Appeal by employer from Opinion and Award entered 24 October
2006 by the North Carolina Industrial Commission. Heard in the
Court of Appeals 18 September 2007.
Wilson and Reives, PLLC, by E. Neil Morris, for plaintiff-
Brooks Stevens & Pope, P.A., by Michael C. Sigmon, for
MARTIN, Chief Judge.
General Parts, Inc., d/b/a Carquest of Sanford (defendant-
employer), Zurich American, and GAB Robins (collectively
defendants) appeal an Opinion and Award by the North Carolina
Industrial Commission (Commission) awarding benefits to employee
Charles Ray Billings (plaintiff). We affirm.
The record reflects that plaintiff was engaged in an
employment relationship with defendant-employer on 2 June 2003 as
a part-time automotive parts delivery truck driver. The seventy-
three-year-old plaintiff had been employed with defendant-employer
in this capacity for six years. On that date, plaintiff was
returning to defendant-employer's place of business after making a
delivery in defendant-employer's pickup truck. Plaintiff suffered
a blackout while operating the truck, ran off the street near a
railroad crossing, and struck a light pole, causing the truck to
roll over. At the scene, plaintiff was conscious and alert, but
complained of head pain. Plaintiff was transported to Central
Carolina Hospital (CCH) where he underwent a CT scan of his head
on the same day.
The CT scan noted a [s]mall focus of increased attenuation
identified adjacent to the superior sylvian fissu[r]e which may
possibly represent a [cerebral] contusion. On 4 June 2003,
plaintiff underwent an MRI of the brain. The MRI noted an acute
punctate right cerebellar infarct and noted there was neither
subdural bleeding nor an acute contusion in the left parietal lobe,
but could not exclude the presence of a small contusion. Plaintiff
was discharged from CCH on 4 June 2003 with diagnoses of a syncopalepisode (i.e., a sudden loss of consciousness) and an acute right
cerebellar small lacunar infarct (i.e., a stroke).
After a follow-up appointment on 9 June 2003 with his primary
care physician, certified internist Dr. Steven Michael, plaintiff
was referred to certified neurologist and neurophysiologist Dr.
Mohan C. Deochand for further evaluation. On 12 June 2003, Dr.
Deochand saw plaintiff who complained of suffering from headaches
for several days after his discharge from the hospital. Dr.
Deochand diagnosed plaintiff with a right cerebellar infarct. On
16 June 2003, plaintiff returned to Dr. Deochand complaining of
more bleeding from his nose.
On 22 July 2003, Dr. Michael saw plaintiff for a checkup.
Plaintiff complained of episodes of right facial numbness. On
2 August 2003, Dr. Deochand saw plaintiff who complained of pain
and weakness in his legs and difficulty walking. Plaintiff also
complained of neck pain radiating into the right side of his head.
On 5 August 2003, plaintiff arrived in a wheelchair to see Dr.
Michael for complaints of headache with nausea and ongoing muscle
weakness. Dr. Michael's neurological exam revealed a slight
decrease in the strength of plaintiff's left upper and lower
On 7 August 2003 at 4:00 a.m., plaintiff was seen at the CCH
Emergency Department complaining of a sharp, throbbing headache
that woke him up. The following day, he was seen by Dr. Sangeeta
Sawhney who admitted plaintiff to CCH's Intensive Care Unit due to
complaints of severe headaches and new onset left-sided weakness.
An MRI performed that afternoon showed that plaintiff had obviousbilateral subdural hematomas present_i.e., bleeding in the
subdural space of the brain_that were larger on the right than the
left. The subdural hematomas appeared to be subacute in nature
but age [was] indeterminate. The MRI showed no other sign of an
infarct. Based on his critical condition, plaintiff was
transported to Wake Medical Center (Wake Med) for further
treatment. A CT scan done later that evening showed bilateral
subdural fluid collections present and noted a subsequent right to
left hemispheric shift.
On 9 August 2003, neurosurgeon Dr. Russell Margraf performed
a right frontal craniotomy for evacuation and drainage of acute on
subacute subdural hematoma. Dr. Margraf noted that a
considerable amount of dark clot and crank case oil fluid under
pressure [was] evacuated and a drain was sewn into place in
On 15 August 2003, a neurological consult was requested after
an onset of uncontrolled violent movements in plaintiff's right
lower extremities. Neurologist Dr. Susan A. Glenn noted that these
movements were consistent with a right lower extremity
hemiballismus which may present a small new stroke, or possibl[e]
sequela of plaintiff's brain injury from the subdural hematomas.
A 15 August 2003 MRI reported persistent bilateral subdural
hematomas and acute bilateral posterior cerebral artery territory
infarctions or strokes.
After plaintiff's condition continued to deteriorate, he was
admitted and transferred to Wake Med Rehabilitation Hospital (Wake
Med Rehab) on 18 August 2003 for assistance with control of thehemiballismus of the right lower extremity. Plaintiff was noted to
be lethargic, disoriented, and incapable of following simple
directions. Plaintiff remained at Wake Med Rehab until his
discharge and transfer on 5 September 2003 to Laurels of Chatham,
a long-term care facility, due to his sharp decline and severe
deficits in cognition and mobility. At the time of his discharge
from Wake Med Rehab, plaintiff required assistance for feeding,
grooming, toileting, and movement. Plaintiff's condition improved
during his four-month stay at Laurels of Chatham to allow plaintiff
to return home in December 2003, even though he continued to have
problems with involuntary movement of his legs. Board certified
family medicine specialist Dr. John Corey began treating plaintiff
in Laurels of Chatham and continued to see plaintiff after he left
the long-term care facility and returned home. Dr. Corey
determined that plaintiff was unable to work due to his cognitive
impairment and the movement disorders of his legs, and found that
plaintiff was completely and permanently disabled as a result of
these medical problems.
On 31 October 2003, defendant-employer denied plaintiff's
claim on the grounds that plaintiff's injuries were not the direct
result of a work-related accident. After receiving evidence, a
deputy commissioner filed an Opinion and Award which determined
that plaintiff's injuries were the direct result of a work-related
accident and ordered defendants to pay for all existing and future
medical expenses incurred as a result of plaintiff's motor vehicle
accident, as well as total disability benefits from the date of the
accident until the Commission decided otherwise. Defendantsappealed to the full Commission. On 24 October 2006, the
Commission entered an Opinion and Award affirming the deputy
commissioner's decision, with some modifications. This appeal
Our Supreme Court has repeatedly held 'that our Workers'
Compensation Act should be liberally construed to effectuate its
purpose to provide compensation for injured employees or their
dependents, and its benefits should not be denied by a technical,
narrow, and strict construction.' Adams v. AVX Corp.
, 349 N.C.
676, 680, 509 S.E.2d 411, 413 (1998) (quoting Hollman v. City of
, 273 N.C. 240, 252, 159 S.E.2d 874, 882 (1968)).
The Industrial Commission and the appellate courts have
distinct responsibilities when reviewing workers' compensation
claims. See Deese v. Champion Int'l Corp.
, 352 N.C. 109, 114,
530 S.E.2d 549, 552 (2000). The Industrial Commission is 'the
fact finding body,' Adams
, 349 N.C. at 680, 509 S.E.2d at 413
(quoting Brewer v. Powers Trucking Co.
, 256 N.C. 175, 182,
123 S.E.2d 608, 613 (1962)), and is 'the sole judge of the
credibility of the witnesses and the weight to be given their
(quoting Anderson v. Lincoln Constr. Co.
265 N.C. 431, 433_34, 144 S.E.2d 272, 274 (1965)). On appeal,
'[t]he findings of fact by the Industrial Commission are
conclusive . . . if supported by any competent evidence.' Id.
681, 509 S.E.2d at 414 (quoting Gallimore v. Marilyn's Shoes
292 N.C. 399, 402, 233 S.E.2d 529, 531 (1977)). These findings
'are conclusive on appeal . . . even though there be evidence thatwould support findings to the contrary
(quoting Jones v.
Myrtle Desk Co.
, 264 N.C. 401, 402, 141 S.E.2d 632, 633 (1965))
(emphasis added). 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. Id.
(citing Doggett v. South Atl.
, 212 N.C. 599, 194 S.E. 111 (1937)). An opinion and
award of the Industrial Commission will only be disturbed upon the
basis of a patent legal error. Roberts v. Burlington Indus.,
, 321 N.C. 350, 354, 364 S.E.2d 417, 420 (1988) (citing Hoffman
v. Truck Lines, Inc.
, 306 N.C. 502, 505, 293 S.E.2d 807, 809
(1982)). Therefore, this Court 'does not have the right to weigh
the evidence and decide the issue on the basis of its weight.
Th[is] [C]ourt's duty goes no further than to determine whether the
record contains any evidence tending to support the finding.'
, 349 N.C. at 681, 509 S.E.2d at 414 (quoting Anderson
265 N.C. at 434, 144 S.E.2d at 274). With these as our guiding
principles, we now address defendants-appellants' assignments of
Defendants have asserted forty-eight assignments of error
relating to three issues: (1) whether plaintiff's 2 June 2003
motor vehicle accident arose out of his employment with
defendant-employer; (2) whether plaintiff's initial head injury and
later subdural hematoma were the result of the 2 June 2003 motor
vehicle accident; and (3) whether plaintiff's second stroke and
resulting medical disability were the result of the 2 June 2003
motor vehicle accident. Defendants failed to present argumentsaddressing Assignments of Error 3 and 4 regarding Finding of
Fact 4, as well as Assignments of Error 43 through 48 regarding
Conclusions of Law 4, 5, 6, and the Commission's Award. These
assignments of error are deemed abandoned.
N.C.R. App. P. 28(a)
(2007) (Questions raised by assignments of error in appeals from
trial tribunals but not then presented and discussed in a party's
brief, are deemed abandoned.).
 Defendants first contend the Industrial Commission erred
when it concluded that plaintiff's 2 June 2003 motor vehicle
accident arose out of his employment with defendant-employer. We
In order to be compensable under the Act, an employee's
injury by accident must arise out of and in the scope of
employment. Rackley v. Coastal Painting
, 153 N.C. App. 469, 472,
570 S.E.2d 121, 123 (2002). Our Supreme Court has held that a
determination that an injury arose out of and in the course of
employment is a mixed question of law and fact, 'and where there is
evidence to support the Commissioner's findings in this regard,
[the appellate court is] bound by those findings.' Rose v. City
of Rocky Mount
, 180 N.C. App. 392, 396, 637 S.E.2d 251, 254 (2006)
(quoting Barham v. Food World
, 300 N.C. 329, 331, 266 S.E.2d 676,
678 (1980)) (alteration in original).
'In the course of the employment' is construed to refer to
the time, place and circumstances under which the accident occurs.
Warren v. City of Wilmington
, 43 N.C. App. 748, 750, 259 S.E.2d
786, 788 (1979) (citing Hinkle v. Lexington
, 239 N.C. 105,79 S.E.2d 220 (1953)). 'Arising out of' the employment is
construed to require that the injury be incurred because of a
condition or risk created by the job. Id.
In other words, [t]he
basic question [to answer when examining the arising out of
requirement] is whether the employment was a contributing cause of
the injury. Roberts
, 321 N.C. at 355, 364 S.E.2d at 421 (citing
Allred v. Allred-Gardner, Inc.
, 253 N.C. 554, 557, 117 S.E.2d 476,
It is well established in North Carolina that the Workers'
Compensation Act should be liberally construed and that [w]here any
reasonable relationship to employment exists, or employment is a
contributory cause, th[is] [C]ourt is justified in upholding the
award as arising out of employment. Hollin v. Johnston Cty.
Council on Aging
, 181 N.C. App. 77, 84, 639 S.E.2d 88, 93 (2007)
(quoting Kiger v. Bahnson Service Co.
, 260 N.C. 760, 762, 133
S.E.2d 702, 704 (1963)) (first alteration in original) (internal
quotation marks omitted). The employment-related accident 'need
not be the sole causative force to render an injury compensable.'
Holley v. ACTS, Inc.
, 357 N.C. 228, 231, 581 S.E.2d 750, 752 (2003)
(quoting Hansel v. Sherman Textiles
, 304 N.C. 44, 52, 283 S.E.2d
101, 106 (1981)).
Our appellate courts have stated that [w]hen the employee's
idiopathic condition is the sole cause of the injury, the injury
does not arise out of the employment. Mills v. City of New Bern
122 N.C. App. 283, 285, 468 S.E.2d 587, 589 (1996) (citing Vause v.
Vause Farm Equip. Co.
, 233 N.C. 88, 92_93, 63 S.E.2d 173, 176
(1951)). However, [t]he injury does arise out of
the employmentif the idiopathic condition of the employee combines with
attributable to the employment' to cause the injury. Id.
Hollar v. Montclair Furniture Co.
, 48 N.C. App. 489, 496,
269 S.E.2d 667, 672 (1980)) (emphasis added) (second alteration in
original). [I]f the employment 'aggravate[s], accelerate[s], or
combine[s] with the [employee's preexisting] disease or infirmity
to produce' the injury, that injury arises out of the employment.
(fifth alteration in original). In other words, 'where the
accident and resultant injury arise out of both
condition of the workman and hazards incident to the employment,
the employer is liable. But not so where the idiopathic condition
is the sole cause
of the injury.' Vause
, 233 N.C. at 92_93,
63 S.E.2d at 176 (emphasis added).
[W]hen an employee's duties require him to travel, the
hazards of the journey are risks of the employment. Roberts
321 N.C. at 359, 364 S.E.2d at 423 (citing Hinkle v. Lexington
239 N.C. 105, 79 S.E.2d 220 (1953)). '[A]n injury caused by a
highway accident is compensable if the employee at the time of the
accident is acting in the course of his employment and in the
performance of some duty incident thereto.' Id.
(quoting Hardy v.
, 246 N.C. 581, 585, 99 S.E.2d 862, 866 (1957)).
In the present case
, the parties stipulated that the accident
occurred in the course of plaintiff's employment with defendant-
employer. The Commission found that plaintiff suffered a syncopal
episode (i.e., blackout) while operating defendant-employer's
truck, after which time the truck ran off the road, hit a light
pole, and flipped over. Plaintiff was not off-duty and engaged ina purely personal errand when the accident occurred. Chavis v.
TLC Home Health Care
, 172 N.C. App. 366, 385, 616 S.E.2d 403, 417
(2005) (Tyson, J. dissenting). Plaintiff did not get a warning of
an approaching seizure and purposefully pull the truck off the
road, park it, and [lie] down on the seat in a place of apparent
safety, with all of the ordinary dangers of his employment
suspended and in repose. Vause
, 233 N.C. at 98, 63 S.E.2d at 180.
In this case, plaintiff was returning to defendant-employer's place
of business after making a delivery in defendant-employer's pickup
truck. The Commission concluded:
The hazards or risks incidental to plaintiff's employment
were a contributing proximate cause of plaintiff's
accident and resulting injuries. The risk of driving a
truck aggravated, accelerated, or combined with
plaintiff's pre-existing condition to produce his injury.
Thus, plaintiff's injuries arose out of and in the course
of his employment, as they were the result of his June 2,
2003 work-related accident.
(Citations omitted.) The Commission's conclusion was supported by
its findings of fact and correct as a matter of law.
In support of their contention that plaintiff's accident did
not arise out of his employment, defendants alternatively argue
that the Commission erroneously relied on Allred v. Allred-Gardner,
, 253 N.C. 554, 117 S.E.2d 476
(1960), and argue that
plaintiff's injury does not survive an increased risk analysis.
Defendants contend that Allred
relied on the positional risk
analysis to support its conclusion that the plaintiff's injury was
compensable as arising out of his employment_a doctrine now
rejected by our courts and replaced by the increased risk
analysis. While [w]e agree that the 'increased risk' test and not
the 'positional risk' rule is the law of the State, we disagreewith defendants' contention that the Commission erroneously applied
the latter. Rose
, 180 N.C. App. at 401, 637 S.E.2d at 257.
Our Supreme Court has relied on the increased risk analysis
to determine whether injuries arose out of the claimant's
employment primarily where an employee interrupts his work for
his employer to engage in personal conduct unrelated to the
employer's business. Dodson v. Dubose Steel, Inc.
, 159 N.C. App.
1, 13, 582 S.E.2d 389, 397 (2003) (Steelman, J., dissenting), rev'd
, 358 N.C. 129, 591 S.E.2d 548 (2004) (for reasons stated
in the concurring and dissenting opinion of Steelman, J.). Here,
since plaintiff was returning to defendant-employer's place of
business after making a delivery on behalf of defendant-employer in
defendant-employer's pickup truck at the time of the accident, an
increased risk analysis is not relevant.
We also disagree with defendants' inference that
acceptance of the increased risk doctrine precludes the Commission
from relying on Allred
in its conclusions of law. This Court has
, the claimant was driving a truck for work when
he blacked out and hit a pole. The fact that the
plaintiff blacked out due to an idiopathic condition and
that he was driving a truck for work at the time was
sufficient to support a finding that the accident arose
out of claimant's employment. No findings were required
that the claimant's injury was made more severe or caused
solely by the fact that he was driving a truck.
, 153 N.C. App. at 474, 570 S.E.2d at 125 (citation
omitted). We believe the facts of the present case are consistent
with this interpretation of Allred
. Therefore, we affirm the
Commission's ruling that plaintiff's 2 June 2003 motor vehicleaccident arose out of his employment with defendant-employer and
find no error.
 Defendants next contend that the Industrial Commission
erred when it concluded that plaintiff's initial head injury and
later subdural hematoma were the result of the 2 June 2003 motor
vehicle accident. Again, we must disagree.
Viewed in the light most favorable to plaintiff, the evidence
showed that the 2 June 2003 CT scan found the following: There is
increased attenuation identified adjacent to the superior portion
of the left sylvian fissure. This finding may possibly represent
a cerebral contusion. The 4 June 2003 MRI brain imaging found, in
part: The head CT previously performed demonstrated a focus of
increased attenuation in the left parietal lobe. A small contusion
cannot be excluded. This MRI also found that there was [n]o
evidence of left parietal lobe contusion. Since both findings
were included in the same MRI report, the Commission was correct to
allow for the possibility that a small contusion existed. The
Discharge Summary further noted that plaintiff was involved in a
motor vehicle accident which le[d] to closed head trauma with
injuries sustained to the left side of his head and a left ear
Additionally, during his 3 June 2003 examination of plaintiff
at CCH, neurologist and neurophysiologist Dr. Deochand testified
that plaintiff had a scalp tenderness over the left temporal
parietal region_a finding that he testified was significant. Healso testified that the 4 June 2003 MRI could not exclude any
contusion over the left parietal region.
Neurosurgeon Dr. Margraf testified, I think if the CAT scan
suggested a small contusion, it's possible that there very well
could have been a small contusion there. And the best way to
follow that up would be with another CAT scan, not with a[n] MRI
scan because [a]n MRI scan is very poor at visualizing blood,
acute blood, particularly if it's just a small amount . . . [a]nd,
really, CAT scan is best. Dr. Margraf further testified that the
MRI scan is maybe not as sensitive at picking up a small amount of
acute blood, such as a small contusion, on the convexity.
Next, the Commission found that the greater weight of the
medical evidence and the testimony of Dr. Margraf and Dr. Freedman
supported a finding that plaintiff's subdural hematomas were
related to the accident.
Dr. Mitchell Freedman, a board certified neurologist,
testified that the type of head trauma plaintiff sustained in the
2 June 2003 motor vehicle accident could facilitate the development
of subdural hematomas over a period of a month or two. Dr.
Freedman further testified that it was quite common that an MRI
performed two days following a head trauma would not reflect any
evidence of subdural hematomas that may have been facilitated by
that head trauma. He testified that subdural hematomas represent
a very slow leak of blood and develop very, very insidiously and
very slowly. He said that very often the patients who suffer
from subdural hematomas have trauma which dates back to one, twoor even three months before the subdurals were found. Dr.
Assuming there is no other history of other head
injuries, then it is more likely than not that the motor
vehicle accident was the cause of the subdural. There
does not appear in the medical record to be any other
specific head injuries of sufficient magnitude to
override or to trump that issue as the cause of the
Dr. Freedman conceded that subdural hematomas can occur
spontaneously, but concluded:
[I]f you have a man who's had a closed head injury and
two months later develops a subdural, . . . and there's
no other interceding explanation, clotting disorders,
medical problems, other trauma, then I think you have to
say that it is more likely than not that the motor
vehicle accident was the cause of the subdural.
On cross examination, Dr. Freedman reiterated, [H]ere's a guy
that's in a car accident, hits a light pole. He has a laceration
of the ear and then two months later has a subdural. It's kind of
Dr. Margraf testified that he ordered a CT scan of plaintiff
when he first saw him on 8 August 2003. He testified that the CT
scan showed that plaintiff had bilateral subdural hematomas
involving both the left and right side, where the right subdural
hematoma was larger. Dr. Margraf recommended a craniotomy on
plaintiff's right side, based on the increased size of the right
subdural hematoma, in which he would start with a relatively
simple burr hole for evacuation of the subdural, which is a small
removal of bone . . . opening the covering around the brain and
draining the subdural liquid to release the pressure. During the
surgery, Dr. Margraf found crank case oil or dark blood which he
described as a sign of a more chronic subdural, meaning two weeks. . . or older. When asked whether Dr. Margraf had an opinion
based on a reasonable degree of medical certainty as to the cause
of plaintiff's bilateral subdural hematomas, Dr. Margraf testified,
I believe that the subdurals, given the history, are related to
the traumatic event to the head[_i.e., the motor vehicle
accident_]which [plaintiff] sustained on . . .  June 2003. He
testified that it was not unusual that subdural hematomas would not
be evident on an MRI scan two days post trauma. Dr. Margraf
testified that plaintiff likely had a slowly progressing chronic
subdural hematoma, which could be tolerated for some period of time
until the increase in pressure caused him to become symptomatic.
Defendants also rely on Young v. Hickory Business Furniture
353 N.C. 227, 538 S.E.2d 912 (2000), to argue that there was no
competent evidence to find causation of plaintiff's subdural
hematomas since the cause could not be definitively established.
, plaintiff claimed she developed fibromyalgia as a result
of an employment-related injury. Fibromyalgia is an illness or
condition of unknown etiology for which there were no physical
tests that one [could] perform, or testing of any kind with regard
to chemical abnormality in the body, which would indicate whether
a person has fibromyalgia. Young
, 353 N.C. at 231, 538 S.E.2d at
915. When considering this issue, the Court noted:
Due to the complexities of medical science, particularly
with respect to diagnosis, methodology and determinations
of causation, this Court has held that where the exact
nature and probable genesis of a particular type of
injury involves 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. However, when such expert
opinion testimony is based merely upon speculation and
conjecture, it can be of no more value than that of alayman's opinion. As such, it is not sufficiently
reliable to qualify as competent evidence on issues of
at 230, 538 S.E.2d at 915 (citation omitted). In Young
found that, because plaintiff's treating rheumatologist was
not only unable to determine the cause of plaintiff's fibromyalgia,
but also could not definitively diagnose plaintiff with
fibromyalgia, the testimony_which was the only evidence offered in
support of plaintiff's claim_was based entirely upon conjecture
and speculation. Id.
at 231, 538 S.E.2d at 915. We do not
is analogous to the present case
Unlike fibromyalgia, there are physical tests which can be
performed to indicate whether a person has subdural hematomas, and
one of those tests was performed in the present case
. The 8 August
2003 MRI clearly indicated that plaintiff had obvious bilateral
subdural hematomas present which appear[ed] to be subacute in
nature but age [was] indeterminate. Testimony was presented to
the Commission that a common cause of subdural hematomas is head
trauma like the one suffered by plaintiff in the 2 June accident.
However, defendants contend that testimony from some experts
indicated that it was possible that plaintiff could have developed
the subdural hematomas as a result of prior undiagnosed small
strokes, spontaneous hemorrhaging due to plaintiff's treatment with
Plavix following the 2 June 2003 accident, or due to an intervening
fall between plaintiff's 4 June MRI and 8 August MRI.
This Court has held that [s]o long as there is some evidence
of substance which directly or by reasonable inference tends tosupport the findings, this Court is bound by such evidence, even
though there is evidence that would have supported a finding to the
, 180 N.C. App. at 400, 637 S.E.2d at 257 (internal
quotation marks omitted). Therefore, based on plaintiff's medical
records and the testimony of treating physicians, we hold there is
sufficient evidence to support the Commission's findings that
plaintiff's initial head injury and later subdural hematoma were
the result of the 2 June 2003 motor vehicle accident. We find no
error and affirm the Commission's findings.
 Finally, defendants contend that the Commission erred when
it determined that plaintiff's second stroke and resulting medical
disability were the result of the 2 June 2003 motor vehicle
accident. Defendants contend that plaintiff's subdural hematoma
was diagnosed and treated successfully by Dr. Margraf with the
9 August 2003 craniotomy and evacuation and drainage of the
The Commission found that the August 9, 2003 surgery
performed by Dr. Margraf lessened plaintiff's disability, helped
effect a cure to his subdural hematomas, and gave him relief from
that condition. However, Dr. Margraf testified and the Commission
found that, although plaintiff's initial recovery went well, a few
days after the craniotomy, plaintiff suffered increased confusion
and began to exhibit some ballistic movements involving the right
lower extremity and, to some extent, the right upper extremity.
The 15 August 2003 MRI following the 9 August craniotomy showed apersistence of his bilateral subdural hematomas, although the right
subdural was significantly smaller following the craniotomy. Dr.
Margraf testified that the most obvious conclusion for the cause
of the new infarct [or stroke] could be related to the subdural
collection and the shift and pressure that [plaintiff] had
associated with the subdural. That would be number one on my
list. Finally, Dr. Margraf testified that the subdural hematoma
was a significant contributing factor to the stroke suffered by
plaintiff on 15 August 2003. The Commission gave greater weight
to the expert opinion of Dr. Margraf and found that, [b]ased on
the greater weight of the medical evidence, . . . plaintiff's
subdural hematomas, resulting medical problems, functional
deterioration, and disability are all related to the June 2, 2003
motor vehicle accident that arose out of and in the course of
Therefore, we hold there is sufficient evidence to support the
Commission's findings that plaintiff's second stroke and resulting
impairment were the result of the 2 June 2003 motor vehicle
accident. We affirm the Commission's Opinion and Award.
Judges STROUD and ARROWOOD concur.
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