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  "name": "WILLIAM DAVIS, Employee v. HARRAH'S CHEROKEE CASINO, Employer, LEGION INSURANCE COMPANY (Now assigned to the NORTH CAROLINA INSURANCE GUARANTY ASSOCIATION), Carrier",
  "name_abbreviation": "Davis v. Harrah's Cherokee Casino",
  "decision_date": "2008-01-25",
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    "parties": [
      "WILLIAM DAVIS, Employee v. HARRAH\u2019S CHEROKEE CASINO, Employer, LEGION INSURANCE COMPANY (Now assigned to the NORTH CAROLINA INSURANCE GUARANTY ASSOCIATION), Carrier"
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        "text": "HUDSON, Justice.\nDefendant employer challenges the Industrial Commission\u2019s determination that plaintiff\u2019s ongoing disability and medical treatment were the result of a compensable injury. We hold that the Commission properly found and concluded that plaintiff\u2019s ongoing disability and medical treatment were related to and resulted from his compensable injury. We affirm the award.\nIn May 2001 plaintiff injured his back while removing a monitor from a slot machine at work. Initially, he sought treatment from his chiropractor, Dr. Guy Karcher, who referred plaintiff to a neurosurgeon, Jon M. Silver, M.D., in August of that year. On 7 September 2001, Dr. Silver performed a microlumbar discectomy. Although plaintiff returned to work in October 2001 because he was afraid of being fired if he did not, he continued to have back and leg pain. In early November 2001, plaintiff called Dr. Silver due to ongoing symptoms of pain, which were similar to those he had experienced before the surgery. Dr. Silver ordered an MRI, which was performed on 20 December 2001, and which showed scar tissue and degenerative changes. At a follow-up visit late in December 2001, plaintiff reported that he had felt significant pain in his back and legs since he fell at home in late November. Dr. Silver ordered more tests including a CAT scan performed on 2 April 2002, which revealed degenerative and \u201cpostoperative changes,\u201d and he performed another surgery later that month. Plaintiff was unable to return to work after the second surgery.\nEventually, Harrah\u2019s fired plaintiff for not returning to work. Defendants denied plaintiff\u2019s workers\u2019 compensation claim for medical treatment and ongoing disability in their Form 19 (report of employee\u2019s injury or occupational disease), by Form 61 (\u201cDenial of Workers\u2019 Compensation Claim\u201d), in their Form 33R (response to request for hearing), and in multiple assignments of error in the record on appeal. However, although defendants have brought forward assignments of error challenging the entire award to plaintiff, as they did not bring forward to the Court of Appeals any challenges to the compensability of the original work-related injury, those challenges are abandoned. Defendants contended that plaintiff\u2019s fall at home broke the chain of causation related to the original injury. The Commission found and concluded otherwise.\nThe Commission found as fact, inter alia, that as a result of plaintiff\u2019s original injury, he had \u201cmore of a propensity to develop degenerative changes at that level over time\u201d and that he would have more difficulty recovering from any further injury. The Commission also found that any further injury would be \u201clikely to result in worse symptoms\u201d than if plaintiff had not had the surgery required by the previous work-related injury and that as of the date of the hearing, plaintiff remained totally disabled due to severe back pain radiating down his legs. Thus, the Commission concluded that plaintiff\u2019s ongoing pain and disability, as well as the April 2002 surgery and followup treatment, were related to his compensable injury and awarded benefits accordingly. The Court of Appeals affirmed the award in a divided opinion.\nThe majority in the Court of Appeals upheld all but one of the Commission\u2019s factual findings, all of its conclusions of law, and its award, based on the overall determination that plaintiff\u2019s current medical condition and disability resulted from his injury at work. Davis, 178 N.C. App. at 609-16, 632 S.E.2d at 579-83. The majority also held that plaintiff\u2019s fall at home in November 2001 did not amount to an intervening event that broke the chain of causation from the original injury. Id. at 610, 632 S.E.2d at 580. The dissenter would have held that the critical findings of fact in favor of plaintiff were not supported by the medical evidence, and would have reversed the Commission. Id. at 616, 632 S.E.2d at 583. Defendants filed a notice of appeal on the basis of the dissenting opinion in the Court of Appeals, and we granted defendants\u2019 petition for discretionary review of additional issues.\nIn their New Brief, defendants identify sections \u201cI.-B\u201d and \u201cII\u201d as being before this Court based upon the dissenting opinion in the Court of Appeals. Defendants frame these issues as follows:\nI.B. THE COURT OF APPEALS ERRED IN RELYING UPON HORNE [Home v. Universal Leaf Tobacco Processors, 119 N.C. App. 682, 459 S.E.2d 797, disc. rev. denied, 342 N.C. 192, 463 S.E.2d 237 (1995)], AS THERE WAS NO COMPETENT EVIDENCE IN THE INSTANT CASE THAT THE INJURY FOLLOWING THE SLIP AND FALL WAS CAUSALLY RELATED TO THE COMPENSABLE INJURY OF MAY 2001.\nII. THE COURT OF APPEALS ERRED IN AFFIRMING THE FULL COMMISSION\u2019S OPINION AND AWARD WHICH CONCLUDED THAT PLAINTIFF-APPELLEE\u2019S SURGERY IN APRIL OF 2002 WAS CAUSALLY RELATED TO THE COMPENSABLE INJURY OF MAY 2001 WHERE NO MEDICAL EVIDENCE ESTABLISHED THE SLIP AND FALL INJURY PRECEDING THE SURGERY WAS AN AGGRAVATION OF THE COMPENSABLE INJURY.\nIn both of these sections of the brief defendants argue, in essence, that the evidence is insufficient to support the findings underpinning the award in favor of plaintiff, particularly the findings connecting plaintiff\u2019s second surgery and ongoing symptoms to the original compensable injury. Although defendants discuss at some length testimony that would have supported different findings, they do not argue that any particular findings of the Commission were unsupported by the evidence. In both arguments I and II, defendants bring forward assignments of error to findings 4 (in part) and 14, 15, and 18. For purposes of our analysis, we consider the evidence in support of findings 14 and 15, which appear to be the primary focus of defendants\u2019 arguments here, as in the Court of Appeals. In pertinent part, these findings state:\n14. While Dr. Silver opined at his deposition that the second surgery was primarily to correct degenerative changes, he did indicate that changes seen on the MRI relating to scarring and fibrosis around the nerve were related to plaintiff\u2019s first surgery. . . .[long quotation from surgical note omitted].\nIt is clear from this description that in addition to the degenerative changes to plaintiff\u2019s ligamentous flavum, the second surgery involved removal of scar tissue from the first surgery.\n15. As has already been found as fact [in finding 13] above, plaintiff\u2019s first surgery would have made him more prone to develop degenerative changes, specifically ligamentous changes. The ligamentum flavum Dr. Silvers [sic] removed is a primary spinal ligament, and was identified, along with the scarring, as a primary cause of the stenosis seen on the April 1, 2002, MRI.\nThe Workers\u2019 Compensation Act provides that the Industrial Commission is the sole judge of the credibility of the witnesses and the weight of the evidence. N.C.G.S. \u00a7 97-84,-85,-86 (2005); Adams v. AVX Corp., 349 N.C. 676, 680-81, 509 S.E.2d 411, 413 (1998) (citing Anderson v. Lincoln Constr. Co., 265 N.C. 431, 433-34, 144 S.E.2d 272, 274 (1965)). We have repeatedly held that the Commission\u2019s findings of fact \u201care conclusiv\u00e9 on appeal when supported by competent evidence, even though there be evidence that would support findings to the contrary.\u201d E.g. Jones v. Myrtle Desk Co., 264 N.C. 401, 402, 141 S.E.2d 632, 633 (1965) (per curiam). Further, \u201c[t]he evidence tending to support plaintiff\u2019s claim is to be viewed in the light most favorable to plaintiff, and plaintiff is entitled to the benefit of every reasonable inference to be drawn from the evidence.\u201d Adams, 349 N.C. at 681, 509 S.E.2d at 414 (citation omitted); accord Deese v. Champion Int\u2019l Corp., 352 N.C. 109, 115, 530 S.E.2d 549, 553 (2000). Appellate review of an opinion and award from the Industrial Commission is generally limited to determining \u201c(1) whether the findings of fact are supported by competent evidence, and (2) whether the conclusions of law are justified by the findings of fact.\u201d Clark v. Wal-Mart, 360 N.C. 41, 43, 619 S.E.2d 491, 492 (2005) (citing Hendrix v. Linn-Corriher Corp., 317 N.C. 179, 186, 345 S.E.2d 374, 379 (1986)).\nAfter careful review, we conclude that the evidence fully supports these findings of fact. Referring to finding of fact 14, the surgical note quoted within the finding itself supports the final sentence, which determines that plaintiffs second surgery involved removal of scar tissue from the first surgery. The Court of Appeals noted that the finding contains extensive \u201crecitations of Dr. Silver\u2019s testimony and written surgery notes,\u201d but that in light of the last sentence, the finding is \u201cadequate.\u201d Davis, 178 N.C. App. at 612, 632 S.E.2d at 580. We agree with this analysis.\nIn finding 15, the Commission determined that plaintiff\u2019s first surgery made him more prone to develop degenerative changes, which in turn were a \u201cprimary cause\u201d of the second surgery. The Court of Appeals first noted that finding 15 refers back to and relies upon finding 13, which was not challenged on appeal. Id. at 612, 632 S.E.2d at 581. The court then held that finding 15 was not supported by the evidence, to the extent it found that the plaintiff specifically (as opposed to \u201csomeone\u201d in general) was more prone to develop degenerative changes. Id. This part of the court\u2019s analysis includes a misapplication of the standard of review on appeal, which we must address.\nIn his deposition, Dr. Silver testified that he saw plaintiff on 29 October 2001, for a regularly scheduled six-week followup visit after his discectomy. Dr. Silver allowed plaintiff to return to work so he would not lose his job, but advised him to avoid heavy lifting to the extent possible. Dr. Silver also explained that plaintiff called him on 7 November 2001, before his reported slip and fall at home, to report that he was experiencing pain \u201csimilar to that before surgery.\u201d In response to a question from plaintiff\u2019s counsel about whether \u201cthe first procedure that you performed, the discectomy\u201d would \u201cmake someone more susceptible to injury from a fall,\u201d Dr. Silver responded in part:\nI think it would make people more \u2014 I think it does two things.\nFirst, in someone that has what might otherwise be a relatively minor injury . . . having scar tissue in there ... I think makes it more difficult for them to get over a strain type injury.\nThe other thing it does is, by taking down part of the joint and by disrupting ligaments, there is also more of a propensity to develop degenerative changes at that level over time just as any injury to the joint space would be; a football injury or fall. So over time I think they are more prone to develop degenerative changes.\nThe long answer to your question is, yeah, I think there are two ways and the answer is yes. (Emphasis added.)\nDr. Silver\u2019s entire answer to this question specifically asking about the discectomy he performed on plaintiff was incorporated into finding of fact 13, which has not been challenged on appeal, and is thus binding. Later in his deposition, Dr. Silver answered the specific question, \u201cDoes Mr. Davis have a greater likelihood of continued degenerative changes . . . ?\u201d, by saying in part that plaintiff is \u201ccertainly . . . more prone to further and more rapid advanced degenerative changes.\u201d The Court of Appeals erred in its statement that \u201cthere is no evidence in the record to support the Commission\u2019s more specific finding as to plaintiff\u2019s propensity to develop degenerative changes.\u201d Id. at 612, 632 S.E.2d at 581. Because the evidence above unequivocally shows otherwise, we explicitly disavow this statement and hold that finding 15 is supported by the evidence when the standard of review is properly applied.\nTaking the evidence in the light most favorable to plaintiff, as the decisions of this Court require, the Commission made the findings and reached the conclusions above. The evidence recited above, as well as the portion of Dr. Silver\u2019s testimony and records quoted in finding 14 itself, supports findings 14 and 15. In those findings, the Commission determined that the second surgery was necessitated by degenerative changes and scar tissue resulting from the original injury and first surgery.\nBecause the findings of fact, including numbers 4, 14, 15 and 18, are thus conclusive, we turn to the arguments defendants have brought forward directed at the related conclusions of law. The critical conclusions of law are numbers 1, 3, 4 and 6, which read as follows:\n1. On or about May 26, 2001, plaintiff sustained a specific traumatic incident, arising out of and in the course of his employment with Harrah\u2019s Cherokee Casino. As a consequence, he injured his lower back, sustaining a herniated disc. N.C. Gen. Stat. \u00a7 97-2(6).\n3. As a consequence of his back injury, plaintiff required medical treatment, including the surgery performed by Dr. Silver on September 7, 2001, and the second surgery, performed on April 22, 2002. Defendants are responsible for payment of all such reasonably necessary medical treatment incurred by plaintiff for the lower back injury, including said surgeries, and followup to those surgeries. N.C. Gen. Stat. \u00a7\u00a7 97-2(19) and 97-25.\n4. As a consequence of his back injury, plaintiff was unable to earn wages in any employment and was temporarily totally disabled from June 26, 2001, through October 31, 2001, and from December 27, 2001, and continuing until plaintiff is able to earn the same or greater wages as he was earning when first injured. Defendants are responsible for payment to plaintiff of wage loss compensation at the rate of $283.09 per week during this period. N.C. Gen. Stat. \u00a7 97-29.\n6. Also at issue is whether the fall that plaintiff suffered outside his home in late November or early December 2001 was an intervening causal event sufficient to bar plaintiff from further compensation. For this to be the case, any injury resulting from his fall would have to be entirely independent of the compensable injury. . . . The slip and fall on ice aggravated the earlier injury and the pain and medical consequences were a natural progression of the earlier injury.\nAs noted above, conclusion 1 has not been challenged on appeal, but 3, 4 and 6 have been assigned as error. In argument II, defendants contend that the findings above, based on Dr. Silver\u2019s testimony, do not support conclusions of law that the second surgery (conclusion 3) and plaintiff\u2019s resulting disability (conclusion 4) are related to the original injury.\nWe hold that the findings discussed above support the Commission\u2019s conclusions. Plaintiff injured his back moving a monitor from a slot machine at work and required surgery in September 2001 as a result. The Commission found and concluded that this injury was compensable under the Workers\u2019 Compensation Act. The original injury and surgery led to scar tissue and made him more prone to degenerative changes, which in turn necessitated the second surgery in April 2002. Thus, conclusions 3 and 4 are fully supported by the Commission\u2019s findings. In light of these conclusions \u2014 that plaintiff\u2019s medical treatments for his back, including both surgeries, as well as his ongoing disability resulted from his May 2001 injury at work- \u2014 the award of benefits including all compensation for medical treatment and ongoing total disability is entirely appropriate.\nDefendants argue, as they did in the Court of Appeals, that the Commission and Court of Appeals misapplied the legal principles of causation to this workers\u2019 compensation case. This argument is directed at conclusion 6 quoted above. The majority in the Court of Appeals disagreed, noting that \u201cuncontested findings\u201d of fact 5 and 6 (pertaining to plaintiff\u2019s symptoms between early November 2001 and his second surgery in April 2002) support this conclusion. Davis, 178 N.C. App. at 610, 632 S.E.2d at 580. The Court of Appeals relied on its decision in Home to justify the conclusion that aggravation of a primary injury is compensable unless due to an independent intervening event resulting from plaintiff\u2019s own intentional conduct. Id. (citing Home, 119 N.C. App. at 685, 459 S.E.2d at 799). The dissenter agreed with the legal principles set forth in Home, but did not agree that the medical evidence here established an aggravation of the original injury. Id. at 618, 632 S.E.2d at 584.\nThis issue is before this Court on discretionary review. Defendants state the issue in their new brief as follows:\nI.A. THE COURT OF APPEALS ERRED IN RELYING UPON HORNE. AS THE HORNE COURT MISAPPLIED THE CAUSATION PRINCIPLES OF AGGRAVATION OF A COMPENSABLE INJURY.\nWe conclude that application of these principles is not necessary to the disposition of this case.\nHere, the evidence supports the Commission\u2019s findings that the first surgery was necessitated by the work-related injury of May 2001 and that the second surgery and ongoing disability resulted directly from the original injury and first surgery. These findings, in turn, support the Commission\u2019s conclusions that defendants are responsible for payment for all \u201csuch reasonably necessary medical treatment incurred by plaintiff for the lower back injury, including said surgeries, and follow-up to those surgeries.\u201d We recognize that the Commission addressed the issue of intervening cause because defendants raised it, but given conclusions 1, 3 and 4, conclusion 6 is simply unnecessary. Neither the Commission nor the Court of Appeals needed to consider whether any intervening cause occurred because the Commission properly found and concluded that plaintiff\u2019s injury in May 2001 is compensable and that all of plaintiff\u2019s medical treatments and ongoing disability have resulted therefrom. In so finding and concluding, the Commission by implication declined to attribute causation to any intervening event.\nFor the reasons stated above, the opinion of the Court of Appeals affirming the Commission\u2019s opinion and award is modified and affirmed.\nMODIFIED AND AFFIRMED.",
        "type": "majority",
        "author": "HUDSON, Justice."
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    "attorneys": [
      "Law Offices of Lee and Smith, P.A., by D. Andrew Turman, for plaintiff-appellee.",
      "Hedrick Eatman Gardner & Kincheloe, L.L.P., by Allen C. Smith, Andrew S. Culicerto, and Margaret M. Kingston, for defendant-appellants.",
      "Sumwalt Law Firm, by Vernon Sumwalt, for the North Carolina Academy of Trial Lawyers, amicus curiae."
    ],
    "corrections": "",
    "head_matter": "WILLIAM DAVIS, Employee v. HARRAH\u2019S CHEROKEE CASINO, Employer, LEGION INSURANCE COMPANY (Now assigned to the NORTH CAROLINA INSURANCE GUARANTY ASSOCIATION), Carrier\nNo. 456A06\n(Filed 25 January 2008)\n1. Workers\u2019 Compensation\u2014 findings of fact \u2014 sufficiency of evidence\nThe Industrial Commission did not err in a workers\u2019 compensation case by its findings of fact 14 and 15 supporting the conclusion that plaintiff\u2019s ongoing disability and medical treatment were the result of a compensable injury, and that plaintiff\u2019s fall at home in November 2001 did not amount to an intervening event that broke the chain of causation from the original injury, because: (1) with regard to finding of fact 14, the surgical note quoted within the finding itself supports the final sentence, which determines that plaintiff\u2019s second surgery involved removal of scar tissue from the first surgery; (2) with regard to finding of fact 15, there was evidence in the record to support the Commission\u2019s more specific finding as to plaintiff\u2019s propensity to develop degenerative changes; and (3) the evidence recited above, as well as the portion of plaintiff\u2019s surgeon\u2019s testimony and records quoted in finding 14 itself, supports findings 14 and 15.\n2. Workers\u2019 Compensation\u2014 conclusions of law \u2014 causation\u2014 intervening cause\nThe Industrial Commission did not err in a workers\u2019 compensation case by its conclusions of law numbers 3, 4 and 6 that plaintiff\u2019s ongoing disability and medical treatment were the result of a compensable injury, and that plaintiff\u2019s fall at home in November 2001 did not amount to an intervening event that broke the chain of causation from the original injury, because: (1) the finding that plaintiff injured his back moving a monitor from a slot machine at work, and required surgery in September 2001 as a result, support the Commission\u2019s conclusions; (2) the finding that the original injury and surgery led to scar tissue and made him more prone to degenerative changes, which in turn necessitated the second surgery in April 2002, supports conclusions 3 and 4; (3) in light of these conclusions that plaintiff\u2019s medical treatments for his back, including both surgeries, as well as his ongoing disability resulted from his May 2001 injury at work, the award of benefits including all compensation for medical treatment and ongoing total disability was entirely appropriate; and (4) although defendants contend the Commission misapplied the legal principles of causation in conclusion number 6, the Commission addressed the issue of intervening cause since defendants raised it, but given conclusions 1, 3 and 4, conclusion 6 was simply unnecessary when the Commission properly found and concluded that plaintiff\u2019s injury in May 2001 is compensable and that all of plaintiff\u2019s medical treatments and ongoing disability have resulted therefrom.\nAppeal pursuant to N.C.G.S. \u00a7 7A-30(2) from the decision of a divided panel of the Court of Appeals, 178 N.C. App. 605, 632 S.E.2d 576 (2006), affirming an opinion and award filed- on 20 June 2005 by the North Carolina Industrial Commission. On 5 October 2006, the Supreme Court allowed defendants\u2019 petition for discretionary review of additional issues. Heard in the Supreme Court 15 February 2007.\nLaw Offices of Lee and Smith, P.A., by D. Andrew Turman, for plaintiff-appellee.\nHedrick Eatman Gardner & Kincheloe, L.L.P., by Allen C. Smith, Andrew S. Culicerto, and Margaret M. Kingston, for defendant-appellants.\nSumwalt Law Firm, by Vernon Sumwalt, for the North Carolina Academy of Trial Lawyers, amicus curiae."
  },
  "file_name": "0133-01",
  "first_page_order": 211,
  "last_page_order": 220
}
