Bell v. Goodyear Tire & Rubber Co.

IN THE COURT OF APPEALS OF NORTH CAROLINA
No. COA15-1299
Filed: 21 March 2017
North Carolina Industrial Commission, I.C. No. 890382
CELIA A. BELL, Employee, Plaintiff,
v.
GOODYEAR TIRE AND RUBBER COMPANY, Employer, LIBERTY MUTUAL
INSURANCE COMPANY, Carrier, Defendants.
Appeal by defendants and cross-appeal by plaintiff from opinion and award
entered 3 September 2015 by the North Carolina Industrial Commission. Heard in
the Court of Appeals 26 April 2016.
Law Offices of Kathleen G. Sumner, by Kathleen G. Sumner, for plaintiff-
appellee and cross-appellant.
Hedrick Gardner Kincheloe & Garofalo, LLP, by Matthew J. Ledwith and M.
Duane Jones, for defendant-appellants and cross-appellees.
BRYANT, Judge.
Where defendants failed to rebut the presumption that plaintiff’s 2013
shoulder injury was causally related to her compensable 2007 shoulder injury, we
affirm the Industrial Commission’s conclusion and award of disability compensation.
Where defendants failed to reinstate plaintiff’s temporary total benefits following
defendants’ admission of plaintiff’s right to compensation and notice of her
unsuccessful trial return to work and where defendants further failed to file with the
Industrial Commission a request to terminate plaintiff’s disability compensation,
BELL V. GOODYEAR TIRE & RUBBER CO.
Opinion of the Court
defendants are subject to a ten percent penalty for payments due to plaintiff following
her unsuccessful trial return to work. Where the Commission acted within its
discretion by denying plaintiff an award of attorney fees and costs, we affirm the
denial of plaintiff’s request.
On 12 May 2007, plaintiff Celia A. Bell was employed by defendant-employer
Goodyear Tire and Rubber Company as a tire builder. When pulling and twisting a
tire carcass, she felt a “pop” in her right shoulder. Plaintiff was examined by Dr.
Christopher Barnes, who “performed an arthroscopic subacromial decompression and
arthroscopic superior labrum anterior and posterior (SLAP) lesion repair” to her right
shoulder. Plaintiff filed a Form 18, Notice of Accident to Employer and Claim of
Employee regarding the injury to her right shoulder. Defendant entered a Form 26A,
Employer’s Admission of Employee’s Right to Permanent Disability which was
approved by the Commission on 21 December 2008. After defendant filed three Form
60s, Employer’s Admission of Employee’s Right to Compensation, altering the
compensation amount and the body part injured, Deputy Commissioner Chrystal
Redding Stanback filed an Opinion and Award in which she concluded that plaintiff
sustained a “compensable injury to her right shoulder pursuant to N.C. Gen. Stat. §
97-2(6), and concluded Plaintiff was entitled to payment of future necessary medical
compensation for her compensable injury pursuant to N.C. Gen. Stat. § 97-25.1.”
(Emphasis added).
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BELL V. GOODYEAR TIRE & RUBBER CO.
Opinion of the Court
On 9 January 2010, plaintiff again injured her right shoulder at work. The
parties entered into a Consent Order approved by the Industrial Commission,
wherein “the parties agree[d] that the . . . right shoulder exacerbation injury [was] a
continuance of the admittedly compensable right shoulder injury sustained on May
12, 2007.”
Following the 2010 incident, plaintiff was examined by Dr. Robert Carroll, a
physician board certified in orthopedics, specializing in shoulder treatment.
Dr. Carroll . . . probed the biceps tendon and noted a suture
anchor which had grasped tissue from the middle
glenohumeral ligament. Dr. Carroll then debrided the scar
tissue at the suture site, released the glenohumeral
ligament and removed the suture material. Dr. Carroll
testified that Plaintiff’s symptoms were likely coming from
the acromioclavicular joint and the rotator cuff but it was
also possible her pain was due to the biceps tendon.
On 14 March 2012, Dr. Carroll noted that plaintiff had achieved maximum medical
improvement (MMI) and assigned her permanent physical restrictions to avoid
carrying over 45 pounds, lifting more than 25 pounds from waist to shoulder, and
over 40 pounds from waist to floor. However, when defendant could not provide
plaintiff a job within those physical restrictions, plaintiff did not return to work.
On 21 December 2012, plaintiff reported to Dr. Carroll after she felt pain in
her right shoulder while raking her yard. “Dr. Carroll assessed right shoulder pain
and possible proximal biceps tendinitis.” He prescribed a steroid taper and pain
medication.
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BELL V. GOODYEAR TIRE & RUBBER CO.
Opinion of the Court
On 19 August 2013, plaintiff returned to work in a position that defendant
described as within her permanent physical restrictions. On 6 September, plaintiff
was performing heavy lifting when, again, she felt a “pop” in her right shoulder.
Plaintiff sought treatment at a clinic later that day. On 9 September, plaintiff was
seen by Dr. Carroll. “Dr. Carroll found limited and uncomfortable internal rotation
and relative weakness of the rotator cuff.” Plaintiff was assigned restrictions of no
lifting or carrying over 5 pounds and no pulling or pushing over 10 pounds. But
because defendants could not accommodate these restrictions, plaintiff did not return
to work until 3 October 2013, when Dr. Carroll assigned new physical restrictions:
“no lifting or carrying over 20 pounds, no pulling or pushing over 30 pounds, no work
over shoulder height, and the ability to take 10-minute breaks every two hours.”
Back on 12 September 2013, defendant filed a Form 28T, Notice of Termination
of Compensation by Reason of Trial Return to Work, which indicated that payments
of temporary total disability benefits to plaintiff were terminated on 18 August 2013
due to plaintiff’s trial return to work on 19 August 2013. On 16 September 2013,
defendant filed a Form 62, Notice of Reinstatement or Modification of Compensation.
However, defendant “pulled and destroyed” the form and failed to reinstate plaintiff’s
disability compensation.
Plaintiff returned to work on 3 October and continued through 23 October
2013, when she again returned to Dr. Carroll with complaints of shoulder pain.
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BELL V. GOODYEAR TIRE & RUBBER CO.
Opinion of the Court
Plaintiff was diagnosed with “proximal biceps tendinitis” in her right shoulder. Given
new work restrictions, which defendant was unable to accommodate, plaintiff did not
return to work after 23 October 2013 and remained out of work through 27 May 2015
(the date this matter was heard before the North Carolina Industrial Commission).
On 14 October 2013, plaintiff filed a motion with the Industrial Commission to
request reinstatement of temporary total disability compensation. Defendants
challenged whether “[p]laintiff’s current complaints resulting in work restrictions
[were] causally related to the accepted May 12, 2007 injury or to the documented
lifting incident without accident of September 6, 2012.”
The matter came before a deputy commissioner who concluded that “[t]he
medical opinion testimony in this case [was] insufficient to establish that [p]laintiff’s
biceps tendon is causally related to Plaintiff’s original right shoulder injury in 2007
or subsequent re-injury in 2010[,]” and denied plaintiff’s claim for additional
temporary total disability compensation benefits stemming from the 6 September
2013 incident. Plaintiff appealed to the Full Commission (“the Commission”).
On 3 September 2015, the Commission filed an Opinion and Award reversing
the opinion and award of the deputy commissioner. In its findings of fact, the
Commission noted testimony from three physicians (Drs. Kevin Speer, Christopher
Barnes, and Carroll) that was equivocal as to whether plaintiff’s 6 September 2013
injury to her biceps tendon was causally related to her admittedly compensable 12
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BELL V. GOODYEAR TIRE & RUBBER CO.
Opinion of the Court
May 2007 right shoulder injury. However, the Commission noted that due to the
Parsons presumption, a rebuttable presumption that additional medical treatment is
related to an initial compensable injury (as discussed in Parsons v. Pantry, 126 N.C.
App. 540, 485 S.E.2d 867 (1997)), defendants had the burden of proof to show that
the September 2013 injury and treatment was not directly related to the 2007
compensable injury. The Commission concluded defendants failed to rebut the
presumption. The Commission thus determined that plaintiff’s attempted trial
return to work was unsuccessful due to her 12 May 2007 injury. Defendants
Goodyear Tire and Rubber Company and Liberty Mutual Insurance Company were
ordered to pay plaintiff temporary total disability benefits for the stated periods from
9 September to 5 October 2013 and from 24 October 2013 to the date of hearing, and
until plaintiff returned to work or otherwise ordered by the Commission.
Defendants and plaintiff both appeal.
__________________________________________
On appeal, (I) defendants argue the Commission erred by concluding plaintiff’s
shoulder injury was causally related to her compensable work injury. On cross-
appeal, plaintiff argues the Commission erred by failing to (II) conclude that
defendants were required to immediately reinstate compensation benefits upon
learning of plaintiff’s failed trial return to work and (III) assess a late penalty and
impose sanctions as a result.
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BELL V. GOODYEAR TIRE & RUBBER CO.
Opinion of the Court
Standard of Review
The Commission is the ultimate finder of fact in a workers’ compensation case.
Adams v. AVX Corp., 349 N.C. 676, 680, 509 S.E.2d 411, 413 (1998). This Court
reviews an award from the Commission to make two determinations: “(1) whether
the findings of fact are supported by competent evidence, and (2) whether the
conclusions of law are justified by the findings of fact.” Clark v. Wal-Mart, 360 N.C.
41, 43, 619 S.E.2d 491, 492 (2005) (citation omitted). On appeal, findings of fact may
be set aside if there is a complete lack of competent evidence to support them. Young
v. Hickory Bus. Furniture, 353 N.C. 227, 230 538 S.E.2d 912, 914 (2000). Even if
there is evidence to support a contrary finding, the Industrial Commission’s findings
of fact are conclusive on appeal if they are supported by competent evidence.
Sanderson v. Ne. Constr. Co., 77 N.C. App. 117, 121, 334 S.E.2d 392, 394 (1985)
(citation omitted). The Commission’s conclusions of law are reviewed de novo. Griggs
v. E. Omni Constructors, 158 N.C. App. 480, 483, 581 S.E.2d 138, 141 (2003).
Defendants’ appeal
I
Defendants argue that the Commission erred by concluding plaintiff’s shoulder
injury was causally related to her compensable 12 May 2007 work injury. Defendants
contend the injury sustained on 6 September 2013 was to the biceps tendon and assert
that it is a part of the body different from the superior labrum and rotator cuff
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BELL V. GOODYEAR TIRE & RUBBER CO.
Opinion of the Court
plaintiff injured on 12 May 2007. Thus, defendants argue the Commission erred by
applying the Parsons presumption and, as a result, improperly shifted the burden of
proof to defendants to disprove the causal relationship between the injuries. We
disagree.
“In a worker’s compensation claim, the employee has the burden of proving
that his claim is compensable. An injury is compensable as employment-related if
any reasonable relationship to employment exists.” Holley v. ACTS, Inc., 357 N.C.
228, 231, 581 S.E.2d 750, 752 (2003) (citations omitted). Once an employee has
established a causal relationship between a workplace accident and the injury, an
employer is required to pay future medical treatment directly related to the original
compensable injury. Parsons, 126 N.C. App. at 541–42, 485 S.E.2d at 869. “Where a
plaintiff's injury has been proven to be compensable, there is a presumption that the
additional medical treatment is directly related to the compensable injury. The
employer may rebut the presumption with evidence that the medical treatment is not
directly related to the compensable injury.” Perez v. Am. Airlines/AMR Corp., 174
N.C. App. 128, 135, 620 S.E.2d 288, 292 (2005) (citations omitted) (citing Parsons,
126 N.C. App. at 542, 485 S.E.2d at 869); see also id. at 136 n.1, 620 S.E.2d at 293 n.1
(“We can conceive of a situation where an employee seeks medical compensation for
symptoms completely unrelated to the compensable injury. But the burden of
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BELL V. GOODYEAR TIRE & RUBBER CO.
Opinion of the Court
rebutting the presumption of compensability in this situation, although slight, would
still be upon the employer.”).
Defendants accepted plaintiff’s 12 May 2007 right shoulder injury as
compensable, and on 28 October 2009, Deputy Commissioner Stanback issued an
opinion and award concluding there was a “substantial risk of the necessity of future
medical compensation for Plaintiff for her compensable injury.” Defendants argue
the Commission erred in applying the Parson’s presumption because plaintiff
sustained a new injury to a different body part. We disagree. Defendants accepted
the compensability of the injury to plaintiff’s right shoulder and will not be heard to
say now that the right bicep tendon, a part of the right shoulder complex, is not
connected to the right shoulder. Defendants challenge to the Commission’s
application of the Parson’s presumption must fail, and defendants properly had the
burden of proof to rebut the presumption that a causal relationship existed between
the injuries.
Before this Court, defendants contest the causal relationship between
plaintiff’s 12 May 2007 shoulder injury and the proximal biceps tendinitis diagnosed
after plaintiff’s 6 September 2013 incident. They assert that they have met the
burden of proof that plaintiff’s bicep injury is causally related to her 6 September
2013 incident, identifying proximal biceps tendinitis, and not causally related to the
compensable injury occurring 12 May 2007.
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BELL V. GOODYEAR TIRE & RUBBER CO.
Opinion of the Court
The Commission reviewed testimony from three physicians, each of whom
examined plaintiff: Dr. Carroll, Dr. Barnes, and Dr. Speer. After reviewing the
testimony of Dr. Barnes, a board-certified orthopedic surgeon specializing in
treatment of upper extremities, the Commission made the following unchallenged
finding of fact1:
[Dr. Barnes testified that a] superior labral tear is repaired
at the location where the biceps tendon attaches to the
shoulder socket. Once the labrum is repaired, it is not as
strong as it was prior to the tear, in part because it fills
with scar tissue. The superior labral repair [conducted as
a result of the 12 May 2007 injury] placed Plaintiff at a
higher risk of having an injury to the biceps tendon.
And though defendants also challenge the Commission’s finding of fact regarding Dr.
Carroll’s testimony, in their brief to this Court, defendants acknowledge the
viewpoint expressed by both Drs. Speer and Barnes “that Dr. Carroll is the provider
in the best position to give an opinion as [to] the state of Plaintiff’s shoulder between
the 2011 surgery and the 6 September 2013 Urgent Care presentation.” We note in
pertinent part that the finding of fact based on Dr. Carroll’s testimony is consistent
with the Commission’s unchallenged finding of fact regarding Dr. Barnes’s testimony.
[Dr. Carroll] went on to testify that the biceps tendon is
part of the “complex,” that where the bicep[] attaches to the
bone is where the anterior labrum is, and that the multiple
shoulder surgeries Plaintiff had put her at risk for further
injury, and there it is related. However, he ultimately
1In support of this finding, the Commission cited Dr. Barnes testimony: “ ‘I think it’s going to
boil down to is I don’t know if she hurt it at work, . . .’ but the prior superior labral repair ‘places her
at a higher risk of subsequent injuries.’ ”
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BELL V. GOODYEAR TIRE & RUBBER CO.
Opinion of the Court
concluded that it was too speculative for anyone to say
whether her pain is coming from the 2013 event, or all
related back to May 12, 2007.
Three physicians examined plaintiff, each board certified in orthopedics and
specializing in treatment of the shoulder or upper extremities. And each testified
that he could not say to a reasonable degree of medical certainty that plaintiff’s 2013
diagnosis of proximal biceps tendinitis was caused by her 12 May 2007 compensable
injury. Nevertheless, Drs. Barnes and Carroll each testified that the superior labral
repair plaintiff underwent in 2007 weakened the complex where her bicep attaches
to the shoulder socket and placed plaintiff at a higher risk for injury to the bicep
tendon. Thus, this testimony lends support to the presumption that additional
medical treatment to plaintiff’s right shoulder complex is directly related to the 12
May 2007 compensable right shoulder injury. Perez, 174 N.C. App. at 135, 620 S.E.2d
at 292 (establishing a compensable injury raises a presumption that future medical
treatment is related to the compensable injury). Therefore, there was sufficient
evidence to support the Commission’s findings of fact and conclusions of law that the
medical treatment of plaintiff’s right shoulder proximal biceps tendinitis was causally
related to her 12 May 2007 compensable right shoulder injury. With the burden of
proof shifted, defendants failed to present evidence to disprove the causal connection.
See id. at 135, 620 S.E.2d at 292 (rebutting the presumption of a causal connection
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BELL V. GOODYEAR TIRE & RUBBER CO.
Opinion of the Court
between a compensable injury and future medical treatment is initially the
employer’s burden). Accordingly, defendants’ argument is overruled.
Plaintiff’s cross-appeal
II & III
On cross-appeal, plaintiff argues that the Commission erred by failing to
conclude that defendants were required to immediately reinstate disability
compensation benefits upon notice that her trial return to work was unsuccessful
thus subjecting defendants to sanctions in the form of a late payment penalty,
attorney fees, and costs. We agree in part.
Pursuant to the Workers’ Compensation Rules of the Industrial Commission,
“when compensation for total disability being paid pursuant to N.C. Gen. Stat. § 97-
29 is terminated because the employee has returned to work for the same or a
different employer, such termination is subject to the trial return to work provisions
of N.C. Gen. Stat. § 97-32.1.” Workers’ Comp. R. of N.C. Indus. Comm’n 404A(1),
2014 Ann. R. (N.C.) 1275, 1283. Pursuant to General Statutes, section 97-32.1,
an employee may attempt a trial return to work for a period
not to exceed nine months. . . . If the trial return to work is
unsuccessful, the employee’s right to continuing
compensation under G.S. 97-29 [(“Rates and duration of
compensation for total incapacity”)] shall be unimpaired
unless terminated or suspended thereafter pursuant to the
provisions of [the Workers’ Compensation Act].
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Opinion of the Court
N.C. Gen. Stat. § 97-32.1 (2015) (emphasis added); see also Burchette v. E. Coast
Millwork Distribs, Inc., 149 N.C. App. 802, 808–09, 562 S.E.2d 459, 463 (2002)
(discussing the statutory authority for ceasing and reinstating disability
compensation pursuant to N.C. Gen. Stat. §§ 97-18.1 and -32.1). “If during the trial
return to work period, the employee must stop working due to the injury for which
compensation had been paid, the employee should complete and file with the
Industrial Commission a Form 28U[, (‘Request that compensation be reinstated’)] . .
. .” Workers’ Comp. R. 404A(2). “If the employee fails to provide the required
certification of an authorized treating physician as specified in [Workers’ Comp. R.
404A(2)], . . . the employer or carrier/administrator shall not be required to resume
payment of compensation.” Id. 404A(3) (emphasis added). However, interpreting
N.C. Gen. Stat. § 97-32.1, this Court has held that “[t]hough an employee ‘should’ give
notice to an employer of an unsuccessful trial return to work via a Form 28U prior to
total disability compensation resuming, a Form 28U is not required for reinstatement
of compensation.” Davis v. Hospice & Palliative Care of Winston-Salem, 202 N.C.
App. 660, 668, 692 S.E.2d 631, 637 (2010) (emphasis added) (citing I.C. Rule 404A(3)
(2009); Burchette, 149 N.C. App. at 809, 562 S.E.2d at 463)); accord Jenkins v. Pub.
Serv. Co. of N.C., 134 N.C. App. 405, 411, 518 S.E.2d 6, 10 (1999) (“If [a] trial return
to work is unsuccessful, the employee’s right to continuing compensation under G.S.
97-29 [for total incapacity] shall be unimpaired . . . . To expedite reinstatement of an
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Opinion of the Court
employee’s compensation pending a determination by the Commission of whether an
employee’s return to work was unsuccessful, the Commission’s rules provide that an
employee may file a Form 28U ‘Request that Compensation be Reinstated.’ . . . Upon
the filing of a properly completed Form 28U, the defendant-employer shall forthwith
resume payment of compensation for total disability.” (alterations in original)
(citations omitted)), rev’d in part on other grounds, 351 N.C. 341, 524 S.E.2d 805(2000).
To the extent that there is a contradiction between General Statutes, section
97-32.1 (stating where “the trial return to work is unsuccessful, the employee’s right
to continuing compensation . . . shall be unimpaired”) and Workers’ Compensation
Rule 404A(3) (stating where an employee fails to file a Form 28U with the Industrial
Commission “the employer or carrier/administrator shall not be required to resume
payment of compensation”), this Court has held that General Statutes, section 97-
32.1 controls.2 See Davis, 202 N.C. App. at 668, 692 S.E.2d at 637 (citing Burchette,
149 N.C. App. at 809, 562 S.E.2d at 463–64); see also id. at 669, 692 S.E.2d at 637(“[E]mployers do not have the right to present evidence before reinstating disability
compensation following notice of an unsuccessful return to work. When an employer
2 “To make its purpose that the North Carolina Workmen’s Compensation Act shall be
administered exclusively by the North Carolina Industrial Commission effective, the General
Assembly has empowered the said Industrial Commission to make rules, not inconsistent with this act,
for carrying out the provisions of the act . . . .” Chaisson v. Simpson, 195 N.C. App. 463, 473, 673
S.E.2d 149, 158 (2009) (quoting Winslow v. Carolina Conf. Ass'n, 211 N.C. 571, 579, 191 S.E. 403, 408
(1937) (internal quotation marks omitted)).
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Opinion of the Court
receives notice, either through a Form 28U or other means of acquiring actual
knowledge, then disability compensation should be reinstated automatically.”).
Here, the Commission made the following unchallenged finding of fact:
21. Defendants had notice in September 2013 that the
trial return to work was unsuccessful; however, defendants
took the position that the condition which rendered
Plaintiff unable to work after September 9, 2013 and
October 24, 2013 was not causally related to the injury she
had sustained at work on May 12, 2007.
The Commission concluded that plaintiff had an unsuccessful trial return to work
and that
it would be inconsistent with the policy and intent behind
N.C. Gen. Stat. § 97-32.1 to conclude that Plaintiff is not
entitled to further benefits . . . . Therefore, as a result to
the injury of May 12, 2007, plaintiff was temporarily and
totally disabled from September 9, 2013 to October 5, 2013,
and again from October 24, 2013 to the present and
ongoing.
Plaintiff contends that the Commission “should have [further concluded] that
. . . defendants were obligated to reinstate [plaintiff]’s compensation immediately . . .
.” (Emphasis added). In accordance with General Statutes, section 97-32.1 and the
opinion issued by this Court in Davis, we agree. See N.C.G.S. § 97-32.1 (“If the trial
return to work is unsuccessful, the employee’s right to continuing compensation
under G.S. 97-29 shall be unimpaired . . . .”); Davis, 202 N.C. App. at 668, 692 S.E.2d
at 637 (“Total disability compensation must be reinstated under N.C. Gen. Stat. § 97-
32.1 . . . as soon as an employer has knowledge that an employee’s return to work has
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Opinion of the Court
been unsuccessful.” (citation omitted)); cf. Jenkins, 134 N.C. App. at 411, 518 S.E.2d
at 10.
Plaintiff further contends that because defendant failed to automatically
reinstate disability compensation after notice that plaintiff’s trial return to work was
unsuccessful, defendant was required to pay plaintiff an additional ten percent of the
outstanding total disability payments at the time of the 3 September 2015 Opinion
and Award.
General Statutes, section 97-18, “[i]f any installment of compensation is not
paid within 14 days after it becomes due, there shall be added to such unpaid
installment an amount equal to ten per centum (10%) thereof, which shall be paid at
the same time as, but in addition to, such installment . . . .” N.C. Gen. Stat. § 97-
18(g) (2015).
In Burchette, 149 N.C. App. 802, 562 S.E.2d 459, a panel of this Court
considered whether the Commission’s assessment of a ten percent penalty, pursuant
to section 97-18(g) was in error. The facts indicated that the employee suffered a
compensable injury, received disability benefits, and subsequently attempted a trial
return to work. However, the return to work was unsuccessful. The employer’s
contention on appeal was the employee’s failure to file a Form 28U “reliev[ed] the
employer of any responsibility to resume payment of disability compensation.” Id. at
808, 562 S.E.2d at 463. The Court panel disagreed.
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Opinion of the Court
[O]nce [the defendant-employer] had knowledge that [the
plaintiff-employee]’s trial return to work was unsuccessful,
they were required to reinstate compensation pursuant to
the Form 21[3] . . . . At the time the trial return to work was
unsuccessful, the defendants did not qualify for the
exception listed in N.C.G.S. § 97-18.1(b.)[4] Defendants’
remedy at that point, if they felt plaintiff's refusal to work
was unjustified, was to file a Form 24 [(a request to
terminate benefits)] pursuant to N.C.G.S. § 97-18.1(c). As
a result of defendants’ failure to follow these procedures,
defendants are subject to the ten percent penalty pursuant
to N.C.G.S. § 97-18(g).
Id. at 809, 562 S.E.2d at 463–64.
Here, in finding of fact 20, the Commission found that following plaintiff’s
unsuccessful trial return to work, “[d]efendants filed a Form 62, Notice of
Reinstatement or Modification of Compensation, indicating that payment of
3
[A] Form 21 agreement (approved by the Commission) represents an
admission of liability by the employer for disability compensation
pursuant to the Workers' Compensation Act (the “Act”). [S]ee . . .
[Radica v. Carolina Mills, 113 N.C. App. 440, 447, 439 S.E.2d 185, 190
(1994)] (Form 21 agreement is an admission by employer of liability,
entitling employee to continuing presumption of disability).
Kisiah v. W.R. Kisiah Plumbing, 124 N.C. App. 72, 77, 476 S.E.2d 434, 436 (1996).
4 As cited in Burchette, North Carolina General Statutes, section 97-18.1 states that
[a]n employer may terminate payment of compensation for total
disability being paid pursuant to G.S. 97-29 when the employee has
returned to work for the same or a different employer . . . . The
employer shall promptly notify the Commission and the employee, on
a form prescribed by the Commission, of the termination of
compensation . . . .
149 N.C. App. at 808, 562 S.E.2d at 463 (quoting N.C. Gen. Stat. § 97-18.1 (1999)).
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Opinion of the Court
temporary total disability benefits would be reinstated on September 11, 2013” before
the form was “pulled and destroyed.” In finding of fact 21, the Commission made the
following unchallenged statement:
21. Defendants had notice in September 2013 that the
trial return to work was unsuccessful; however, defendants
took the position that the condition which rendered
Plaintiff unable to work after September 9, 2013 and
October 24, 2013 was not causally related to the injury she
had sustained at work on May 12, 2007.
The record fails to reflect any action by defendants giving notice to plaintiff or the
Commission to contest plaintiff’s right to compensation in accordance with our
General Statutes, section 97-18(c) (“If the employer or insurer denies the employee's
right to compensation, the employer or insurer shall notify the Commission, on or
before the fourteenth day after it has written or actual notice of the injury . . ., or
within such reasonable additional time as the Commission may allow, and advise the
employee in writing of its refusal to pay compensation on a form prescribed by the
Commission.” N.C. Gen. Stat. § 97-18(c) (2015)). Defendants simply refused to
reinstate plaintiff’s disability compensation benefits following notice of plaintiff’s
unsuccessful trial return to work. Therefore, in consideration of the Commission’s
findings of fact, including the conclusion that plaintiff’s trial return to work was
unsuccessful due to her 7 May 2012 compensable injury, we hold that defendants are
subject to a penalty of ten percent (10%) on temporary total disability compensation
benefits not paid to plaintiff following the end of her trial return to work in accordance
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Opinion of the Court
with General Statutes, section 97-18(g). We remand this matter to the Commission
for entry of an Opinion and Award consistent with this opinion.
Plaintiff further contends that the Commission erred in failing to consider the
imposition of sanctions, including attorney fees and costs pursuant to N.C. Gen. Stat.
§ 97-88.1.
“The decision whether to award or deny attorney’s fees rests within the sound
discretion of the Commission and will not be overturned absent a showing that the
decision was manifestly unsupported by reason.” Thompson v. Fed. Express Ground,
175 N.C. App. 564, 570, 623 S.E.2d 811, 815 (2006) (citation omitted). Under section
97-88.1, “[i]f the Industrial Commission shall determine that any hearing has been
brought, prosecuted, or defended without reasonable ground, it may assess the whole
cost of the proceedings including reasonable fees for defendant’s attorney or plaintiff’s
attorney upon the party who has brought or defended them.” N.C. Gen. Stat. § 97-
88.1 (2015).
We note that in its Opinion and Award, the Commission reasoned that
“[d]efendants’ defense of this matter was not grounded in unfounded litigiousness
and Plaintiff is not entitled to attorney’s fees pursuant to N.C. Gen. Stat. § 97-88.1.
Thus, the Commission considered the award of attorney fees and costs and denied
them, as was within its discretion. Accordingly, this argument is overruled.
REVERSED IN PART AND REMANDED; AFFIRMED IN PART.
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Opinion of the Court
Judges STROUD and DIETZ concur.
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