Hale v. Barnes Distribution – NC Workers’ Compensation Appeal

The award of workers’ compensation benefits in North Carolina isn’t the end of the story. In many cases, employers or insurance companies will challenge the continuity of these benefits. knees

Such was the case in Hale v. Barnes Distribution, recently weighed by the North Carolina Court of Appeals, wherein the plaintiff appealed the commission’s finding that his employer properly ceased payments of his workers’ compensation benefits.

According to court records, the court’s hands were somewhat tied due to a mediated agreement the employee made in obtaining his benefits in the first place.

The mediated settlement agreement was that employer/ insurer would cover his workers’ compensation claim for total disability benefits – unless and until his primary care physician released him at least for light duty.

Worker was injured when he tripped over a rock and fell in a parking lot while working as an account representative for his employer. Soon after the injury, he filed a claim for workers’ compensation.

In May 2012, both parties participated in a mediated settlement conference, as ordered by the commission. The result of the mediation was that employer would immediately pay for plaintiff’s total replacement surgery. The company was also required to pay total disability payments until defendant was released by his doctor with or without work restrictions. The agreement also stipulated that the disability payments could be resumed after his doctor released him to work “if appropriate.”

Plaintiff underwent a total knee replacement surgery in August 2012. A full year later, in September 2013, his physician released him for light duty for an eight-hour work day.

At that point, defendant employer submitted a Form 28, which effectively ended plaintiff’s disability payments, per the mediated agreement.

In response, plaintiff filed a Form 33, in which he requested a hearing before his disability payments were ended. At the hearing, the full commission did affirm the sole commissioner’s findings. Plaintiff appealed.

The North Carolina Court of Appeals weighed plaintiff’s assertion that the commission had made several mistakes, including:

  • Making findings of fact that were not supported by the evidence;
  • Making the conclusions of law that were not justified by the findings of fact.

Plaintiff had the burden of proving his claims. He could establish his disability in one of four ways, per N.C. Gen. Stat. § 97–2(9). Those include producing medical evidence that he is incapable of work, producing evidence he may be capable of some work but after reasonable effort proved unsuccessful in obtaining work, proving that some pre-existing conditions (age, lack of education, etc.) preclude obtaining work or that he has obtained work at a wage less than employment.

Here, commission found plaintiff hadn’t satisfied any of these factors, as he was reportedly not disabled as a consequence of his injury by accident because, according to his physician, he is still able to work. Further, he had not as of that juncture conducted a reasonable job search within his restrictions.

Because the appellate court ruled the commission’s findings were at least supported by some competent evidence, these findings were binding on appeal.

If you have been injured at work, contact the Lee Law Offices at 800-887-1965.

Additional Resources:

Hale v. Barnes Distribution, Aug. 2, 2016, North Carolina Court of Appeals

More Blog Entries:

Dion v. Batten – Subrogation Lien on North Carolina Workers’ Compensation Benefits, Aug. 28, 2016, Charlotte Workers’ Compensation Lawyer Blog

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