{ "id": 4132730, "name": "MITZI McCRARY, Plaintiff v. KING BIO, INC., Employer, ISURITY INSURANCE SERVICES/NCME FUND, Carrier, Defendants", "name_abbreviation": "McCrary v. King Bio, Inc.", "decision_date": "2013-02-05", "docket_number": "No. COA12-405", "first_page": "378", "last_page": "389", "citations": [ { "type": "official", "cite": "225 N.C. App. 378" } ], "court": { "name_abbreviation": "N.C. Ct. App.", "id": 14983, "name": "North Carolina Court of Appeals" }, "jurisdiction": { "id": 5, "name_long": "North Carolina", "name": "N.C." }, "cites_to": [ { "cite": "619 S.E.2d 495", "category": "reporters:state_regional", "reporter": "S.E.2d", "case_ids": [ 12633954, 12633955 ], "year": 2005, "opinion_index": 0, "case_paths": [ "/se2d/619/0495-01", "/se2d/619/0495-02" ] }, { "cite": "619 S.E.2d 491", "category": "reporters:state_regional", "reporter": "S.E.2d", "case_ids": [ 12633952 ], "year": 2005, "pin_cites": [ { "page": "492", "parenthetical": "quoting Gallimore v. Marilyn's Shoes, 292 N.C. 399, 402, 233 S.E.2d 529, 531 (1977)" } ], "opinion_index": 0, "case_paths": [ "/se2d/619/0491-01" ] }, { "cite": "673 S.E.2d 149", "category": "reporters:state_regional", "reporter": "S.E.2d", "case_ids": [ 12642853 ], "year": 2009, "pin_cites": [ { "page": "156", "parenthetical": "quoting Johnson v. Herbie's Place, 157 N.C. App. 168, 180, 579 S.E.2d 110, 118, disc. review denied, 357 N.C. 460, 585 S.E.2d 760 (2003)" } ], "opinion_index": 0, "case_paths": [ "/se2d/673/0149-01" ] }, { "cite": "63 S.E. 2d 173", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1951, "pin_cites": [ { "page": "176" } ], "opinion_index": 0 }, { "cite": "233 N.C. 88", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 8599630 ], "year": 1951, "pin_cites": [ { "page": "92" } ], "opinion_index": 0, "case_paths": [ "/nc/233/0088-01" ] }, { "cite": "283 S.E.2d 101", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1981, "pin_cites": [ { "page": "106", "parenthetical": "quoting Vause v. Equipment Co., 233 N.C. 88, 92, 63 S.E. 2d 173, 176 (1951)" } ], "opinion_index": 0 }, { "cite": "304 N.C. 44", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 8565283 ], "year": 1981, "pin_cites": [ { "page": "52", "parenthetical": "quoting Vause v. Equipment Co., 233 N.C. 88, 92, 63 S.E. 2d 173, 176 (1951)" } ], "opinion_index": 0, "case_paths": [ "/nc/304/0044-01" ] }, { "cite": "264 S.E.2d 810", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1980, "pin_cites": [ { "page": "813-14" } ], "opinion_index": 0 }, { "cite": "46 N.C. App. 228", "category": "reporters:state", "reporter": "N.C. App.", "case_ids": [ 8549900 ], "year": 1980, "pin_cites": [ { "page": "233-35" } ], "opinion_index": 0, "case_paths": [ "/nc-app/46/0228-01" ] }, { "cite": "247 Or. 420", "category": "reporters:state", "reporter": "Or.", "case_ids": [ 2096855 ], "weight": 2, "year": 1967, "pin_cites": [ { "page": "426" }, { "page": "756" } ], "opinion_index": 0, "case_paths": [ "/or/247/0420-01" ] }, { "cite": "538 S.E.2d 912", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 2000, "pin_cites": [ { "page": "915-17", "parenthetical": "fibromyalgia" } ], "opinion_index": 0 }, { "cite": "353 N.C. 227", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 135777 ], "year": 2000, "pin_cites": [ { "page": "230-33", "parenthetical": "fibromyalgia" } ], "opinion_index": 0, "case_paths": [ "/nc/353/0227-01" ] }, { "cite": "581 S.E.2d 750", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 2003, "pin_cites": [ { "page": "753-54", "parenthetical": "deep vein thrombosis" } ], "opinion_index": 0 }, { "cite": "357 N.C. 228", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 491657 ], "year": 2003, "pin_cites": [ { "page": "233-34", "parenthetical": "deep vein thrombosis" } ], "opinion_index": 0, "case_paths": [ "/nc/357/0228-01" ] }, { "cite": "139 S.E. 2d 753", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1965, "pin_cites": [ { "page": "760" } ], "opinion_index": 0 }, { "cite": "263 N.C. 317", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 8569848 ], "year": 1965, "pin_cites": [ { "page": "325" } ], "opinion_index": 0, "case_paths": [ "/nc/263/0317-01" ] }, { "cite": "265 S.E.2d 389", "category": "reporters:state_regional", "reporter": "S.E.2d", "weight": 3, "year": 1980, "pin_cites": [ { "page": "391", "parenthetical": "quoting Gillikin v. Burbage, 263 N.C. 317, 325, 139 S.E. 2d 753, 760 (1965)" }, { "page": "391" } ], "opinion_index": 0 }, { "cite": "300 N.C. 164", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 8559969 ], "weight": 3, "year": 1980, "pin_cites": [ { "page": "167", "parenthetical": "quoting Gillikin v. Burbage, 263 N.C. 317, 325, 139 S.E. 2d 753, 760 (1965)" }, { "page": "168" }, { "page": "168-69" } ], "opinion_index": 0, "case_paths": [ "/nc/300/0164-01" ] }, { "cite": "360 N.C. 54", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 3794376 ], "year": 2005, "opinion_index": 0, "case_paths": [ "/nc/360/0054-01" ] }, { "cite": "469 S.E.2d 552", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1996, "opinion_index": 0 }, { "cite": "343 N.C. 302", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 798979 ], "year": 1996, "opinion_index": 0, "case_paths": [ "/nc/343/0302-01" ] }, { "cite": "463 S.E.2d 259", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1995, "pin_cites": [ { "page": "261" } ], "opinion_index": 0 }, { "cite": "120 N.C. App. 538", "category": "reporters:state", "reporter": "N.C. App.", "case_ids": [ 11916614 ], "year": 1995, "pin_cites": [ { "page": "541-42" } ], "opinion_index": 0, "case_paths": [ "/nc-app/120/0538-01" ] }, { "cite": "581 S.E.2d 778", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 2003, "pin_cites": [ { "page": "784" } ], "opinion_index": 0 }, { "cite": "158 N.C. App. 341", "category": "reporters:state", "reporter": "N.C. App.", "case_ids": [ 9187488 ], "year": 2003, "pin_cites": [ { "page": "350" } ], "opinion_index": 0, "case_paths": [ "/nc-app/158/0341-01" ] }, { "cite": "608 S.E.2d 357", "category": "reporters:state_regional", "reporter": "S.E.2d", "pin_cites": [ { "page": "361" } ], "opinion_index": 0 }, { "cite": "168 N.C. App. 469", "category": "reporters:state", "reporter": "N.C. App.", "case_ids": [ 8470306 ], "pin_cites": [ { "page": "475" } ], "opinion_index": 0, "case_paths": [ "/nc-app/168/0469-01" ] }, { "cite": "233 S.E.2d 529", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1977, "pin_cites": [ { "page": "531" } ], "opinion_index": 0 }, { "cite": "292 N.C. 399", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 8569857 ], "year": 1977, "pin_cites": [ { "page": "402" } ], "opinion_index": 0, "case_paths": [ "/nc/292/0399-01" ] }, { "cite": "360 N.C. 41", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 3788691 ], "year": 2005, "pin_cites": [ { "page": "43", "parenthetical": "quoting Gallimore v. Marilyn's Shoes, 292 N.C. 399, 402, 233 S.E.2d 529, 531 (1977)" } ], "opinion_index": 0, "case_paths": [ "/nc/360/0041-01" ] }, { "cite": "597 S.E.2d 695", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 2004, "pin_cites": [ { "page": "701", "parenthetical": "citation omitted" } ], "opinion_index": 0 }, { "cite": "358 N.C. 488", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 2986640 ], "year": 2004, "pin_cites": [ { "page": "496", "parenthetical": "citation omitted" } ], "opinion_index": 0, "case_paths": [ "/nc/358/0488-01" ] }, { "cite": "585 S.E.2d 760", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 2003, "opinion_index": 0 }, { "cite": "357 N.C. 460", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 491744, 491866, 491659, 491910 ], "year": 2003, "opinion_index": 0, "case_paths": [ "/nc/357/0460-04", "/nc/357/0460-01", "/nc/357/0460-02", "/nc/357/0460-03" ] }, { "cite": "579 S.E.2d 110", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 2003, "pin_cites": [ { "page": "118" } ], "opinion_index": 0 }, { "cite": "157 N.C. App. 168", "category": "reporters:state", "reporter": "N.C. App.", "case_ids": [ 9185540 ], "year": 2003, "pin_cites": [ { "page": "180" } ], "opinion_index": 0, "case_paths": [ "/nc-app/157/0168-01" ] }, { "cite": "195 N.C. App. 463", "category": "reporters:state", "reporter": "N.C. App.", "case_ids": [ 4165354 ], "year": 2009, "pin_cites": [ { "page": "470", "parenthetical": "quoting Johnson v. Herbie's Place, 157 N.C. App. 168, 180, 579 S.E.2d 110, 118, disc. review denied, 357 N.C. 460, 585 S.E.2d 760 (2003)" } ], "opinion_index": 0, "case_paths": [ "/nc-app/195/0463-01" ] }, { "cite": "530 S.E.2d 549", "category": "reporters:state_regional", "reporter": "S.E.2d", "weight": 2, "year": 2000, "pin_cites": [ { "page": "553" }, { "parenthetical": "citation omitted" } ], "opinion_index": 0 }, { "cite": "352 N.C. 109", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 684964 ], "year": 2000, "pin_cites": [ { "page": "116" } ], "opinion_index": 0, "case_paths": [ "/nc/352/0109-01" ] } ], "analysis": { "cardinality": 1096, "char_count": 26806, "ocr_confidence": 0.732, "pagerank": { "raw": 4.03580807328026e-08, "percentile": 0.13343866765977475 }, "sha256": "0a2e16de5323778b63998af0143176efc22f06b8a883c3eada2b3fc795c56616", "simhash": "1:2da154aa10b3947c", "word_count": 4240 }, "last_updated": "2023-07-14T19:12:03.865649+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [ "Judges ROBERT N. HUNTER, JR., and McCULLOUGH concur." ], "parties": [ "MITZI McCRARY, Plaintiff v. KING BIO, INC., Employer, ISURITY INSURANCE SERVICES/NCME FUND, Carrier, Defendants" ], "opinions": [ { "text": "ERVIN, Judge.\nDefendants King Bio, Inc., and Isurity Insurance Services appeal from a Commission order awarding workers\u2019 compensation medical benefits to Plaintiff Mitzi McCrary. In challenging the Commission\u2019s order, Defendants argue that the Commission erroneously awarded medical benefits to Plaintiff on the grounds that Plaintiff failed to present competent medical evidence to prove that her wrist injury was caused by a workplace accident that occurred on 14 October 2009, and that this Court should rectify this error by simply reversing the Commission\u2019s decision rather than requiring further proceedings on remand. After careful consideration of Defendants\u2019 challenges to the Commission\u2019s order in light of the record and the applicable law, we conclude that the Commission\u2019s order should be affirmed.\nI. Background\nA. Substantive Facts\nDefendant King Bio operated King Bio, a homeopathic medical supplier, and Carolina Bison, a supplier of bison meat, at a joint facility. Plaintiff, who was bom on 16 September 1955, started working as an inventory and purchasing manager for both entities on 28 August 1998. In the course of its business, Carolina Bison received packages of meat, which were sometimes frozen and which varied in size. One of the duties that Plaintiff performed for Carolina Bison was to assist with the repackaging of meat into smaller packages.\nOn 14 October 2009, Plaintiff was assisting Bemave Acevedo, a warehouse manager, in repackaging a bison meat order that had a total weight of approximately fifteen hundred pounds and had been separated into twenty-five packages, each of which weighed approximately sixty pounds. After Mr. Acevedo unloaded the packages of meat and placed them on a work table, Plaintiff lifted each package from the work table onto a scale, wiped it down, weighed it, and labeled it. In addition to being heavier and bulkier than usual, the packages which made up this order had been frozen, were slippery and had to be handled using more force and grip than was normally the case.\nAs Plaintiff was lifting one of the packages of meat onto the scale, it slipped from her hand. As she tried to catch the falling package, Plaintiff felt a \u201cpop\u201d in her wrist and experienced \u201cvery intense\u201d pain. Mr. Acevedo, who was facing Plaintiff and located approximately four to five feet away from her, saw the package of meat fall out of Plaintiff\u2019s hand, observed Plaintiff try to catch the package, and heard Plaintiff\u2019s wrist \u201cpop.\u201d Plaintiff told Mr. Acevedo that \u201cshe [had] done something to her wrist.\u201d\nIn spite of her injury, Plaintiff worked the remainder of the day with assistance from Mr. Acevedo. On the following day, Plaintiff continued to experience pain in her right wrist and reported her injury to her supervisor. At that point, Plaintiff was given a brace for her wrist.\nOn 23 October 2009, Plaintiff sought treatment from Sisters of Mercy Urgent Care. On 27 October 2009, Sisters of Mercy Urgent Care provided Defendant with an \u201cEmployee Medical Care Report\u201d which noted that Plaintiff\u2019s 14 October 2009 right wrist injury was work related. On 29 October 2009, Plaintiff sought treatment from Dr. Ronald Neimkin, a hand surgeon with Carolina Hand Surgery Associates. At that time, Plaintiff informed Dr. Neimkin that she had undergone bilateral carpal tunnel releases twenty years earlier. After referring Plaintiff to Dr. Terry McGhee for an EMG, nerve conduction studies, and an MR arthrogram in order to determine whether there were any soft tissue tears in her right wrist, Dr. Neimkin released Plaintiff to work subject to certain restrictions. Plaintiff did not miss any work as a result of her wrist injury and has not sought disability compensation.\nB. Procedural History\nOn 17 December 2009, Plaintiff filed an Industrial Commission Form 18 asserting a claim for workers\u2019 compensation medical benefits on the grounds that she had injured her right hand while \u201crepackaging unusually heavy, frozen meat\u201d on 14 October 2009. On 26 October 2009, Defendants filed a Form 19 in which they reported Plaintiff\u2019s injury to the Commission, indicated that Plaintiff had been working with frozen meat when her \u201cwrist popped,\u201d and noted that the incident had been \u201cwitnessed by [a] fellow employee.\u201d On 4 December 2009, Defendants filed a Form 61 in which they denied Plaintiff\u2019s claim on the grounds that \u201cno injury by accident occurred within the course and scope of [Plaintiff\u2019s] employment\u201d but agreed to pay for \u201cauthorized medical treatment through 12/04/2009.\u201d On 3 June 2010, Plaintiff filed a Form 33 in which she requested that her claim for medical benefits be set for hearing. Defendants filed a Form 33R response to Plaintiff\u2019s request for a hearing in which they alleged, in pertinent part, that:\n. . . [P]laintiff did not suffer an injury to her hand and wrist as a result of an accident in that she was performing her normal work duties in the normal manner at the time that she sustained an injury to her wrist. Defendants further contend that [P]laintiff has not been diagnosed with any condition other than an alleged upper-extremity injury. . . .\nOn 17 November 2010, Deputy Commissioner Victoria M. Homick conducted a hearing concerning the merits of Plaintiff\u2019s claim for workers\u2019 compensation medical benefits. On 16 May 2011, Deputy Commissioner Homick entered an order denying Plaintiff\u2019s claim, finding, in pertinent part, that \u201cthe incident on October 14, 2009 occurred while [P]laintiff was performing her work duties in the normal manner without any unusual circumstance which would constitute an interruption of her job routine\u201d and that \u201cthere is insufficient evidence to show that the condition in [P]laintiff\u2019s right hand was a result of any work injury that she may have sustained on October 14, 2009.\u201d On 23 May 2011, Plaintiff noted an appeal to the Commission from Deputy Commissioner Homick\u2019s order.\nThe Commission heard Plaintiff\u2019s claim on 19 October 2011. On 23 December 2011, the Commission, by means of an order entered by Commissioner Bernadine S. Ballance with the concurrence of Commissioner Danny McDonald, reversed Deputy Commissioner Homick\u2019s decision and awarded Plaintiff workers\u2019 compensation medical benefits. Commissioner Tammy Nance dissented from the order based upon her inability to conclude that Plaintiff had suffered an injury by accident. Defendants noted an appeal to this Court from the Commission\u2019s decision.\nII. Legal Analysis\nA. Standard of Review\nAppellate review of a Commission order is \u201climited to reviewing whether any competent evidence supports the Commission\u2019s findings of fact and whether the findings of fact support the Commission\u2019s conclusions of law,\u2019\u2019Deese v. Champion Int\u2019l Corp., 352 N.C. 109, 116, 530 S.E.2d 549, 553 (2000), with the Commission having sole responsibility for evaluating the weight and credibility to be given to the record evidence. Id. (citation omitted). \u201c[Findings of fact which are left unchallenged by the parties on appeal are \u2018presumed to be supported by competent evidence\u2019 and are, thus \u2018conclusively established on appeal.\u2019 \u201d Chaisson v. Simpson, 195 N.C. App. 463, 470, 673 S.E.2d 149, 156 (2009) (quoting Johnson v. Herbie\u2019s Place, 157 N.C. App. 168, 180, 579 S.E.2d 110, 118, disc. review denied, 357 N.C. 460, 585 S.E.2d 760 (2003)). However, the \u201cCommission\u2019s conclusions of law are reviewed de novo.\u201d McRae v. Toastmaster, Inc., 358 N.C. 488, 496, 597 S.E.2d 695, 701 (2004) (citation omitted).\n\u201cTo establish \u2018compensability\u2019 under the North Carolina Workers\u2019 Compensation Act (the Act), a \u2018claimant must prove three elements: (1) [t]hat the injury was caused by an accident; (2) that the injury arose out of the employment; and (3) that the injury was sustained in the course of employment.\u2019 \u201d Clark v. Wal-Mart, 360 N.C. 41, 43, 619 S.E.2d 491, 492 (2005) (quoting Gallimore v. Marilyn\u2019s Shoes, 292 N.C. 399, 402, 233 S.E.2d 529, 531 (1977)). The \u201cclaimant in a workers\u2019 compensation case bears the burden of initially proving \u2018each and every element of compensability[.]\u2019... by a \u2018greater weight\u2019 of the evidence or a \u2018preponderance\u2019 of the evidence.\u201d Adams v. Metals USA, 168 N.C. App. 469, 475, 608 S.E.2d 357, 361 (quoting Whitfield v. Laboratory Corp. of Am., 158 N.C. App. 341, 350, 581 S.E.2d 778, 784 (2003), and Phillips v. U.S. Air, Inc., 120 N.C. App. 538, 541-42, 463 S.E.2d 259, 261 (1995), aff\u2019d, 343 N.C. 302, 469 S.E.2d 552 (1996)), aff\u2019d, 360 N.C. 54, 619 S.E.2d 495 (2005). In reviewing the Commission\u2019s determinations, the Supreme Court has noted that:\n[t]here will be \u201cmany instances in which the facts in evidence are such that any layman of average intelligence and experience would know what caused the injuries complained of.\u201d On the other hand, where 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.\nClick v. Freight Carriers, 300 N.C. 164, 167, 265 S.E.2d 389, 391 (1980) (quoting Gillikin v. Burbage, 263 N.C. 317, 325, 139 S.E. 2d 753, 760 (1965)). We will now review Defendants\u2019 challenge to the Commission\u2019s order utilizing the applicable standard of review.\nB. Causation\nIn their brief, Defendants argue that there is \u201cno competent medical evidence in this case to satisfy Plaintiff\u2019s burden of proof that she sustained an injury to her wrist as a result of the incident that . . . occurred on October 14, 2009.\u201d We do not find Defendants\u2019 argument persuasive.\nAs a preliminary matter, we note that Defendants have not argued that the record lacks sufficient evidence to support the Commission\u2019s determinations that (1) Plaintiff was involved in a workplace accident that occurred in the course and scope of her employment on 14 October 2009; (2) Plaintiff experienced intense pain both immediately after the accident and later; (3) Plaintiff subsequently experienced intermittent numbness to her hand and fingers; and (4) further testing is needed in order to resolve issues such as the specific mechanism that led to Plaintiffs injury and the extent, if any, to which the 14 October 2009 accident may have implicated the carpel tunnel syndrome for which she had received treatment twenty years prior to the accident. Instead, Defendants\u2019 challenge to the Commission\u2019s decision is focused on the lawfulness of the Commission\u2019s determination that the pain that Plaintiff has experienced and continues to experience stemmed from the 14 October 2009 accident.\nIn its order, the Commission found as fact that:\n4. On October 14, 2009, Plaintiff was assisting warehouse manager, Bemave Acevedo, in repackaging a bison meat order\n5. Plaintiff testified that while lifting one of the packages of meat onto the scale, the package began to slip from her hand and as she tried to catch it, she immediately felt a \u201cpop\u201d in her wrist accompanied by \u201cvery intense\u201d pain. Plaintiff told Mr. Acevedo that \u201cshe [had] done something to her wrist.\u201d Mr. Acevedo witnessed the incident. He testified that he was working in the same area as Plaintiff and was about four (4) to five (5) feet away with his head facing her. He observed the package of meat falling out of Plaintiff\u2019s hand, observed Plaintiff catching the package and heard Plaintiff\u2019s arm \u201cpop.\u201d The Full Commission finds the testimony of Plaintiff and Mr. Acevedo regarding how Plaintiff\u2019s injury occurred to be credible.\n7. Susie King, Vice President of King Bio, testified that... she had no reason to question the veracity of the information provided to her by Mr. Acevedo . . . [and that] Mr. Acevedo was the best person to know what was received, loaded and unloaded on October 14, 2009[.] . . . The Full Commission gives greater weight to Mr. Acevedo\u2019s testimony on the weight of the meat packages on October 14, 2009 over any contrary evidence.\n9. After her injury, Plaintiff worked the remainder of the day with assistance from Mr. Acevedo. Due to continuing pain in her right wrist, Plaintiff reported her injury to her supervisor on October 15, 2009 and was given a brace for her wrist.\n10. Plaintiff sought treatment from Sisters of Mercy Urgent Care on October 23, 2009. According to the medical notes from that visit, she reported a right wrist injury after pulling/packing meat on October 14, 2009. . . .\n11. On October 27, 2009, Sisters of Mercy Urgent Care provided Defendant-Employer with an \u201cEmployee Medical Care Report.\u201d The report noted that Plaintiffs right wrist injury on October 14, 2009 was work related. . . .\n12. On October 29, 2009, Plaintiff sought treatment from Dr. Ronald Neimkin, a hand surgeon with Carolina Hand Surgery Associates. According to Dr. Neimkin\u2019s notes, [after the incident,] ... Plaintiff began experiencing right wrist pain with swelling, numbness and tingling of the right hand with pain being a seven (7) out of ten (10). Plaintiff informed Dr. Neimkin that she had undergone bilateral carpal tunnel releases twenty (20) years prior. Dr. Neimkin diagnosed her with possible carpal tunnel syndrome and possible cervical radiculopathy. He was also concerned that Plaintiff might have a possible ligament tear or triangular fibrocartilage tear of her right wrist. He referred Plaintiff to Dr. Terry McGhee for an EMG and nerve conduction studies and an MR arthrogram to help delineate whether there were any soft tissue tears in her right wrist. . . .\n15. After considering all of the evidence presented, the Full Commission gives less weight to Plaintiffs recorded statement and to the descriptions of how the injury occurred found in medical records, than to Plaintiffs testimony at [the] hearing before the Deputy Commissioner which is corroborated by the eye witness testimony of Mr. Acevedo.\n17. On November 13, 2009, Plaintiff presented to Dr. Glen Gaston, an orthopedic surgeon. His medical notes indicated that Plaintiff began to experience ulnar sided right wrist pain radiating into her elbow and with intermittent numbness to her hand and fingers after handling frozen meat packages at work on October 14, 2009. ... He diagnosed Plaintiff as having ulnar nerve carpal impaction with some diffuse pain and numbness with a history of bilateral carpal tunnel release. Dr. Gaston recommended an ulnocarpal joint injection and . . . administered an injection of Celestone and Lidocaine in the ulnocarpal joint[.]. . .\n18. On February 16, 2010, Plaintiff returned to Dr. Ronald Neimkin, with continued complaints of pain in her right wrist on the ulnar side, radiating to her thumb with constant numbness and tingling in all of her digits. ... Dr. Neimkin again recommended EMG studies and an MR Arthrogram.\n19. On the issue of causation, in a March 10, 2010 letter, Dr. Gaston opined that, \u201cwhile her work did not cause her ulnocarpal impaction; it very likely did cause the acute pain associated with it.\u201d Dr. Gaston further opined that[,] based on Plaintiffs ongoing right wrist pain, he would recommend an MRI to test for a possible concomitant TFCC tear.\n23. The Full Commission finds as fact that Plaintiff has proven that her injury occurred as the result of an accident. When the slippery, frozen package of meat unexpectedly slipped out of Plaintiffs hand on October 14, 2009, and she sustained an injury to her wrist as she tried to catch it, this slipping incident constituted an unlooked for and untoward event, which was an interruption of Plaintiffs normal work routine and was, thus, an accident under the Workers\u2019 Compensation Act. Therefore, Plaintiff sustained a compensable iryury by accident arising out of and in the course of her employment on October 14, 2009.\n24. Based upon a preponderance of the evidence, the Full Commission finds that Plaintiff\u2019s right wrist pain on the ulnar side, radiating to her thumb, with numbness and tingling in all of her digits, is causally related to her injury by accident on October 14, 2009. No doctors were deposed; however, the medical records from Sisters of Mercy Urgent Care indicated that the right wrist injury Plaintiff sustained on October 14, 2009 was work related. Dr. Gaston also noted that Plaintiffs acute pain in her right wrist is \u201cvery likely\u201d work related. Additionally, Plaintiff testified, and the Full Commission finds as fact, that as a result of the accident, she immediately felt immense pain in her right wrist and has had right wrist pain, numbness and tingling since that time. Plaintiff has not reached maximum medical improvement from her injury.\n25. As a result of her injury, Plaintiff needs further diagnostic testing to evaluate and determine whether the ulnocarpal impaction, the possible TFCC tear, and other suspected right wrist conditions are causally related to her injury.\nWe conclude that the evidence supports the Commission\u2019s findings, which in turn support its conclusions of law with respect to the compensability issue.\nIn urging us to reach a contrary conclusion, Defendants argue that this case \u201cinvolves a complicated medical issue for which an expert medical opinion is required\u201d and that \u201c[t]he facts of this case are sufficiently complex as to require expert opinion on medical causation.\u201d In support of this assertion, Defendants cite several cases holding that expert medical evidence was required to establish a causal relationship between an accident or injury and the specific diagnosis proffered by a claimant. However, each of the decisions upon which Defendants rely involves conditions which are clearly beyond the diagnostic capabilities of an ordinary layperson. For example, in Click, in which the plaintiff sought compensation for a herniated disc, the Supreme Court noted the \u201cdifficulty of pinpointing the precise causative factors [underlying] disc injuries\u201d and held that expert medical evidence was required to establish the cause of the claimant\u2019s herniated disc. Click, 300 N.C. at 168, 265 S.E.2d at 391. See also, e.g., Holley v. ACTS, Inc., 357 N.C. 228, 233-34, 581 S.E.2d 750, 753-54 (2003) (deep vein thrombosis), and Young v. Hickory Bus. Furn., 353 N.C. 227, 230-33, 538 S.E.2d 912, 915-17 (2000) (fibromyalgia).\nIn this present case, unlike those upon which Defendants rely, the Commission did not conclude that Plaintiff suffered from a specific disease that could only be diagnosed based upon information contained in expert medical testimony. Instead, the Commission found, in essence, that the accident during which Plaintiff\u2019s wrist \u201cpopped\u201d caused the pain she was experiencing. Defendants have not cited any authority in support of the proposition that a workplace accident that is followed by and appears to immediately result in severe pain is not compensable unless or until a specific medical diagnosis is made. Instead, the appellate courts in this jurisdiction have indicated that there is no need for expert medical testimony in order to establish a link between a work-related accident and the plaintiff\u2019s current condition in circumstances similar to the one at issue here.\nFor example, in Click, 300 N.C. at 168-69, 265 S.E.2d at 392 the Supreme Court stated that \u201cthe \u2018distinguishing features\u2019 of most compensation cases holding [that] medical testimony [would be] unnecessary to make a prima facie case of causation include \u2018[a]n uncomplicated situation, the immediate appearance of symptoms, the prompt reporting of the occurrence by the workman to his superior and consultation with a physician, and the fact that the plaintiff was theretofore in good health and free from any disability of the kind involved\u2019 \u201d coupled with \u201c \u2018the absence of expert testimony that the alleged precipitating event could not have been the cause of the injury\u2019 \u201d) (quoting Uris v. State Compensation Dept., 247 Or. 420, 426, 427 P.2d 753, 756 (1967)). See also Slizewski v. Seafood, Inc., 46 N.C. App. 228, 233-35, 264 S.E.2d 810, 813-14 (1980) (holding that \u201cthe evidence was sufficient to support the Commission\u2019s finding of fact that the hematoma caused brain damage rendering the plaintiff a partial hemiplegic and reducing his visual capabilities\u201d given that, \u201c[p]rior to the fall, plaintiff was a healthy young man with no history of seizures, paralysis or visual disability;\u201d that the plaintiff \u201cwent into convulsions which continued after he was admitted to the hospital\u201d \u201c[a]s soon as [he] fell landing directly on his head;\u201d and that a physician testified that, \u201cthe day after the fall, . . . plaintiff was completely unconscious, had some movement on his right side but had no movement of his left arm and leg and had a complete left hemiplegia\u201d). As a result, given that the situation at issue here was \u201cuncomplicated,\u201d that Plaintiff\u2019s wrist pain appeared \u201cimmediately\u201d after the accident and has continued since that time, that one of Plaintiff\u2019s co-workers observed the accident and corroborated Plaintiff\u2019s account of the circumstances surrounding her injury, that Plaintiff promptly reported the injury to her superiors and sought medical treatment, and that Plaintiff did not have any pain in her wrist prior to the injury, we conclude that Plaintiff was not required to present expert testimony in order to make the necessary showing of a causal link between the injury and her wrist pain in this case.\nFurthermore, even if expert testimony concerning the causal relationship between Plaintiff\u2019s 14 October 2009 accident and the intense pain that Plaintiff experienced immediately after trying to grab the falling meat packet were necessary for a finding of compensability, we note that the Commission found that Dr. Gaston addressed \u201cthe issue of causation\u201d in a letter and stated that Plaintiff\u2019s work \u201cvery likely did cause the acute pain associated with\u201d Plaintiff\u2019s ulnocarpal impaction. Although Defendants contend that this letter does not constitute competent causation-related evidence because it was written in response to a letter asking for an opinion concerning the relationship between Plaintiff\u2019s general working conditions and a possible occupational disease, Dr. Gaston clearly characterized Plaintiff\u2019s injury in the letter in question by stating that:\n[Plaintiff] had an injury to her wrist while at work on October 14, 2009 when she had immediate ulnar-sided wrist pain. . . . Sub-sequently, her work comp case was denied. The patient has questions concerning whether or not this truly is a work related injury.\nAs a result, the record does, in fact, contain expert opinion evidence describing the relationship between Plaintiff\u2019s work-related injury and her subsequent wrist pain.\nFinally, Defendants direct our attention to evidence tending to show that, some twenty years before the accident, Plaintiff was treated for carpel tunnel syndrome. The record does not, however, contain any evidence tending to show that Plaintiff suffered from carpel tunnel syndrome at any time after the conclusion of that treatment. Moreover, according to well-established North Carolina law:\nIn workers\u2019 compensation actions the rule of causation is that where the right to recover is based on injury by accident, the employment need not be the sole causative force to render an injury compensable.\n\u201c[If the employee] by reason of constitutional infirmities is predisposed to sustain injuries while engaged in labor, nevertheless the leniency and humanity of the law permit him to recover compensation if the physical aspects of the employment contribute in some reasonable degree to bring about or intensify the condition which renders him susceptible to such accident and consequent injury.\u201d\nHansel v. Sherman Textiles, 304 N.C. 44, 52, 283 S.E.2d 101, 106 (1981) (quoting Vause v. Equipment Co., 233 N.C. 88, 92, 63 S.E. 2d 173, 176 (1951)). As a result, even if preexisting carpal tunnel syndrome contributed to the pain that Plaintiff suffered as a result of the accident, that fact would not render her injury noncompensable.\nHI. Conclusion\nThus, for the reasons set forth above, we conclude that none of Defendants\u2019 challenges to the Commission\u2019s order have merit. As a result, the Commission\u2019s order should be, and hereby is, affirmed.\nAFFIRMED.\nJudges ROBERT N. HUNTER, JR., and McCULLOUGH concur.\n. After Defendants denied her workers\u2019 compensation claim, Plaintiff was unable to obtain further medical treatment for her wrist.\n. The parties appear to agree that further testing is required to identity the precise mechanism implicated by Plaintiff\u2019s \u201cpopped\u201d wrist; however, having denied Plaintiff\u2019s request for additional medical treatment after 4 December 2009, Defendants have limited Plaintiff\u2019s ability to obtain any additional testing necessary to explain the reason that Plaintiff was continuing to experience wrist pain.\n. Although Defendants argue that Plaintiff has failed to satisfy the requirements for relying on non-expert testimony bearing on the causation issue on the grounds that her prior treatment of carpal tunnel syndrome showed that she was not in good health and free from a disability of the wrist prior to her injury, the record contains, as we note elsewhere, no indication that Plaintiff was experiencing any wrist-related difficulty at or at any recent time before the date that she was injured.\n. Having declined to reverse the Commission\u2019s order on compensability-related grounds, we need not reach Defendants\u2019 argument concerning the extent, if any, to which we should order further proceedings on remand in light of the Commission\u2019s alleged error.", "type": "majority", "author": "ERVIN, Judge." } ], "attorneys": [ "Ganly & Ramer, by Thomas R Ramer, for Plaintiff-appellee.", "Orbock Ruark & Dillard, PA, by Barbara E. Ruark and Jessica E. Lyles, for Defendant-appellants." ], "corrections": "", "head_matter": "MITZI McCRARY, Plaintiff v. KING BIO, INC., Employer, ISURITY INSURANCE SERVICES/NCME FUND, Carrier, Defendants\nNo. COA12-405\nFiled 5 February 2013\nWorkers\u2019 Compensation \u2014 compensability\u2014wrist injury \u2014 catching frozen package\nA workers\u2019 compensation award arising from a hand injury sustained in an effort to catch a large package of frozen bison meat that had slipped was affirmed. The evidence supported the Commission\u2019s findings, which in turn supported its conclusions of law with respect to compensability. Plaintiff was not required to present expert testimony in order to make the necessary showing of a causal link between the injury, during which her wrist \u201cpopped,\u201d and her immediate wrist pain. However, the record contained expert opinion evidence describing the relationship between plaintiff\u2019s work-related injury and her subsequent wrist pain. Finally, even if her twenty-year-old pre-existing carpal tunnel syndrome contributed to the pain, that fact would not render her injury noncompensable.\nAppeal by defendants from Opinion and Award entered 23 December 2011 by the North Carolina Industrial Commission. Heard in the Court of Appeals 13 September 2012.\nGanly & Ramer, by Thomas R Ramer, for Plaintiff-appellee.\nOrbock Ruark & Dillard, PA, by Barbara E. Ruark and Jessica E. Lyles, for Defendant-appellants." }, "file_name": "0378-01", "first_page_order": 388, "last_page_order": 399 }