State News : North Carolina

Johnnie Wilkes was a 62-year-old landscaper working in the Recreation and Parks Department for the City of Greensboro. He had worked for the City for approximately nine years.  On April 21, 2010, Mr. Wilkes was involved in a car accident.  Mr. Wilkes was treated for an abrasion to his head, broken ribs, and injuries to his neck, back, pelvis, and left hip.  He underwent a brain MRI, which was negative for acute infarction but revealed mild paranasal sinus disease resulting from a concussion.  The claim was accepted by the City on a Form 60.  Mr. Wilkes was discharged from the hospital the next day.  Mr. Wilkes later sought treatment for anxiety and depression.

After the hearing, a deputy commissioner found that Mr. Wilkes’ anxiety and depression were causally related to the April 21, 2010 accident. It was also found that it would be futile for Mr. Wilkes to seek employment due to pre-existing conditions that were personal to him; such as age, IQ, work history, and physical conditions as a result of the at-work injury.  Defendants appealed and the Full Commission reversed the deputy commissioner’s decision, holding that Mr. Wilkes failed to meet his burden of proving that his anxiety and depression were caused by the accident, and that he was no longer entitled to temporary total disability benefits because he had presented insufficient evidence that a job search would be futile.  Mr. Wilkes appealed this decision to the Court of Appeals.

The Court of Appeals held that Mr. Wilkes was entitled to medical compensation for his anxiety and depression. The Court relied on theParsons presumption and two subsequent cases to find that this additional medical treatment was related to the April 21, 2010 injury.  The Court specifically cited a footnote in thePerez v. Am. Airlines/AMR Corp. case that noted, “[w]e can conceive of a situation where an employee seeks medical compensation for symptoms completely unrelated to the compensable injury.  But the burden of rebutting the presumption of compensability in this situation, although slight, would still be upon the employer” (emphasis inWilkes decision).  The Court therefore held that, in light of the previously filed Form 60 accepting Mr. Wilkes’ claim as compensable, there was a rebuttable presumption that Mr. Wilkes’ anxiety and depression were causally related to the accepted injury.  The Court remanded the case to the Commission to determine if the City had rebutted the presumption.

The Court also found that Mr. Wilkes had successfully demonstrated that searching for work would be futile based on his pre-existing, personal conditions. The Court factually distinguished this case from theFields v. H&E Equip. Servs., LLC case (which was included in a prior Risk Alert).  The Court noted that Mr. Wilkes was 60 years old, had worked as a landscaper with the City since 2001, had been employed in medium to heavy duty labor positions for his entire adult life, only attended school until the 10^th grade, was physically incapable of performing his prior job as a landscaper, had difficulty reading and comprehending written material, and had a low IQ putting him in the impaired range.  Specifically, the Court highlighted that Mr. Wilkes had a lack of transferrable skills and that there was medical evidence of his intellectual impairment and difficulty with reading comprehension.  The Court found that, generally, plaintiffs are not required to present medical evidence or vocational expert testimony to establish futility, which appears to contradict the recent holding inFields.  The Court instead relied on prior case law to hold that, once the plaintiff establishes futility through his or her own testimony, the burden shifts to the defendants to show that suitable jobs were available and that the plaintiff is capable of obtaining one considering his physical and vocational conditions and limitations.  The Court found that the City had not carried its burden to show that suitable jobs were available and Mr. Wilkes capable of obtaining a job in light of his conditions, thus entitling him to additional indemnity benefits.

Risk Handling Hints:  The decision in Wilkes extends theParsons presumption to apply to injuries not previously accepted and even to injuries entirely different from the injuries included on a Form 60.  The burden is then on the defendants to produce evidence that additional claimed injuries are not causally related to the accepted conditions.  This is an extension of the prior case law where the courts had previously been unwilling to apply the presumption to entirely different body parts.  The Court relied on side notes in prior cases to take extend this analysis to apply to wholly different injuries.  Going forward, employers and carriers should be aware that they will have the burden of rebutting compensability for any claimed injury regardless of what injuries or body parts are listed on the Form 60.  As a result of this decision, employers and carriers should work on gathering medical evidence that disputes causation as soon as they become aware of any claimed injury.

In addition, employers and carriers should obtain medical evidence and vocational experts to rebut an employee’s contention that it is futile to seek employment. This decision re-establishes that an employee’s testimony alone will be enough to carry his or her burden of proving futility.  Defendants will then be responsible for rebutting this presumption through expert testimony and evidence.