Below are what we consider to be three of the most important workers’ compensation decisions in North Carolina over the past year.
Dunbar v. Acme Southern
In the case of Dunbar v. Acme Southern, (856 SE 2d 856, 377 NC 219) the employee, who sustained a compensable injury in 1998, entered a settlement agreement to resolve all indemnity benefits allowing the employee’s medical compensation to continue. The medical provider, however, began to bill Medicare instead of the provider in 2013. Since neither the employee or the provider was aware of this change, the billing to Medicare continued for two years until the issue was discovered.
Ultimately, the Court of Appeals determined N.C. Gen. Stat. § 97-25.1 stating that “[t]he right to medical compensation shall terminate two years after the employer’s last payment of medical or indemnity compensation” applied in this case, and the Court affirmed the Full Commission Opinion and Award and the employee’s claim for additional medical compensation was denied.
Practice Tip — The language of N.C. Gen. Stat. § 97-25.1 is very clear. The entitlement to additional medical compensation is barred if a payment has not been made on a claim in two years. There are only two exceptions to this rule. Payments on claims must be monitored closely to ensure they are made correctly and within the correct time period.
Griffin V. Absolute Fire Control
The Supreme Court of North Carolina affirmed, per curiam, the Court of Appeal’s decision in Griffin v. Absolute Fire Control (854 SE 2d 578, 376 NC 727). After being injured on the job and undergoing treatment for two years, an employee was permanently restricted by his physician from physical activities including the heavy lifting necessary for his job as a pipefitter. He was offered a different job by his employer, Absolute Fire Control, following his injury, but the employee did not think the new job was suitable employment.
Although the N.C. Industrial Commission found that the job was suitable for the employee, the Court of Appeals and Supreme Court of North Carolina reversed that decision. They found that the burden of disability cases shifts to the employer to show that the employee is capable of suitable employment. Suitable employment was defined as jobs that are available on the competitive marketplace.
Practice Tip – In these types of cases, an employee’s age, education and experience matter. Employers cannot offer work not available in the general labor market to an employee injured on the job in order to escape liability. Defendants must be able to present evidence that the job in question is available in the competitive marketplace.
Sprouse v. Turner Trucking Company
In Sprouse v. Turner Trucking Company, __N.C. App. __, __ S.E.2d __, he Plaintiff was a long-haul truck driver and was involved in a compensable accident on September 24, 2016. The truck driver was treated for neck, back and buttocks pain after the accident but, thinking the pain was due to sciatic, didn’t notify the employer in writing of the medical treatment. The employee returned to the nurse for treatment of cervical and lumbar pain and arm weakness a year later and was referred for an MRI. She stopped working, filed for short- and long-term disability, and submitted a post-surgical claim for workers’ compensation benefits.
Although the Full Commission affirmed the Deputy Commissioner’s Opinion and Award finding in favor of the Plaintiff on the issue of causation, reasonable excuse for a delayed notice, and lack of prejudice to Defendants, the decision was reversed by the Court of Appeals. The Court found Plaintiff had failed to establish causation due to her medical history and failed to provide timely notice.
Practice Tip – The decision underscores the need for written notice in such cases under NCGS 97-22. The employee provided verbal notice to her employer of her medical treatment, but failed to provide written notice.