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1. Appeal and Error--preservation of issues--failure to include record or transcript
references
Defendants' third assignment of error in the record on appeal in a workers' compensation
case is dismissed based on a failure to include clear and specific record or transcript references in
violation of N.C. R. App. P. 10(c), because: (1) defendants made only a blanket reference to
transcript volumes I and II without making reference to a particular error, and there are 3,285
transcript pages in the transcripts; and (2) defendants failed to specify which documents should
have been included in the transcripts, and failed to provide specific record or transcript
references.
2. Workers' Compensation_notice of accident--timeliness--findings of fact--reasonable
excuse for failing to provide written notice--prejudice based on delay in written
notification
The Industrial Commission erred in a workers' compensation case by failing to address
whether plaintiff employee timely reported her claim under N.C.G.S. § 97-22 and whether her
case should be barred for her failure to do so because: (1) although the evidence demonstrated,
and the full Commission found, that defendant had actual knowledge of plaintiff's accident, the
Commission failed to make the crucial finding that plaintiff provided a reasonable excuse for her
failure to timely provide written notice of her accident; and (2) N.C.G.S. § 97-22 also requires
that the Commission be satisfied that the employer has not been prejudiced by the delay in
written notification, and the mere existence of actual notice without more cannot satisfy the
statutorily required finding with respect to prejudice. The case is remanded for specific findings
with respect to whether plaintiff satisfied her burden of showing a reasonable excuse for not
providing defendant employer with written notice of her accident within thirty days of its
occurrence, and for adequate findings of fact with respect to the issue of prejudice to defendant
employer.
3. Workers' Compensation_-causation of injuries--competent evidence-_headaches--
hand and wrist--knee--breast implants
Although the Industrial Commission did not err in a workers' compensation case by
finding there was competent evidence that causally related plaintiff's various injuries to her
motor vehicle accident of 16 May 2001 including for headaches, her right hand and wrist, and her
knee, it erred when it concluded plaintiff sustained compensable injuries to her bilateral breast
implants. The case is remanded for a determination of the appropriate amount of compensation
for the replacement of plaintiff's right breast implant, because although breast implants satisfy
the statutory requirement under N.C.G.S. § 97-2(6) as compensable prosthetic devices that
functions as part of the body, plaintiff's breast implant surgeon testified unequivocally that the
rippling in the left breast implant most likely was due to the original implant's being underfilled
and that the rippling was not caused or aggravated by the accident.
4. Appeal and Error--preservation of issues--failure to argue
Although defendants contend the full Commission erred in a workers' compensation case
by its finding of fact number 24, this assignment of error is dismissed, because defendants failed
to make an argument in their brief relating to this assignment of error or the full Commission's
findings with respect to plaintiff's teeth as required by N.C. R. App. P. 28(b)(6).
5. Workers' Compensation_-disability--burden of proof
The Industrial Commission did not err in a workers' compensation case by concluding
that plaintiff carried her burden of proving disability because: (1) plaintiff showed that defendant
did not provide light-duty work to her other than for two days in June 2002, a doctor testified that
plaintiff would have difficulty performing her regular job until at least February 2003 following
her knee surgery in June 2002, and plaintiff showed she was placed on one-handed work
restrictions by a doctor that was scheduled to continue until at least January 2004; (2) although
plaintiff returned to work on a few occasions during the pertinent time period, such intermittent
and infrequent work days did not constitute a successful trial return to work; and (3) defendants
failed to carry their burden of proving that plaintiff was capable of obtaining suitable
employment and failed to rebut the ongoing presumption of disability.
6. Workers' Compensation--lien--third-party settlement
The Industrial Commission erred in a workers' compensation case by failing to award
defendants a lien on all amounts accepted by plaintiff in her third-party settlement with her
uninsured motorists carrier, and the case is remanded for findings consistent with this Court of
Appeals opinion, because: (1) N.C.G.S. § 97-10.2(j) provides that either party may apply to the
superior court for a determination of the subrogation amount, regardless of whether both parties
consented to the third-party settlement, if justified by the equities of the case; (2) contrary to the
full Commission's conclusion, defendants' credit does not depend upon an award by the superior
court since N.C.G.S. § 97-10.2(h) clarifies that the lien is automatic, and instead plaintiff may
apply to the superior court for a determination of the lien amount under N.C.G.S. § 97-10.2(j);
and (3) unless and until plaintiff applies to the superior court for a determination of the
subrogation amount, defendants are entitled to a lien on all corresponding uninsured motorist
benefits received by plaintiff, less the portion expended for the cost of replacing plaintiff's left
breast implant.
Judge WYNN dissenting.
Anne R. Harris, for plaintiff-appellee.
Robinson & Lawing, L.L.P, by Jolinda J. Babcock and Eleasa H.
Allen, for defendants-appellants.
JACKSON, Judge.
Maxim Healthcare/Allegis Group (defendant-employer) and its
insurance carrier, Kemper Insurance Company/American Protection
Insurance c/o Specialty Risk Services (collectively, defendants),
appeal from an order of the Full Commission of the North Carolina
Industrial Commission (Full Commission) filed 15 March 2006
awarding workers' compensation benefits to Penny M. Rumple
Richardson (plaintiff). For the reasons stated below, we affirm
in part, reverse in part, and remand for further proceedings not
inconsistent with this opinion.
In 1996, plaintiff began working for defendant-employer , a
medical staffing agency with approximately 400 employees . As a
certified nursing assistant, plaintiff worked either in a long-term
care facility or in a client's home. Plaintiff's work duties
varied with the particular assignment and could be very strenuous
to very light, with work ranging from total patient care to
sitting with an elderly or disabled patient. Work assignments were
made either when an employee contacted defendant-employer to see if
work was available or when defendant-employer contacted an employee
seeking to fill a particular assignment. Employees could turn down
jobs, and many of defendant-employer's employees, including
plaintiff, worked a sporadic schedule.
On 16 May 2001, plaintiff was assigned work assisting a
paraplegic client with bathing, dressing, and general care.
Plaintiff left the client's house to pick up food, and while
traveling at approximately fifty-five miles per hour in the right-
hand lane, another vehicle drifted out of the left-hand lane andstruck plaintiff's vehicle. The impact caused plaintiff's vehicle
to spin out of control and strike a cement median barrier. The
vehicle's air bags did not deploy , and plaintiff hit her head and
right knee on something in the car. The driver of the other
vehicle did not stop. As a result of the accident, plaintiff
immediately experienced swelling in her face and right knee.
Plaintiff also sustained injuries to her chest as a result of the
accident.
Emergency Medical Services (EMS) arrived at the scene of the
accident and noted that plaintiff complained of pain in the left
side of her head. EMS also noted edema to the left side of
plaintiff's upper lip. EMS transported plaintiff to Moses Cone
Memorial Hospital, where she was treated for headache, difficulty
breathing, contusions, swelling around her mouth and chin, and
moderate pain and soreness around her head, face, and chest.
Additionally, plaintiff began experiencing a decrease in the
size of her breast implants as well as a rippling of the breasts
almost immediately after the motor vehicle accident. Plaintiff,
who had obtained the implants approximately five years prior to the
accident, reported her concerns to the physicians at the emergency
room. The physicians performed a visual inspection but noted no
asymmetry.
Within twenty to thirty minutes after the accident, plaintiff
called defendant-employer and reported the accident to her
supervisor. Defendant-employer acknowledged that it first learned
of the injury on 16 May 2001 _ the date of the accident _ onIndustrial Commission Form 19, dated 9 August 2002. Also shortly
after the accident, plaintiff filed uninsured motorists claims with
Nationwide Insurance (Nationwide) _ the insurance carrier for
plaintiff's motor vehicle _ for the personal injuries she sustained
as a result of the accident.
On 17 May 2001, plaintiff presented to her family physician at
Eagle Family Medicine, complaining of significant soreness,
particularly in her shoulders and upper back. The physical
examination revealed tenderness and soft tissue swelling over
plaintiff's left cheek as well as a contusion on the inside of her
upper lip. Plaintiff was given a note that provided that she was
not to return to work until 6 June 2001 due to medical reasons.
On 31 May 2001, plaintiff presented to Dr. David M. Bowers
(Dr. Bowers), a board certified specialist in plastic surgery,
and expressed concerns that there was a decrease in the size of
the implants, fairly immediately [after the accident]. Plaintiff
also informed Dr. Bowers of some rippling in the implants and
that she was no longer filling out the bras that she . . . bought
post surgery. Dr. Bowers testified that plaintiff's right breast
implant had ruptured, and the left breast implant, although it did
not appear to have ruptured, exhibited signs of rippling. On 7
June 2001, Dr. Bowers performed bilateral breast re-augmentation _
specifically, he removed the original implants and replaced them
with new implants. Nationwide paid Dr. Bowers for his work,
pursuant to plaintiff's claim with Nationwide. Following thesurgery on 7 June 2001, Dr. Bowers restricted plaintiff from
working until 24 July 2001.
Plaintiff also sought treatment for her right knee. Prior to
the accident, she had undergone two knee surgeries, after which
plaintiff had been able to return to work without restrictions.
Following the accident, plaintiff began experiencing pain and
swelling in her right knee, and on 9 July 2001, she presented to
Dr. Peter G. Dalldorf (Dr. Dalldorf) for treatment. Dr. Dalldorf
confirmed plaintiff's complaints and referred her to physical
therapy. Plaintiff followed up with Dr. Dalldorf on 30 July 2001,
complaining of intense pain since her accident in her right knee.
As a result, Dr. Dalldorf injected plaintiff's right knee and
restricted plaintiff from working from 9 July 2001 until 6 August
2001.
Plaintiff returned to work on a regular basis on 7 August
2001,
(See footnote 1)
but ceased working on 6 October 2001 to have surgery on her
right knee on 9 October 2001. Between October 2001 and May 2002,
when plaintiff returned to Dr. Dalldorf , she was limited in her
abilities to crawl, climb, or stoop as well as lift, position, and
turn patients. Nevertheless, plaintiff regularly contacted
defendant-employer requesting to be assigned to light-duty jobs
that she was capable of performing. Plaintiff testified thatdefendant-employer rarely offered her modified work that she was
physically capable of performing, and during this time, plaintiff
worked a total of eight days, performing light-duty jobs as they
became available and were offered to her. Defendant-employer used
plaintiff's wages on nearly all of these days to pay her health
insurance costs.
On 25 June 2002, Dr. Dalldorf performed a second post-accident
surgery on plaintiff's right knee. Plaintiff has not worked since
this surgery and has been under work restrictions from her
physicians. On 8 October 2002, Dr. Dalldorf performed a third
post-accident surgery on plaintiff's knee. Dr. Dalldorf testified
that although plaintiff had chondromalacia patella prior to the
motor vehicle accident, plaintiff's motor vehicle accident
aggravated her pre-existing condition, and she would not have
needed the three surgeries but for the motor vehicle accident. Dr.
Dalldorf further noted on 5 February 2003 that plaintiff would have
trouble performing her regular job duties.
Plaintiff also has experienced discomfort in her right hand
since the accident. On 22 January 2003, plaintiff presented to Dr.
Marshall C. Freeman (Dr. Freeman), complaining that she had been
experiencing bilateral hand numbness and tingling, especially on
her right hand, since May 2001. Plaintiff also explained her hand
condition to Dr. Dalldorf on 5 February 2003. Dr. Dalldorf
reviewed the nerve conduction studies performed by Dr. Freeman,
noted that the studies revealed a mild carpal tunnel syndrome on
her right hand, and injected plaintiff's hand with Depo-Medrol. Plaintiff returned to Dr. Dalldorf on 26 February 2003, complaining
of continued discomfort in her right hand. Having already
prescribed a brace and injection for plaintiff, Dr. Dalldorf
decided to refer plaintiff to Dr. Gary R. Kuzma (Dr. Kuzma).
On 6 March 2003, plaintiff presented to Dr. Kuzma, who is
board certified in orthopedics and hand surgery , complaining of
numbness and tingling in her hand. Plaintiff also indicated that
[s]he felt as though it was gradually getting worse. Plaintiff
indicated to Dr. Kuzma that she had been experiencing pain since
her motor vehicle accident. Dr. Kuzma diagnosed plaintiff with
carpal tunnel syndrome as well as arthrosis in her right thumb .
Dr. Kuzma recommended immobilizing plaintiff's thumb and wrist by
placing her right hand in a splint. On 4 June 2003, Dr. Kuzma
performed a carpal tunnel release on plaintiff's right hand . On 5
January 2004, Dr. Kuzma testified that plaintiff remained under his
care and on one-handed work restrictions. He also opined that
plaintiff may require additional surgery on her thumb in the
future.
Since her 16 May 2001 motor vehicle accident, plaintiff also
has experienced daily and continuous headaches. Plaintiff
complained of a headache at the time of the accident to EMS
workers. Plaintiff first sought treatment for her headaches on 23
October 2002 when she visited Dr. Freeman. Dr. Freeman's initial
examination revealed bilateral occipital nerve tenderness along
with a decreased range of motion of plaintiff's cervical spine.
Over the course of his care of plaintiff, Dr. Freeman diagnosedplaintiff with cervicogenic headache as well as occipital
neuralgia as well as a previous comorbid condition of fibromyalgia
and migraine headache without aura. Dr. Freeman prescribed a
variety of medications and performed trigger point injections and
occipital nerve blocks, but plaintiff exhibited no significant
improvement. Dr. Freeman testified that further options existed
for treating plaintiff's headaches, including additional trigger
point injections, botulinum-toxin injections, and integrative
therapies. Plaintiff did not follow up on the integrative
therapies, which Dr. Freeman explained typically are not covered by
insurance.
Finally, plaintiff's injuries as a result of the motor vehicle
accident included several dental injuries. Plaintiff initially
presented to Dr. Dennis Torney (Dr. Torney), a board certified
endodontist, on 30 April 2002. Dr. Torney has performed root
canals on several teeth on the left side of plaintiff's mouth,
including multiple root canals on some of those teeth. Dr. Torney
also has performed dental work and crowns on the teeth that
underwent root canal therapy. These teeth all are on the left side
of plaintiff's mouth _ the side of her face impacted during the
accident. Plaintiff has received treatment for teeth numbers 12,
13, 14, 15, 19, 23, and 24, although the Full Commission found that
the repair to tooth number 19 was the result of a previous
inadequate root canal, as opposed to the motor vehicle accident.
After receiving her final check from Nationwide, plaintiff
filed for workers' compensation benefits on 24 June 2002. Defendants denied liability on 9 September 2002. On 30 October
2003, a hearing was held before Deputy Commissioner George T. Glenn
II, and on 17 June 2004, Deputy Commissioner Glenn issued an
Opinion and Award in favor of plaintiff. Defendants appealed to
the Full Commission, which entered an Opinion and Award on 15 March
2006 affirming Deputy Commissioner Glenn's decision with
modifications. Chairman Buck Lattimore filed a dissenting opinion.
On 14 April 2006, defendants filed timely notice of appeal.
On appeal, defendants contend that: (1) the Full Commission
erred in failing to properly address whether plaintiff timely
reported her claim pursuant to North Carolina General Statutes,
section 97-22 and whether the case should be barred for her failure
to do so; (2) no competent evidence causally relates plaintiff's
various alleged injuries to the accident; (3) the Full Commission
failed to properly place the burden of proving disability on
plaintiff and that plaintiff presented insufficient evidence of
disability; and (4) the Full Commission erred in failing to award
defendants a lien on all amounts accepted by plaintiff in her
third-party settlement in contravention of North Carolina General
Statutes, section 97-10.2.
[1] As a preliminary matter, we note that defendants' third
assignment of error in the record on appeal violates the North
Carolina Rules of Appellate Procedure. Pursuant to Rule 10(c),
[e]ach assignment of error shall . . . state
plainly, concisely and without argumentation
the legal basis upon which error is assigned.
An assignment of error is sufficient if it
directs the attention of the appellate court
to the particular error about which thequestion is made, with clear and specific
record or transcript references.
N.C. R. App. P. 10(c)(1) (2006). In their third assignment of
error, defendants contend: The Full Commission erred in omitting
relevant stipulated documents from the transcript of the evidence
prepared by the Industrial Commission. The assignment of error
does not indicate to which documents defendants are referring, and
this Court has held that [a]ssignments of error which are 'broad,
vague, and unspecific . . . do not comply with the North Carolina
Rules of Appellate Procedure.' Hedingham Cmty. Ass'n v. GLH
Builders, Inc., 178 N.C. App. 635, 641, 634 S.E.2d 224, 228
(quoting In re Lane Company-Hickory Chair Div., 153 N.C. App. 119,
123, 571 S.E.2d 224, 226.27 (2002)), disc. rev. denied, 360 N.C.
646, 636 S.E.2d 805 (2006). Additionally, assignments of error are
required to include clear and specific record or transcript
references, N.C. R. App. P. 10(c)(1) (2006) (emphasis added), but
defendants' third assignment of error makes only the blanket
reference to Transcripts Volumes I and II. See State v. Walters,
357 N.C. 68, 95, 588 S.E.2d 344, 360 (Defendant identifies the
'Entire Transcript' as the basis for the assignment of error
alleging ineffective assistance of counsel, as contained in the
record on appeal. As there are 3,285 transcript pages in this
case, a reference to the entire transcript is not a reference to a
'particular error', nor is it 'clear and specific.'), cert.
denied, 540 U.S. 971, 157 L. Ed. 2d 320 (2003). In effect,
defendants' third assignment of error fails to specify which
documents should have been included in the transcripts and fails toprovide specific record or transcript references. It is not the
role of the appellate courts . . . to create an appeal for an
appellant. Viar v. N.C. Dep't of Transp., 359 N.C. 400, 401, 610
S.E.2d 360, 360 (per curiam), reh'g denied, 359 N.C. 643, 617
S.E.2d 662 (2005). Accordingly, defendants' third assignment of
error is dismissed.
[2] In their first argument, defendants contend that the Full
Commission erred in failing to properly address whether plaintiff
timely reported her claim pursuant to North Carolina General
Statutes, section 97-22 and whether the case should be barred for
her failure to do so. We agree.
North Carolina General Statutes, section 97-22 provides that
an injured employee must give written notice to his employer
immediately on the occurrence of an accident, or as soon
thereafter as practicable . . .; but no compensation shall be
payable unless such written notice is given within 30 days after
the occurrence of the accident . . . . N.C. Gen. Stat. § 97-22
(2001). In the instant case, it is undisputed that plaintiff did
not provide written notice of the accident until she filed her
workers' compensation claim on 24 June 2002, over one year after
her accident on 16 May 2001.
An employee is excused from the thirty-day notice requirement,
however, if the employee has a reasonable excuse . . . for not
giving such notice and . . . the employer has not been prejudiced
thereby. Id. As this Court recently noted,
included on the list of reasonable excuses
would be, for example, a belief that one'semployer 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.
Chavis v. TLC Home Health Care, 172 N.C. App. 366, 377, 616 S.E.2d
403, 412 (2005) (internal quotation marks and alterations omitted)
(quoting Jones v. Lowe's Cos., Inc., 103 N.C. App. 73, 75, 404
S.E.2d 165, 166 (1991)), appeal dismissed, 360 N.C. 288, 627 S.E.2d
464 (2006). The burden is on the employee to show a 'reasonable
excuse.' Id. (citing Jones, 103 N.C. App. at 75, 404 S.E.2d at
166).
Here, plaintiff telephoned her supervisor within thirty
minutes after the accident and reported the motor vehicle accident
to him. Indeed, defendants concede that they had actual knowledge
of the accident on the day it happened. Although the evidence
demonstrates and the Full Commission found that defendant had
actual knowledge of plaintiff's accident, the Full Commission
failed to make any finding that plaintiff provided a reasonable
excuse for her failure to timely provide written notice of her
accident. As this Court has noted, [w]hile 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.
Watts v. Borg Warner Auto., Inc., 171 N.C. App. 1, 5, 613 S.E.2d
715, 719, aff'd, 360 N.C. 169, 622 S.E.2d 492 (2005) (per curiam).
The determination whether or not there is a reasonable excuse for
plaintiff's failure to file in writing is crucial. Although[a]ctual notice by the employer has been previously held by this
Court to be a reasonable excuse for not giving written notice
within thirty days, Chavis, 172 N.C. App. at 378, 616 S.E.2d at
413, we must remand this case to the Full Commission for specific
findings with respect to whether plaintiff satisfied her burden of
providing a reasonable excuse for not providing defendant-employer
with written notice of her accident within thirty days of its
occurrence.
Additionally, the inquiry pursuant to section 97-22 does not
conclude with a finding of reasonable excuse. Section 97-22 .
. . also requires that the [F]ull Commission be satisfied that the
employer has not been prejudiced by the delay in written
notification[,] . . . [and] [t]he burden is on the employer to show
prejudice. Id.
Here, the Full Commission found that [i]n light of . . .
defendants' actual notice of . . . plaintiff's accident in May
2001, . . . defendants were not prejudiced by her failure to
immediately file a written notice. However, the mere existence of
actual notice, without more, cannot satisfy the statutorily
required finding with respect to prejudice, as the issue of
prejudice pursuant to section 97-22 must be evaluated in relation
to the purpose of the notice requirement:
The purpose of the notice-of-injury
requirement is two-fold. It allows the
employer to provide immediate medical
diagnosis and treatment with a view to
minimizing the seriousness of the injury, and
it facilitates the earliest possible
investigation of the circumstances surrounding
the injury.
Booker v. Duke Med. Ctr., 297 N.C. 458, 481, 256 S.E.2d 189, 204
(1979); see also Jones, 103 N.C. App. at 76.77, 404 S.E.2d at 167.
Accordingly, we remand this case for adequate findings of fact with
respect to the issue of prejudice to defendant-employer pursuant to
section 97-22. See Westbrooks v. Bowes, 130 N.C. App. 517, 527.29,
503 S.E.2d 409, 416.17 (1998) (remanding the case to the Full
Commission for specific findings on whether the employer was
prejudiced pursuant to section 97-22).
[3] Next, defendants contend that no competent evidence
causally relates plaintiff's various injuries to her motor vehicle
accident of 16 May 2001. We agree in part and disagree in part.
When reviewing decisions of the North Carolina Industrial
Commission, this Court must determine whether there is competent
evidence in the record to support the Commission's findings of fact
and whether those findings, in turn, justify the Commission's
conclusions of law. See Perkins v. U.S. Airways, 177 N.C. App. 205,
210.11, 628 S.E.2d 402, 406 (2006), disc. rev. denied, 361 N.C.
356, 644 S.E.2d 231 (2007). With respect to causation, it is well-
established that
[e]xpert testimony that a work-related injury
'could' or 'might' have caused further injury
is insufficient to prove causation when other
evidence shows the testimony to be 'a guess or
mere speculation.' However, when expert
testimony establishes that a work-related
injury 'likely' caused further injury,
competent evidence exists to support a finding
of causation.
Cannon v. Goodyear Tire & Rubber Co., 171 N.C. App. 254, 264, 614
S.E.2d 440, 446.47 (citations omitted), disc. rev. denied, 360 N.C.
61, 621 S.E.2d 177 (2005).
In the instant case, plaintiff sought workers' compensation
benefits for: (1) the replacement of her breast implants, (2)
treatment for headaches, (3) treatment for carpal tunnel syndrome
and arthrosis in her right wrist and thumb, (4) treatment for and
surgeries to her right knee, and (5) treatments and procedures
performed on her teeth. We address each injury separately in the
above listed order.
Pursuant to our Workers' Compensation Act, [i]njury shall
include breakage or damage to eyeglasses, hearing aids, dentures,
or other prosthetic devices which function as part of the body.
N.C. Gen. Stat. § 97-2(6) (2001). Although this Court has not
addressed the issue of compensability of damage to breast implants,
we have affirmed workers' compensation awards for cosmetic surgery.
See, e.g., Ray v. Pet Parlor, 169 N.C. App. 236, 609 S.E.2d 256
(2005). We believe that the weight of authority supports a
determination that breast implants satisfy the statutory
requirement as a compensable prosthetic device that functions as
part of the body. See N.C. Gen. Stat. § 97-2(6) (2001); see, e.g.,
Wal-Mart Stores, Inc. v. VanWagner, 990 S.W.2d 522 (Ark. 1999)
(finding that substantial evidence supported the Workers'
Compensation Commission's decision that the employee suffered a
compensable injury to her right breast implant in the course of her
employment); In re Smith, 34 P.3d 696 (Or. Ct. App. 2001)(affirming an order of the Workers' Compensation Board that
concluded that the employee had suffered a compensable injury when
an on-the-job accident caused one of her saline breast implants to
collapse); see also Cowen v. Wal-Mart, 93 P.3d 420, 424 (Alaska
2004) (injury to the employee's breast implant was presumptively
compensable).
Following her motor vehicle accident on 16 May 2001, plaintiff
noted that her right breast was smaller than it had been prior to
the accident. Plaintiff also noted rippling in her left breast.
On 31 May 2001, plaintiff presented to Dr. Bowers, a board
certified specialist in plastic surgery, and expressed concerns
that her breast implants had ruptured. Subsequently, on 7 June
2001, Dr. Bowers removed and replaced plaintiff's original breast
implants.
During his deposition, Dr. Bowers was presented with a
hypothetical scenario that echoed plaintiff's description of the
accident and her injuries. In response, Dr. Bowers opined that
the accident more than likely caused the leak in the right breast
implant and that even if the accident did not directly cause the
leak, the trauma most definitely could have accelerated or
aggravated such a leak. Dr. Bowers, however, noted that the left
breast implant had not ruptured, and he could not state with any
certainty that the rippling evident in the left breast was a result
of the motor vehicle accident, as opposed to an underfilling of the
implant.
[DEFENSE COUNSEL]: And so am I also correct
that we must come to the conclusion, then,that the rippling [in the left breast] was due
to underinflation, or underfilling?
[DR. BOWERS]: Right.
[DEFENSE COUNSEL]: Okay. So as far as the left
one, your _ would it be your opinion that the
left one was not ruptured by this accident?
It wasn't ruptured at all, correct?
[DR. BOWERS]: It wasn't _ it did not appear to
me that it was ruptured at all.
[DEFENSE COUNSEL]: Okay. And I take it that
you cannot state more than 50 percent that the
rippling was due to the accident as opposed to
due to underfilling?
[DR. BOWERS]: Right. That's correct.
(Emphasis added). Notwithstanding the Full Commission's finding
that [t]he damage to plaintiff's breast implants were [sic] caused
or aggravated by the accident (emphasis added), Dr. Bowers
consistently distinguished between the two breast implants.
[PLAINTIFF'S COUNSEL]: Okay. And now let me
go back and review your testimony regarding
the left versus the right breast. And I guess
what I'm trying to figure out is, are you
giving two different opinions, left versus
right, or is your opinion the same for both
the left and right concerning whether the
trauma either caused or aggravated _
[DR. BOWERS]: Well, after _ after the surgery
I think the left _ the left implant was not
affected by the _ by the injury because the
left implant, I didn't see any evidence of a
leak in it. The right implant, I think, is
the one where I think it potentially was
damaged by the _ by the accident. Or there
was some sort of damage to the right impact
[sic] such that it had been affected in a way
that the left implant had not been. And I
think what I was seeing with the left implant
was simply that there was just less saline
than the 475 cc's.
(Emphasis added). The Full Commission found that replacement of the left breast
implant was necessary because the replacements would have to be
symmetrical and evenly matched. Replacement of one implant
required replacement of both. Dr. Bowers, however, never
testified to this effect. Instead, he stated unequivocally that
the rippling in the left breast most likely was due to the original
implant's being underfilled and that the rippling was not caused or
aggravated by the accident. Accordingly, we hold that the Full
Commission correctly ruled with respect to the replacement of
plaintiff's right breast implant, but erred in concluding that
plaintiff sustained compensable injuries to her . . . bilateral
breast implants. (Emphasis added). Therefore, plaintiff is
entitled only to compensation for replacement of the right breast
implant, and we remand to the Full Commission for a determination
as to the appropriate amount of compensation for such replacement.
We next review the Full Commission's ruling that plaintiff was
entitled to workers' compensation benefits for her headaches.
During her motor vehicle accident, plaintiff sustained an impact to
her head, as evidenced in the EMS report as well as the emergency
room records. Dr. Freeman, plaintiff's treating physician for her
headaches, testified as to the cause of plaintiff's headaches.
Defendants assert on appeal that Dr. Freeman's opinions changed
throughout the deposition and that [h]is opinions are indecisive
at best. We disagree.
To the extent defendants contend Dr. Freeman was not a
credible witness, we decline to rule on that issue. See Anderson v.Lincoln Constr. Co., 265 N.C. 431, 433.34, 144 S.E.2d 272, 274
(1965) (The Commission is the sole judge of the credibility of the
witnesses and the weight to be given their testimony.).
Furthermore, defendants misconstrue Dr. Freeman's testimony, which
appears consistent with respect to plaintiff's headaches. During
his deposition, Dr. Freeman opined:
It would be my opinion that this person, who
did not previously suffer from daily head or
neck pain prior to the accident, did suffer
the chronic daily head and neck pain as
reported to me as a consequence of the motor
vehicle accident.
Dr. Freeman clarified that plaintiff's fibromyalgia diagnosis did
not alter his conclusion, stating that without a history of
documented fibromyalgia, the accident caused the pain the patient
states, and [i]f she had fibromyalgia previously, then . . . the
accident exacerbated an underlying condition. Dr. Freeman
explained that the only way he would be unable to state with any
certainty that the accident caused the headaches or aggravated an
underlying condition would be [i]f the patient had an extended
period of pain-free, say, beginning a week or two after the initial
injury. However, Dr. Freeman testified that [f]rom the very
beginning the patient has stated she's experienced a daily headache
since the time of her accident. Accordingly, the Full Commission
did not err in accepting Dr. Freeman's testimony and ruling that
plaintiff's headaches constituted a compensable injury.
Next, plaintiff sought and obtained compensation for treatment
for carpal tunnel syndrome in her right wrist and arthrosis in her
right thumb. Once again, defendants effectively request this Courtto re-weigh the evidence presented before the Full Commission.
However, [t]his Court does not re-weigh evidence or assess
credibility of witnesses. Sharpe v. Rex Healthcare, 179 N.C. App.
365, 370, 633 S.E.2d 702, 705 (2006).
Dr. Dalldorf testified that plaintiff's right wrist and thumb
pain was not related to the motor vehicle accident . Dr. Dalldorf
further explained that he was not even convinced she had carpal
tunnel syndrome. Defendants contend that the Full Commission
improperly disregarded this testimony in favor of that of Dr.
Kuzma. Dr. Kuzma opined that plaintiff's motor vehicle accident,
as described to him in a hypothetical question during his
deposition, either caused or at least aggravated or accelerated
plaintiff's carpal tunnel syndrome and arthrosis. Although
plaintiff did not seek treatment for carpal tunnel syndrome
symptoms for more than a year after the accident, Dr. Kuzma
explained that [m]ost carpel tunnel syndromes are going to take a
period of time to develop. . . . Depending, again, on the trauma,
the direction of trauma, it may take a longer period of time for it
to actually show up. As this Court has held, [t]he Commission
may weigh the evidence and believe all, none or some of the
evidence. Hawley v. Wayne Dale Constr., 146 N.C. App. 423, 428,
552 S.E.2d 269, 272, disc. rev. denied, 355 N.C. 211, 558 S.E.2d
868 (2001). It is not for this Court to evaluate the comparative
weight of Dr. Dalldorf's and Dr. Kuzma's testimony. Competent
evidence supports the Full Commission's finding that the treatment
for plaintiff's right hand and wrist was the result of her motorvehicle accident, and accordingly, this portion of defendants'
assignment of error is overruled.
Defendants also contest the Full Commission's findings and
conclusions with respect to plaintiff's right knee. Defendants
note that plaintiff did not report complaints of knee pain in the
first several weeks following the accident. Defendants further
argue that Dr. Dalldorf's theories as to causation stemmed from
his hypothesis that plaintiff's knee hit the dashboard during the
accident _ a fact unsubstantiated by competent evidence.
Plaintiff testified that she felt her knee hit something
because it was _ it had started swelling. Plaintiff also
testified that her knee began swelling within a couple of hours
after the accident. Defendants cross-examined plaintiff about,
inter alia, her knee and her failure to report it to physicians at
the emergency room. As there is nothing in the record to indicate
that plaintiff's deposition testimony was incompetent and
defendants have presented no argument to this effect, we agree that
the basis for Dr. Dalldorf's theories as to causation was supported
by competent evidence, as opposed to mere speculation or
conjecture. See Hatcher v. Daniel Int'l Corp., 153 N.C. App. 776,
780, 571 S.E.2d 20, 23 (2002).
Dr. Dalldorf testified that although plaintiff had
chondromalacia patella prior to the motor vehicle accident,
plaintiff's motor vehicle accident aggravated her pre-existing
condition, and she would not have needed the three surgeries but
for the motor vehicle accident. Specifically, Dr. Dalldorftestified, [M]y opinion is that if she hadn't been in the
accident, she wouldn't have needed the subsequent surgeries. So I
feel that the accident caused her to need these additional
operations. Accordingly, we hold that the Full Commission did not
err in finding plaintiff's right knee injuries and surgeries to be
compensable under our Workers' Compensation Act.
[4] Defendants next contend that the Full Commission's Finding
of Fact number 24 _ relating to the compensability of treatment
performed on plaintiff's teeth _ was not supported by competent
evidence. Defendants list this assignment of error as one of
seventeen assignments of error supporting the second question
presented in their brief. However, defendants make no argument in
their brief relating to this assignment of error or the Full
Commission's findings with respect to plaintiff's teeth.
Assignments of error . . . in support of which no reason or
argument is stated or authority cited, will be taken as abandoned.
N.C. R. App. P. 28(b)(6) (2006).
[5] In their next argument, defendants contend that the Full
Commission erred in concluding that plaintiff carried her burden of
proving disability. We disagree.
'Disability,' within the North Carolina Workers' Compensation
Act, 'means incapacity because of injury to earn the wages which
the employee was receiving at the time of injury in the same or any
other employment.' Clark v. Wal-Mart, 360 N.C. 41, 43, 619 S.E.2d
491, 493 (2005) (quoting N.C. Gen. Stat. § 97-2(9)). The burden of
proving the existence and extent of a disability lies with theemployee seeking compensation. See id. (citing Hendrix v.
Linn-Corriher Corp., 317 N.C. 179, 185, 345 S.E.2d 374, 378
(1986)). In order for a plaintiff to establish a claim for either
temporary or permanent disability under the Workers' Compensation
Act,
the Commission must find: (1) that plaintiff
was incapable after his injury of earning the
same wages he had earned before his injury in
the same employment, (2) that plaintiff was
incapable after his injury of earning the same
wages he had earned before his injury in any
other employment, and (3) that this
individual's incapacity to earn was caused by
plaintiff's injury.
Hilliard v. Apex Cabinet Co., 305 N.C. 593, 595, 290 S.E.2d 682,
683 (1982). This Court has explained that
[t]he employee may meet this burden in one of
four ways: (1) the production of medical
evidence that he is physically or mentally, as
a consequence of the work related injury,
incapable of work in any employment; (2) the
production of evidence that he is capable of
some work, but that he has, after a reasonable
effort on his part, been unsuccessful in his
effort to obtain employment; (3) the
production of evidence that he is capable of
some work but that it would be futile because
of preexisting conditions, i.e., age,
inexperience, lack of education, to seek other
employment; or (4) the production of evidence
that he has obtained other employment at a
wage less than that earned prior to the
injury.
Russell v. Lowes Prod. Distribution, 108 N.C. App. 762, 765, 425
S.E.2d 454, 457 (1993) (internal citations omitted).
In the case sub judice, the Full Commission properly found
that plaintiff satisfied her burden of proving her disability as a
result of her work-related injuries. Plaintiff's motor vehicleaccident occurred on 16 May 2001, and plaintiff's family physician
wrote her out of work from 17 May 2001 to 6 June 2001. Dr. Bowers,
plaintiff's breast implant surgeon, wrote plaintiff out of work
from 7 June 2001 to 24 July 2001. After injecting plaintiff's
right knee, Dr. Dalldorf restricted plaintiff from working from 9
July 2001 through 6 August 2001. Plaintiff attempted to return to
work on 7 August 2001, but became disabled once again after knee
surgery on 9 October 2001. After this first knee surgery,
plaintiff worked one day in October 2001, four days in November
2001, one day in January 2002, and two days in February 2002.
Plaintiff did not earn wages from this work, however, as defendants
used plaintiff's wages to pay her health insurance premiums.
Plaintiff worked and earned wages on two occasions in June 2002
prior to her final period of ongoing disability, which began on 25
June 2002 with a second knee surgery and continued until the
hearing on this matter in October 2003. However, plaintiff was
able to work these two days only because sitter jobs were
available and offered to her. Other than these two days,
defendant-employer did not make such light-duty work available to
plaintiff. Following plaintiff's June 2002 knee surgery, Dr.
Dalldorf explained that plaintiff would have had difficulty
performing her regular job until at least February 2003. By March
2003, however, plaintiff was placed on one-handed work restrictions
by Dr. Kuzma for her carpal tunnel syndrome and arthrosis, with
such restrictions scheduled to continue until Dr. Kuzma's
deposition in January 2004. Plaintiff satisfied her initial burden of proving disability
under the Workers' Compensation Act. Although plaintiff returned
to work on a few occasions during the time period at issue, such
intermittent and infrequent work days do not constitute a
successful trial return to work. Pursuant to North Carolina
General Statutes, section 97-32.1,
an employee may attempt a trial return to work
for a period not to exceed nine months.
During a trial return to work period, the
employee shall be paid any compensation which
may be owed for partial disability pursuant to
[section] 97-30. If the trial return to work
is unsuccessful, the employee's right to
continuing compensation under [section] 97-29
shall be unimpaired unless terminated or
suspended thereafter pursuant to the
provisions of this Article.
N.C. Gen. Stat. . 97-32.1 (2001) (emphasis added).
As plaintiff carried her burden of proving disability, the
burden then shifted to defendants to disprove her claim. Our
Supreme Court has explained that
[i]f an injured employee establishes a
compensable injury, the burden shifts to the
employer to rebut the employee's evidence. As
to the injured employee's ability to work,
this burden requires the employer to come
forward with evidence to show not only that
suitable jobs are available, but also that the
plaintiff is capable of getting one, taking
into account both physical and vocational
limitations.
Johnson v. S. Tire Sales & Serv., 358 N.C. 701, 708, 599 S.E.2d
508, 513 (2004) (internal quotation marks and citations omitted).
In the instant case, the Full Commission found that between
October 2001 and May 2002, plaintiff testified that she regularly
contacted defendant-employer seeking light-duty work, butdefendant-employer rarely offered her the modified work that she
was physically capable of performing based upon her restrictions.
The Full Commission also found that while the accounts manager for
defendant-employer testified that plaintiff had been offered light-
duty assignments, the accounts manager did not know the dates or
nature of such job offers, and he admitted that defendant-employer
did not keep records of such offers. Because of his lack of
personal knowledge, his testimony was found not to be credible. As
'findings of fact by the Industrial Commission are conclusive on
appeal if supported by any competent evidence,' Adams v. AVX
Corp., 349 N.C. 676, 681, 509 S.E.2d 411, 414 (1998) (quoting
Gallimore v. Marilyn's Shoes, 292 N.C. 399, 402, 233 S.E.2d 529,
531 (1977)), we hold that defendants failed to carry their burden
of proving that plaintiff was capable of obtaining suitable
employment. Defendants, therefore, failed to rebut the ongoing
presumption of disability, and accordingly, this assignment of
error is overruled.
[6] In their final argument, defendants contend that the Full
Commission erred in failing to award defendants a lien on all
amounts accepted by plaintiff in her third-party settlement with
Nationwide. We agree.
As provided in section 97-10.2(b), an injured employee has the
exclusive right to enforce the liability of a third party within
the first twelve months following the injury. See N.C. Gen. Stat.
. 97-10.2(b) (2001). Pursuant to subsection (h), [i]n any
proceeding against or settlement with the third party, every partyto the claim for compensation shall have a lien to the extent of
his interest . . . upon any payment made by the third party by
reason of such injury or death. N.C. Gen. Stat. . 97-10.2(h)
(2001) (emphasis added). Although this subsection provides that an
employee . . . shall [not] make any settlement with or accept any
payment from the third party without the written consent of the
[employer], the statute further provides that employer consent to
a third-party settlement is not required [i]f either party follows
the provisions of subsection (j) of this section. N.C. Gen. Stat.
§ 97-10.2(h) (2001). Pursuant to subsection (j),
[n]otwithstanding any other subsection in this
section, in the event that a judgment is
obtained by the employee in an action against
a third party, or in the event that a
settlement has been agreed upon by the
employee and the third party, either party may
apply to the resident superior court judge of
the county in which the cause of action arose,
where the injured employee resides or the
presiding judge before whom the cause of
action is pending, to determine the
subrogation amount. After notice to the
employer and the insurance carrier, after an
opportunity to be heard by all interested
parties, and with or without the consent of
the employer, the judge shall determine, in
his discretion, the amount, if any, of the
employer's lien, whether based on accrued or
prospective workers' compensation benefits,
and the amount of cost of the third-party
litigation to be shared between the employee
and employer.
N.C. Gen. Stat. . 97-10.2(j) (2001). Therefore, either party may
apply to the superior court for a determination of the subrogation
amount, regardless of whether both parties consented to the third-
party settlement. Although cognizant of the potential for
plaintiff to receive a double recovery via the operation of[section] 97-10.2(j)[,] . . . we [previously have] determined that
the statute contemplated and allowed for such a recovery if
justified by the equities of the case. Wiggins v. Bushranger Fence
Co., 126 N.C. App. 74, 77.78, 483 S.E.2d 450, 452, disc. rev.
denied, 346 N.C. 556, 488 S.E.2d 825 (1997).
In the case sub judice, following her 16 May 2001 motor
vehicle accident, plaintiff filed a claim against Nationwide, the
carrier of the uninsured motorist coverage of the vehicle she had
been driving. As the Full Commission properly found, the settled
claim filed by . . . plaintiff against Nationwide is, in fact, a
third-party claim. The Full Commission, however, concluded that
defendants shall be entitled to a credit, if any, as duly awarded
by a superior court pursuant to [North Carolina General Statutes,
section] 97-10.2. (Emphasis added).
Contrary to the Full Commission's conclusion, defendants'
credit does not depend upon an award by the superior court, since
section 97-10.2(h) clarifies that the lien is automatic. See N.C.
Gen. Stat. . 97-10.2(h) (2001) (providing that every party to the
claim for compensation shall have a lien to the extent of his
interest . . . upon any payment made by the third party (emphasis
added)). Instead, plaintiff may apply to the superior court for a
determination of the lien amount pursuant to section 97-10.2(j),
which this Court has described as permitting the superior court to
adjust the amount of a subrogation lien. Ales v. T.A. Loving Co.,
163 N.C. App. 350, 353, 593 S.E.2d 453, 455 (2004) (emphasis
added). Unless and until plaintiff applies to the superior courtfor a determination of the subrogation amount, defendants are
entitled to a lien on all corresponding uninsured motorist benefits
received by plaintiff, less the portion expended for the cost of
replacing plaintiff's left breast implant. See Tise v. Yates
Constr. Co., Inc., 345 N.C. 456, 459, 480 S.E.2d 677, 679 (1997)
(holding that damages awarded against a third party are to be
reduced only by the amount which the employer would otherwise be
entitled to receive therefrom by way of subrogation).
Accordingly, we reverse this portion of the Full Commission's
Opinion and Award and remand to the Full Commission for findings
not inconsistent with this opinion.
Affirmed in part; Reversed in part; and Remanded.
Judge WYNN dissents in part and concurs in the results only in
part in a separate opinion.
Judge STEELMAN concurs.
WYNN, Judge, dissenting in part and concurring in the results
only in part.
Because I find that the majority reweighs the evidence in this
case and improperly substitutes its judgment for that of the Full
Commission, I respectfully dissent.
I note at the outset that this Court's review of an Opinion
and Award of the Full Commission 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). Most significantly, this Court
does not have the right to weigh the 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. Adams v. AVX Corp., 349 N.C. 676, 681, 509
S.E.2d 411, 414 (1998) (emphasis added) (quoting Anderson v.
Lincoln Constr. Co., 265 N.C. 431, 434, 144 S.E.2d 272, 274
(1965)), reh'g denied, 350 N.C. 108, 532 S.E.2d 522 (1999).
Thus, if there is any evidence at all, taken in the light most
favorable to the non-moving party, the finding of fact made by the
Full Commission stands, even if there is substantial evidence
supporting the opposing position. Id. Findings may therefore be
set aside on appeal only where there is a complete lack of
competent evidence to support them. Rhodes v. Price Bros., 175
N.C. App. 219, 221, 622 S.E.2d 710, 712 (2005) (emphasis added and
quotation omitted).
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