Vance v. Laurels Healthcare Holdings, Emp'r, Pma Cos.

• Decision Date: 04 January 2022
• Docket Number: No. COA21-198,COA21-198
• Citation: 866 S.E.2d 536 (Table)
• Parties: Genevieve Carter VANCE, Plaintiff, v. LAURELS HEALTHCARE HOLDINGS, Employer, PMA Companies, Carrier, Defendants.
• Court: North Carolina Court of Appeals

866 S.E.2d 536 (Table)

Genevieve Carter VANCE, Plaintiff,

v.LAURELS HEALTHCARE HOLDINGS, Employer, PMA Companies, Carrier, Defendants.

No. COA21-198

Court of Appeals of North Carolina.

Filed January 4, 2022

Ganly & Ramer, P.L.L.C., Asheville, by Thomas F. Ramer, for Plaintiff-Appellant.

Sizemore McGee, P.L.L.C., by Steven W. Sizemore, for Defendants-Appellees.

CARPENTER, Judge.

¶ 1Genevieve Carter Vance("Plaintiff") appeals from an opinion and award (the "Opinion and Award") entered 19 January 2021 by the full North Carolina Industrial Commission(the "Commission").Because we hold the Commission's conclusion that Plaintiff failed to show she sustained an injury by accident is unsupported by competent evidence, we reverse the Opinion and Award and remand the matter to the Commission.

I.Factual and Procedural Background

¶ 2This case arises out of Plaintiff's workers’ compensation claim, which was denied by Defendant PMA Companies on 11 September 2018.On 26 September 2018, Plaintiff requested the claim be assigned for hearing.On 25 March 2019, an evidentiary hearing was held before Deputy Commissioner Jesse Tillman, III("Deputy Commissioner Tillman").The issues before Deputy Commissioner Tillman were: (1) whether Plaintiff sustained a compensable injury by accident to her left knee on 18 July 2018; and (2) what benefits Plaintiff was entitled to receive.

¶ 3 The evidence of record tends to show the following: Plaintiff, a licensed physical therapy assistant ("PTA") since 2008, began employment with Laurels of Summit Ridge, a facility of Laurels Healthcare Holdings ("Employer"), in 2012.As part of her job, Plaintiff is often required to use her physical strength to facilitate movements for patients who have mobility problems.The patients may have stiff, erratic, or unusual movements.Plaintiff's "job duties include progressing the plan of care ... set forth by the supervisor and therapist."Plaintiff, as a PTA, uses therapeutic interventions and modalities pursuant to state and federal standards.

¶ 4 On 18 July 2018, Plaintiff was injured while working with patient "J.W."Prior to the incident, Plaintiff had never lifted J.W. from a seated to a standing position by herself, although she had previously worked with J.W. on several occasions with another assistant.When asked on direct examination at the 25 March 2019 hearing if she understood that "J.W. was considered to be a two-person lift,"Plaintiff responded, "[n]ot necessarily, not always."On cross-examination, Plaintiff clarified that J.W. could "get up" with certain modifications.In a recorded statement taken by PMA Companies on 14 August 2018, Plaintiff added, "[w]hen I say ‘modifications,’ like if the bed is raised to a certain height[,]he's able to get up without a lot of physical assist."To the best of Plaintiff's knowledge, she had not worked with any patients larger than J.W. Plaintiff had reviewed J.W.’s chart—including progress notes, needed assessments, and prior treatments—the morning of the date of injury "[t]o get a clear indication as to what he needs to work on."

¶ 5 J.W. weighs approximately 300 pounds and stands about six feet, three inches tall.Due to a degenerative condition, he does not have hip flexors.As a result, J.W. has a decreased range in motion for bending or leaning forward.J.W.’s legs are continually extended out, so he needs assistance with pushing his legs back in order to lean forward or stand up.He can walk with the assistance of a walker once standing.

¶ 6 On 18 July 2018, J.W. was walking with another therapist to Employer's gym when he saw Plaintiff.J.W. expressed to Plaintiffhe"would like to practice transfers" and "getting up and down"; these tasks were within J.W.’s plan of care.After Plaintiff could not find another assistant to help with the transfer, Plaintiff took J.W. "inside the gym and ... positioned him within the parallel bars" as J.W. sat in a wheelchair in a reclined position of about forty-five degrees.Plaintiff removed the foot pedals from J.W.’s wheelchair so he could stand.Plaintiff then put her gait belt around J.W.’s waist and ensured his feet were in proper position.She next instructed J.W. to lean forward and advised him he would help by shifting his weight to a standing position on the count of three.As J.W. leaned forward, Plaintiff placed her body close to J.W. while holding the gait belt, put her left foot first and her right foot behind her, and shifted her weight to assist J.W. in standing up.According to Plaintiff, J.W. "requir[ed] more effort than [she] expected" when he went to stand up.Plaintiff's expectations were based on her prior two-person lifts, and she"exerted all [her] force to get [J.W.] from a seated to a standing position."As a result, Plaintiff shifted her weight onto her left knee and felt discomfort and pain in the knee.She shifted her weight again onto her left knee in assisting him back down in a seated position.Plaintiff returned J.W. to his room and continued to work on the administrative duties of her job.Although her knee was "really hurting,"she did not seek medical care since "it's not uncommon to have aches and pains" in her line of work.

¶ 7Plaintiff continued to have pain in her knee days later.She reported the accident to her supervisors, Charles Fox("Mr. Fox") and Charles Jenson Simonetti("Mr. Simonetti"), on 26 July 2018 and completed an incident report on 7 August 2018.As directed by Employer, Plaintiff was seen at an urgent care facility for her injury and was placed on "sit down duty only."After her claim was denied, Plaintiff was released of light duty and placed on Family and Medical Leave Act("FMLA") leave and short-term disability.Plaintiff requested she be referred to Dr. Charles James DePaolo, III("Dr. DePaolo"), a board-certified orthopedic surgeon.

¶ 8 In his 5 June 2019 deposition, Dr. DePaolo testified that a meniscal tear is typically caused by a traumatic event where a knee is "plant[ed] and twist[ed]."Dr. DePaolo opined that Plaintiff's shift of her weight onto her knee contributed to the injury for which he treated Plaintiff.Dr. DePaolo recommended therapy to increase her motion and later performed an outpatient arthroscopy surgical procedure on Plaintiff's left knee.Based on his operative findings as well as Plaintiff's prior MRI scans from 22 August 2018, Dr. DePaolo concluded Plaintiff had a "medial meniscus tear and a small lateral meniscus tear."Dr. DePaolo testified Plaintiff's impairment rating is likely "in the range of ten to fifteen percent" due to her injury and subsequent surgery.Nevertheless, Plaintiff was ultimately released to full duty work.

¶ 9 Mr. Simonetti, a licensed PTA and Director of Rehabilitative Services for Employer, testified he supervised twelve PTAs including Plaintiff as it pertained to the administrative and financial aspects of their work, but did not supervise their clinical work.The performance of Plaintiff's physical therapy activities was supervised by two physical therapists, one of whom was Mr. Fox.Mr. Simonetti testified Employer considered J.W. to be a "max assist," meaning he could contribute twenty-five percent or less to a lift.Mr. Simonetti explained that a patient could be classified as a "max assist" one day, and a "moderate assist" or a "minimal assist" another day.Furthermore, Mr. Simonetti acknowledged Employer had determined J.W. to be a two-person lift on and leading up to 18 July 2018—in other words, "two people would be needed to stand him because of his size, his weight, et cetera."Despite Employer's classifications for J.W., Mr. Simonetti had worked with J.W. on a sit-to-stand transfer without the assistance of another therapist on at least one occasion.

¶ 10 Mr. Simonetti described Employer's policy of requiring employees engaged in physical therapy activities to "have a [g]ait belt on the patient" at all times.A gait belt is placed around a patient's waist, held by the therapist, and is used to control the direction of movement of a patient's hips and pelvis.With the use of a gait belt, a therapist can safely maneuver how and where a patient's body moves.Employer also uses mechanical lifts in certain circumstances, including when it is put in a patient's plan of care or when a therapist recommends it.When asked at the 25 March 2019 hearing before Deputy Commissioner Tillman what would change a therapist's abilities to safely help J.W. out of a chair, Mr. Simonetti responded, "[i]f he's not having a good day,""[i]f the [gait] belt is cinched in tight and moved,"[i]f the [patient] loses ... balance," or "[i]f the therapist lost their position."In other words, according to Mr. Simonetti, it would "take something unexpected" to cause a therapist to be injured.

¶ 11 On 13 December 2019, Deputy Commissioner Tillman entered his opinion and award.He found as fact, inter alia , that "Plaintiff's work duties were interrupted through being required to lift J.W. without the assistance of a second staff person and, in doing so, unexpectedly putting an unusual amount of strain on her left knee."He then concluded, inter alia :

3.While her job duties normally required her to work with physically challenged patients, the Plaintiff did not normally lift six feet four inch three hundred-pound patients without assistance.Therefore, on July 18, 2018, Plaintiff suffered a compensable injury by accident when she was required to lift J.W. without the assistance of a second staff person and, in doing so, was unexpectedly required to put an unusual amount of strain on her left knee.(Citations omitted).

Based on Deputy Commissioner Tillman's conclusions of law, he awarded Plaintiff benefits under the Workers’ Compensation Act.

¶ 12 On 27 December 2019, Employer appealed to the Commission.The Commission heard oral arguments on 20 May 2020.On 19 January 2021, the Commission entered its Opinion and Award, reversing Deputy Commissioner Tillman's decision.It found, ...