Downing v. the Department of Transportation is a case that discusses the rights of workers who are seeking retirement benefits and Worker’s Compensation (WC) benefits at the same time.
If you are injured as a result of your work, it is important to know the legal standards that apply to you when benefits are being determined. Having an experienced North Carolina worker’s compensation attorney is crucial in recovering benefits.
The facts of this case begin in 2004 when Downing (Employee), first experienced unmanageable pain and went to see his doctor. It was found that Downing was suffering from a gradual injury that caused him to have chronic back, leg and hip pain.
Gradual injuries are commonly referred to as cumulative injuries. These are the types of injuries that arise over time and are a result of repetitive and continuous motion in a specific body area.
In this case, Downing was suffering from pre-existing spinal stenosis, which was aggravated by his work activities at the Department of Transportation (DOT). This is an important fact to note in your North Carolina worker’s compensation case because in Worker’s Compensation claims for gradual injuries, the injury does not have to be a cause of only the work activities. But in order to receive benefits under WC, you must prove that the employees work activities were a substantial factor in causing the employees injury.
After Downing’s diagnosis in 2004, he felt he could not continue to work at the DOT. He decided to retire in order to receive retirement benefits. However, he soon after rescinded the application and eventually went back to work full-time with the permission of his doctor. Rules surrounding WC benefits are triggered upon the original retirement application. Therefore in this case, because Downing applied for retirement in 2004 the presumption was triggered at that time although he rescinded the application.
Less than one year later, Downing formally retired from the DOT. After his retirement Downing went to work part time which caused his prior symptoms to re-emerged. He subsequently had spinal fusion surgery and requested benefits from the DOT. He was awarded benefits associated with the 2004 injury but nothing additional in the form of incapacity benefits.
The question in this case became whether an employee who suffered gradual injuries from their work with an employer is entitled to WC benefits for aggravating factors that made employee’s injuries worse after the employee left their employment. The court cites a very important legal principal, the retirement presumption. This legal principal was created in order to assist fact finders in their determination of whether an employee is still eligible for WC benefits as they reach the end of their working career.
Basically, the court says that an employee is not entitled to WC benefits when they themselves terminate their employment and are receiving non-disability retirement benefits. Applying this principal to this case, because Downing retired from the DOT and was receiving retirement benefits, the court held that he was not entitled to any more WC benefits.
In order to determine if the employee is entitled to WC benefits after their retirement, the employee must prove that after their injury they were unable to work for a period of time. They must also prove that they suffered a loss of earnings or earning capacity that was not compensated for in their retirement benefit plan. Downing could have rebutted this retirement presumption by proving that it is more likely than not that because of the work-related injury, he was unable to perform the type of work that correlated with his qualifications.
The court stresses that the employees focus must be in proving that there was a “total physical inability to perform any work that would otherwise be suitable to the employee’s qualifications, training and experience.” See Costales, 832 A.2d 790. Obviously Downing could not prove this, as he was able to work part-time after he retired.
In application, when you are injured at work or as a result of your work, it is important to know the law as it applies to your situation. You deserve to get the benefits you are entitled to.
If you, someone you work with or someone you love has been injured in an accident on the job or needs to file a workers’ compensation claim in North Carolina, contact the Carolina injury attorneys at the Lee Law Offices today for a free and confidential appointment to discuss your rights. Call 800-887-1965.