All
opinions are subject to modification and technical correction prior to official
publication in the North Carolina Reports and North Carolina Court of Appeals
Reports. In the event of discrepancies between the electronic version of an
opinion and the print version appearing in the North Carolina Reports and North
Carolina Court of Appeals Reports, the latest print version is to be considered
authoritative.
NO. COA07-536
NORTH CAROLINA COURT OF APPEALS
Filed:
5 February 2008
STEVIE JOHNSON,
Employee-Plaintiff,
v. North
Carolina Industrial Commission
I.C.
File No. 441316
CITY OF WINSTON-SALEM,
Employer,
SELF-INSURED,
Defendant.
Appeal by Defendant from Opinion and Award entered 5
February 2007 by the North Carolina Industrial Commission. Heard in the Court of Appeals 14 November
2007.
Roderick
T. McIver for Plaintiff.
Wilson
& Coffey, LLP, by Kevin B. Cartledge and Jason L. Jelinek, for Defendant.
STEPHENS, Judge.
Stevie Johnson (“Plaintiff”), a custodial maintenance worker
for the City of Winston-Salem (“Defendant”), developed bilateral carpal tunnel
syndrome, gout, and arthritis, and claimed disability benefits resulting
therefrom. Defendant denied Plaintiff’s
claim by filing a Form 61 with the Industrial Commission.
In an Opinion and Award filed 17 May 2006, Deputy
Commissioner Bradley W. Houser held that Plaintiff’s employment caused or
significantly contributed to the development of his bilateral carpal tunnel
syndrome. He further determined that
there was insufficient evidence to conclude that Plaintiff’s employment caused
or significantly contributed to his development of gout or arthritis. Plaintiff was awarded temporary total
disability benefits pursuant to N.C. Gen. Stat. §97-29 and medical expenses
related to his bilateral carpal tunnel syndrome. Both parties appealed to the Full Commission.
In an Opinion and Award filed 5 February 2007, a majority of
the Full Commission affirmed Deputy Commissioner Houser’s Opinion and Award
with modifications, finding that Plaintiff was not at maximum medical
improvement and ordering further medical treatment for Plaintiff.
From the Opinion and Award of the Full Commission, Defendant
appeals.
I. FACTS
Plaintiff, a 38-year-old high school graduate, worked for
Defendant as a recreational center custodian for approximately 15 years. His duties included sweeping, mopping,
dusting, polishing, washing windows, washing baseboards, disposing of trash,
and removing gum from floors and bleachers.
In performing these duties, Plaintiff was required to use a mechanized
buffer on the floors and a machine to shampoo the carpet. Additionally, Plaintiff worked some overtime
for Defendant on weekends, stripping and waxing gym floors in several
recreational centers throughout Winston-Salem.
His primary duty during his overtime work was to operate the stripping
and buffing machinery, which necessitated the nearly constant gripping and
twisting of his hands and wrists.
Plaintiff performed all of these duties throughout his 15-year period of
employment.
Prior to filing his workers’ compensation claim, Plaintiff
had been diagnosed with the following: gout, arthritis, hypercholesterolemia,
congestive heart failure, underlying idiopathic cardiomyopathy, shortness of
breath, chest pain, bilateral knee pain, obesity, atrial fibrillation, tingling
and numbness in his hands, hypertension, diabetes, and degenerative joint
disease in his knees.
Dr. Anthony DeFranzo, who treated Plaintiff for his carpal
tunnel syndrome and was aware of Plaintiff’s prior medical conditions,
testified to the following: Plaintiff’s gout and arthritis were aggravated by
his employment but were not caused by his work activities; the combination of
Plaintiff’s gout, arthritis, and carpal tunnel syndrome resulted in a
significant disability in both hands; Plaintiff’s employment exposed him to an
increased risk of developing carpal tunnel syndrome as opposed to members of
the general public not so exposed; and Plaintiff had not yet reached maximum
medical improvement.
Dr. James T. Burnette, Ph.D., CPE, an ergonomist, reviewed
Plaintiff’s work activities and determined that they were repetitive in nature
and exposed him to an increased risk of developing bilateral carpal tunnel
syndrome as opposed to members of the general public not so exposed.
II. DISCUSSION
Appellate review of an Opinion and Award of the Full
Commission is limited to a determination of whether the Full Commission’s
findings of fact are supported by any competent evidence, and whether those
findings support the Full Commission’s legal conclusions. Adams v. AVX Corp., 349 N.C. 676, 509
S.E.2d 411 (1998), reh’g denied, 350 N.C. 108, 532 S.E.2d 522
(1999). The Full Commission’s
conclusions of law are reviewable de novo. Whitfield v. Lab. Corp. of Am., 158 N.C. App. 341, 581
S.E.2d 778 (2003).
A. Compensable Injury
Defendant first contends that the evidence was insufficient
to support the Full Commission’s determination that Plaintiff’s carpal tunnel
syndrome is a compensable injury.
Specifically, Defendant argues there was insufficient evidence for the
Full Commission to find that Plaintiff’s employment with Defendant increased
his risk of contracting carpal tunnel syndrome. We disagree.
For an injury to be compensable under our Workers’
Compensation Act, it must be either the result of an “accident arising out of
and in the course of employment or an ‘occupational disease.’” Hansel v. Sherman Textiles, 304 N.C.
44, 51, 283 S.E.2d 101, 105 (1981).
Although certain “occupational diseases” are specifically listed as
compensable conditions under N.C. Gen. Stat. §97-53, carpal tunnel syndrome is
not among them. Thus, this disorder is
compensable only if (1) it is “proven to be due to causes and conditions which
are characteristic of and peculiar to a particular trade, occupation or employment[,]”
and (2) it is not an “ordinary disease of life to which the general public is
equally exposed outside of the employment.”
Booker v. Duke Med. Ctr., 297 N.C. 458, 468, 256 S.E.2d 189, 196
(1979); N.C. Gen. Stat. §97-53(13) (2005).
“A disease is ‘characteristic’ of a profession when there is
a recognizable link between the nature of the job and an increased risk of
contracting the disease in question.” Booker,
297 N.C. at 472, 256 S.E.2d at 198. A
disease is “peculiar to the occupation” when the conditions of the employment
result in a hazard which distinguishes it in character from employment
generally; the disease need not be one that originated exclusively from the
employment. Id. at 473, 256
S.E.2d at 199. Furthermore, the statute
does not preclude coverage for all ordinary diseases of life, but only for
those “‘to which the general public is equally exposed outside of the
employment.’” Id. at 475, 256
S.E.2d at 200 (quoting N.C. Gen. Stat. §97-53(13)).
Here, Dr. DeFranzo testified that Plaintiff’s job
contributed significantly to the development of Plaintiff’s carpal tunnel
syndrome. He explained:
[F]rom
what I understand, [Plaintiff] did multiple duties as a custodian using his
hands to do various tasks all day, but he also used vibrating equipment like
floor buffers and things. And when it
comes to carpal tunnel syndrome, tools that vibrate are notorious for
aggravating and causing carpal tunnel syndrome.
. . . .
[L]ess
than one (1) percent -- point six (.6) percent of the population develops
carpal tunnel syndrome in the general population that do not do repetitive
tasks at work. And there is about a six
(6) percent incidence of carpal tunnel syndrome in job activities that require
repetitive work. So there’s about a ten
(10) times increase . . . of carpal tunnel syndrome in patients that do lots of
work with their hands.
Moreover, when directly asked whether
Plaintiff’s job duties would “increase his risk of [developing] carpal tunnel
syndrome[,]” Dr. DeFranzo replied, “Yes. . . . [P]atients that do repetitive
work [with their hands] have an increased incidence of carpal tunnel
syndrome.” This testimony is sufficient
evidence to support the Full Commission’s finding that “Plaintiff’s employment
with Defendant . . . exposed him to an increased risk of developing bilateral
carpal tunnel syndrome as opposed to members of the general public not so
exposed.”
Defendant cites Keller v. City of
Wilmington Police Dep’t, 65 N.C. App. 675, 309 S.E.2d 543 (1983),[Note
1] disc. review allowed, 310 N.C. 625, 315 S.E.2d 690 (1984),
[Note 1] for the proposition that Plaintiff must prove that carpal tunnel
syndrome is “peculiar to janitors or custodians.” However, in Lumley v. Dancy Constr. Co., 79 N.C. App. 114,
339 S.E.2d 9 (1986), this Court disavowed the holding in Keller,
stating: “It is well settled that this Court may not overrule nor modify
decisions of the Supreme Court of North Carolina. Thus, any language in Keller which might be interpreted as
defining the language ‘peculiar to’ differently than was set forth in Booker
is ineffective and should have no precedential value.” Lumley, 79 N.C. App. at
121-22, 339 S.E.2d at 14 (citation omitted).
Accordingly, based on Dr. DeFranzo’s
testimony and the test enunciated in Booker, we conclude the evidence
was sufficient to support the Full Commission’s finding that Plaintiff’s carpal
tunnel syndrome is a compensable occupational disease.
B. Disability
Defendant next contends that Plaintiff
failed to establish disability within the meaning of the Act. We disagree.
An employee who suffers a compensable
injury is disabled under the Act if the injury results in an “incapacity . . .
to earn the wages which the employee was receiving at the time of injury in the
same or any other employment.” N.C.
Gen. Stat. §97-2(9) (2005).
Consequently, determination of whether a worker is disabled focuses on
the injured employee’s diminished capacity to earn wages, rather than upon his
physical impairment. Peoples v. Cone
Mills Corp., 316 N.C. 426, 342 S.E.2d 798 (1986). The employee has the burden of proving the existence and extent
of his disability, Hall v. Chevrolet Co., 263 N.C. 569, 139 S.E.2d 857
(1965), and he 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. Distrib., 108 N.C. App.
762, 765, 425 S.E.2d 454, 457 (1993) (citations omitted).
The Full Commission concluded that
Plaintiff is temporarily totally disabled and thus entitled to an award for
total disability under N.C. Gen. Stat. §97-29, and that Plaintiff met his
burden of proving disability under the first prong of Russell. While we agree with the Full Commission’s
ultimate conclusion that Plaintiff is totally disabled and entitled to
temporary total disability benefits, we conclude that Plaintiff has met his
burden of proving disability under the third prong of Russell.
In support of its conclusion that
Plaintiff is entitled to an award for total disability, the Full Commission
made the following pertinent findings of fact:
1. As
of the date of the hearing before the Deputy Commissioner, Plaintiff was
thirty-eight years of age, having a date of birth of September 8, 1967, and was
a high school graduate.
2. At
the time of the filing of his claim, Plaintiff had worked for Defendant as a
custodian at an assigned recreational center for approximately fifteen years. .
. .
. . . .
5. .
. . Dr. DeFranzo diagnosed Plaintiff as having bilateral carpal tunnel syndrome
and excused Plaintiff from work beginning March 4, 2004. . . .
6. Prior
to the filing of his claim in this matter, Plaintiff had been diagnosed with
gout, arthritis, hypercholesterolemia, congestive heart failure, underlying
idiopathic cardiomyopathy, obesity, atrial fibrillation, hypertension,
diabetes, and degenerative joint disease of his knees. . . .
. . . .
9. For
treatment of Plaintiff’s bilateral carpal tunnel syndrome, Dr. DeFranzo
recommended surgical release procedures.
On June 12, 2004, Dr. DeFranzo performed a release on Plaintiff’s left
wrist. Dr. DeFranzo medically excused
Plaintiff from all work pending an appointment with a rheumatologist and
referred him to physical therapy. Dr.
DeFranzo recommended performing the right release procedure after Plaintiff had
sufficiently recovered from the left release procedure. As of the hearing date before the Deputy
Commissioner, Plaintiff had not undergone this right wrist procedure.
10. Dr.
DeFranzo continued to treat Plaintiff until September 2004, when he referred
Plaintiff to a rheumatologist. As of
the date of the hearing before the Deputy Commissioner, a rheumatologist had
not treated Plaintiff. . . .
. . . .
16. Based
upon the credible medical and vocational evidence of record, the Full
Commission finds that as a result of his bilateral carpal tunnel syndrome,
Plaintiff has been unable to earn any wages in any employment since March 4,
2004.
A thorough review of the record
establishes that these findings of fact are supported by competent evidence and
thus are binding on appeal. Defendant
argues, however, that Plaintiff did not offer any evidence that it would be
futile for him to search for a job. In
support of this argument, Defendant relies on Dr. DeFranzo’s testimony that
this
kind of a person could have a security job, for instance, where they’re just
punching a time clock. And if they’re,
you know, not in a position where they have to combat an individual. If they’re looking at monitor screens, you
know, there are probably things he could do if his education would allow or if
he can be reeducated to allow him to do other things.
In Little v. Anson Cty. Schs. Food
Serv., 295 N.C. 527, 246 S.E.2d 743 (1978), our Supreme Court determined
that the Full Commission erred in denying the plaintiff benefits for total
disability based on the testimony of a physician that “there are some gainful
occupations that someone with [plaintiff’s] degree of neurological problem
could pursue[.]” Id. at 531, 246 S.E.2d at 745. The Court stated:
We
first note that [the physician’s] quoted statement is an oblique generality
which sheds no light on plaintiff’s capacity to earn wages. Uncontradicted evidence establishes that she
is over fifty years of age, somewhat obese, has an eighth grade education, and
at the time of her accident had been working as a laborer earning less than
$2.00 per hour. The relevant inquiry
under G.S. 97-29 is not whether all or some persons with plaintiff’s degree of
injury are capable of working and earning wages, but whether plaintiff herself
has such capacity.
. . . .
[The
physician’s] testimony sheds no light on plaintiff’s capacity to pursue gainful
employment. Consequently his testimony
affords no basis for the Commission to conclude plaintiff has not suffered
total incapacity for work.
Id. at 531-32, 246 S.E.2d at 746.
As in Little, here the relevant
inquiry is whether Plaintiff himself is capable of working and earning wages,
not whether all or some persons with Plaintiff’s degree of injury have such
capacity. Dr. DeFranzo’s quoted
statement is a generality which sheds no light on Plaintiff’s capacity to earn
wages. Thus, this statement affords no
basis to conclude that Plaintiff has not suffered total incapacity for
work. In fact, Dr. DeFranzo never
released Plaintiff to work. He
testified that Plaintiff “was unable to perform any job that would involve
significant repetitive activity or any type of heavy-duty lifting with his
hands” and that if Plaintiff was no better than the last time Dr. DeFranzo had
seen Plaintiff in September 2004,[Note 3] he would suggest that
Plaintiff seek vocational rehabilitation to be assigned a “permanent sedentary
light-duty type of job . . . .”
Furthermore, the fact that Plaintiff can
perform light-duty work does not in itself preclude the Full Commission from
making an award for total disability if the evidence shows that, because of
preexisting limitations, Plaintiff is not qualified to perform the kind of
light-duty jobs that might be available in the marketplace. Peoples, 316 N.C. 426, 342 S.E.2d 798.
[I]f
other pre-existing conditions such as an employee’s age, education and work
experience are such that an injury causes him a greater degree of incapacity
for work than the same injury would cause some other person, the employee must
be compensated for the incapacity which he or she suffers, and not for the
degree of disability which would be suffered by someone with superior education
or work experience or who is younger or in better health.
Little, 295 N.C. at 532, 246 S.E.2d at 746.
Here, the uncontradicted evidence
established that Plaintiff has only a high school education, had been working
as a custodian for Defendant for almost his entire adult working life, and has
a litany of medical problems including gout, arthritis, hypercholesterolemia,
congestive heart failure, underlying idiopathic cardiomyopathy, obesity, atrial
fibrillation, hypertension, diabetes, and degenerative joint disease of his
knees. There was no evidence that
Plaintiff was offered or received any kind of vocational rehabilitation
services. Given Plaintiff’s limited
education, limited work experience, and limited training, in addition to his
poor health, his compensable injury causes him a greater degree of incapacity
than the same injury would cause some other person with superior education or
work experience, or who is in better health.
Thus, all the evidence tends to show that any current effort by
Plaintiff to obtain sedentary light-duty employment, the only employment Dr.
DeFranzo testified that Plaintiff is physically capable of performing, would
have been futile.[Note 4]
Accordingly, the Full Commission did not
err in concluding that Plaintiff is temporarily totally disabled under N.C.
Gen. Stat. §97-29 and entitled to compensation therefor.
C. Apportionment
Next, Defendant contends the Full
Commission erred in not apportioning Plaintiff’s benefits because the evidence
presented indicated that “only a small quantifiable percentage of Plaintiff’s
injuries were [sic] related to his employment.”
Where a plaintiff is rendered totally
unable to earn wages, partially as a result of a compensable injury and
partially as a result of a non-work-related medical condition, the plaintiff is
entitled to an award for total disability under N.C. Gen. Stat. §97-29. Counts v. Black & Decker Corp.,
121 N.C. App. 387, 465 S.E.2d 343 (1996).
However, a plaintiff’s total disability benefits may be apportioned when
sufficient evidence is presented to allow the Commission to ascertain the
percentage of the plaintiff’s disability that is caused by the occupational
disease. Weaver v. Swedish Imports
Maint., Inc., 319 N.C. 243, 354 S.E.2d 477 (1987). Thus, apportionment is not proper where
there is no evidence attributing a percentage of the plaintiff’s total
incapacity to earn wages to his compensable injury, Errante v. Cumberland
Cty. Solid Waste Mgmt., 106 N.C. App. 114, 415 S.E.2d 583 (1992), or where
the evidence before the Commission renders an attempt at apportionment between
work-related and non-work-related causes speculative. Harrell v. Harriet & Henderson Yarns, 314 N.C. 566,
336 S.E.2d 47 (1985).
In Errante, the evidence
established that the plaintiff’s non-work-related anemia and diabetes caused
part of the plaintiff’s permanent and total disability, thus permitting the
application of judicial apportionment.
However, “no evidence was presented attributing any percentage of
plaintiff’s total incapacity [to earn wages] solely to his compensable
injuries.” Errante, 106 N.C.
App. at 120, 415 S.E.2d at 586.
Furthermore, a testifying physician stated that there was “no way
anybody [could] honestly say” what percentage of the plaintiff’s total
disability was caused by his compensable injuries and what percentage was
caused by his noncompensable medical problems.
Id. at 120, 415 S.E.2d at 587.
Accordingly, the Court ruled that the “plaintiff [was] entitled to full
compensation for total and permanent disability.” Id.
In Counts, 121 N.C. App. 387, 465
S.E.2d 343, the plaintiff injured her shoulders while working on an assembly
line. A doctor assigned a 20 percent
permanent partial disability rating to the use of both arms. The plaintiff also suffered from a
non-job-related arthritic condition of her hands. This Court refused to apportion the plaintiff’s award of total
disability compensation as the permanent partial disability rating did not
address what percentage of the plaintiff’s total disability to earn wages was
attributable to her compensable arm and shoulder injury and what percentage was
attributable to her noncompensable osteoarthritic condition. “Thus, there was no evidence from which the
Commission could apportion the award and [the] plaintiff [was] entitled to full
compensation for her total and permanent disability.” Id. at 391, 465 S.E.2d at 346.
Here, on direct examination, Dr. DeFranzo
testified as follows:
A. .
. . I thought that [Plaintiff] had about a five (5) percent permanent
impairment in each hand from carpal tunnel syndrome . . . and that the gout and
osteoarthritis was so severe in this patient that he may have actually had a
fifty (50) percent disability in each hand; but five (5) percent of that
impairment would be from carpal tunnel syndrome in each hand.
. . . .
Q. Doctor,
is the Plaintiff’s carpal tunnel syndrome debilitating to any extent?
A. The
carpal tunnel syndrome itself has given him a five (5) percent disability in
each hand, however, his arthritis and his gout have given him significant more
disability. And in my opinion, I
thought he had probably a fifty (50) percent disability in each hand. His joints are extremely stiff and they do
not move, which limits his grip strength, and he has pain when he attempts to
use his hands repetitively now. And all
those factors together contribute to his disability.
. . . .
Q. Doctor,
you -- in your letter -- assigned the patient a permanent partial disability
rating of up to fifty (50) percent of his hands?
. . . .
Would it be necessary for you to give an accurate opinion
of his partial and permanent disability - - would it be necessary for you to
see him again or would it be helpful?
A. Yes.
When we do a disability rating, we actually measure the motion in each joint --
each and every joint of the hand. . . .
On cross-examination, Dr. DeFranzo further
testified as follows:
Q. Is
there any way to say -- to categorize the job or, you know, any sort of
attributation of the job as contributing to his carpal tunnel “x” percent over
the gout or over the arthritis that he has?
A. If
it’s osteoarthritis and gout -- and the gout is reasonably well controlled, in
my opinion is probably, you know, sixty (60) percent the job, since he did it
for fifteen (15) years, and forty (40) percent the other factors. That would be probably my assessment;
however, I think his disability purely from carpal tunnel syndrome is probably
going to be five (5) percent in each hand from carpal tunnel syndrome. So the majority of his disability is from
the arthritis and the gout, and the stiffness in his hands and lack of motion,
which are caused by the arthritis.
. . . .
Q. I
know you gave a five (5) percent PPD rating for carpal tunnel, but there’s
another rating of fifty (50) percent.
Do I understand it correctly that you’re saying, “I’m giving him a fifty
(50) percent as of February, but really to make this an accurate diagnosis, I’d
like to see him again.” . . .
A. Yes,
it -- I’m just saying that five (5) percent of his disability is from the
carpal tunnel syndrome in each hand; however, his hands just don’t work
ninety-five (95) percent.
. . . .
He’s got at best -- I thought -- at that time about a fifty (50) percent use of his hands, not from just the carpal tunnel syndrome, but from all the other contributing conditions. Now, a large part of that sixty (60) percent might be work-related if it’s just wear-and-tear osteoarthritis.
Defendant argues that the above testimony
shows that carpal tunnel syndrome accounts for only five percent of Plaintiff’s
disability. We disagree. To the contrary, it appears that the five
percent “disability” to which Dr. DeFranzo testified most likely represents a
permanent partial disability (or functional impairment) rating and not the
extent to which Plaintiff’s carpal tunnel syndrome contributed to his overall
disability. As in Counts, a
permanent partial disability rating is not evidence of the extent to which
Plaintiff’s carpal tunnel syndrome contributed to his inability to earn
wages. At best, Dr. DeFranzo’s
testimony is equivocal as to whether he was expressing an opinion on a
permanent partial impairment rating or attempting to apportion the percentage
to which Plaintiff’s occupational disease contributed to his disability. When evidence is capable of more than one
interpretation, the Commission is not required to accept an interpretation
urged by one party over other obvious interpretations. It is also notable that Dr. DeFranzo was
never asked what percentage of Plaintiff’s inability to earn wages was
attributable solely to his carpal tunnel syndrome. As in Errante and Counts, we thus conclude here
that the evidence was insufficient to require the Commission to apportion the
award.
In Pitman v. Feldspar Corp., 87
N.C. App. 208, 360 S.E.2d 696 (1987), disc. review denied, 321
N.C. 474, 364 S.E.2d 924 (1988), this Court remanded the case to the Industrial
Commission for further findings regarding whether any portion of the
plaintiff’s total incapacity to work was caused by conditions unrelated to
employment. The plaintiff was diagnosed
with silicosis after 23 years of exposure to silica dust and stopped working as
a result. The Commission awarded the
plaintiff total disability benefits.
Advisory Medical Committee reports suggested that the plaintiff was
completely incapacitated for work by reason of silicosis. However, the testimony and report of a physician
tended to show that the plaintiff had, in addition to silicosis, a chronic
obstructive lung disease which was due to smoking and possibly to asthma. The physician also stated that 50 percent of
the plaintiff’s total respiratory impairment was unrelated to the
silicosis. The Commission found that
the plaintiff was “totally disabled because of his pulmonary condition. The occupational disease silicosis makes a
very significant contribution to plaintiff’s total disability.” Id. at 211, 360 S.E.2d at 697. However, because the Commission failed to
make specific findings regarding the portion of the plaintiff’s total
incapacity to work that was caused by his non-work-related health conditions,
this Court remanded the case for specific findings.
In this case, however, it is not proper
to remand to the Full Commission for further findings of fact because, unlike
in Pitman where the Commission “failed to resolve crucial issues of
fact” regarding apportionment, id. at 215, 360 S.E.2d at 699, here, the
Commission specifically found that “[b]ased upon the credible medical and
vocational evidence of record, the Full Commission finds that as a result of
his bilateral carpal tunnel syndrome, Plaintiff has been unable to earn any
wages in any employment since March 4, 2004.”
Insufficient evidence was presented showing what, if any, percentage of
Plaintiff’s disability was caused solely by his carpal tunnel syndrome. Moreover, the evidence does not establish
that Plaintiff would have been disabled as the result of his pre-existing
health conditions in the absence of the work-related carpal tunnel
syndrome. Even after Plaintiff was
diagnosed with congestive heart failure and gout, and suffered two mini
strokes, he continued to work with no change in his performance or duties. It was only after he “lost all the uses of
[his] hands and wrists” as a result of his carpal tunnel syndrome that
he was forced to stop doing his job.
Accordingly, as there was competent
evidence to support the Commission’s finding that Plaintiff was disabled as a
result of his bilateral carpal tunnel syndrome, and insufficient evidence was
presented from which the Commission
could apportion the award, the Commission correctly awarded Plaintiff full compensation
for his total disability.
D. Maximum Medical Improvement
By its final assignment of error,
Defendant contends the Full Commission erred in concluding that Plaintiff had
not reached maximum medical improvement from his carpal tunnel syndrome. We disagree.
The term “maximum medical improvement” is
not defined by statute. N.C. Gen. Stat.
§97-31 provides compensation for temporary disability during the “healing
period.” The healing period ends when,
“after a course of treatment and observation, the injury is discovered to be
permanent and that fact is duly established.” Crawley v. Southern Devices, Inc., 31 N.C. App. 284, 289, 229
S.E.2d 325, 329 (1976). The point at
which the injury has stabilized is often called “maximum medical
improvement.” Carpenter v. Indus.
Piping Co., 73 N.C. App. 309, 311, 326 S.E.2d 328, 330 (1985).
Here, Dr. DeFranzo testified that he
first saw Plaintiff in February of 2004, and that nerve conduction studies were
done on Plaintiff’s hands. The results
of those studies were so significant for carpal tunnel syndrome that Dr.
DeFranzo did not feel Plaintiff should continue to work until after surgery.
Plaintiff was written out of work on 4 March 2004 and never released back to
work. Plaintiff underwent
surgery on his left hand on 19 April 2004, but surgery was never done on
Plaintiff’s right hand. Dr. DeFranzo
testified that he would want to see Plaintiff again to determine if Plaintiff
may need surgery on his right hand, or whether Plaintiff “may continue to have
problems with his hands that later will not be correctable by surgery.”
Although Plaintiff needed physical
therapy after his left carpal tunnel release surgery, he was only able to go to
therapy a couple of times before his health insurance ran out. He testified that each visit to the therapist
would have cost him “maybe between 50 and 100 dollars” and that continuing his
medical insurance under COBRA would have cost him about $300 a month, almost
one third of his monthly income.
Plaintiff was last examined by Dr.
DeFranzo on 29 September 2004. Dr. DeFranzo
testified that if Plaintiff had not received any treatment since that date, he
would need further medical treatment for his hands. Dr. DeFranzo also testified that it would be necessary to see
Plaintiff again in order to give an accurate opinion on Plaintiff’s “proper
disability rating[.]”
Defendant argues that, like the plaintiff
in Aderholt v. A.M. Castle Co., 137 N.C. App. 718, 529 S.E.2d 474
(2000), who voluntarily chose not to undergo further surgery, and thus was
found to have reached maximum medical improvement, Plaintiff’s “decision to
discontinue treatment” in this case necessarily leads to the conclusion that he
has reached maximum medical improvement.
However, as Defendant points out, Plaintiff discontinued his treatment
for financial reasons. More
specifically, Plaintiff’s health insurance expired after he left work due to
his medical conditions. Thus, unlike
the plaintiff in Aderholt, Plaintiff’s inability to seek medical
treatment here was hardly a voluntary “decision to discontinue treatment.” Furthermore, unlike the plaintiff in Aderholt,
evidence in this case indicates that Plaintiff will resume the treatment
required to stabilize his carpal tunnel syndrome when he is financially able to
do so.
Accordingly, as the evidence tends to
show that Plaintiff’s medical treatment for his carpal tunnel syndrome may not
be complete, that Plaintiff requires further medical evaluation at a minimum,
and that Plaintiff’s condition has not stabilized, the Commission correctly
determined that Plaintiff has not reached maximum medical improvement. Defendant’s assignment of error is
overruled.
For the reasons stated above, the
decision of the Full Commission is
AFFIRMED.
Judge CALABRIA concurs.
Judge ARROWOOD concurs in part and
dissents in part per separate opinion.
1. In Keller, this Court held that
the Commission improperly awarded compensation to the plaintiff, a patrol
officer, for phlebitis because that disease was “not peculiar to the occupation
of patrol officer, but rather is peculiar to all occupations which require a
great deal of sitting whether the profession be that of a secretary, judge, or
airline pilot.” 65 N.C. App. at 678,
309 S.E.2d at 545.
2. Although the North Carolina Supreme
Court granted discretionary review, the case was never heard so no Supreme
Court decision was rendered.
3. At the hearing, Plaintiff was unable to
make a fist with his left hand and indicated that it is “swollen all the time
now.” Plaintiff also testified that he
has no use of his right hand as he can’t grip anything with it, and that
“everything” has gotten worse.
4. We note that, as of the date of the
hearing, treatment recommended by Dr. DeFranzo for Plaintiff’s carpal tunnel
syndrome had not been completed, Plaintiff had not reached maximum medical
improvement, and Dr. DeFranzo testified without contradiction that it would be
necessary for Plaintiff to be further evaluated to determine the extent of
permanent impairment to his hands after he reached maximum improvement.
NO. COA07-536
NORTH CAROLINA COURT OF APPEALS
Filed:
5 February 2008
STEVIE JOHNSON,
Employee-Plaintiff,
v. North
Carolina Industrial Commission
I.C.
File No. 441316
CITY OF WINSTON-SALEM,
Employer,
SELF-INSURED,
Defendant.
ARROWOOD, Judge concurring in part and dissenting
in part.
I concur in the holdings announced in
Sections A, B, and D of the Court’s majority opinion. I respectfully dissent from Section C of the Court’s opinion
affirming the Commission’s failure to
apportion Claimant’s disability.
The Commission found and concluded that
Claimant’s employment neither caused nor significantly contributed to his gout
or arthritis. These findings and
conclusions when coupled with Dr. DeFranzo’s testimony cited by the majority at
pages 15 through 17 of the Opinion are, in my opinion, sufficient to require
the Commission to make additional findings regarding what portion of Claimant’s disability is related to his
employment.
I would, therefore, remand this case for
further findings regarding what percentage of Claimant’s disability is
attributable to his job with the City.
I believe such additional findings are mandated by Weaver v. Swedish
Imports Maintenance, Inc., 319 N.C. 243, 354 S.E.2d 477 (1987) and Pitman
v. Feldspar Corp., 87 N.C. App. 208, 360 S.E.2d 696 (1987), disc. review
denied, 321 N.C. 474, 364 S.E.29 924 (1988).