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and technical correction prior to official publication in the North Carolina
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NO. COA07-318
NORTH CAROLINA COURT OF APPEALS
Filed:
18 December 2007
CHARLES RAY BILLINGS,
Employee,
Plaintiff,
v. North
Carolina Industrial Commission
I.C.
File No. 364402
GENERAL PARTS, INC.,
Employer,
ZURICH AMERICAN,
Carrier,
GAB ROBINS,
Administering
Agent,
Defendants.
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-appellee.
Brooks
Stevens & Pope, P.A., by Michael C. Sigmon, for defendants-appellants.
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 syncopal episode
(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 extremities.
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 “obvious bilateral 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 plaintiff’s head.
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 the hemiballismus 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.
Defendants appealed 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 follows.
_________________________
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
Raleigh, 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
testimony.’” Id. (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.
at 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 that would support findings to
the contrary.’” Id. (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. Warehouse Co., 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., Inc., 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.’” Adams,
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
error.
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 arguments addressing 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.”).
I.
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 disagree.
“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, 479 (1960)).
“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
County Council on Aging, __ N.C. App. __, __, 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 employment if the idiopathic condition of
the employee combines with ‘risk[s] attributable to the
employment’ to cause the injury.” Id.
(quoting 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.” Id. (fifth
alteration in original). In other
words, “‘where the accident and resultant injury arise out of both the
idiopathic 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. Small, 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 in a 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, Inc., 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 disagree with 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
per curiam, 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 our State’s
acceptance of the increased risk doctrine precludes the Commission from relying
on Allred in its conclusions of law.
This Court has determined:
In Allred,
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.
Rackley, 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 vehicle accident “arose out of” his employment with
defendant-employer and find no error.
II.
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 laceration.”
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.”
He also 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, two or even three months before the subdurals were found.” Dr. Freedman testified:
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 subdural.
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 a no-brainer.”
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 . . . [2] 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. In Young, 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 a layman’s opinion. As such, it is not sufficiently reliable to
qualify as competent evidence on issues of medical causation.
Id. at 230, 538
S.E.2d at 915 (citation omitted). In Young,
the Court 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
believe Young 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 to
support the findings, this Court is bound by such evidence, even though there
is evidence that would have supported a finding to the contrary.” Rose, 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.
III.
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 subdural
hematoma.
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 a persistence 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 plaintiff’s employment.”
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.
Affirmed.
Judges STROUD and ARROWOOD concur.