Pomeroy v. Tanner Masonry

565 S.E.2d 209, 151 N.C. App. 171, 2002 N.C. App. LEXIS 709
CourtCourt of Appeals of North Carolina
DecidedJuly 2, 2002
DocketCOA01-505
StatusPublished
Cited by14 cases

This text of 565 S.E.2d 209 (Pomeroy v. Tanner Masonry) is published on Counsel Stack Legal Research, covering Court of Appeals of North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pomeroy v. Tanner Masonry, 565 S.E.2d 209, 151 N.C. App. 171, 2002 N.C. App. LEXIS 709 (N.C. Ct. App. 2002).

Opinion

CAMPBELL, Judge.

Tanner Masonry (Employer) and USF&G Insurance (collectively, Defendants) appeal from a 19 December 2000 opinion and award of the North Carolina Industrial Commission (the Commission). Specifically, Defendants contend the Commission erred in concluding that Daniel Pomeroy (Plaintiff) is “entitled to reasonably necessary medical treatment related to his compensable injury by accident for so long as such treatment tends to effect a cure, provide relief or lessen the period of disability.” Plaintiff likewise appeals from the Commission’s 19 December 2000 opinion and award, contending the Commission erred in finding and concluding that “Plaintiffs current lack of employment or inability to work, if any, is not causally related to his injury of June 14, 1994 and plaintiff has not undergone a substantial change of condition related to his injury by accident.” Plaintiff also appeals from a 19 February 2001 opinion and award in which the Commission concluded that it did not have jurisdiction to rule on Plaintiffs motion for reconsideration.

On 14 June 1994, Plaintiff, while working as a mason foreman for Employer, was injured when he fell six to eight feet from a scaffold and landed on a bolt, which penetrated his lower back. Plaintiff was taken to Lake Norman Regional Medical Center, where Dr. Marcus Wever, a board-certified general surgeon, performed surgery on Plaintiffs back, during which the puncture wound to Plaintiffs back was fully explored, irrigated, cleaned of debris and closed. Following surgery, Plaintiff remained in the hospital for a few days. On 15 June 1994, Dr. William A. Kutner, an orthopaedic surgeon, examined Plaintiff and found no obvious fractures associated with Plaintiffs injuries. Plaintiff was discharged from the hospital on 18 June 1994.

Following his discharge from the hospital, Plaintiff was examined by Dr. Wever in the outpatient clinic on several occasions. On 17 August 1994, after Plaintiffs final follow-up appointment, Dr. Wever released him to return to work the following week with no restrictions or permanent partial impairment indicated. Dr. Wever opined *174 that Plaintiff had reached maximum medical improvement consistent with his injury and indicated that Plaintiff would “be seen in followup on an as-needed basis.” Following his injury, Plaintiff also received physical therapy for his back. On 26 August 1994, Plaintiffs physical therapist instructed him to return to work the following Monday (29 August 1994) with no restrictions or permanent partial impairment indicated.

On 27 June 1994, Plaintiff and Defendants entered into an Industrial Commission Form 21 Agreement for Compensation for Disability (Form 21 Agreement) stating that Plaintiff “sustained an injury by accident arising out of and in the course of [his] employment [with Employer]” on 14 June 1994, and that the accident resulted in a “back injury.” The Form 21 Agreement was approved by the Commission on 5 August 1994. Under the terms of the Form 21 Agreement, Defendants paid Plaintiff compensation at the rate of $346.68 per week for temporary total disability from 14 June 1994 to 28 August 1994. Defendants also paid for Plaintiff’s medical treatment in the total amount of $9,056.10.

On 29 August 1994, Plaintiff returned to work for Employer at full duty without restrictions. Plaintiffs return to work was noted on an Industrial Commission Form 28B executed and filed by Defendants on 29 August 1994. The Form 28B also noted that Plaintiff’s final compensation check was forwarded to him on 29 August 1994. The Form 28B did not indicate the weekly wage at which Plaintiff had returned to work. By its terms, this Form 28B did not purport to close Plaintiff’s case, for it appears that additional medical expenses were yet to be paid by Defendants.

On 24 October 1994, Defendants filed a second Form 28B notifying Plaintiff that his case was closed and that he had two years from the date of receipt of his final compensation check in which to notify the Commission, in writing, that he claimed further benefits. See N.C. Gen. Stat. § 97-47 (2001). This second Form 28B also did not indicate the weekly wage at which Plaintiff had returned to work.

In December 1994, Plaintiff stopped working for Employer and moved to New York. Plaintiff returned to work in New York two or three weeks later as a mason for H & R Masonry, where he worked for approximately one year. While working for H & R Masonry, Plaintiff earned lower wages than he had earned while working for Employer. Plaintiff attributed his lower wages to the economic recession affecting New York at the time. According to Plaintiff’s testimony, he *175 stopped working for H & R Masonry because he could not perform as expected due to continuing problems with his back.

Plaintiff was also employed in New York by Yancey Conant Masonry (Yancey), where he worked as a mason for four or five months. While working for Yancey, Plaintiff earned wages equal to those he had earned while working for Employer prior to moving to New York. Plaintiff stopped working for Yancey in December of 1995. According to Plaintiff, he had to stop working for Yancey due to back problems. Plaintiff was unemployed from December 1995 until this case was heard by the Deputy Commissioner on 28 January 1998.

On 10 January 1996, Plaintiff was examined in New York by Dr. Jalal Sadrieh, an orthopaedic surgeon. Dr. Sadrieh ordered an x-ray of Plaintiffs lumbar spine, which showed no evidence of foreign material and that Plaintiffs bony structures and disc spaces were normal. Dr. Sadrieh was given an oral history of Plaintiffs back problems, but did not review any records from Plaintiffs treatment for his compensable back injury in North Carolina. Dr. Sadrieh diagnosed Plaintiff with “acute and subacute low back sprain with sciatica and possible disc herniation.” Dr. Sadrieh referred Plaintiff to physical therapy and recommended that he undergo an MRI. On 19 February 1996, Plaintiff returned to Dr. Sadrieh. Plaintiff had not been to physical therapy, nor had plaintiff undergone an MRI, because Defendants had refused to authorize insurance coverage for such medical treatment. Plaintiff was last examined by Dr. Sadrieh on 19 February 1996.

On 21 February 1996, Plaintiff was examined by Dr. Vincent Sportelli, a chiropractor. Plaintiff remained under the care of Dr. Sportelli until 4 October 1996. During this time, Plaintiff was seen by Dr. Sportelli on a total of forty-two occasions. In his deposition testimony, Dr. Sportelli opined that Plaintiff had a sixty-five percent (65%) permanent partial disability to the pelvic girdle causally related to the injury suffered by Plaintiff on 14 June 1994. However, the record shows that Dr. Sportelli’s opinion was based solely on the history provided by Plaintiff and the Plaintiffs condition at the time Dr. Sportelli examined him. Dr. Sportelli had no access to the records from Plaintiffs 14 June 1994 back injury and subsequent treatment in North Carolina. As a result, Dr. Sportelli was under the impression that Plaintiffs earlier back injury was caused by a fifteen to twenty foot fall, while the records from North Carolina make it clear that Plaintiff only fell six to eight feet. Defendants refused to authorize insurance coverage for Plaintiff’s treatment by Dr. Sportelli.

*176

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Cite This Page — Counsel Stack

Bluebook (online)
565 S.E.2d 209, 151 N.C. App. 171, 2002 N.C. App. LEXIS 709, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pomeroy-v-tanner-masonry-ncctapp-2002.