Ajdini v. Frank Lill & Son, Inc.

Pursuant to statute (§ 31-294c (b)), whenever an employer contests liability to pay workers' compensation benefits, the employer ''shall file'' with the workers' compensation administrative law judge, on or before the twenty-eighth day after the employer has received the employee's written notice of claim, a notice of intention to contest the employee's right to compensation benefits. The defendants, F Co. and F Co.'s insurer and third-party workers' compensa- tion benefit administrator, appealed from the decision of the Compensa- tion Review Board, which upheld the decision of the administrative law judge precluding the defendants from contesting liability for injuries sustained by the plaintiff during the course of his employment with F Co. Within twenty-eight days of receiving the plaintiff's notice of claims, F Co. mailed to the administrative law judge a notice of intention to contest the plaintiff's right to compensation benefits pursuant to § 31- 294c (b), but the administrative law judge did not receive the notice of intention until after the twenty-eight day statutory period elapsed. The administrative law judge thereafter granted the plaintiff's motion to preclude the defendants from contesting liability, concluding that, because F Co. had failed to commence payment for the claims or file its notice of intention to contest within twenty-eight days following receipt of the plaintiff's notice of claims, as required by § 31-294c (b), the defendants were presumed to have accepted the compensability of the plaintiff's alleged injuries and precluded from contesting his claims. The board upheld the administrative law judge's decision, and, there- after, the defendants appealed. Held that the board properly upheld the administrative law judge's decision to preclude the defendants from contesting liability, as F Co. did not file its notice of intention to contest with the administrative law judge on or before the twenty-eighth day after receiving the plaintiff's no

<bold>Workers' Compensation — Causation — fibromyalgia — doctor's opinion</bold> <bold>testimony</bold> <block_quote> The Court of Appeals erred in concluding that competent evidence was presented to support the Industrial Commission's findings of fact with regard to the cause of plaintiff-employee's fibromyalgia based solely on the opinion testimony of one doctor.</block_quote>

<bold>1. Workers' Compensation — Seagraves test — injured employee's</bold> <bold>right to continuing benefits — termination for misconduct</bold> <block_quote> Our Supreme Court adopts the <italic>Seagraves</italic>, <cross_reference>123 N.C. App. 228</cross_reference> (2003), test for determining an injured employee's right to continuing workers' compensation benefits after being terminated for misconduct whereby an employer must demonstrate initially that the employee was terminated for misconduct, the same misconduct would have resulted in the termination of a nondisabled employee, and the termination was unrelated to the employee's compensable injury, in order to find that an employee constructively refused suitable work, thus barring workers' compensation benefits for lost earnings unless the employee is then able to show that his inability to find or hold other employment at a wage comparable to that earned prior to the injury is due to the work-related injury.</block_quote> <bold>2. Workers' Compensation — constructive refusal of suitable</bold> <bold>employment — termination for misconduct unrelated to</bold> <bold>workplace injuries</bold> <block_quote> The Industrial Commission erred in a workers' compensation case by concluding that defendant employer met its burden of providing competent evidence that plaintiff employee's failure to perform her UPC labeling duties was not related to her prior compensable injury under workers' compensation, which thereby led to her termination for misconduct and denial of additional workers' compensation benefits based on an alleged failure to accept a suitable position reasonably offered by her employer, because: (1) the evidence relied upon by the Commission's majority indicated that plaintiff was having continuing problems in the wake of, and as a result of, her injuries; (2) there was no competent evidence referenced in the Commission's opinion and award that supported a showing by defendant employer that