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    "judges": [
      "Chief Judge MARTIN and Judge HUNTER, JR. concur."
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    "parties": [
      "STEVE R. JONES, Employee, Plaintiff v. STEVE JONES AUTO GROUP, Employer, and UNIVERSAL UNDERWRITERS GROUP, Carrier, Defendants"
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        "text": "STEPHENS, Judge.\nI. Procedural History\nOn 3 January 2005, Plaintiff Steve R. Jones completed an Industrial Commission Form 18 seeking benefits for disability allegedly due to mold exposure in his place of employment. On 9 September 2005, Defendant Steve Jones Auto Group and Defendant Universal Underwriters Group (collectively, \u201cDefendants\u201d) completed a Form 61 denying Plaintiff\u2019s claim. On 22 May 2006, Plaintiff filed a Form 33 request for hearing. The claim was heard by Deputy Commissioner Wanda Blanche Taylor on 21 June 2007. Deputy Commissioner Taylor entered an Opinion and Award on 1 February 2008 awarding Plaintiff benefits. From this Opinion and Award, Defendants appealed to the Full Commission. The matter was heard by the Full Commission on 5 August 2008, and by Opinion and Award entered 12 September 2008, the Full Commission affirmed with modifications Deputy Commissioner Taylor\u2019s Opinion and Award. Defendants appeal.\nIT. Factual Background\nPlaintiff, 51 years old at the time the matter was heard by the Full Commission, is part-owner of Steve Jones Auto Group. In 1998, in his capacity as minority owner and employee, Plaintiff opened two new dealerships, Steve Jones Honda and Steve Jones Chevrolet. Plaintiff served as general manager of both dealerships.- Plaintiff was responsible for making all management decisions, and oversaw sales, finance, and insurance. Plaintiff often worked 10-hour days and was described as very professional, sharp, and good with both customers and finances. At no time prior to mid-2000 did Plaintiff experience any medical ailments that prevented him from performing his duties and responsibilities on a full-time basis.\nBetween late 1999 and mid-2000, the building which housed Steve Jones Honda, and Plaintiffs office, was remodeled. After the remodeling was completed, Plaintiff moved back into his office in the building. However, Myrick Construction\u2019s failure to properly caulk and seal along the base of the exterior wall of Plaintiff\u2019s office caused water intrusion into the wallboard, wall cavity, sheetrock, and carpeting of Plaintiffs office.\nIn late 2000, Plaintiff began to experience medical problems, including excessive and uncontrolled coughing, wheezing, a burning sensation in his nose and mouth, headaches, dizziness, and a lack of energy. Plaintiffs work performance began to deteriorate as Plaintiff lost his ability to calculate numbers in his head, and Plaintiff had severe memory problems. Plaintiff\u2019s medical and performance issues continued to worsen until September 2003. Plaintiff continued to receive a wage of $10,000 per month during this time, even though he was not performing his duties as general manager.\nIn April 2003, Steve Jones Auto Group\u2019s majority owner, Tom Davis, removed Plaintiff as general manager of the dealerships. Davis continued to pay Plaintiff his monthly salary until 28 December 2005. Plaintiff has not received a salary since that date.\nIn August 2003, Plaintiff\u2019s wife was undergoing a medical procedure performed by Dr. Jonathan Hasson, a vascular surgeon. During the procedure, Plaintiff began to cough uncontrollably and had to leave the room. After the procedure, Dr. Hasson spoke with Plaintiff about his symptoms and work conditions. Dr. Hasson opined that Plaintiff\u2019s symptoms may be the result of mold exposure. Following Plaintiff\u2019s discussion with Dr. Hasson, Plaintiff contacted Myrick Construction and had a representative from Myrick cut several holes in the wall of his office. The holes revealed that the wall cavity was \u201cheavily laden\u201d with black mold, with mold growing inside the sheetrock, insulation, and electrical receptacles.\nPlaintiff then contacted Mike Shrimanker of EEC, Inc., a certified industrial hygienist, registered professional engineer, certified safety professional, certified audio-metric technician, and certified Asbestos Hazard Emergency Response Act inspector. Mr. Shrimanker advised Plaintiff to leave the office and lock the door until Mr.' Shrimanker arrived. When Mr. Shrimanker arrived, he observed black mold on the back of the sheetrock that had been cut out of the wall and on the backs of Plaintiffs chairs. Mr. Shrimanker took air and tape samples from inside Plaintiffs office to identify what kinds of mold were present. He also took air and tape samples from outside the building.\nThe mold testing established that there was no stachybotrys, commonly known as black mold, in the outdoor samples, but high levels of stachybotrys in the samples taken from inside Plaintiff\u2019s office. Mr. Shrimanker testified that stachybotrys should not have been present inside or outside of Plaintiff\u2019s office in any amount and that the average member of the general public is not exposed to stachybotrys on a regular basis. The testing further revealed that there was no aspergillus, another type of mold, in the outdoor samples, but elevated levels of aspergillus in the samples taken from inside Plaintiff\u2019s office. In addition, the testing revealed small levels of penicillium, a type of mold, in the outdoor samples, and significantly higher levels of penicillium in the samples taken from inside Plaintiff\u2019s office. Mr. Shrimanker testified that although aspergillus and penicillium are commonly found in the outside air, their levels should be greater outdoors than indoors. Testing of Plaintiff\u2019s home revealed no elevated levels of mold.\nDr. Donald E. Schmechel, a clinical professor of medicine at Duke University and board certified in neurology and psychology, first saw Plaintiff on 13 October 2003. He performed a physical examination of Plaintiff and diagnosed him with \u201casthmatic reactive airway disease.\u201d Dr. Schmechel also performed a neurological exam, which included cognitive screening, and diagnosed Plaintiff with \u201cmild cognitive impairment^]\u201d According to Dr. Schmechel, there is no indication that Plaintiff suffered from any cognitive defects prior to his exposure to mold. It was Dr. Schmechel\u2019s opinion that Plaintiff\u2019s pulmonary airway disease is most likely the cause of his cognitive dysfunction.\nDr. Peter Kussin, an associate clinical professor of medicine at Duke University in the Division of Pulmonary, Allergy, and Critical Care Medicine, first saw Plaintiff on 23 October 2003. According to Dr. Kussin, before Plaintiff\u2019s exposure to mold, Plaintiff\u2019s childhood asthma had resolved and was asymptomatic. In October of 2003, however, Dr. Kussin reported that Plaintiff had evidence of both upper and lower airway problems, including hyperinflation of the lungs, inflammation and narrowing of his airways, and abnormalities of his upper airway and vocal chords. Dr. Kussin opined that Plaintiff\u2019s persistent asthma and related symptoms were caused by his exposure to mold at work.\nPlaintiff also saw Dr. David C. Thornton, a physician at the Pinehurst Medical Clinic and board certified in internal, pulmonary, critical care, and sleep medicine, in October 2003. At the time of Plaintiff\u2019s first visit, he complained of a marked aggravation in his respiratory symptoms, including sudden onsets of shortness of breath and a terrible cough. Plaintiff also reported having problems with memory and dizziness, and an inability to focus. Dr. Thornton testified that stachybotrys is at the top of the list of dangerous molds because it is capable of provoking an immune response and because it produces toxins that can affect the human body and human function. Dr. Thornton opined that Plaintiff\u2019s prolonged exposure to the combination of stachybotrys, aspergillus, and penicillium \u201cperpetuated and established in [Plaintiff] an immunologic state that perpetuated a very serious illness.\u201d In Dr. Thornton\u2019s opinion, Plaintiff\u2019s exposure to the high levels of mold at work was \u201cthe factor\u201d in the onset of Plaintiff\u2019s lung inflammation.\nIII. Discussion\nAppellate review of an opinion and award of the Full Commission is generally limited to (i) whether the Commission\u2019s findings of fact are supported by competent evidence, and (ii) whether the Commission\u2019s 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). The Full Commission\u2019s conclusions of law are reviewed de novo. Bond v. Foster Masonry, Inc., 139 N.C. App. 123, 127, 532 S.E.2d 583, 585 (2000).\nA. Occupational Disease\nBy Defendants\u2019 first argument, Defendants contend that the Commission erred in concluding that Plaintiff contracted an occupational disease as defined by N.C. Gen. Stat. \u00a7 97-53(13). We disagree.\nN.C. Gen. Stat. \u00a7 97-53, which lists various compensable occupational diseases, does not include pulmonary airway disease among these. However, a disease not specifically listed in the statute may nonetheless be compensable pursuant to N.C. Gen. Stat. \u00a7 97-53(13), which defines an occupational disease as\n[a]ny disease . . . which is proven to be due to causes and conditions which are characteristic of and peculiar to a particular trade, occupation or employment, but excluding all ordinary diseases of life to which the general public is equally exposed outside of the employment.\nN.C. Gen. Stat. \u00a7 97-53(13) (2007). Our Supreme Court has interpreted this language as requiring three elements in order to prove that a disease is an occupational disease: (1) the disease must be characteristic of and peculiar to the claimant\u2019s particular trade, occupation, or employment; (2) the disease must not be an ordinary disease of life to which the public is equally exposed outside of the employment; and (3) there must be proof of a causal connection between the disease and the employment. Rutledge v. Tultex Corp./Kings Yarn, 308 N.C. 85, 93, 301 S.E.2d 359, 365 (1983); accord Hardin v. Motor Panels, Inc., 136 N.C. App. 351, 354, 524 S.E.2d 368, 371, disc. review denied, 351 N.C. 473, 543 S.E.2d 488 (2000). The first two elements of the Rutledge test are satisfied where the employee can show that \u201cthe employment exposed the worker to a greater risk of contracting the disease than the public generally.\u201d Rutledge, 308 N.C. at 94, 301 S.E.2d at 365. The third element is satisfied if the employment \u201c \u2018significantly contributed to, or was a significant causal factor in, the disease\u2019s development.\u2019 \u201d Hardin, 136 N.C. App. at 354, 524 S.E.2d at 371 (citation omitted). Since Rutledge, this two-pronged requirement for proving an occupational disease, increased risk and causation, has been approved and applied repeatedly by this Court and the North Carolina Supreme Court. Hassell v. Onslow County Bd. of Educ., 362 N.C. 299, 306, 661 S.E.2d 709, 714 (2008).\n1. Increased Risk\nDefendants first challenge the sufficiency of the evidence to support the Commission\u2019s determination that Plaintiff\u2019s employment exposed him to an increased risk of contracting his illness as compared to the public generally. Specifically, Defendants argue that \u201c[t]he Commission disregarded our Supreme Court precedent which requires a link between the nature of an employment and the alleged occupational disease.\u201d We are unpersuaded by Defendants\u2019 argument and conclude that, on the record before us, we are bound by the prior decision of this Court in Robbins v. Wake Cty. Bd. of Educ., 151 N.C. App. 518, 566 S.E.2d 139 (2002).\nIn Robbins, plaintiff filed a claim with the Commission seeking compensation for his wife\u2019s contraction of and death from mesothelioma. Plaintiff\u2019s wife .(\u201cMs. Robbins\u201d) had worked for defendant as a secretary and graphic artist from 1978 to 1981. During her employment, Ms. Robbins worked at defendant\u2019s central administrative office building in a large room on the second floor that was divided by partitions. She also spent about two hours per day in the office\u2019s print shop and made daily trips to the basement of the building to place materials in courier boxes, which were located next to the boiler room. In 1988, a survey performed on the building revealed that the building contained substantial amounts of asbestos in the ceiling plaster, wall plaster, floor tile, pipe insulation in the boiler room and print shop, vibration dampers of the heating system, and numerous other areas.\nIn late 1992, Ms. Robbins developed a persistent cough. In January of 1993, a chest x-ray revealed a suspicious shadow in her lung, and a CT scan confirmed the presence of an egg-sized tumor in her right lung. Ms. Robbins was diagnosed with mesothelioma, a cancer most often associated with asbestos exposure. She died of the disease in June 1995 at the age of 41.\nThe Full Commission found and concluded that Ms. Robbins had contracted a compensable occupational disease as a result of her employment with defendant. In so concluding,\n[t]he Commission found as fact that [Ms. Robbins\u2019] employment at defendant\u2019s . . . facility exposed her to a greater risk of contracting mesothelioma than the public generally. The Commission found that while the nature of [Ms. Robbins\u2019] employment as a secretary and graphic artist did not place her at risk for contracting the disease, the fact that her employment required her to work in a building with higher-than-normal levels of asbestos did place her at such a risk, and that the risk was higher than that to which the general public was exposed, as not all buildings contain significant amounts of friable asbestos.\nId. at 521, 566 S.E.2d at 142 (emphasis added). In upholding the opinion and award of the Full Commission, this Court concluded that the Commission\u2019s findings were supported by the testimony of Dr. Victor Roggli, an expert in the pathology of asbestos-related diseases of the lung, including mesothelioma. Dr. Roggli testified that it was his opinion that Ms. Robbins\u2019 exposure to asbestos at the building placed her at an increased risk for developing mesothelioma. He opined that mesothelioma is a disease which is characteristic of particular trades or occupations, such as Robbins\u2019 employment, where the employee is exposed to asbestos.\nDr. Roggli also testified that mesothelioma is not an ordinary disease of life that is typically seen in the general population. Dr. Roggli stated that mesothelioma is very rare among the general population, and that it is estimated that there exist only one or two cases per million people per year where mesothelioma develops without asbestos exposure. Thus, this Court concluded that \u201cthe Commission\u2019s findings with respect to the first two elements of the Rutledge test were sufficiently supported by competent evidence.\u201d Id. at 522, 566 S.E.2d at 142-43. This Court further concluded that the Commission\u2019s findings supported the Commission\u2019s conclusion of law that, as a result of her employment with defendant, Ms. Robbins sustained a compensable occupational disease within the meaning of N.C. Gen. Stat. \u00a7 97-53(13).\nIn the present case, the Full Commission found as fact that \u201cPlaintiff\u2019s employment, and specifically, his exposure to mold for approximately three years, exposed [P]laintiff to a greater risk of developing his pulmonary airway disease than members of the general public not so employed.\u201d\nThis finding is supported by competent evidence in the record. Mr. Shrimanker testified that under normal conditions, \u201c[t]he general public doesn\u2019t get exposed to stachybotrys\u201d at any level. The results of the mold testing performed by Mr. Shrimanker on 27 August 2003 revealed a \u201clarge quantity\u201d of stachybotrys in the tape and air samples taken from plaintiff\u2019s office, with no stachybotrys outside. Additionally, the test results revealed no aspergillus in the outdoor sample, but elevated levels of aspergillus in the samples from Plaintiff\u2019s office, and small levels of penicillium in the outdoor sample, with significantly higher levels of penicillium in samples taken from Plaintiff\u2019s office.\nDr. Thornton testified that stachybotrys is \u201cperhaps the most noxious [mold] and most likely to affect human health in an adverse way.\u201d He further testified that Plaintiff\u2019s exposure to stachybotrys, aspergillus, and other molds present in his office placed him at an increased risk, greater than that of members of the general public, of developing the inflammation in his lungs.\nDr. Kussin also testified that while there may be as many as five million adults in this country with asthma, no more than \u201c[one] percent have asthma as a result of occupational exposures or environmental exposures that are not allergic . ...\u201d He further testified that \u201ceven a smaller subset of that [one] percent\u201d sustain the type of problems that Plaintiff experienced.\nWe conclude that this testimony is competent to support the Commission\u2019s finding that Plaintiff\u2019s work placed him at an increased risk for contracting pulmonary airway disease.\nDefendants argue that Plaintiff\u2019s testimony that he had visited hundreds of automobile dealerships in his 20-year career but only two had contained mold, as well as Dr. Thornton\u2019s testimony that he knows of no correlation between the auto dealership industry and mold-related disease, shows that there is no link between mold-related disease and auto dealerships. However, as in Robbins, although the nature of Plaintiff\u2019s employment as an automobile dealership manager did not increase his risk for contracting pulmonary airway disease, the fact that his employment required him to work in a building contaminated with mold did place him at an increased risk. Competent evidence in the record supports the Commission\u2019s determination that the risk to which Plaintiff was exposed was greater than the risk to which the general public is exposed as stachybotrys should not have been present in Plaintiff\u2019s office in any amount. Because the Commission\u2019s findings are supported by competent evidence, this Court is bound by them, even though the record also contains contrary evidence. Gilberto v. Wake Forest Univ., 152 N.C. App. 112, 118, 566 S.E.2d 788, 792 (2002).\n2. Causation\nDefendants next argue that the expert medical testimony relied upon by the Commission was not sufficient to prove a causal connection between Plaintiff\u2019s illness and his employment. Specifically, Defendants argue that medical experts erroneously premised their opinions \u201con the temporal relationship between discovery of mold [in] [P]laintiff\u2019s office and the onset of [Plaintiff\u2019s symptoms.\u201d Defendants\u2019 argument is meritless.\n\u201c[W]here the exact nature and probable genesis of a particular type of injury involves complicated medical questions far removed from the ordinary experience and knowledge of laymen, only an expert can give competent opinion evidence- as to the cause of the injury.\u201d Click v. Pilot Freight Carriers, Inc., 300 N.C. 164, 167, 265 S.E.2d 389, 391 (1980). However, \u201c \u2018expert opinion testimony [that] is based merely upon speculation and conjecture ... is not sufficiently reliable to qualify as competent evidence on issues of medical causa-. tion.\u2019 \u201d Cannon v. Goodyear Tire & Rubber Co., 171 N.C. App. 254, 262, 614 S.E.2d 440, 445 (quoting Young v. Hickory Bus. Furn., 353 N.C. 227, 230, 538 S.E.2d 912, 915 (2000)), disc. review denied, 360 N.C. 61, 621 S.E.2d 177 (2005); see also Dean v. Carolina Coach Co., 287 N.C. 515, 522, 215 S.E.2d 89, 94 (1975) (\u201c[A]n expert is not competent to testify as to a causal relation which rests upon mere speculation or possibility.\u201d).\nThe Commission made the following findings of fact regarding causation:\n25. Dr. Thornton was of the opinion that [Pjlaintiffs exposure to mold in the [workplace] was the cause of the inflammation in his lungs.\n29. In Dr. Thornton\u2019s opinion, the debilitating symptoms that [P]laintiff exhibits, including problems with breathing, coughing, inflamed airways, and the acceleration or exacerbation of those symptoms, as well as his cognitive defects are all caused by long term exposure to stachybotrys and other molds and their toxins.\n33. The basis for Dr. Thornton\u2019s causation opinion is not just the temporal relationship, which he described a[s] \u201cquite compelling,\u201d but the level of mold on the occupational health testing, the types of mold present, the intensity of the exposure, the duration of the exposure, and the fact that anti-bodies were identified in [Plaintiff's blood stream.\n37. Dr. Kussin was of the opinion that [P]laintiff\u2019s persistent asthma was causally related to his exposure to mold at the [workplace]. . . .\n56. Plaintiffs [workplace] exposure to mold caused [P]laintiff\u2019s pulmonary condition and was a substantial contributing factor in the development of [P]laintiff\u2019s pulmonary airway disease and resulting conditions.\n(Emphasis added.)\nDr. Thornton opined that Plaintiffs prolonged exposure to the combination of stachybotrys, aspergillus, and penicillium \u201cperpetuated and established in [Plaintiff] an immunologic state that perpetuated a very serious illness\u201d and that Plaintiffs symptoms and problems \u201cwere significantly aggravated if not caused completely\u201d by his exposure to mold in the workplace. Dr. Thornton explained that while \u201cthere is not a specific medical test that would clearly demonstrate definitively\u201d that Plaintiffs exposure to mold caused his illness, based on \u201cthe constellation of . . . [Plaintiffs] symptoms, the time course of their onset, [and Plaintiffs] response to therapy],]\u201d he felt strongly that Plaintiffs illness was caused by his exposure to mold in his workplace. Thus, contrary to Defendants\u2019 contention, Dr. Thornton\u2019s opinion is not based solely \u201con the temporal relationship between discovery of mold [in] [Plaintiff\u2019s office and the onset of [P]laintiff\u2019s symptoms.\u201d\nDr. Kussin testified that he did not know of another irritant or exposure, other than the mold, that would have been the primary cause of Plaintiff\u2019s symptoms and opined that Plaintiff\u2019s persistent asthma and related symptoms were caused by his exposure to mold at work.\nAlthough Defendants argue that \u201c[P]laintiff\u2019s treating physicians assumed drastic mold exposure based on air sampling data that did not reflect the air [P]laintiff breathed daily,\u201d Defendants cite no evidence from the record and make no argument in support of this assertion. Moreover, our review of the evidence reveals no support for this statement.\nWe conclude that the testimony of Dr. Thornton and Dr. Kussin is competent evidence to support the Commission\u2019s findings of fact that Plaintiff\u2019s exposure to mold at his place of work caused his illness. This Court is thus bound by these findings. Gilberto, 152 N.C. App. at 118, 566 S.E.2d at 792.\n3. Personal Sensitivity\nDefendants further argue that Plaintiff\u2019s illness is not compensable as it is the result of a preexisting personal sensitivity. We disagree.\nThis Court has held that an individual\u2019s personal sensitivity to chemicals does not result in an occupational disease compensable under our workers\u2019 compensation scheme. See, e.g., Hayes v. Tractor Supply Co., 170 N.C. App. 405, 612 S.E.2d 399 (2005), disc. review denied, 359 N.C. 851, 619 S.E.2d 505 (2005); Nix v. Collins & Aikman, Co., 151 N.C. App. 438, 566 S.E.2d 176 (2002). In Hayes, plaintiff had an allergic reaction to the chemical naphthalene, which was stocked in plaintiff\u2019s employer\u2019s store. Plaintiff had a long history of allergies and reactions to substances, including a diagnosis of \u201cchemical sensitivity,\u201d prior to her exposure to naphthalene at work. Hayes, 170 N.C. App. at 406, 612 S.E.2d at 401. Because plaintiff had a \u201cheightened peculiar susceptibility to chemicals . . . [which] predated the exposure to naphthalene[,]\u201d id. at 409, 612 S.E.2d at 402, this Court affirmed the Commission\u2019s conclusion that plaintiff had failed to prove \u201cthat her employment with defendant-employer placed her at an increased risk of contracting the present condition[.]\u201d Id. at 408, 612 S.E.2d at 402 (quotation marks omitted).\nSimilarly, in Nix, plaintiff developed hyperactive airway disease. Although plaintiff contended that his condition was caused by his exposure to chemicals in the workplace, a testifying physician opined that \u201cplaintiff was only at an increased risk due to his \u2018idiopathic\u2019 sensitivity to chemicals at the workplace[,]\u201d Nix, 151 N.C. App. at 444, 566 S.E.2d at 179, and that \u201conly plaintiff\u2019s sensitivities to the chemicals made him more susceptible to the disease.\u201d Id. at 444, 566 S.E.2d at 180. Thus, this Court affirmed the Commission\u2019s conclusion that \u201c[plaintiff\u2019s condition was caused by his personal, unusual sensitivity to small amounts of certain chemicals.\u201d Id. at 441, 566 S.E.2d at 178 (quotation marks omitted).\nIn this case, the Commission made the following findings of fact relevant to whether Plaintiff\u2019s illness was a result of a preexisting personal sensitivity:\n30. Dr. Thornton was of the opinion that [Plaintiff\u2019s exposure to mold was occupational in nature and not a personal sensitivity that produces \u201ca noxious reaction.\u201d . . .\n63. Plaintiff\u2019s disability was not caused by a \u201cpersonal sensitivity\u201d to mold.\nDr. Thornton testified that \u201c[i]n situations of allergic mediated asthma, or occupational asthma mediated by a toxin, we often see a worsening of asthma due to the inflammatory response from an intense exposure.\u201d Dr. Thornton explained that the reaction can last for weeks, months, or longer, and symptoms can linger for years after the exposure to the toxin has terminated. He further explained that \u201c[t]his is a common scenario in a number of different asthmatic exposures in the workplace, and could certainly be seen with any intense exposure to a mold. . . . And so, this is different than a sensitivity, for example, to something that produces a noxious reaction.\u201d Dr. Thornton further testified that \u201cafter an intense exposure, an allergic response is established. After the establishment of the allergic response, then that allergic response can continue and be perpetuated for years.\u201d Dr. Thornton stated that he had no way to know if Plaintiff was sensitive to the molds that were present in his office before he was exposed to them there. When asked if the exposure that Plaintiff experienced at his place of employment could have created an allergic response to the molds, Dr. Thornton replied, \u201cYes.\u201d\nDr. Kussin testified that Plaintiffs reaction to the mold was \u201cnot an allergy in the way you\u2019re allergic to dust or cats or . . . ragweed. The changes that occur in the type of asthma that [Plaintiff] has can only be described generically as inflammatory, and the word \u2018allergic\u2019 doesn\u2019t necessarily need to be invoked.\u201d\nThus, unlike in Hayes and Nix, and contrary to Defendants\u2019 contention, there is no evidence in this case that Plaintiff had a heightened peculiar susceptibility to mold which predated his exposure to the mold at his workplace. To the contrary, the evidence establishes that Plaintiff\u2019s sensitivity to mold was caused by his exposure to mold in the workplace. Accordingly, there is competent evidence to support the Commission\u2019s findings of fact on this issue. Defendants\u2019 argument is overruled.\nWe reiterate that, although the record contains evidence which would support contrary findings, the Commission\u2019s findings regarding the genesis and nature of Plaintiff\u2019s occupational disease are sufficiently supported by competent evidence in the record and are thus conclusive on appeal. Robbins, 151 N.C. App. at 523, 566 S.E.2d at 143. We hold that these findings support the Commission\u2019s conclusion of law that, as a result of Plaintiff\u2019s employment with Defendant Steve Jones Auto Group, Plaintiff developed a compensable occupational disease withing the meaning of N.C. Gen. Stat. \u00a7 97-53(13).\nB. Occupational Mold Exposure\nDefendants next assert that \u201c[t]here is no competent evidence that distinguishes Plaintiffs occupational mold exposure from mold that is ubiquitous in the environment.\u201d Specifically, Defendants argue that the Commission\u2019s findings of fact 10 through 17 are not supported by competent evidence.\nThe challenged findings of fact are as follows:\n10. Mr. Shrimanker observed black mold in [P]laintiff\u2019s office prior to the tests. This mold was located on the inside of the sheetrock, insulation, and electrical receptacles as well as in the carpet in [P]laintiff\u2019s office. According to Shrimanker, the sheetrock behind the wall had also been \u201ccovered with mold\u201d due to defects in construction, and the saturation had been going for a \u201clong time.\u201d\n11. Mr. Shrimanker was of the opinion that under normal conditions to which the general public is exposed, stachybotrys should not be present at any level. Although penicillium and aspergillus are commonly found in the outside air, the levels of aspergillus and penicillium should be greater outdoors than indoors. The mold testing performed on August 27, 2003 found no stachybotrys in the outdoor sample and high levels of stachybotrys in the tape and air samples in [P]laintiff\u2019s office. According to Mr. Shrimanker, both the air and bulk samples \u201cindicated that stachybotrys spores were present in high concentrations.\u201d . . . There were small levels of penicillium in the outdoor sample, but the levels of penicillium in the air and tape samples in [Plaintiff\u2019s] office were significantly greater than the outdoor sample.\n12. Exposure to stachybotrys, which contains mycotoxins, can cause different symptoms in different individuals. Common symptoms include coughing, headache, dizziness, malaise, burning in the nose and mouth, and cold and flu-like symptoms. Plaintiff was experiencing most, if not all, of these symptoms between late 2000 and August 27, 2003 when the samples were originally tested.\n13. Stachybotrys is known as \u201cblack mold,\u201d and, according to Mr. Shrimanker, is the most dangerous of the molds because of its ability to produce mycotoxins. Stachybotrys may produce a trichothecene mycotoxin-sutratoxin H \u2014 \u201cwhich is poisonous by inhalation.\u201d Penicillium can cause extrinsic asthma and some species can also produce mycotoxins. Aspergillus can also produce mycotoxins.\n14. As the mold dries out, it can be released by pressure, or walking on the carpet and by air movement through the use of air conditioning or heating unit. Defendants\u2019 expert, Dr. Dalton, agreed with this assessment. According to Mr. Shrimanker, mold can also travel from wall cavities into air through openings in the wall, including electrical receptacles.\n15. The stachybotrys, penicillium, and aspergillus species found in [P]laintiff\u2019s office in the late 2000 through August 27, 2003 were released into the air in the office.\n16. Between late 2000 and August 2003, as a result of [Pjlaintiff\u2019s presence in his office, he was exposed to and inhaled mold spores, including stachybotrys, penicillium and aspergillus.\n17. Plaintiff\u2019s home was tested for mold and no unusual or elevated levels of mold were found.\nMr. Shrimanker testified that upon entering Plaintiff\u2019s office, he observed black mold on the inside of the sheetrock and on the back sides of Plaintiff\u2019s chairs. Mr. Shrimanker also took photographs which showed mold on the sheetrock, insulation, and electrical receptacles in Plaintiff\u2019s office. Mr. Shrimanker\u2019s report states that \u201cno sealer or wall barrier(s) were installed at ground level near the wall(s) adjacent to the downspout\u201d and, thus, \u201c[i]t would be reasonable to assume that water enters the building and has kept the carpet and the interior space between the walls wet during heavy rain episodes.\u201d Mr. Shrimanker testified that \u201cwhen rain stops and over a period of time the carpet dries out, and people walk and so forth, it will kick the spores into the air.\u201d\nMr. Shrimanker took tape samples of the mold from the back of the sheetrock, the back of the wallpaper, and the exterior sheetrock wall. Air samples were also taken from inside Plaintiff\u2019s office and outside the building. The analysis of the samples indicates that stachybotrys spores \u201cwere present in high concentrations\u201d inside Plaintiff\u2019s office. Penicillium and aspergillus were present inside as well. A report from testing done on Plaintiffs home revealed the presence of some mold spores, but not at unusual or elevated levels.\nDefendants contend that there is no competent evidence that the mold escaped the wall cavity or that Plaintiff breathed the mold. However, Mr. Shrimanker testified that mold spores are blown through the air conditioning and heating vents and escape through the space surrounding electrical outlets, network cables, and drop ceilings. Photographs show mold on the electrical receptacles in Plaintiff\u2019s office. Furthermore Mr. Shrimanker testified that the carpet was contributing to the mold found in Plaintiff\u2019s office and recommended that the carpet be replaced during remediation. Although Mr. Shrimanker did not test the carpet to determine if mold was present under the carpet, he testified that, based on his observations and experience, there should have been. Mr. Shrimanker also testified that the day the carpet was pulled up to be replaced, he observed that the carpet was \u201c \u2018full of mold.\u2019 \u201d After the carpet had been removed, tape samples showed stachybotrys still on the floor. Furthermore, Mr. Shrimanker testified that when dry, moldy carpet is walked on or disturbed in some other manner, the mold spores can get released into the air.\nDefendants argue that Mr. Shrimanker\u2019s testimony was\u2018\u201c[in] competent evidence of an occupational exposure to mold\u201d as he did not test the carpet to determine if it contained mold or what kinds of mold were present. However, Mr. Shrimanker testified that he observed mold on the carpet and acknowledged that identifying mold is \u201cwhat [he] do[es] for a living[.]\u201d Furthermore, the tape and air samples taken from Plaintiff\u2019s office identified that stachybotrys, penicillium, and aspergillus were present in Plaintiff\u2019s office.\nMr. Shrimanker testified that the general public is not exposed to stachybotrys under normal circumstances. He explained that stachybotrys is not found outdoors and is only found indoors when there has been water intrusion and there is an organic material such as paper or cellulose present upon which the mold can thrive. Mr. Shrimanker further testified that stachybotrys, or black mold, is the most dangerous kind of mold and that the presence of aspergillus and p\u00e9nicillium in addition to stachybotrys is like adding \u201cinsult to an injury\u201d in that aspergillus and penicillium make the illness from stachybotrys exposure worse. Mr. Shrimanker\u2019s report indicates that stachybotrys may produce mycotoxins such as sutratoxin \u201cwhich is poisonous by inhalation.\u201d Penicillium can cause extrinsic asthma and some species can produce mycotoxins. Aspergillus can also produce mycotoxins.\nBased on his experience, it was Mr. Shrimanker\u2019s opinion that Plaintiffs symptoms, including the. reaction in his lungs, cough, fever, and burning eyes, were consistent with long-term exposure to stachybotrys, aspergillus, and penicillium.\nNotwithstanding this testimony, Defendants further argue that the air samples taken on 27 August 2003 did not reflect the air quality Plaintiff breathed. While Mr. Shrimanker testified that on any given day, depending on the conditions, an air sample can reveal differing levels of mold in the same room, he further explained that any level of stachybotrys, whether it be on a tape sample or in the air, in an indoor facility is cause for concern as an individual should not be exposed to stachybotrys to any degree. Furthermore, \u201c[o]ur Supreme Court rejected the requirement that an employee quantify the degree of exposure to the harmful agent during his employment.\u201d Matthews v. City of Raleigh, 160 N.C. App. 597, 606, 586 S.E.2d 829, 837 (2003) (quotation marks and citations omitted).\nWe conclude that the foregoing testimony is competent to support the challenged findings of fact regarding Plaintiff\u2019s occupational mold exposure. Thus, the assignments of error upon which Defendants\u2019 argument is based are overruled.\nG. Lien on Third-Party Settlement Proceeds\nDefendants finally argue that, pursuant to N.C. Gen. Stat. \u00a7 97-10.2, they are entitled to a lien against third-party settlement proceeds received by Plaintiff. Plaintiff responds that Defendants failed to offer evidence at the hearing on the issue of a lien, and, thus, have waived any right to pursue a lien. However, the parties stipulated to the following:\nDefendants\u2019 issues to be addressed by the Commission are:\ne. If [P]laintiff\u2019s claim is compensable, have third-party settlement proceeds been distributed, to whom were they distributed, and, pursuant to N.C. Gen. Stat. \u00a7 97-10.2(h), may any resulting lien be enforced against persons receiving such funds[.]\nFurthermore, the record contains a \u201cSettlement Agreement and Release of Claims\u201d wherein\nSteve Jones Auto Group, Inc. d/b/a Steve Jones Honda, Steven R. Jones, and Sherrie L. Jones (collectively referred to as \u201cPlaintiffs\u201d), Myrick Construction, Inc. (\u201cMyrick\u201d), Commercial Acoustical and Drywall, Inc. (\u201cCAD\u201d), and Rockingham Paint and Glass Center, Inc. (\u201cRPGC\u201d)\nentered into a settlement agreement for claims arising out of \u201cdefects in the construction and renovation of the Steve Jones Honda dealership\u201d providing for the payment of $1,000,000 to Plaintiffs. Pursuant to that agreement,\nSteven R. Jones agrees that any government or private liens, claims or demands for workers\u2019 compensation liens and/or medical expenses and services, and/or any unpaid bills owed for medical related services rendered to him prior to the date of this Agreement, will be paid from the sum he is to receive pursuant to this settlement agreement prior to distribution to him.\nWe conclude that Defendants have not waived their right to pursue a lien against such third-party settlement proceeds.\nAn injured employee has the exclusive right to enforce the liability of a third party within the first twelve months following an injury. N.C. Gen. Stat. \u00a7 97-10.2(b) (2007). Pursuant to subsection (h) of section 97-10.2, \u201c [i]n any proceeding against or settlement with the third party, every party to the claim for compensation shall have a lien to the extent of his interest . . . upon any payment made by the third party by reason of such injury or death.\u201d N.C. Gen. Stat. \u00a7 97-10.2(h) (2007). This lien \u201cmay be enforced against any person receiving such funds[,]\u201d id., is a lien against \u201call amounts paid or to be paid\u201d to the employee, Hieb v. Lowery, 344 N.C. 403, 408, 474 S.E.2d 323, 326 (1996) (emphasis removed), and is mandatory in nature. Radzisz v. Harley Davidson of Metrolina, Inc., 346 N.C. 84, 90, 484 S.E.2d 566, 569 (1997).\nHere, the Commission failed to determine whether third-party settlement proceeds had been distributed; if so, to whom they were distributed; and whether Defendants were entitled to a lien on those funds under N.C. Gen. Stat. \u00a7 97-10.2. Accordingly, we remand this case to the Commission to address and resolve the lien issue raised by Defendants.\nAFFIRMED in part and REMANDED in part with instructions.\nChief Judge MARTIN and Judge HUNTER, JR. concur.\n. The Commission errantly stated that \u201c[t]he testing found no aspergillus in the tape and air samples in [Plaintiffs] office.\u201d However, the uncontradicted evidence established that the testing revealed no aspergillus in the outdoor samples, but elevated levels of aspergillus in the samples taken from inside Plaintiffs office.\n. Although Defendants assert that the Commission\u2019s finding that \u201ctesting showed no mold in [Plaintiff\u2019s house\u201d is not supported by competent evidence, the Commission did not make such a finding. The Commission found that \u201cno unusual or elevated levels of mold\u201d were present in Plaintiff\u2019s house. (Emphasis added.)",
        "type": "majority",
        "author": "STEPHENS, Judge."
      }
    ],
    "attorneys": [
      "Van Camp, Meacham & Newman, PLLC, by Thomas M. Van Camp, for Plaintiff",
      "Brooks, Stephens & Pope, PA., by Matthew P. Blake and James A. Barnes TV, for Defendants."
    ],
    "corrections": "",
    "head_matter": "STEVE R. JONES, Employee, Plaintiff v. STEVE JONES AUTO GROUP, Employer, and UNIVERSAL UNDERWRITERS GROUP, Carrier, Defendants\nNo. COA08.1593\n(Filed 3 November 2009)\n1. Workers\u2019 Compensation\u2014 workplace mold \u2014 requirement to work in contaminated location\nThe Industrial Commission did not err in a workers\u2019 compensation case by concluding that plaintiff contracted an occupational disease from mold in his office. Although the nature of plaintiff\u2019s work as an auto dealership manager did not increase his risk for contracting pulmonary airway disease, the fact that his employment required him to work in a building contaminated with mold did place him at an increased risk.\n2. Workers\u2019 Compensation\u2014 workplace mold \u2014 causal connection to illness\nThere was competent evidence in a workers\u2019 compensation case to support the Industrial Commission\u2019s findings that plaintiff\u2019s workplace exposure to mold caused his illness. There was no support for defendant\u2019s statement that the air sampling relied on by plaintiff\u2019s treating physicians did not reflect the air plaintiff breathed.\n3. Workers\u2019 Compensation\u2014 workplace mold \u2014 no evidence of peculiar sensitivity\nAlthough defendants arg\u00fced in a mold-related workers\u2019 compensation case that plaintiff\u2019s illness was the result of a preexisting personal sensitivity and was not compensable, there was no evidence that plaintiff had a heightened peculiar sensitivity to mold before his exposure in the workplace.\n4. Workers\u2019 Compensation\u2014 workplace mold \u2014 findings\u2014 ubiquitous mold\nTestimony in a workers\u2019 compensation proceeding was competent to support challenged findings regarding plaintiff\u2019s occupational mold exposure despite defendant\u2019s contention that there was no competent evidence to distinguish plaintiff\u2019s occupational exposure from ubiquitous mold.\n5. Workers\u2019 Compensation\u2014 third-party settlement \u2014 lien not waived \u2014 remand\nDefendants in a workers\u2019 compensation case did not waive their right to pursue a lien against third-party settlement proceeds where such a lien was the subject of a stipulation and a settlement agreement. The Industrial Commission failed to determine whether third-party settlement proceeds had been distributed, or to whom, and whether defendants were entitled to a lien. The matter was remanded.\nAppeal by Defendants from Opinion and Award entered 12 September 2008 by the North Carolina Industrial Commission. Heard in the Court of Appeals 18 May 2009.\nVan Camp, Meacham & Newman, PLLC, by Thomas M. Van Camp, for Plaintiff\nBrooks, Stephens & Pope, PA., by Matthew P. Blake and James A. Barnes TV, for Defendants."
  },
  "file_name": "0458-01",
  "first_page_order": 484,
  "last_page_order": 502
}
