. Hardy opined that
plaintiff's pain was the result of a strain
problem rather than a disk problem. A whole
body bone scan was performed on 28 August
2000, and Dr. Hardy found no evidence of
increased uptake in any of the vertebral
bodies in the thoracic region. Dr. Hardy
opined that operative treatment was not
warranted and that plaintiff did not have a
compression fracture.
18. On or about mid-April 2000, plaintiff suffered
an injury by accident arising out of and in
the course of his employment with defendant-
employer. Plaintiff's injury resulted in
multiple areas of muscle strain to his back.
As of 28 August 2000, plaintiff was capable of
returning to work earning the same or greater
wages. Dr. Ira Hardy noted that plaintiff
could return to work and no restrictions were
given. Plaintiff did in fact find employment
as a tire changer on 12 September 2000.
19. Plaintiff presented to Dr. Shepard Rosenblum
on 11 December 2000. Dr. Rosenblum reviewed
plaintiff's MRIs and found no frank disk
herniation. He diagnosed plaintiff with
multiple areas of back strain. After
continuing treatment of steroids, physical
therapy and time, Dr. Rosenblum had nothing
further to recommend to plaintiff except a
referral to a spine surgeon. He released
plaintiff from his care on 17 May 2001.
20. On 24 July 2001, plaintiff sought treatment
with Dr. Leonard D. Nelson at RaleighOrthopaedic Clinic for his complaints of lower
back and bilateral leg pain. Dr. Nelson's
examination was essentially unremarkable and
he diagnosed plaintiff with mechanical low
back pain and recommended a lumbar MRI to rule
out spinal stenosis. The MRI returned within
normal limits and Dr. Nelson indicated on 2
August 2001, that he saw no evidence of any
acute injury or neurologic impingement. Dr.
Nelson also indicated that plaintiff could
return to his job as a plumber.
21. On 24 August 2001, plaintiff returned to Dr.
Nelson with fairly severe mechanical back
pain. Dr. Nelson ordered discograms at L3-4,
L4-5 and L5-S1. On 20 September 2001, Dr.
Nelson informed plaintiff that the discograms
revealed L5-S1 HNP and degenerative disc
disease. During his deposition testimony Dr.
Nelson testified that plaintiff just had a
painful disk at L5-S1; the disk was not
herniated or bulging. Surgical options were
discussed and plaintiff considered possible
spinal fusion surgery. On 4 October 2001,
plaintiff elected to proceed with the surgery.
He was given an out-of-work note for an
indefinite period of time. Decompression and
fusion of L5-S1 with Steffee plate surgery was
performed by Dr. Nelson on 6 November 2001.
22. Plaintiff continued to treat post-operatively
with Dr. Nelson during which time Dr. Nelson
ordered a lumbar myelogram and EMG/NCV
studies, both of which returned negative. On
29 August 2002, Dr. Nelson released plaintiff
at maximum medical improvement with a 30%
permanent partial disability rating to his
back and permanent work restrictions within
the guidelines of a Functional Capacity
Evaluation that was performed per his
recommendation on 13 August 2002.
23. Plaintiff testified at the hearing before the
Deputy Commissioner that since the surgery he
remains unable to work and suffers
debilitating pain 24 hours per day.
24. The results of the 13 August 2002 FCE indicate
that plaintiff's activities should be limited
as follows: no squatting, occasional stair
climbing, 4.2 pounds carrying, 4.5 poundspushing and pulling, and 9.3 pounds lifting
from desk to chair.
25. Dr. Nelson opined that while it would be rare
for an injury from the type of acute trauma
that plaintiff described to produce long-term
lower back pain, he also opined that
plaintiff's mid-April 2000 injury might have
caused the lower back pain for which he sought
treatment in July 2000. Dr. Nelson also
testified that the diagnostic studies and
surgery did not provide information one way
or the other as to whether plaintiff's
condition was chronic in nature or the result
of a work place injury. Based upon the prior
MRIs and the whole body scan taken of
plaintiff in August 2000, the medical records
of Drs. Hardy and Rosenblum and other evidence
presented, the Full Commission finds that
plaintiff's surgery and resulting disability
were not causally related to his mid-April
2000 injury by accident.
26. Plaintiff testified that he earned $9.00 per
hour while working for defendant-employer.
Pursuant to the Form 19 filed by defendant-
employer, the Full Commission finds that
plaintiff's average weekly wage was $380.00,
which yields a weekly compensation rate of
$253.34.
The Full Commission concluded that:
1. Plaintiff sustained a compensable work-related
injury due to a specific traumatic incident in
mid-April 2000, when he was involved in a
physical confrontation with a co-worker and
suffered an injury to his back. Plaintiff's
injury resulted in multiple areas of muscle
strain to his back. N.C. Gen. Stat. § 97-
2(6).
2. As of 28 August 2000, plaintiff was capable of
returning to work earning the same or greater
wages. Defendant-employer had terminated
plaintiff's employment; however, plaintiff
found employment elsewhere as a tire changer
on 12 September 2000. Russell v. Lowe's Prod.
Distrib., 108 N.C. App. 762, 425 S.E.2d 454
(1993). 3. As a result of his work place injury,
plaintiff was disabled from 8 May 2000 until
12 September 2000. Plaintiff is entitled to
temporary total disability compensation in the
weekly amount of $253.34, beginning on 8 May
2000, and continuing until 12 September 2000.
N.C. Gen. Stat. § 97-29.
4. Plaintiff is entitled to have defendants pay
for all medical treatment incurred through 11
December 2000, which is related to his
compensable injury. Plaintiff's treatment
with Dr. Nelson and the resulting surgery were
not related to his compensable injury. N.C.
Gen. Stat. 97-25.
In its opinion and award entered 13 October 2003, the Full
Commission awarded plaintiff $253.34 per week from 8 May 2000 until
12 September 2000 for temporary total disability compensation. It
also ordered defendants to pay for plaintiff's medical treatment
relating to his back muscle strain. From this award, plaintiff and
defendants appeal.
____________________________________
We first address defendants' appeal. In their appeal,
defendants contend the evidence presented to the Full Commission is
insufficient to support the Commission's finding of fact number 18
and conclusion of law number 1. We disagree.
The scope of this Court's review of a workers' compensation
award is limited to a determination of (1) whether the
Commission's findings of fact are supported by any competent
evidence in the record; and (2) whether the Commission's findings
justify its conclusions of law. Goff v. Foster Forbes Glass Div.,
140 N.C. App. 130, 132-33, 535 S.E.2d 602, 604 (2000) (citation
omitted). The appellate court 'does not have the right to weighthe evidence and decide the issue on the basis of its weight. The
court's duty goes no further than to determine whether the record
contains any evidence tending to support the finding.' Rogers v.
Lowe's Home Improvement, ___ N.C. App. ___, ___, 612 S.E.2d 143,
146 (2005) (quoting Adams v. AVX Corp., 349 N.C. 676, 681, 509
S.E.2d 411, 414 (1998) (internal quotation marks and citation
omitted)). The facts found by the Commission are conclusive upon
appeal to this Court when they are supported by [any] competent
evidence, even when there is evidence to support contrary
findings. Hodgin v. Hodgin, 159 N.C. App. 635, 639, 583 S.E.2d
362, 365 (2003) (internal quotation marks and citations omitted).
The evidence tending to support plaintiff's claim is to be viewed
in the light most favorable to plaintiff, and plaintiff is entitled
to the benefit of every reasonable inference to be drawn from the
evidence. Adams, 349 N.C. at 681, 509 S.E.2d at 414 (citation
omitted).
The claimant in a workers' compensation case bears the burden
of initially proving 'each and every element of compensability,'
including a causal relationship between the injury and his
employment. Adams v. Metals USA, 168 N.C. App. 469, 475, 608
S.E.2d 357, 361 (quoting Whitfield v. Laboratory Corp. of Am., 158
N.C. App. 341, 350, 581 S.E.2d 778, 784 (2003)), aff'd, ___ N.C.
___, 619 S.E.2d 495 (2005). There must be competent evidence to
support the inference that the accident in question resulted in the
injury complained of, i.e., some evidence that the accident at
least might have or could have produced the particular disabilityin question. Click v. Freight Carriers, 300 N.C. 164, 167, 265
S.E.2d 389, 391 (1980). The degree of proof required . . . is the
'greater weight' of the evidence or 'preponderance' of the
evidence. Phillips v. U.S. Air, Inc., 120 N.C. App. 538, 541-42,
463 S.E.2d 259, 261 (1995) (citation omitted).
N.C. Gen. Stat. § 97-2(6) (2003) provides in pertinent part:
With respect to back injuries, . . . where
injury to the back arises out of and in the
course of the employment and is the direct
result of a specific traumatic incident of the
work assigned, injury by accident shall be
construed to include any disabling physical
injury to the back arising out of and causally
related to such incident. . . .
Where a case presents complicated medical questions[,] . . .
only an expert can give competent opinion evidence as to the cause
of the injury. Click, 300 N.C. at 167, 265 S.E.2d at 391
(citations omitted). Recognizing the continuing medical
difficulty in determining the etiology of intervertebral diseases
and injuries our Supreme Court in Click noted, generally, such
cases present complicated medical questions. Id. at 168, 265
S.E.2d at 391. Although expert testimony as to the possible cause
of a medical condition is admissible if helpful to the jury, it is
insufficient to prove causation, particularly when there is
additional evidence or testimony showing the expert's opinion to be
a guess or mere speculation. Holley v. ACTS, Inc., 357 N.C. 228,
233, 581 S.E.2d 750, 753 (2003) (internal quotation marks and
citations omitted). While [d]octors are trained not to rule out
medical possibilities no matter how remote[,] . . . merepossibility has never been legally competent to prove causation.
Id. at 234, 581 S.E.2d at 754 (citation omitted).
Thus, the Court has held testimony that an
event could or might be the cause of an
injury to be insufficient to support a causal
connection where there is further evidence
tending to show that the expert's opinion is
mere guess or speculation.
Hodgin, 159 N.C. App. at 641, 583 S.E.2d at 366.
In the instant case, the Commission found as a fact, in
finding number 18, that the compensable injury plaintiff suffered
was multiple areas of muscle strain to his back. Defendants do
not challenge the Commission's specific finding that the injury
plaintiff suffered was muscle strain to his back. Instead,
defendants challenge the sufficiency of the evidence to establish
a causal link between plaintiff's having been thrown to the ground
at work and this condition.
We next review the evidence presented to determine whether
there was competent medical evidence to support the Commission's
conclusion that plaintiff's condition was caused by the altercation
at his employment. Defendants contend that neither the testimony
of Dr. Jensen, nor the testimony of Dr. Nelson, establishes the
necessary causal link between plaintiff's altercation at work and
plaintiff's back muscle strain. In response, plaintiff argues it
is the medical treatment notes of Dr. Rand which support the
Commission's conclusion that there was sufficient evidence of
causation. We agree with plaintiff in this regard. Plaintiff's altercation at work occurred in mid-April 2000.
On 11 May 2000, and again on 23 May 2000, plaintiff saw Dr. Tom
Rand of the Wilson Orthopaedic Center.
On 11 May 2000 Dr. Rand noted:
Complicated problem related to an injury on
the job about 2 months previously. . . . The
[patient's] complaints are hurting all over
from the head to the toes which makes him
impossible to evaluate. He does have
apparently some neck pain and some back pain
but I am really not sure. It could be that he
is developing some generalized degenerative
arthritis.
Again on 23 May 2000 Dr. Rand noted:
Condition is unchanged. I believe his pain
symptomatology is a result of that event being
beat up on the job or having a fight or
whatever did happen and I doubt this is going
to resolve until he has completed his legal
aspects of his case. In the meantime, will
start him on PT and see if this will help
some. He really didn't benefit from
[medications]. His lab work was [negative]
for arthritis. His bone scan was normal and I
found no significant orthopaedic pathology.
He does, of course, continue to have pain.
Further evaluation is difficult to decide what
would be appropriate at this point.
Dr. Rand saw plaintiff within a few weeks of the altercation
and found no significant orthopaedic pathology or arthritis.
According to Dr. Rand, the pain sypmtomatolgy was a result of
the altercation at work. This, in conjunction with the
Commission's finding that plaintiff suffered a back muscle strain,
the condition diagnosed by Dr. Hardy, helps establish causation.
On these facts, Dr. Rand's notes establish a causal link between
the altercation in the workplace and the back muscle strain.
This assignment of error is overruled.
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