MIRIAM GORE,
Employee,
Plaintiff,
v. N.C. Industrial Commission
I.C. No. 43566
MYRTLE/MUELLER,
Employer-Defendant,
TRAVELERS INSURANCE COMPANY,
Carrier-Defendants.
Leah L. King, for plaintiff-appellee.
Hedrick, Eatman, Gardner & Kincheloe, L.L.P., by Thomas M.
Morrow and Dana C. Moody, for defendant-appellants.
JACKSON, Judge.
Myrtle/Mueller and Travelers Insurance Company (defendants)
appeal from the Opinion and Award of the Full Commission of the
North Carolina Industrial Commission
entered 10 February 2005 by
Commissioner Christopher Scott. Heard in the Court of Appeals 8
May 2006.
From 1985 to April 2000, Miriam Gore (plaintiff) was
employed by Haworth, a manufacturer of office furniture, as aninspector. Plaintiff worked as a case cleaning inspector
performing random inspections until January 2000, when she was
transferred to a station where she performed inspections full time,
pushing and pulling desks. On 12 January 2000, sixty-one-year-old
plaintiff slipped and fell on a patch of ice in the parking lot of
defendants' premises (January accident). On 31 March 2000,
plaintiff testified that she suffered an aggravation of her back
injury or a new back injury as a result of heavy lifting and
pushing in the course of her employment with defendants (March
accident).
Defendant Myrtle/Mueller's acting human resource manager, Vera
Walker (Walker), testified that she was aware of plaintiff's
January accident on the day the incident occurred. She recalled
filling out a report for the January accident, but not until May
2000. Walker recalled completing a report for the March accident
but could not recall the specific date she filled out the report.
On 25 May 2000, plaintiff and Walker completed a Form 18 for the
March accident, although neither Walker nor plaintiff filed this
Form 18 with the Industrial Commission.
Furthermore, Walker
testified that she told plaintiff that she would check the Form 18
and find out where it needs to go. On 26 May 2000, defendants
filed a Form 61 for the January accident with the Industrial
Commission denying plaintiff's claim, and made no reference with
regards to the March accident.
On 31 March 2000, plaintiff presented to Dr. John Hodgson who
diagnosed plaintiff with Sciatica and prescribed Celebrex for herpain. On 18 April 2000, plaintiff returned to Dr. Hodgson with
continued complaints of back pain, as well as arthritic symptoms in
her knees, hips, and joints. Following his examination, Dr.
Hodgson diagnosed plaintiff with severe back pain and underlying
severe osteoarthritis. Dr. Hodgson took X-rays of plaintiff's back
that revealed Grade II spondylolisthesis at L5-S1 with marked disk
narrowing. On 2 May 2000, Dr. Hodgson diagnosed plaintiff with
back pain due to degenerative disk disease and spondylolisthesis.
Dr. Hodgson indicated that plaintiff was 100 percent disabled due
to back pain from degenerative disk disease and listed 26 April
2000 as plaintiff's last day of work.
On 12 July 2000, plaintiff presented to Dr. Stephen J. Candela
for a second opinion evaluation. Dr. Candela noted that plaintiff
suffered from pain on her left side and left hip. Dr. Candela
diagnosed plaintiff with low back pain syndrome and trochanteric
bursitis. Plaintiff continued to see Dr. Candela until 26 April
2001.
On 20 June 2002, plaintiff presented to Dr. Louie E.
Tsiktsiris of Carolina Arthritis Associates. Dr. Tsiktsiris
determined that plaintiff suffered from degenerative arthritis of
her neck and back, myofascial pain, and Grade IV spondylolisthesis
of her lumbar spine.
On 5 July 2002, plaintiff presented to Dr. Thomas Melin of
Coastal Neurological Associates for a neurosurgical evaluation.
Dr. Melin confirmed the diagnosis of L5-S1 spondylolisthesis with
resultant back and leg pain and ordered an MRI of plaintiff'slumbar spine. The MRI scan was performed on 11 July 2002, and
revealed as L5 spondylolysis with Grade II L5-S1 spondylolisthesis,
as well as biforaminal stenosis.
On 31 July 2002 and 20 August 2002, Dr. Charles Hahn with
Center for Pain Management, PLLC administered epidural steroid
injections into plaintiff's lower lumbar spine area.
On 13 July 2004, the Full Commission reviewed the matter upon
the appeal of plaintiff from the Opinion and Award by Deputy
Commissioner Nancy Gregory, filed 11 December 2003. The Full
Commission held that defendants shall pay plaintiff total
disability and plaintiff's past and future medical expenses.
Defendants appeal to this Court.
On appeal, defendants argue two issues: (1) the Full
Commission erred by concluding that the Industrial Commission had
jurisdiction over plaintiff's claims; and (2) the Full Commission
erred by concluding that plaintiff suffered from a compensable
injury by accident under the Workers' Compensation Act.
First, defendants argue that the Full Commission erred by
concluding that the Industrial Commission had jurisdiction over
plaintiff's claims.
Findings of jurisdictional facts are not conclusive on appeal,
even when supported by competent evidence. Craver v. Dixie
Furniture Co., 115 N.C. App. 570, 577, 447 S.E.2d 789, 794 (1994).
If the Industrial Commission's jurisdiction is challenged, the
Court may consider all evidence in the record and reach an
independent determination. Id. The jurisdiction of the Industrial Commission is limited by
statute. Parker v. Thompson-Arthur Paving Co., 100 N.C. App. 367,
369, 396 S.E.2d 626, 628 (1990) (citing Letterlough v. Atkins, 258
N.C. 166, 168, 128 S.E.2d 215, 217 (1962)). North Carolina General
Statutes . 97-24 states that [t]he right to compensation under
this Article shall be forever barred unless (i) a claim . . . is
filed with the Commission . . . within two years after the
accident[.] N.C. Gen. Stat. . 97-24(a) (2005). The two year
limitation has
repeatedly been held to be a condition precedent to
the right to compensation and not a statute of limitations. Id.
(citing Montgomery v. Horneytown Fire Dep't, 265 N.C. 553, 555, 144
S.E.2d 586, 587 (1965)). A consequence of finding the timely
filing of a claim to be a condition precedent is that the failure
to do so becomes a jurisdictional bar to the right to receive
compensation. Id. (citing McCrater v. Stone & Webster Eng'g
Corp., 248 N.C. 707, 709, 104 S.E.2d 858, 860 (1958)). Dismissal
of a claim is proper where there is an absence of evidence that the
Industrial Commission acquired jurisdiction by the timely filing of
a claim or by the submission of a voluntary settlement agreement to
the Commission. Reinhardt v. Women's Pavillion, Inc., 102 N.C.
App. 83, 86-87, 401 S.E.2d 138, 140-41 (1991)(citing Barham v.
Kaysar-Roth Hosiery Co., Inc., 15 N.C. App. 519, 190 S.E.2d 306
(1972)). A jurisdictional bar cannot be overcome by consent of the
parties, by waiver or by estoppel. Hart v. Thomasville Motors,
Inc., 244 N.C. 84, 88, 92 S.E.2d 673, 676 (1956). This Court has held that a letter to the Industrial Commission
was sufficient for purposes of filing a claim. Cross v. Fieldcrest
Mills, Inc., 19 N.C. App. 29, 31, 198 S.E.2d 110, 112 (1973).
Furthermore, a plaintiff's filed Form 18 is sufficient to give an
employer notice of the injury and to file a claim with the
Industrial Commission. See Wall v. Macfield/Unifi, 131 N.C. App.
863, 864-65, 509 S.E.2d 798, 799-800 (1998). Pursuant to the
Workers' Compensation Rules of the North Carolina Industrial
Commission, [i]n addition to providing the Form 19 to the
employee, the employer shall also provide a blank Form 18 for use
by the employee. Workers' Comp. R. of N.C. Indus. Comm'n 104,
2006 Ann. R. (N.C.) 958. Form 19 contains the following
boilerplate language:
Making a Claim - To be sure you have filed a
claim, complete a Form 18, Notice of Accident,
within two years of the date of the injury and
send a copy to the Industrial Commission and
to your employer. The employer is required by
law to file this Form 19, but the filing of
the Form 19 does not satisfy the employee's
obligation to file a claim. The employee must
file a Form 18 even though the employer may be
paying compensation without an agreement, or
the Commission may have opened a file on this
claim. A claim may also be made by a letter
describing the date and nature of the injury
or occupational disease. This letter must be
signed and sent to the Industrial Commission
and to your employer.
With respect to plaintiff's January accident, Walker testified
that she was aware of plaintiff's accident the day it occurred, but
that she did not recall completing paperwork for the January
accident until May 2000. On 26 May 2000, defendants denied
plaintiff's claim by completing a Form 61.
On 8 June 2000,defendants filed a Form 19 with the Industrial Commission. On 31
January 2002, plaintiff filed a Form 18 with the Industrial
Commission. On 14 March 2002, plaintiff filed a Form 33 with the
Industrial Commission, requesting that her claim be assigned for
hearing.
Here, plaintiff failed to file a timely claim with the
Industrial Commission by submitting a Form 18 or a letter within
two years of her January accident. Therefore, plaintiff failed to
satisfy the condition precedent of providing notice of her workers'
compensation claim to the Industrial Commission within two years of
her January accident. Furthermore, neither plaintiffs nor
defendants can confer jurisdiction with the Industrial Commission
by consent, waiver, or estoppel. Therefore, the Industrial
Commission does not have jurisdiction over plaintiff's workers'
Compensation claim for the January accident.
As to plaintiff's March accident, Walker and plaintiff
completed a Form 18 on 25 May 2000. However, upon a review of the
record, neither plaintiff nor defendants filed the Form 18 with the
Industrial Commission. On 26 November 2001, plaintiff wrote a
letter to the Industrial Commission regarding the dates and nature
of the March accident, and attached a Form 33.
Here, plaintiff sufficiently filed a claim for her March
accident because she provided notice of her claim to the Industrial
Commission within two years of the accident by writing a letter on
26 November 2001. See Cross, supra. Therefore, the Full
Commission did not err by concluding that the Industrial Commissionhad jurisdiction over plaintiff's workers' compensation claim for
her March accident.
Because we hold that the Industrial Commission did not have
jurisdiction over plaintiff's January accident, and that they did
have jurisdiction over plaintiff's March accident, we do not
address defendants' equitable estoppel argument.
We now turn to whether the Full Commission erred by concluding
that plaintiff suffered from a compensable injury by accident
pursuant to the Workers' Compensation Act.
Appellate review of an award from the Industrial Commission
is generally limited to two issues: (1) whether the findings of
fact are supported by competent evidence, and (2) whether the
conclusions of law are justified by the findings of fact. Clark v.
Wal-Mart, 360 N.C. 41, 43, 619 S.E.2d 491, 492 (2005)(citing
Hendrix v. Linn-Corriher Corp., 317 N.C. 179, 186, 345 S.E.2d 374,
379 (1986)). Although it is well established that the Industrial
Commission is the sole judge of the credibility of the witnesses
and the evidentiary weight to be given their testimony, findings of
fact by the Commission may be set aside on appeal 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). The Commission's conclusions of law are reviewed de novo.
Griggs v. Eastern Omni Constructors, 158 N.C. App. 480, 483, 581
S.E.2d 138, 141 (2003).
Pursuant to North Carolina General Statutes, Section 97-2(6),
'[i]njury and personal injury' shall mean only
injury by accident arising out of and in thecourse of the employment[.]. . . With respect
to back injuries, however, 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.
N.C. Gen. Stat. . 97-2(6) (2005). There are two theories on which
a back injury claimant can proceed: (1) that claimant was injured
by accident; or (2) that the injury arose from a specific traumatic
incident. Fish v. Steelcase, Inc., 116 N.C. App. 703, 707, 449
S.E.2d 233, 237 (1994) cert. denied, 339 N.C. 737, 454 S.E.2d 650
(1995)(citing Richards v. Town of Valdese, 92 N.C. App. 222, 224,
374 S.E.2d 116, 118 (1988), disc. review denied, 324 N.C. 337, 378
S.E.2d 799 (1989)).
An injury is compensable as employment-related if any
reasonable relationship to employment exists. Kiger v. Bahnson
Serv. Co., 260 N.C. 760, 762, 133 S.E.2d 702, 704 (1963).
Although the employment-related accident 'need not be the sole
causative force to render an injury compensable,' the plaintiff
must prove that the accident was a causal factor by a preponderance
of the evidence. Holley v. ACTS, Inc., 357 N.C. 228, 231-32, 581
S.E.2d 750, 752 (2003) (quoting Hansel v. Sherman Textiles, 304
N.C. 44, 52, 283 S.E.2d 101, 106 (1981); Ballenger v. ITT Grinnell
Indus. Piping, Inc., 320 N.C. 155, 158-59, 357 S.E.2d 683, 685
(1987)). In Morrison v. Burlington Indus., our Supreme Court held
that
when an employee afflicted with a pre-
existing disease or infirmity suffers apersonal injury by accident arising out of and
in the course of his employment, and such
injury materially accelerates or aggravates
the pre-existing disease or infirmity and thus
proximately contributes to the death or
disability of the employee, the injury is
compensable, even though it would not have
caused death or disability to a normal
person.
Morrison v. Burlington Indus., 304 N.C. 1, 16, 282 S.E.2d 458, 469
(1981) (quoting Little v. Anson County Schools Food Serv., 295 N.C.
527, 531-32, 246 S.E.2d 743, 746 (1978)(quoting Anderson v.
Northwestern Motor Co., 233 N.C. 372, 374, 64 S.E.2d 265, 267
(1951))).
Similarly, if other pre-existing conditions
such as an employee's age, education and work
experience are such that an injury causes him
a greater degree of incapacity for work than
the same injury would cause some other person,
the employee must be compensated for the
incapacity which he or she suffers, and not
for the degree of disability which would be
suffered by someone with superior education or
work experience or who is younger or in better
health.
Id. (quoting Little, 295 N.C. at 531-32, 246 S.E.2d at 746).
In cases involving 'complicated medical questions far removed
from the ordinary experience and knowledge of laymen, only an
expert can give competent opinion evidence as to the cause of the
injury.' Holley, 357 N.C. at 232, 581 S.E.2d at 753 (quoting
Click v. Pilot Freight Carriers, Inc., 300 N.C. 164, 167, 265
S.E.2d 389, 391 (1980)). However, when such expert opinion
testimony is based merely upon speculation and conjecture, . . . it
is not sufficiently reliable to qualify as competent evidence on
issues of medical causation. Id. (quoting Young, 353 N.C. at 230,538 S.E.2d at 915). 'The evidence must be such as to take the
case out of the realm of conjecture and remote possibility, that
is, there must be sufficient competent evidence tending to show a
proximate causal relation.' Id. (quoting Gilmore v. Hoke Cty. Bd.
of Educ., 222 N.C. 358, 365, 23 S.E.2d 292, 296 (1942)).
In the present case, the Full Commission's findings of fact
include:
3. On January 12, 2000, . . . plaintiff
slipped and fell on her left shoulder, wrist,
head, and back.
. . .
5. On 31 March 2000, the plaintiff felt a
catch or pop in her back as she pulled a desk.
On this date she went to Dr. Hodgson, her
primary care physician and complained about
back pain. Plaintiff was treated
conservatively with medication and removed
from work for two weeks.
. . .
10. On 6 July 2000 plaintiff was having
significant back pain and Dr. Hodgson referred
plaintiff to Dr. Candella (sic). Plaintiff
reported to Dr. Candella (sic) a history of
having significant back pain after moving
desks. Dr. Candella (sic) treated plaintiff
conservatively with injections of Depomedrol.
This treatment had some success but
plaintiff's back pain returned with activity.
11. Thereafter, the plaintiff was sent to Dr.
Tsiktsiris for an evaluation concerning
arthritis. Dr. Tsiktsiris performed a CT scan
and referred her to Dr. Melin, a neurosurgeon,
and prescribed physical therapy at Columbus
Hospital. The plaintiff attended four
physical therapy session but had worsening
pain and the therapy was discontinued.
12. Dr. Melin diagnosed the plaintiff with L5-
S1 Sponylolisthesis. Dr. Melin indicated that
an L5-S1 fusion could be an option in thefuture. Thereafter, Dr. Hahn at Pain
Management gave the plaintiff two epidural
injections, with the last one being 20 August
2002.
. . .
15. Drs. Hodgson and Melin testified that the
traumas described by plaintiff of 12 January
2000 and 31 March 2000 aggravated her
preexisting, previously asymptomatic back
condition.
16. Dr. Hodgson testified in his deposition
that plaintiff's 12 January 2000 injury could
have exacerbated the - - pain that [plaintiff]
was experiencing or could have caused the
pain.
Based upon these findings of fact, the Full Commission
concluded that:
1. Plaintiff sustained a compensable injury by
accident arising out of and as a direct result
of her employment with defendant in that she
suffered specific traumatic incidents on 12
January 2000 and 31 March 2000. . . .
2. Plaintiff's workplace injuries of 12
January 2000 and 31 March 2000 aggravated a
preexisting, nondisabling condition.
Upon review of the record, the deposition testimonies of Dr.
Hodgson and Dr. Melin were based merely upon speculation and
conjecture, and were not sufficiently reliable to qualify as
competent evidence on issues of medical causation.
With respect to Dr. Hodgson's testimony, he stated that on 31
March 2000, plaintiff presented to him and her chief complaint was
ulcers in her mouth, pressure in her ears, and pain in her left
lower back. Plaintiff never mentioned her January accident or her
March accident at any time. Dr. Hodgson stated that plaintiff
suffered from osteoarthritis, degenerative disc disease, andspondylolisthesis, which is essentially arthritis, and that this
would be a normal condition for a person of plaintiff's age,
weight, and activity level. On direct examination, plaintiff's
attorney presented Dr. Hodgson with a hypothetical about the
January and March accidents, and asked Dr. Hodgson whether that
[January] accident could have caused the back problems that she
presented to you with on March 31st of 2000, to which Dr. Hodgson
answer Ah yes. I think that certainly could've exacerbated or
started the painful process in her back.
Here, Dr. Hodgson did not testify that the January or the
March accident caused plaintiff's injury compensated under the
Industrial Commission's Conclusions. Nor did Dr. Hodgson testify
that plaintiff's arthritis, as a preexisting condition, caused the
injury compensated. Dr. Hodgson's testimony that, under the
hypothetical presented, plaintiff's injury could have exacerbated
her back pain is insufficient to satisfy the requirement of
sufficient competent evidence tending to show a proximate causal
relation between the accident and the injury. Therefore, the
Industrial Commission erred in concluding that the January or March
accident caused plaintiff's back pain.
With respect to Dr. Melin's testimony, Dr. Melin evaluated
plaintiff's condition on 5 and 15 July 2002 because she was
referred to him for spondylolisthesis. Plaintiff never mentioned
her January or March accidents to Dr. Melin. Plaintiff's attorney
asked Dr. Melin if the January and March accident had occurred,
whether these facts and . . . history [were] consistent with thetype of trauma that would cause an L5-S1 spondylolisthesis or
aggravate that pre-existing condition? Dr. Melin replied that
plaintiff informed him that she had severe pain and problems in her
twenties, and that if she had Grade I spondylolisthesis, then this
would be a normal progression of disease. Furthermore, Dr. Melin
testified that the January and March accidents could certainly
tranform a compensated anomoly of the back to become decompensated
and symptomatic, but Dr. Melin did not testify that the January or
March accidents caused plaintiff's back pain.
Here, Dr. Melin did not testify that the January or March
accidents caused plaintiff's injury that the Industrial Commission
deemed compensable. Furthermore, Dr. Melin did not state that
plaintiff had a preexisting condition that was aggravated by the
January or March accidents. Therefore, the Industrial Commission
erred in relying on Dr. Melin's testimony to conclude that the
January and March accidents caused plaintiff's back pain.
In addition to testimony from Dr. Hodgson and Dr. Melin,
plaintiff testified that she did not tell her physicians that the
January or March accidents caused her back pain. Although she
testified that she told the physicians she thought her back pain
was related to work, this statement is insufficient for the
Industrial Commission to conclude that there is competent evidence
that the January and March accidents caused plaintiff's back pain.
Plaintiff testified that she told Dr. Candela that she sustained
injuries at work, but the Industrial Commission did not enterfindings of fact that, according to Dr. Candela's testimony, the
January or March accident caused plaintiff's back pain.
Upon a full review of the record, we hold that the Industrial
Commission's findings of fact were not supported by competent
evidence, and the Industrial Commission erred by concluding that
plaintiff sustained a compensable injury and that plaintiff's
January and March accidents aggravated a preexisting, nondisabling
condition. Accordingly, we reverse.
REVERSED.
Chief Judge MARTIN and Judge Levinson concur.
Report per Rule 30(e).
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