Miller v. Carolinas Medical Center
233 N.C. App. 342
| N.C. Ct. App. | 2014Background
- Employee Miller, a nurse for over 11 years, sustained a 2006 lower back injury at work; 2007 Form 21 awarded 5% PPD based on $689.21 AWW; 2008 back pain worsened and doctor suggested non-work-related cause; 2010 surgery restored her to full capacity; 2011-2013 proceedings sought additional medical benefits and wage verification; the Full Commission reformed the Form 21 wage and awarded additional benefits, leading to Defendant's appeal.
- Form 21 originally approved in 2007 set AWW at $689.21; Full Commission later changed it to $691.11 and ordered $18.90 additional payment.
- Plaintiff sought additional medical compensation and considered a change of condition; Defendant asserted time bars under §97-25.1 and §97-47.
- Material medical actions included three surgeries (first two unsuccessful, third successful in 2010), with Plaintiff returning to nursing in 2010 and continuing.
- Defendant argued last medical payment and verification timing affected eligibility for additional benefits; the case proceeded to the Full Commission which issued mixed conclusions.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Full Commission could reform the Form 21 wage amount. | Miller argues wage calculation followed statute and Swain governs; error was law, not fact. | Carolinas contends reforming wage of $689.21 to $691.11 was proper under verification concept. | Reversal: wage reform was an error of law; original $689.21 remains. |
| Whether Miller's claim for additional medical benefits was time-barred. | Miller contends timely under §97-25.1 and §97-47 post-change condition. | Carolinas argues last medical payment and two-year limit bars claim. | Claim not time-barred; benefits awarded subject to other modifications. |
| Whether the January 20, 2009 payment to Armstrong & Armstrong constituted last medical payment under §97-25.1. | N/A | Payment did not constitute medical compensation; last medical payment was 11/2008. | Payment to Armstrong & Armstrong constitutes last medical payment; timely filing established. |
| Whether verification of the wage figure was timely and the reasonable time rule applies. | Swain requires timely verification or correction within reasonable time. | No timely right to verification after approval; reasonable time passed. | Plaintiff waited unreasonable time; verification denied for 2006 wage; $689.21 remains for that period. |
Key Cases Cited
- Swain v. C & N Evans Trucking Co., Inc., 126 N.C. App. 332 (1997) (form 21 wage computation is an issue of law; mutual mistake may allow rescission)
- Foster v. Carolina Marble & Tile Co., Inc., 132 N.C. App. 505 (1999) (Swain interpreted; law vs. fact distinction in wage computation)
- Colt v. Kimball, 190 N.C. 169 (1925) (reasonable time implied for contractual duties; delay analyzed as law/fact)
- Bond v. Bond Lumber Co., 139 N.C. App. 123 (2000) (cited in support of Form 21 reform context (though not controlling))