256 N.C. App. 635
N.C. Ct. App.2017Background
- Plaintiff Harrison Hall, long‑distance truck driver, suffered a compensable work accident in North Carolina in 2002 that caused severe injuries (including a high amputation and ongoing dialysis). Defendants (U.S. Xpress and Liberty Mutual) voluntarily paid Tennessee workers’ compensation medical and indemnity benefits for years, including large medical payments and a temporary per diem meal allowance.
- In April 2013 Hall filed a North Carolina Industrial Commission Form 18 seeking NC workers’ compensation benefits; defendants later reported the accident to the NC Commission and contested jurisdiction under N.C. Gen. Stat. § 97‑24.
- The parties bifurcated proceedings; Deputy Commissioners and the Full Commission found NC had jurisdiction and awarded medical and indemnity benefits, retroactive attendant‑care reimbursement, and imposed a $5,000 sanction for defendants’ unfounded litigiousness; plaintiff was ordered to contribute $400/month toward handicapped‑accessible housing and per diem payments were discontinued.
- Defendants appealed jurisdiction, retroactive attendant‑care, and sanctions. Plaintiff cross‑appealed limitations on attendant care (8 hrs/day), termination of per diem, and housing contribution.
- The Court of Appeals affirmed: NC Commission had jurisdiction under § 97‑24(a)(ii); retroactive attendant‑care to plaintiff’s wife was properly awarded; sanctions were appropriate; the Commission properly limited attendant care to 8 hours/day and required a $400 monthly contribution for housing.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Subject‑matter jurisdiction under N.C. Gen. Stat. § 97‑24(a)(ii) | Hall: claim filed within two years of last payment of "medical compensation" (payments to out‑of‑state providers) so NC has jurisdiction | Defendants: payments under Tennessee law are not "medical compensation" under § 97‑24 and § 97‑2 definitions; Hall’s claim time‑barred | Affirmed NC jurisdiction; out‑of‑state medical payments count as "medical compensation" and disability payments not under NC law are not "other compensation" that bars § 97‑24(a)(ii) relief. |
| Retroactive attendant‑care payments (wife as provider) | Hall: entitled to reimbursement for attendant care dating back to 2006; sought Commission approval after filing 2013 claim | Defendants: Hall did not seek Commission approval within a reasonable time after selecting his wife; retroactive award improper | Affirmed: Commission reasonably found Hall requested approval within a reasonable time after filing, allowing retroactive attendant‑care reimbursement. |
| Sanctions for unfounded litigiousness | Hall: defendants litigated jurisdiction and compensability without reasonable ground; sanctions appropriate | Defendants: had reasonable legal grounds to contest jurisdiction and compensability | Affirmed sanctions; Court found defendants lacked reasonable grounds given binding precedent (McGhee/Clark) and award was not an abuse of discretion. |
| Scope of attendant‑care, per diem, and housing costs (plaintiff cross‑appeal) | Hall: needs 8–12 hrs/day attendant care; per diem should continue; defendant should pay full housing cost | Defendants: Commission correctly exercised discretion, limited care to 8 hrs/day, ceased per diem, and required plaintiff contribution to rent | Affirmed: Commission may select hours within range (factfinder discretion), per diem not estopped, and Commission properly required a reasonable tenant contribution ($400) toward accessible housing. |
Key Cases Cited
- McGhee v. Bank of Am. Corp., 173 N.C. App. 422 (N.C. Ct. App.) (out‑of‑state payments to medical providers may qualify as "medical compensation" for § 97‑24 purposes)
- Clark v. Summit Contractors Group, Inc., 238 N.C. App. 232 (N.C. Ct. App.) (reaffirmed McGhee; benefits paid under another state’s workers’ comp can be "medical compensation" and indemnity payments not under NC law are not "other compensation")
- Derebery v. Pitt County Fire Marshall, 318 N.C. 192 (N.C.) (employer’s obligation to provide "other treatment or care" can include handicapped‑accessible housing)
- Mehaffey v. Burger King, 367 N.C. 120 (N.C.) (approval from Commission for medical services required within a reasonable time for reimbursement)
- Adams v. AVX Corp., 349 N.C. 676 (N.C.) (evidence viewed in light most favorable to claimant when determining entitlement)
- Burnham v. McGee Bros. Co., 221 N.C. App. 341 (N.C. Ct. App.) (distinguishing ordinary living expenses from extraordinary housing costs; employer may be liable for incremental housing costs)
- Espinosa v. Tradesource, Inc., 231 N.C. App. 174 (N.C. Ct. App.) (Commission has discretion to require employer to pay pro rata difference between pre‑injury and post‑injury rent for accessible housing)