What is a “disability” in the world of workers comp?

KELLY V. RAY OF LIGHT HOMES, COA14-1029: ESTABLISHING DISABILITY

In another recent unpublished opinion out of the Court of Appeals, an issue arose as to whether a claimant adequately established a disability after a work-related injury. This case had quite a few contested issues, however the most informative is the court’s language regarding disability.

In this case, the claimant suffered an injury when she was helping to lift an injured party off the floor at her place of employment. Specifically, she felt a tear in her back. The Industrial Commission awarded the claimant about a year of disability benefits, starting from her date of injury. However, both parties appealed. The claimant asserted that the Industrial Commission erred in only awarding a year of disability benefits. On the other hand, defendants argued that even the year of disability benefits was too much because the claimant had failed to establish she was disabled at all.

Determining the disability of a claimant is a multi-step process. First, disability is statutorily defined as “incapacity because of injury to earn the wages which the employee was receiving at the time of injury in the same or any other employment.” N.C. Gen. Stat. § 97-2(9) (2013). Next, the plaintiff can prove the alleged disability in one of four ways:

(1) produce medical evidence that she is, physically or mentally, as a consequence of a work related injury, incapable of work in any employment;
(2) produce evidence that she is capable of some work, but after a reasonable effort on her part he has been unsuccessful in obtaining employment;
(3) produce evidence that she is capable of some work, but that it would be futile to seek other employment because of other conditions;
(4) produce evidence that she has obtained other employment at a wage less than that earned prior to the injury.

As you can see, the claimant has many avenues in which to prove a disability. In this case, the claimant looked for a job only one time after the accident. Moreover, she had experience in many different types of positions, including clerical positions. The Court also determined that the claimant had failed to promptly seek medical attention after her injury. Finally, medical testimony of multiple physicians who treated claimant failed to show that she was disabled after the accident.

Thus, because of these factors, along with an absence of evidence showing a disability after the incident, the Court of Appeals reversed the Industrial Commission’s award.

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