If an injured worker is under medical restrictions but refuses light duty work that they’re capable of performing, they’re typically denied continued benefits. But sometimes conflicting medical opinions can cause complications in this matter.
For example, in Cromartie v. Goodyear Tire & Rubber Co., an injured worker was placed on different restrictions by several different doctors. When the employer reached out with light duty work, the worker refused based on one doctor’s restrictions.
The employer then sought to terminate benefits since other doctors found she was capable of performing the job, but the North Carolina Court of Appeals ruled the offered job wasn’t suitable and more information was needed on the disability.
Restrictions changed several times during treatment
In May 2014, the worker, a machine operator, sustained a severe laceration to her right hand, requiring sutures. She developed a painful raised scar that didn’t heal and was told to stay off work until July 2014. Her employer paid temporary disability benefits while she was out of work.
After returning to work, she continued to complain of pain and swelling from the scar. The company sent her to see Dr. James Post, who diagnosed her with a “right thumb symptomatic hypertrophic scar with distal neuroma formation of the branch of the radial sensory nerve.” He placed her on work restrictions of no lifting anything greater than 5 pounds and no forceful gripping for four weeks.
The company couldn’t accommodate the restrictions, so it placed her back on temporary disability compensation.
In September 2014, Dr. Post performed a scar revision procedure and issued new work restrictions of no lifting anything greater than 5 pounds and no pushing or pulling greater than 40 pounds. By October 2014, the worker returned to a restricted duty assignment teaching safety courses on the job to accommodate her work limitations.
On Dec. 13, 2014, Dr. Post again changed her work restrictions, this time for no lifting greater than 15 pounds and no pushing or pulling greater than 40 pounds. He also assigned her to physical therapy sessions through Jan. 5, 2015.
Evaluation, independent exam results in new restrictions
As of March 3, 2015, Dr. Post noticed no significant improvement in the worker’s condition and he ordered a complete functional capacity evaluation but her functional capacities couldn’t be determined because “she failed to give maximum voluntary effort.”
Dr. Post determined April 21, 2015, that the worker had reached maximum medical improvement with her right upper extremity at seven percent permanent partial disability. He placed her on permanent work restrictions of no lifting greater than 20 pounds and no repetitive forceful gripping or grasping.
She continued working in the light duty position, and the company didn’t offer her a different permanent position.
Through a consent agreement with the company, the worker agreed to have a one-time visit with a plastic surgeon to perform a functional capacity evaluation of her hand. This resulted in a complex regional pain syndrome diagnosis and a suggestion of sedentary work with no lifting over 10 pounds.
An independent medical exam in November 2015 resulted in a diagnosis of neuropathic pain of her right hand and symptoms of complex regional pain syndrome. The doctor suggested she would benefit from pain management medication. The company reinstated temporary total disability compensation at this time.
Company seeks to terminate benefits
Two years later, the worker was released from the care of the doctor who performed the independent exam and Dr. Post maintained the work restrictions he’d imposed in April 2015.
A job-matching contractor found a job the company felt the worker was capable of that involved driving an industrial truck for 12 hours, rarely lifting up to 25 pounds when items fell from its trailer, and 30 pounds of force, which could be split between each hand by 15 pounds lifting and 15 pounds pushing, to replace the truck’s battery. The doctor who performed the independent medical exam approved the position.
The worker refused the position on March 6, 2018. Ten days later the company filed to have her workers’ compensation benefits terminated because she “unjustifiably refused suitable employment.”
Yet another doctor added to the mix
In response, the worker returned to the plastic surgeon who performed the functional capacity evaluation. The plastic surgeon assigned permanent restrictions of light duty and sedentary work that required lifting of no more than 10 pounds.
A special deputy commissioner with the North Carolina Industrial Commission denied the suspension of benefits finding the refusal was justified in light of the work restrictions placed by the plastic surgeon. The company filed an appeal and contested the worker’s disability.
Meanwhile, the worker agreed to another independent medical exam with yet another doctor. This doctor believed the worker could return to work operating the truck without restrictions after a third functional capacity examination. So the company again offered the truck driver position and again the worker refused.
Industrial commission rules in favor of worker
The worker was approved Nov. 5, 2018, for medical retirement because she’d already qualified for Social Security Disability. A deputy commissioner heard the workers’ compensation case in February 2019, finding the worker was disabled because of her receipt of Social Security Disability benefits and because of the medical testimony of the plastic surgeon, who the deputy commissioner found to be more credible than the other doctors.
The company appealed with the full commission, leading to a decision in favor of the worker because:
- Dr. Post’s expert opinion held more weight than the other doctors’ opinions, and
- the work restrictions imposed by Dr. Post in April 2015 meant the truck driving position wasn’t a suitable job since it fell outside of those restrictions.
Court: Job isn’t suitable, disability status must be clarified
This led the company to file an appeal with the North Carolina Court of Appeals.
The court agreed with the Industrial Commission that, “unless modified in several aspects, (the truck driver position) is not within Plaintiff’s physical limitations … and is therefore not suitable post-MMI employment.”
However, the court found the commission never provided a clear ruling on what the worker’s disability status was, so it remanded the case back to the commission to make explicit findings before the case can proceed further.