I. Background
Plaintiff's father, Donald L. Brown (hereinafter, "Brown" or "Decedent"), was employed as a correctional officer for the North Carolina Department of Correction ("Defеndant"), at Foothills Correctional Institution in Morganton, when he was injured during a work-related training exercise on 25 August 2005 ("the accident"). The accident occurred while Brown was participating in a training exercise during which Brown alleged he injured himself in a fall. Defendant filed a Form 19 "Employer's Report of Employee's Injury" that stated Defendant first became aware of the accidеnt on 19 November 2005. Brown alleged he injured his lower back, left hip, and leg in the accident, but that Brown had not felt injured until the following day, and had not
Defendant submitted a Form 61 "Denial of Workers' Compensation Claim," dated 4 January
Brown filed a sеcond Form 18 on 15 May 2007, again alleging he injured his back on 25 August 2005 when he "was participating in a training exercise[.]" Once again, in this second Form 18, Brown made no claim that he had sustained injuries to his left hip or leg as a result of the accident. Defendant "initiated payment of temporary total disability ... benefits to [Brown] in June 2008 in relation to his compensable back injury." These payments continued until Brown's death. Brown was "assessed at maximum medical improvement" on 10 February 2009, and was "assigned a 15% permanent partial impairment rating to [his] back, and [was] written out of work on a permanent basis" due to his ongoing "chronic back pain."
Brown submitted a third Form 18, "Amended Notice of Accident to Employer," dated 7 October 2010, alleging for the first time that, as a result of the accident, he sustаined injuries "[i]ncluding, but not limited to, [his] back
and left hip and leg
."
2
(emphasis added). In addition
Two days before the hearing date, Brown filed a request that the matter be "postponed indefinitely as there are currently no issues in dispute between the parties" in order to allow the parties "to try to mediate [Brown's] claim[.]" Pursuant to Brown's request, a deputy commissioner filed an order on 9 May 2011 removing the matter from the "May 5, 2011 hearing calendar and the active hearing docket as there [were] no issues currently in dispute." The matter was referred to mediation. The Commission's opinion and award stated: "The parties reached an impasse in sеttlement discussions at mediation. However, [Brown] did not file a new Form 33 request for hearing on the denied claim of left hip injury at any point during his lifetime."
The Commission found that Brown "received significant medical treatment for his left hip from 2007 until his death[.]" This treatment included a total left hip replacement in 2008, "at which time [Brown] denied to the medical provider any specific injury to [his] hip." Brown underwent multiple additional surgical procedures related to his left hip replacement that were complicated by persistent infections. However, "Defendant did not authorize, direct, or pay for any left hip medical treatment[.]"
Temporary total disability benefits related to Brown's back injury, totaling $105,233.12, continued until Brown's death on 1 January 2014. Total medical benefits paid for Brown's compensable back injury amounted to $40,198.87. Brown's death certificate listed alcoholic cirrhosis as the immediate cause of death, and noted
underlying causes of death as hepatic encephalopathy [-altered mental state resulting from alcoholic cirrhosis of the liver R62 -] for a period of weeks prior to death and chronic left hip and psoas muscle abscess refractory to antibiotics [- infeсtion resistant to antibiotics resulting in abscess of hip and associated muscle, likely resultant of Brown's 2008 left hip replacement -] for approximately six years prior to the date of death.
Defendant appealed the deputy commissioner's order to the Commission. Following a hearing on 8 March 2016, the Commission entеred an opinion and award dismissing with prejudice Plaintiff's claims for (1) medical compensation related to Decedent's alleged hip injury, and (2) death benefits pursuant to N.C.G.S. § 97-38. The Commission concluded, inter alia , that (1) Decedent's cause of death was "unrelated to his compensable back injury[;]" and (2) Plaintiff's claim for death benefits based on Decedent's denied hip injury was time-barred under N.C.G.S. § 97-38. Plaintiff appeals.
II. Argument
Plaintiff's sole argument on appeal is that the Commission erred by dismissing her claim for death benefits based on its conclusion that the claim was time-barred pursuant to N.C.G.S. § 97-38. We disagree.
A. Standard of Review
"The standard of review for an opinion and award of the North Carolina Industrial Commission is (1) whether any competent evidence in the record supports the Commission's findings of fact, and (2) whethеr such findings of fact support the Commission's conclusions of law."
B. Analysis
Plaintiff's claim for death benefits is based upon N.C.G.S. § 97-38, which states in relevant part:
If death [of an employee] results proximately from a compensable injury ... and within six years thereafter, or within two years of the final determination of disability, whichever is later, the employer shall pay or cause to be paid, subject to the provisions of other sections of this Article, weekly payments of compensation equal tosixty-six and two-thirds percent (66 2/3 %) of the average weekly wages of the deceased employee at the time of the accident, ... and burial expenses not exceeding ten thousand dollars ($10,000), to the person or persons entitled thereto[.]
[A] death benefits claim [is] a distinct claim of the beneficiaries.... Specifically, our Supreme Court [has] stated:
[D]uring [the injured employee's] lifetime his [beneficiaries] were not parties in interest to the proceeding he brought for the enforcement of his claim. Their right to compensation did not arise until his death and their cause of action was not аffected by anything he did[.]
... The basis of their claim was an original right which was enforceable only after his death.
Accordingly ... a death benefits claim under the Workers' Compensation Act is a distinct claim to those beneficiaries upon the death of the injured [employee]. Notably, because the death benefits claim does not arise until the injured employee's death ... the rights оf the beneficiaries under the Act are not implicated until the injured employee's death.
Pait
,
In addition to the requirements of compensability and proximate causation, N.C.G.S. § 97-38 "imposes express time limitations on the accrual of death benefits claims."
Pait
,
The accident occurred on 25 August 2005. Decedent died on 1 January 2014, and Plaintiff filed her Form 33 seeking death benefits pursuant to N.C.G.S. § 97-38 on 21 August 2014. Plaintiff acknowledges that Decedent did not die "within six years" of the accident and therefore her claim was not timely under that prong of the statute of limitations. However, Plaintiff argues that, because no final determination of disability was ever made, the second prong of the statute of limitations-the "final determination of disability" prong-renders her claim timely. See N.C.G.S. § 97-38 (providing that a claim is timely "[i]f death [of the employee] results proximately from a compensable injury ... within two years of the final determination of disability").
This Court has held that, whеre there has been no final determination of disability with respect to a compensable injury, a claim for death benefits is not time-barred by the statute of limitations as set forth in N.C.G.S. § 97-38.
Shaw v. U.S. Airways, Inc.
,
As noted by the Commission in the opinion and award entered 17 December 2010, defendants paid temporary total disability to [the employee] pursuant to a Form 60 and subsequent Form 62. Entry of these forms raises only a presumption of disability, not a final determination.
Under the Workers' Compensation Act, disability is defined by a diminished capacity to earn wages, not by physical infirmity. Thus, the employee has the burden "to show that he is unable to earn the same wages he had earned before the injury, either in the same employment or in other employment."
There is nothing in thе record to indicate that [the employee] was paid anything other than temporary total benefits pursuant to Forms 60 and 62.
Therefore, as there was no determination of [the employee]'s final determination of disability prior to the Commission's 17 December 2010 opinion and award determining that his death was the proximate result of his 12 July 2000 compensable injury, [the plaintiff's] 8 April 2009 claim for death benefits was not untimely and not barred by the statute of limitations underN.C. Gen. Stat. § 97-38 . 3
Shaw
,
Plaintiff contends, relying on
Shaw
, that because "there [had been] no final determination of disability [with respect to Decedent's
However, this Court in
Shaw
held that, because the employee's
compensable back injury had proximately caused his death
and that because there had been no "final determination of disability"
with respect to that compensable back injury
, the plaintiff's claim for death benefits was not untimely pursuant to N.C.G.S. § 97-38.
Id
. at 541,
In the present case, Brown filed a Form 18, "Notice of Accident," on 20 February 2006, claiming that on 25 August 2005 he sustained a work-related accident to his lower back. Defendant filed a Form 60 on 23 March 2006, admitting Brown's right to compensation for the "low back strain" resulting from his 25 August 2005 "injury by accident." Defendant never filed a Form 60 admitting compensability for any injury to Brown's left hip, nor did the Commission ever make a determination that the hip injury was a compensable work-related injury.
In its opinion and award, the Commission recognized the difference between the facts of
Shaw
and those in the present case, finding that "[P]laintiff [was] not entitled to use [D]ecedent's disability status resulting from his
compensable back injury
to pursue her claim of benefits for death proximately resulting from [D]ecedent's
denied left hip injury
using the two-year statute of limitations provision [in
Under the Workers' Compensation Act, "compensability" and "disability" are distinct concepts, involving different elements of prоof.
Clark v. Wal-Mart
,
We hold that the phrase "final determination of disability," as used in N.C.G.S. § 97-38, is limited to the final determination of disability for the compensable injury that is
specifically alleged to have proximately caused the employee's death
. N.C.G.S. § 97-38 ("[i]f death results
proximately from a compensable injury
... within two years of the final determination of disability, ... the employer shall pay ... weekly payments of compensation") (emphasis added). The final dеtermination of disability for a compensable injury cannot be made unless
the compensability of such injury has already been established
. We note that N.C.G.S. § 97-38 refers to "
the
final determination of disability," not "
a
final determination of disability." This supports our interpretation that the statute contemplates a determination of disability
with respect to the specific injury which forms the basis of the claim for death benefits
.
See
N.C. Dept. of Correction v. N.C. Medical Bd.
,
This Court has previously rejected interpretations of N.C.G.S. § 97-38 that "would lead to absurd results, contrary to the manifest purpose of our Legislature[.]"
Pait
,
We recognize that the application of any statute of limitations may result in hardship to a plaintiff. As our Supreme Court has acknowledged,
application of [N.C. Gen. Stat. §] 97-38 may sometimes have the effect of barring an otherwise valid and provable claim simply because the emplоyee did not die within the requisite period of time.... The remedy for any inequities arising from the statute, however, lies not with the courts but with the legislature.
Booker v. Duke Medical Center
,
III. Conclusion
For the reasons stated above, we hold the Commission did not err in denying Plaintiff's
AFFIRMED.
Judges DAVIS and TYSON concur.
Notes
The record copy of this Form 19 is not signed by any representative of Defendant, does not include a date in the section labeled "Date Completed," nor does it include any file stamp. Assuming it was sent to the Commission as required, there is no record indication of when that occurred.
We note that some of the documentation is file stamped, whereas other dоcumentation, such as this amended Form 18, is not. Because Defendant does not argue otherwise, we presume all record documentation was correctly filed on or near the dates, if any, included on that documentation.
We note that the relevant inquiry is whether the employee's death occurred within two years of the final determination of disability. Because no final determination of disability was ever made, this Court in Shaw determined that the two-year limitations period of this prong had never started to run and, therefore, it could not serve to bar the plaintiff's claim.
