A North Carolina appeals court has upheld a state agency's decision to compensate a nurse for disability and medical treatment sparked by an on-the-job injury, while also ordering the hospital that denied and fought her claims to pay her legal fees.
In February 2008, Terry Cawthorn, a longtime nurse at Mission Hospital in Asheville, N.C., injured her lower back during a post-op patient transfer, according to court records. She reported the injury to her employer and was temporarily placed on restricted duty.
This injury was aggravated by several work-related lifting incidents between March and May. Each was reported to and examined by staff health personnel and, later, by outside specialists. By June, however, even lifting a casserole out of the oven at home sent Ms. Cawthorn into severe spasms and back pain.
In October, she filed a claim with the North Carolina Industrial Commission, which awarded her workers' comp and medical treatment payments for "spondylolisthesis, lumbar stenosis and foraminal stenosis, low back pain, left leg weakness, and radiculopathy."
Mission Hospital appealed the disability designation, citing a lack of supporting evidence. Ms. Cawthorn's injuries, it said, were the result of the casserole-lifting incident only. Plus, it argued, the outside specialists' medical opinions were based on Ms. Cawthorn's subjective reports of the earlier incidents.
Ms. Cawthorn filed her own appeal. While the commission had awarded her disability benefits, it reversed a court decision which ordered the hospital to pay the legal fees she'd incurred to secure them -- the court's sanction for what it said was an unreasonable denial. Ms. Cawthorn sought the reimposition of these sanctions, arguing that the commission had erred in rejecting them.
In its April 19 ruling, the appeals court upheld the commission's awarding of disability benefits - "A subsequent injury is compensable if it is the direct and natural result of a compensable primary injury," it wrote - but also reversed its denial of legal fees, as the hospital had "no room for any legitimate doubt" that Ms. Cawthorn's primary injury was work-related.
The outside specialists' opinions were reliable, the court noted, and the hospital's "intentional disregard of information" and "failure to investigate" the incidents surrounding Ms. Cawthorn's injuries "were certainly not reasonable." In addition, it had refused to accept the reports of its own medical staff and relied on false statements from its own claims adjuster. It sent the case back for hearings to determine the amount of legal fees the hospital would be ordered to pay.
Last month, the state's supreme court rejected Mission Hospital's request for further review of the case, a move which ultimately upheld the appeals court's decision.
According to Ms. Cawthorn's attorney, Tom Ramer of Asheville, N.C., this isn't the first time the hospital has been sanctioned by the court over worker's comp issues. "Unfortunately, my experience with Mission — or other hospitals in the area — is that they don't take care of their employees," he says. "They're often the largest employers around, and they think that they can do whatever they want, which is a sad commentary."
The hospital's attorney did not return a request for comment.
David Bernard
