23027392.doc

NORTH CAROLINA INDUSTRIAL COMMISSION

I.C. NO. 23-027392, DANIELLE GREENE, Employee, Plaintiff, v. FIRSTHEALTH OF THE CAROLINAS, Employer, (PMA MANAGEMENT CORPORATION, Third Party Administrator), Defendant.  

OPINION AND AWARD for the Full Commission by JAMES C. GILLEN, Commissioner.

FILED: 14 July 2026


This case was heard before the Full Commission on 14 January 2026, upon appeal of Plaintiff from an Opinion and Award filed by Deputy Commissioner Wes Saunders on 22 August 2025.  The deposition transcripts of Dr. Neal Shanti and Dr. Lee Dresser are part of the evidence of record.  
APPEARANCES
Plaintiff:	Hardison & Cochran, Raleigh, North Carolina; Joey DeMartin, appearing.

Defendant:	Chartwell Law, Charlotte, North Carolina; Kari L. Schultz, appearing.

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	The Full Commission has reviewed the prior Opinion and Award based upon the record of the proceedings before Deputy Commissioner Saunders, the Form 44 Application for Review, and the briefs and arguments of the parties.  The Full Commission hereby enters the following Opinion and Award pursuant to N.C. Gen. Stat. § 97-85:
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The Full Commission finds as fact and concludes as matters of law the following, which were entered into by the parties in the executed Pre-Trial Agreement, as:
STIPULATIONS
All parties are properly before the Industrial Commission, and the Industrial Commission has jurisdiction over this matter.
All parties are subject to and bound by the North Carolina Workers' Compensation Act.
All parties have been properly designated, and there is no question as to joinder or non-joinder of parties.
An employment relationship existed between Plaintiff and Defendant-Employer on 3 July 2023. At that time, Plaintiff worked for Defendant-Employer as a part-time paramedic.
Defendant-Employer was self-insured on 3 July 2023, with their self-insurance and excess coverage administered by PMA Management Corporation.
Defendant accepted compensability for the thoracic and lumbar spine on 16 October 2023, pursuant to a Form 60 Employer's Admission of Employee's Right to Compensation.
Plaintiff had concurrent employment as an EMT for Optum Services at the time of her 3 July 2023, work injury.
Plaintiff has not returned to work for Defendant-Employer since 6 July 2023.
Plaintiff has been paid compensation consisting of temporary total disability benefits from 23 July 2023, through 25 February 2024.
Plaintiff's average weekly wage with Defendant-Employer was $582.79, with a compensation rate of $388.54.
This claim was originally calendared for hearing before Deputy Commissioner Ashley Moore on 5 August 2024. The hearing calendar was provided to the parties on 1 July 2024.
Plaintiff retained counsel on or about 24 June 2024.  On 16 July 2024, Plaintiff filed a Motion to Remove and Refer to Mediation.  Plaintiff's Motion was granted by Deputy Commissioner Moore pursuant to an Order entered on 26 July 2024.
The parties participated in a mediated settlement conference on 4 December 2024. The mediation resulted in an impasse being declared. Defendant paid the entire $1,050.00 mediator's fee associated with the 4 December 2024, mediation.  Defendant also paid the entire $200.00 report of mediator fee associated with the 4 December 2024, mediation. Defendant is entitled to a credit totaling $625.00 for Plaintiff's half of the mediator's fee and her half of the report of mediator fee.
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PROCEDURAL HISTORY
Defendant filed a Form 60 Employer's Admission of Employee's Right to Compensation on 16 October 2023.  This Form 60 reflects Defendant's admission that Plaintiff sustained a compensable injury to her "Thoracic and Lumbar spine" on 3 July 2023, that disability from the injury began on 23 July 2013, and that temporary total disability compensation commenced on 16 October 2023.  Defendant filed a Form 61 Denial of Workers' Compensation Claim on 13 November 2023 reflecting Defendant's contention that "Plaintiff did not sustain a compensable injury by accident to her neck and shoulders in the incident described, where treatment has been ongoing for a lumbar/thoracic strain injury."  Defendant filed a Form 25R Evaluation for Permanent Impairment dated 17 February 2024 completed by Dr. Neal Shanti.  This Form 25R reflects Dr. Shanti's assignment of a 2% permanent partial impairment to Plaintiff's back and a designation that Plaintiff was at maximum medical improvement.  Defendant filed a Form 28 Return to Work Report on 27 February 2024.  This Form 28 reflects that Plaintiff had returned to work with "Landmark Health," with a "presumed" return to work date of 31 January 2024.  Defendant terminated Plaintiff's temporary total disability benefits in conjunction with the filing of this Form.   
On 13 May 2024, Defendant filed a Form 33, Request for Hearing.  On this Form 33, Defendant averred: "Plaintiff has refused to sign a Form 26A for payment of the PPD rating assigned by her authorized treating provider.  Defendant seeks an Opinion and Award from the Industrial Commission setting the value of the PPD rating, and allowing the applicable statutes of limitations to begin to run."  On 1 July 2024, through newly-hired counsel, Plaintiff filed a Form 18 Notice of Accident to Employer and Claim of Employee, Representative, or Dependent.  This Form 18 avers that Plaintiff sustained injury to her "Spine, bilateral upper extremities" when "[Plaintiff] and her coworker were taking a patient out of the ambulance when her coworker let his side of the stretcher go which left [Plaintiff] holding approx.440 lbs. by herself yanking her upper extremities causing pain to them and her spine."  On 26 July 2024, Deputy Commissioner Ashley Moore, before whom a hearing had been scheduled pursuant to Defendant's Form 33, filed an Order removing this matter from the active hearing docket and referring this matter to mediation.  Deputy Commissioner Moore's Order was filed in response to Plaintiff's 16 July 2024 Motion to Remove and Refer to Mediation. 
Mediator Bruce Hamilton filed a Form MSC5 Report of Mediator dated 4 December 2024 reflecting that the mediated settlement conference held on 4 December 2024 resulted in an impasse.  On 6 December 2024, Plaintiff filed with the Industrial Commission's Executive Secretary's Office a Motion to Reinstate Benefits Pursuant to N.C.G.S. 97-18.1.  This Motion averred, inter alia, that Defendant unliterally terminated Plaintiff's benefits on or about 31 January 2024 without filing and having obtained approval of a Form 24 Application to Terminate or Suspend Payment of Compensation.  In the 6 December 2024 Motion, Plaintiff further argues that Plaintiff had not "returned to work" as indicated on Defendant's 27 February 2024 Form 28 but rather that she had concurrent employment at the time of her injury and maintained this employment subsequent to her 3 July 2023 injury, as it was within her restrictions.  Defense counsel did not receive the 6 December 2024 Motion and was therefore not able to respond. 
 On 30 December 2024, Special Deputy Commissioner Kimberly Fennell issued an Order granting Plaintiff's Motion to Reinstate Benefits compelling Defendant to reinstate temporary total disability compensation from 31 January 2024 and, pursuant to N.C. Gen Stat. 18(g), ordered Defendant to pay a 10% late payment penalty on all installments not paid within 14 days of being due after 31 January 2024.  On 9 January 2025, Defendant filed a Motion for Reconsideration of the 30 December 2024 Order.  The Motion for Reconsideration averred, inter alia, that Plaintiff improperly bypassed the Form 23 process in moving for a reinstatement of benefits, that Plaintiff's Motion to Reinstate Benefits included inaccurate factual allegations, and that the resolution of disputed facts requires factual determinations unable to be made by a Special Deputy Commissioner.  On 13 January 2025, Special Deputy Commissioner Fennell denied Defendant's Motion to Reconsider.  
On 16 January 2025, Defendant filed a notice of appeal of Special Deputy Commissioner Fennell's 30 December 2024.  This matter was assigned to Deputy Commissioner Saunders for hearing.
Prior to the hearing before Deputy Commissioner Saunders, Defendant filed a Motion to Stay, requesting that the effects of the 30 December 2024 Order be stayed pending a final determination by Deputy Commissioner Saunders.  On 28 January 2025, Deputy Commissioner Saunders granted Defendant's Motion to Stay.  Deputy Commissioner Saunders subsequently heard this matter and filed an Opinion and Award on 22 August 2025 reversing the 30 December 2024 Order of Special Deputy Commissioner Fennell and holding, inter alia, that Plaintiff is not entitled to additional temporary total disability benefits.
Plaintiff appealed Deputy Commissioner Saunders' Opinion and Award to the Full Commission. 
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 EXHIBITS
	The following documents were accepted into evidence by the Deputy Commissioner as stipulated exhibits:
Exhibit #1: Executed Pre-Trial Agreement; 
Exhibit #2: Indexed and paginated set of documents including Industrial Commission forms and filings, medical records, recorded statement, wage records, personnel files, and correspondences; 
Exhibit #3: Nurse Case Management Reports; and
Exhibit #4: Atrium Health Wake Forest Baptist Neurology Records. 
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ISSUE

To what benefits is Plaintiff entitled under The Act as a result of her compensable 3 July 2023 back injury?
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Based upon a preponderance of the evidence in view of the entire record, and reasonable inferences flowing therefrom, the Full Commission makes the following:
FINDINGS OF FACT
Plaintiff was 38 years old at the time of the hearing before the Deputy Commissioner.  Plaintiff has an Associate's Degree from Sandhills Community College as well as a Bachelor of Science degree in emergency services from Western Carolina University.  
Plaintiff sustained an admittedly compensable injury by accident on 3 July 2023 while working for Defendant-Employer.  
As of 3 July 2023, Plaintiff held two part-time jobs, working for Defendant-Employer part time as well as Landmark/Optum part-time.  
Plaintiff began working for Defendant-Employer as an Emergency Medical Services Paramedic in June of 2012.  In addition to the certification requirements, Plaintiff's job with Defendant-Employer had physical requirements including but not limited to the ability to stand and walk for long periods of time, the ability to bend and lift with a partner patients and equipment weighing approximately 250 pounds, and the completion of an annual agility test. 
When Plaintiff was hired by Defendant-Employer in 2012, she initially worked part-time before transitioning to a full-time position.  In approximately 2019, Plaintiff planned to return to school and changed her work status with Defendant-Employer from full-time to "casual part-time."  While working casual part-time with Defendant-Employer, Plaintiff would work around 24 hours per week.  To stay employed by Defendant-Employer as a causal part-time employee, Plaintiff was required to work at least two shifts every month. 
In February of 2020, Plaintiff sought secondary employment and was hired by Optum as a part-time paramedic.   
As a paramedic with Optum, Plaintiff is tasked with going to patients' homes and serving as a liaison between patients and their medical providers.  With Optum, a patient will call and speak with a medical provider.  A determination is then made by the medical provider as to whether the patient needs to be evaluated.  If an evaluation is needed, Plaintiff is dispatched to the patient's residence.  Upon arrival, Plaintiff enters the patient's home and performs an assessment.  During an assessment, Plaintiff will take the patient's vitals and perform a physical examination.  Plaintiff then relays her observations to the provider.  The provider then communicates what, if any, treatments are needed on-site, such as an IV, blood draw, etc.  Plaintiff then goes back to her car to get any necessary equipment to perform the provider's orders.  Plaintiff then completes the provider's orders. 
Optum does not maintain a list of physical demands for their paramedic position.  However, the Full Commission finds that the paramedic position requires minimal lifting.  The heaviest single object that Plaintiff would carry while working for Optum is a bag of fluid weighing approximately one pound, or her laptop.   
On 3 July 2023, while working for Defendant-Employer, Plaintiff sustained an admittedly compensable injury by accident resulting in injuries to her thoracic and lumbar spine.  On this date, Plaintiff and a co-worker were removing a patient, and the stretcher the patient was on, from an ambulance.  The patient weighed approximately 300 pounds.  As a stretcher is removed from an ambulance, the stretcher's wheels do not extend to the ground until the wheels have first cleared the floor of the ambulance.  As a result, Plaintiff and her co-worker were holding the weight of the patient and stretcher until the stretcher's wheels could extend.  During this process, prior to the stretcher's wheels extending and locking, Plaintiff's co-worker lost grip, causing Plaintiff to suddenly bear significant additional weight.  This caused Plaintiff to experience an onset of back pain. 
Defendant accepted Plaintiff's claim by filing a Form 60 Employer's Admission of Employee's Right to Compensation with the Industrial Commission dated 16 October 2023.  The Form 60 indicates that Defendant accepted the compensability of Plaintiff's "thoracic and lumbar spine" injuries, that disability from the injury began on 23 July 2023, and that temporary total disability compensation commenced on 16 October 2023. 
Plaintiff worked a regular shift for Defendant-Employer on 5 July 2023.
On 6 July 2023, Plaintiff presented to First Health Convenient Care of Asheboro.  The record from this visit reflects that Plaintiff was experiencing sharp thoracic and lumbar back pain following the 3 July 2023 work incident.  At this visit Dr. Matthew Vreeland diagnosed Plaintiff with a "strain of lumbar region."  Dr. Vreeland's note provided no work restrictions, explaining: "essentially in her job as an EMS worker she should be able to perform her duties using normal . . . caution in lifting." 
On 6 July 2023, Plaintiff worked her last shift with Defendant-Employer. 
At the Deputy Commissioner hearing, Plaintiff testified that, on 22 July 2023, she "bent down and felt a pop in my back, and I lost sensation, and had numbness as well." 
On 23 July 2023, Plaintiff returned to First Health where she was evaluated by PA Christopher Dominguez.  The record from this visit reflects that Plaintiff reported continued back pain along with "bilateral extremity numbness and tingling."  X-rays of Plaintiff's lumbar spine were negative for any abnormalities.  PA Dominguez referred Plaintiff to a physical therapist and to an orthopedist.  PA Dominguez restricted Plaintiff from working on the ambulance pending her orthopedic evaluation.  The 23 July 2023 medical record makes no mention of any 22 July 2023 "bending over" event which caused a pop and loss of sensation.  
On 27 July 2023, claims adjuster Andrea Valentine took Plaintiff's recorded statement.  During the recorded statement, Plaintiff advised Ms. Valentine that she had another part-time job with Optum and that she was still able to perform the Optum job because it required no lifting and it was flexible such that she could work with them whenever she wanted to work.  During this recorded statement, Plaintiff did not mention any 22 July 2023 "bending over" event which caused a pop and loss of sensation.  
Plaintiff began undergoing physical therapy on 17 August 2023, at First Health Outpatient Physical Therapy.  The record from this visit reflects Plaintiff's account of the 3 July 2023 work injury.  The record also contains Plaintiff's report that on 23 July 2023, "she was bending and she felt a pop in her mid back.  [Plaintiff] reports increased pain with numbness in the hands and legs, [Plaintiff] returned to convenient care on 7-23-23.  Lumbar x-ray was completed on 7-23-23 and normal."  
On 18 August 2023, Plaintiff presented for the first time to Dr. Nael Shanti with Cary Orthopaedics.  The record from this visit reflects Plaintiff's account of the 3 July 2023 injury which caused "lower back pain that has extended into the thoracolumbar spine" and that "[o]ver time [Plaintiff] started having bilateral lower extremity pain as well with noted numbness and tingling fairly diffuse in nature as well as burning type sensation in the plantar feet."  On examination, Dr. Shanti noted lumbar discomfort with palpation, a negative straight leg raise, normal reflexes, decreased sensation on the front of her thigh, and flexion to the mid-tibia with extension to 10 degrees.  Dr. Shanti recommended that Plaintiff undergo MRIs of her thoracic and lumbar spine and prescribed her Naproxen.  Dr. Shanti also referred Plaintiff to an orthopedic sports medicine provider for reported right shoulder pain.  Dr. Shanti wrote Plaintiff out of work pending her MRI.  Dr. Shanti's 18 August 2023 record makes no mention of any "bending over" event which caused Plaintiff to experience a pop and loss of sensation on July 22 or 23.
On 18 September 2023, Plaintiff underwent lumbar and thoracic MRIs at Moore Regional First Imaging.  The lumbar MRI report showed normal alignment, no acute osseous abnormalities, and minimal degenerative changes of the lower lumber spine without significant spinal canal or neural foraminal narrowing.  The thoracic MRI showed a normal alignment, well preserved disc space height, no spinal cord signal abnormalities, no significant disc bulges, no mass effects on the spinal cord, and other normal findings.  
On 25 September 2023, Plaintiff returned to Cary Orthopaedics.  Dr. Shanti's record from this visit reflects that Plaintiff's physical therapy had been "discontinued secondary to pain."  Dr. Shanti reviewed Plaintiff's MRIs and noted that there were no significant findings.  Dr. Shanti's 25 September 2023 record reflects that he was "uncertain [o]f [Plaintiff's] etiology of symptoms. [Plaintiff] appeared to demonstrate reported impairment to light touch throughout the body on exam today."  Dr. Shanti's note explained: "I would like to obtain MRI cervical spine without contrast to further evaluate [Plaintiff's] symptoms.  Would also recommend MRI of the brain with and without contrast as well as neurology evaluation to further evaluate [Plaintiff's] symptoms."  During his deposition, Dr. Shanti explained that Plaintiff's reported symptoms were "atypical" and "abnormal."  Dr. Shanti recommended that Plaintiff obtain an MRI of her cervical spine and brain and that Plaintiff undergo an evaluation by a neurologist for a possible neurological condition, such as multiple sclerosis.  Dr. Shanti recommended these tests because he was concerned that Plaintiff may have a neurologic condition. 
On 16 October 2023, Plaintiff returned to Dr. Shanti.  The record from this visit reflects Plaintiff's continued reports of pain in her "neck, middle, and lower back" as well as "diffuse numbness from the top of the head down to the feet."  This record also reflects that Defendant did not authorize Plaintiff to undergo the cervical MRI, brain MRI, or an evaluation with a neurologist.  Dr. Shanti prescribed Plaintiff a work conditioning program.  Dr. Shanti recommended that Plaintiff go through her primary care provider outside of workers' compensation to seek treatment for her denied conditions.  Dr. Shanti continued Plaintiff with work restrictions of light duty work with no lifting greater than ten pounds. 
On 10 November 2023, Plaintiff participated in a second recorded statement, this time with adjuster Cassandra Williams.  During this recorded statement, Plaintiff confirmed that she had a second job with Optum, reported that the job did not require any lifting, and explained that the job entailed travelling to patients' residences and checking their vital signs.   When asked how many hours Plaintiff worked for Optum, Plaintiff reported that she worked between 1-19 hours per week.  Plaintiff also reported that while she was out of work for Defendant-Employer she continued to work "about the same" number of hours as she was working pre-injury with Optum.  
On 10 November 2023, Ms. Williams sent Plaintiff a Form 90 Report of Earnings to complete.  Ms. Williams testified that Plaintiff did not respond to or return the Form 90, despite Ms. Williams calling Plaintiff and leaving voicemail messages.  Plaintiff also never returned the phone calls. 
Defendant filed a Form 61 Denial of Workers' Compensation Claim dated 13 November 2023.  On this form Defendant contends that Plaintiff "did not sustain a compensable injury by accident to her neck and shoulders in the incident described, where treatment has been ongoing for a lumbar/thoracic strain injury."  
On 29 December 2023, Plaintiff returned to Dr. Shanti after completing work conditioning.  The record from this visit reflects that Plaintiff "completed the work conditioning program without notable progress with her symptoms" and that she was still experiencing "baseline neck pain and diffuse body numbness extending from her head to her feet."  Dr. Shanti's 29 December 2023 record reflects that he was unable to attribute Plaintiff's reported symptoms to any structural cause in Plaintiff's back and that he requested "a functional capacity evaluation to determine [Plaintiff's] permanent work status."  Dr. Shanti continued Plaintiff on the same work restrictions.  
On 19 January 2024, Plaintiff underwent an FCE with Joshua Foster, PT at Work Recovery Solutions.  Mr. Foster's record from the FCE found that Plaintiff "failed to give maximum voluntary effort during today's FCE.  Therefore, it is undeterminable at this time safe, maximum lifting capabilities and/or other functional capabilities."  Mr. Foster therefore concluded that "professional judgment (and not merely the FCE results) should be used to determine any restrictions and/or ability to perform work."  Nevertheless, the FCE report reflects that Plaintiff demonstrated the ability to lift in the medium to heavy duty physical demand level, with Plaintiff lifting up to 89.59 pounds during her evaluation. 
On 31 January 2024, Plaintiff returned to Dr. Shanti.  Dr. Shanti noted inconsistent performance on the FCE.  Dr. Shanti's 31 January 2024 note concluded that Plaintiff was at maximum medical improvement and continued: "[c]onsidering MRI findings as well as FCE findings [Plaintiff] will be released without restrictions.  2% PPI rating will be provided for lower back pain."  Dr. Shanti also released Plaintiff from his care, but Plaintiff was told to return if she had concerns or worsening symptoms.  Plaintiff has not undergone any additional treatment with Dr. Shanti since 31 January 2024.  During his deposition, Dr. Shanti testified that he based Plaintiff's lack of work restrictions on the fact that he could not find any objective cause to explain Plaintiff's continued pain.  When Dr. Shanti released Plaintiff, he understood that his assigned work status would allow Plaintiff to return to work as a paramedic with Defendant-Employer.
In a letter dated 31 January 2024, Dr. Shanti wrote that Plaintiff "may return to work full duty immediately with no restrictions."  
On 17 February 2024, Dr. Shanti completed a Form 25R, Evaluation for Permanent Impairment, and formally assigned Plaintiff a 2% rating to the back while also designating that Plaintiff was at maximum medical improvement.  
On 23 April 2024, Plaintiff presented to Dr. Lee Dresser, a neurologist with Atrium Health Wake Forest Baptist, based on Dr. Shanti's prior neurology referral for Plaintiff's unexplained global symptoms.  Plaintiff's evaluation with Dr. Dresser was sought and paid for by Plaintiff.  Dr. Dresser's record from this visit reflects Plaintiff's account of the 3 July 2023 work incident and that Plaintiff "had change in the sensation 7/23/23 on her face when leaning over to drop her hand bag down.  She has had some decreased sensation also in arms, legs and trunk."  Plaintiff also described some urinary incontinence that ultimately resolved as well as persistent burning sensations in her feet as well as posterior neck pain with headaches.  Dr. Dresser's 23 April 2024 record also notes that Plaintiff underwent a 28 March 2024 cervical spine MRI, a 1 September 2023 thoracic spine MRI, and a 1 September 2023 lumbar MRI, all of which were unremarkable.  Due to Plaintiff already undergoing MRIs of her spine that came back unremarkable, Dr. Dresser recommended that Plaintiff undergo a comprehensive metabolic profile.  This test showed a slightly elevated glycosylated hemoglobin level and low-normal range for Vitamin D.  Otherwise, the panel was normal.  
The 23 April 2024 assessment provided by Dr. Dresser reads: 
Fairly rapid onset of alteration in sensation affecting multiple  . . . parts of her body with a fairly unremarkable neurological examination.  She could have some mild carpal tunnel syndrome.  Possibly may have had a small fiber acute sensory neuropathy, but very unusual to affect trunk and face.  It is very encouraging that her examination was unremarkable as well as imaging of her entire spine.  This could be a[n] unusual presentation of demyelinating disease. 

Dr. Dresser also recommended an EMG and expressed that he would order a brain MRI if Plaintiff does not improve.  On 7 June 2024, Plaintiff underwent EMG studies of her bilateral upper extremities.  The report reflects that Plaintiff showed 
mild to moderate right median mononeuropathy at the wrist (carpal tunnel syndrome) and mild right ulnar neuropathy at the elbow.  There was no evidence of a left median mononeuropathy.  There was no evidence of a generalized polyneuropathy to explain [Plaintiff's] whole body paresthesias. 

On 17 June 2024, Plaintiff underwent an MRI of her brain.  The report generated reflects that Plaintiff had an "[u]nremarkable noncontrast MRI appearance of the brain." 
On 18 June 2024, Plaintiff underwent an EMG study of her lower extremities.  This test found no consistent evidence of polyneuropathy or lumbosacral radiculopathy.  The EMG revealed that Plaintiff's "S1 paraspinal showed an increased insertion and spontaneous activity, although the semimembranous, and medial gastric were normal.  There was mild spontaneous activity in the tibialis anterior.  The vastus lateralis was normal."  The EMG record concluded: "There is no consistent evidence for a polyneuropathy or lumbosacral radiculopathy.  The S1 paraspinal findings are of uncertain significance." 
On 24 June 2024, Plaintiff returned to Dr. Dresser to review her recent tests.  Dr. Dresser's overall assessment was "[m]ild to moderate right carpal tunnel syndrome and a mild conduction block of the ulnar nerve on the right elbow."  Dr. Dresser noted that there was spontaneous activity in her S1 paraspinal muscle during her EMG and noted that this could be due to her work injury.  Overall, Dr. Dresser recommended that Plaintiff sleep 7-8 hours on a regular schedule, eat 3 healthy meals a day, perform moderate exercise 30-45 minutes 3-4 times a week, and to continue her efforts to lose weight.  Dr. Dresser made no diagnoses or treatment recommendations as it relates to Plaintiff's lower back.  
On 22 May 2025, the parties took the deposition of Dr. Lee Potter Dresser, who is board certified in neurology, headache medicine, and sleep medicine.  Dr. Dresser testified that he first saw Plaintiff on 23 April 2024.  When asked what he thought overall about Plaintiff's presentation, Dr. Dresser testified that Plaintiff had objective evidence of right carpal tunnel syndrome but that he never "had a really good explanation for … the sensory symptoms involving large parts of her body."  Regarding Plaintiff's foot pain, Dr. Dresser testified that her "plantar nerve response was mildly abnormal," that Plaintiff was borderline diabetic, and that "in people with borderline diabetes, it's not uncommon to have some … mild peripheral neuropathy."  When asked what symptoms he treated Plaintiff for that he would attribute to the work injury, Dr. Dresser responded "it would be hard to say that the objective abnormality, the carpal tunnel syndrome, was related to the work-related injury she had on July 3rd."  Dr. Dresser further testified that Plaintiff's brain MRI was completely normal and reiterated that he could not relate any of the symptoms he saw her for to the work accident.  In response to Plaintiff's hearing testimony that Dr. Dresser had told Plaintiff that she had an "S1 nerve severed in [her] lumbar,"  Dr. Dresser testified that he had not told her that.  Dr. Dresser also clarified that any references in his records-specifically his statements regarding the possibility of the spontaneous activity to her S1 paraspinal muscle being related to her direct trauma-were "pure speculation" and an attempt to find some explanation for Plaintiff's reported symptoms.  
On 28 May 2025, the parties took the deposition of Dr. Neal Shanti, who is board certified in orthopedic surgery.  Dr. Shanti testified that he first saw Plaintiff on 18 August 2023. Dr. Shanti testified that when he wrote her out of work completely, he did not know she was working at another job.  Dr. Shanti added that had he known she was working at another job, he "would have probably wanted to discuss that further" and that, "if the patient feels like she's capable to do certain light-duty capacity . . . then, yeah, I would put her on light-duty restrictions at that point."  Dr. Shanti also testified that it was "possible" that Plaintiff's foot symptoms were related to her diabetes condition.  Dr. Shanti testified that when he released her to return to work at light duty with no lifting more than 10 pounds at the 16 October 2023 appointment, he was not aware that she was working another job at that time.  Dr. Shanti further testified that he did not see anything on the MRIs or x-rays that explained Plaintiff's complaints of ongoing back pain.  Dr. Shanti testified that when he referred Plaintiff for work conditioning at the 16 October 2023 appointment, that he was not aware that Plaintiff was working another job and that this would be something he would have wanted to talk to her about.  Dr. Shanti testified that he assigned the 2% permanent partial disability rating to her back for her "residual ongoing pain complaints."  When asked what injury Plaintiff sustained on 3 July 2023, Dr. Shanti responded, "we would say she has back pain . . . it was caused by the strain of the back or a muscular-type strain to the back since the MRI did not show any objective, significant findings of paresthesias."  Dr. Shanti added that he would "defer that to the neurologist if there's a diagnosis."  Dr. Shanti confirmed during his testimony that Plaintiff reached maximum medical improvement for her compensable back condition on 31 January 2024.  
Pay records submitted into evidence show that in the 52 weeks prior to her work injury, Plaintiff consistently worked for Optum, on average, for 31.78 hours per week.  This is contrary to her responses during the second recorded statement, during which she reported working only 1-19 hours per week.  These records also reflect that, during the year prior to her work injury, Plaintiff had an average weekly wage with Optum of approximately $914.70.   These records also show that, in the 32 weeks after Plaintiff's work injury up to the end of January 2024, Plaintiff worked for Optum on average approximately 40.17 hours per week and worked overtime during 34% of per post-injury weeks.  During this time, Plaintiff had an average weekly wage of approximately $996.32.
During the hearing before the Deputy Commissioner, Plaintiff's supervisor with Optum, Ashley Pope, testified that in January of 2024, Plaintiff contacted her and requested that she convert from part-time to full-time employment with Optum.  Ms. Pope testified that this change did not require a change in how much time Plaintiff worked.  The primary difference between Plaintiff working part-time and full-time is that Plaintiff would be eligible for additional employment benefits.  Plaintiff's payroll records submitted into evidence confirm that in the beginning of January 2024, Plaintiff's wages included additional deductions for a Healthcare Savings Account and Medical Insurance that were not present prior to January 2024.
As discussed previously, Dr. Shanti released Plaintiff to return to work full duty on 31 January 2024.  On 22 February 2024, Ms. Williams had a phone conversation with Plaintiff.  During this conversation, Plaintiff reported to Ms. Williams that she was now working full-duty with a second employer.  Plaintiff also reported to Ms. Williams that she did not intend to return to work with Defendant-Employer due to concerns about the lifting requirements for the job.   
On 27 February 2024, Defendant-Carrier, by and through Ms. Williams, terminated Plaintiff's temporary total disability benefits and filed a Form 28, Return to Work Report, with the Industrial Commission.  On the Form, Defendant-Carrier represented that Plaintiff returned to work on "1/31/24 (presumed)" with Optum.  A copy of this Form 28 was mailed to Plaintiff on 28 February 2024.  
Ms. Williams testified that it was her understanding that she could file a Form 28 to terminate benefits when there had been a return to work at full duty without restrictions.  Ms. Williams also testified that, when she filed the Form 28 and terminated Plaintiff's benefits, Plaintiff had informed her that she had discontinued her work with Defendant-Employer and that she had increased to full-time with her other employment.  
On 28 February 2024, Defendant-Carrier filed a Form 28B, Report of Employer of Compensation and Medical Compensation Paid and Notice of Right to Additional Medical Compensation.  On this Form, Defendant-Carrier confirmed that temporary total disability benefits were paid in this claim from 23 July 2023 to 25 February 2024.  
After the filing of the Form 28 in this matter and termination of Plaintiff's compensation, Plaintiff did not object or seek reinstatement of her benefits until she filed her Motion to Reinstate Benefits on 6 December 2024, 285 days after Defendant terminated Plaintiff's compensation.  
On 25 March 2024, Tammy Kirkley, a Human Resources Manager with Defendant-Employer, sent Plaintiff a letter.  In the letter, Ms. Kirkley notified Plaintiff that subsequent to Plaintiff being released to return to work on 31 January 2024, Defendant-Employer's EMS director had attempted to contact Plaintiff on multiple occasions without success and that Plaintiff had not herself contacted Defendant-Employer with her intentions.  Ms. Kirkley's letter also conveyed that as a casual part-time employee, she was required to work at least two shifts per month to stay employed.  Ms. Kirkley's letter advised Plaintiff to contact her supervisor, Buddy Williams, no later than 1 April 2024 to communicate her intentions, and provided Mr. Williams' phone number.   
Ms. Kirkley testified that in April of 2024, she was notified that Plaintiff had failed to sign up for a shift over the previous two months.  
On April 26, 2024, Ms. Kirkely sent Plaintiff another letter regarding her employment status.  This letter was stipulated into evidence.  In the letter, Ms. Kirkley set forth a timeline documenting the following events: 
On March 22, 2024, Plaintiff's director, Buddy Williams, attempted to contact Plaintiff by telephone many times but was unsuccessful. 
On March 25, 2024, Mr. Kirkley mailed the letter notifying Plaintiff to contact her director to arrange for her return to work; 
On 1 April 2024, Plaintiff emailed Ms. Kirkley acknowledging receipt of the March 25th letter but denied receiving any correspondence from Mr. Williams; 
In the 1 April 2024 email, Plaintiff also advised Ms. Kirkley that she had a physician appointment on 10 April 2024, and would thereafter contact Defendant-Employer with information from that appointment; 
On 3 April 2024, both Mr. Williams and adjuster, Cassandra Williams, confirmed that they had attempted to contact Plaintiff but had been unsuccessful; 
On 12 April 2024, Ms. Kirkley attempted to call Plaintiff but Plaintiff's voicemail was full.  On the same day, Ms. Kirkley sent Plaintiff an email requesting Plaintiff's updated contact information and asking Plaintiff to contact her as soon as possible.  
By April 26, 2024, Plaintiff had not contacted Ms. Kirkley.  

Ms. Kirkley's 26 April 2024 letter also notified Plaintiff that her employment was being terminated.  
Subsequent to Plaintiff's full duty release from Dr. Shanti, Plaintiff has not attempted to search for any other employment.  Plaintiff has only continued her full-time employment with Optum.  
Based upon a preponderance of the evidence in view of the entire record, the Full Commission finds that Plaintiff's neurological conditions and symptoms, as well as her carpal tunnel syndrome, are not causally related to the 3 July 2023 compensable injury.   
Based upon a preponderance of the evidence in view of the entire record, the Full Commission finds that Plaintiff was not disabled for reasons attributable to the 3 July 2023 compensable injury beyond 27 February 2024.
Based upon a preponderance of the evidence in view of the entire record, the Full Commission finds that Plaintiff concealed the full post-injury nature of her job with Optum from Defendant and her medical providers.  In making this finding, the Full Commission notes that Plaintiff, among other things, did not respond to the Form 90 Report of Earnings sent to her in November 2023, did not tell her doctors or nurse case manager that she was working a second job as she was being written out of work, and did not provide an accurate account of her work hours with Optum when she was asked during her 10 November 2023 recorded statement.
Based upon a preponderance of the evidence in view of the entire record, the Full Commission finds that Plaintiff waited 285 days after Defendant terminated her benefits to file a motion for reinstatement.
Based upon a preponderance of the evidence in view of the entire record, the Full Commission finds that Plaintiff reached maximum medical improvement on 31 January 2024.
Based upon a preponderance of the evidence in view of the entire record, the Full Commission finds that Plaintiff has reached the end of the healing period and is at maximum medical improvement, having sustained a 2% permanent partial impairment of her back as a result of the 3 July 2023 work injury, for which Plaintiff is entitled to compensation at a rate of $388.54 per week for a period of 6 weeks, for a total of $2,331.24.  In making this finding, The Full Commission notes Plaintiff's Counsel's representation at the Deputy Commissioner hearing that Plaintiff was not seeking a second opinion on the rating.  
Based upon a preponderance of the evidence in view of the entire record, the Full Commission finds that Defendant paid Plaintiff three weeks and four days of temporary total disability benefits after Plaintiff reached maximum medical improvement. 
Based on the stipulation of the parties, the Full Commission finds that Defendant is entitled to a credit for Defendant's payment of Plaintiff's portion of the mediation expenses associated with this matter in the total amount of $625.00.  
* * * * * * * * * * *
Based upon the foregoing Stipulations and Findings of Fact, the Full Commission makes the following:
		                             CONCLUSIONS OF LAW
Under the Act, Plaintiff has the burden of proving every element of compensability.  As part of this burden, Plaintiff must present convincing evidence establishing these elements.  Whitfield v. Lab Corp. of Amer., 158 N.C. App. 341, 350, 581 S.E.2d 778, 784 (2003).  Regarding the Industrial Commission's ability to draw inferences from the evidence presented, the North Carolina Court of Appeals has held "[it] is for the Commission to determine the credibility of the witnesses, the weight to be given the evidence, and the inferences to be drawn from it. . . ."  Rackley v. Coastal Painting, 153 N.C. App. 469, 472, 570 S.E.2d 121, 124 (2002).  The Industrial Commission is the sole judge of the credibility of witnesses.  Adams v. AVX Corp., 349 N.C. 676, 680, 509 S.E.2d 411, 413 (1998).  As the sole judge of credibility, the Commission may believe all or part or none of any witness's testimony.  Harrell v. J.P. Stevens & Co., Inc., 45 N.C. App. 197, 205, 262 S.E.2d 830, 835 (1980).  The Commission is not required to accept uncontradicted testimony.  Morgan v. Thomasville Furn. Indus., 2 N.C. App. 126, 127-28, 162 S.E.2d 619, 620 (1968).
On 3 July 2023, Plaintiff sustained an admittedly compensable injury by accident to her lumbar and thoracic spine.  N.C. Gen. Stat. § 97-2(6); 97-18(b) (2025).  
Plaintiff in this case has the burden, through expert medical testimony, to prove a causal relationship between her neurological symptoms and the 3 July 2023 accident.  North Carolina law requires that where the exact nature and probable genesis of a particular type of injury involves complicated medical questions far removed from the ordinary experience and knowledge of laymen, only an expert can give competent opinion evidence as to the cause of the injury.  Click v. Pilot Freight Carriers, 300 N.C. 164, 265 S.E.2d 389 (1980).  Additionally, "the entirety of causation evidence" must "meet the reasonable degree of medical certainty standard necessary to establish a causal link."   Holley v. ACTS, Inc., 357 N.C. 228, 235, 581 S.E.2d 750, 754 (2003); Young v. Hickory Bus. Furn., 353 N.C. 227, 230, 538 S.E.2d 912, 915 (2000).  Medical testimony that relies on speculation and conjecture is not sufficiently reliable to qualify as competent evidence concerning the nature and cause of the injury.  Young, 353 N.C. at 230, 538 S.E.2d at 915; Seay v. Wal-Mart Stores, Inc., 180 N.C. App. 432, 637 S.E.2d 299 (2006).  Regarding the expert testimony required to establish causation, the Court of Appeals has held: 
Stating an accident 'could or might' have caused an injury, or 'possibly' caused it is not generally enough alone to prove medical causation; however, supplementing that opinion with statements that something 'more than likely' caused an injury or that the witness is satisfied to a 'reasonable degree of medical certainty' has been considered sufficient. 

Carr v. Dep't of Health and Human Serv. (Caswell Ctr.), 218 N.C. App. 151, 155, 720 S.E.2d 869, 873 (2012) (citations omitted). Here, the Full Commission concludes that the medical testimony in this case is insufficient to establish that Plaintiff's neurological condition/symptoms were caused by the 3 July 2023 workplace accident. N.C. Gen. Stat. §97-2(6) (2025); Holley, 357 N.C. at 235, 581 S.E.2d at 754; Young, 353 N.C. at 230, 538 S.E.2d at 915; Hodgin v. Hodgin, 159 N.C. App. 635, 640, 583 S.E.2d 362, 365 (2003); Peagler v. Tyson Foods, Inc., 138 N.C. App. 593, 598, 532 S.E.2d 207, 210-211 (2000).
In this case there is the possibility of the Parsons presumption applying to the medical treatment for Plaintiff's neurological condition given the Form 60 filed by Defendant. If additional medical treatment for a compensable injury is required, there can arise a rebuttable presumption that the treatment is directly related to the compensable injury - with defendants having the burden of producing evidence showing the treatment is not directly related to the compensable injury.  Reinninger v. Prestige Fabricators, Inc., 136 N.C. App. 255, 259, 523 S.E.2d 720, 723 (1999).  To rebut the presumption, defendants must "present 'expert testimony or affirmative medical evidence tending to show that the treatment [Plaintiff seeks] is not directly related to the compensable injury[.]'"  Gonzalez v. Tidy Maids, Inc., 239 N.C. App. 469, 477, 768 S.E.2d 886, 893 (2015) (quoting Perez v. Am. Airlines/AMR Corp., 174 N.C. App. 128, 137, 620 S.E.2d 288, 293 (2005)).  In the case at bar, Defendant has presented expert testimony sufficient to rebut this presumption, should it apply.  Furthermore, N.C. Gen. Stat. § 97-82(b), as revised, states that a plaintiff is not entitled to this presumption for ". . . medical treatment for an injury or condition not identified in the form prescribed by the Commission pursuant to G.S. 97-18(b) or G.S. 97-18(d)."  N.C. Gen. Stat. § 97-82(b) (2025); see Clark v. The Sanger Clinic, 175 N.C. App. 76, 79, 623 S.E.2d 293, 296 (2005) (holding that when a claimant suffers from a different injury than the one(s) identified at the time of the filing of the Form, the Parsons presumption does not apply to the newly identified injury).  In the case at bar, the conditions for which Plaintiff now seeks treatment are different from any "injury or condition" identified on Defendant's Form 60.  Thus, Plaintiff is not entitled to the presumption.  Id.
Pursuant to N.C. Gen. Stat. § 97-18.1(b), "[a]n employer may terminate payment of compensation for total disability being paid pursuant to N.C. Gen. Stat. § 97-29, when the employee has returned to work for the same or different employer."  Pursuant to N.C. Gen. Stat. § 97-18.1(c), "[a]n employer seeking to terminate or suspend compensation being paid pursuant to G.S. 97-29 for a reason other than those specified in subsection (b) of this section shall notify the employee and the employee's attorney of record in writing of its intent to do so on a form prescribed by the Commission."  The "form prescribed by the Commission" in N.C. Gen. Stat. § 97-18.1(c) is a Form 24 Application to Terminate or Suspend Payment of Compensation, the filing of which, pursuant to Industrial Commission procedures, leads to an informal hearing before a Special Deputy Commissioner and a written administrative decision.  In this case, rather than initiating the Form 24 process, Defendant terminated Plaintiff's total disability payments pursuant to N.C. Gen. Stat. § 97-18.1(b), providing notification with a Form 28 Return to Work Report. 
N.C. Gen. Stat. § 97-18.1 does not include a provision covering the specific situation presented by this case - in which 1) Plaintiff, post injury, maintained pre-existing concurrent employment while written out of work; 2) Plaintiff, post injury, changed the nature of the concurrent employment to a full-time position, and 3) Plaintiff, post-injury, was released to return to work without restrictions.  Further, there is no case law discussing whether N.C. Gen. Stat. § 97-18.1(b) or N.C. Gen. Stat. § 97-18.1(c) should be applied in this situation.
Fonville v General Motors Corp., which is cited by both parties, considers a much different factual situation.  200 N.C. App. 267, 269, 683 S.E.2d 445, 447 (2009).  In Fonville, the injured claimant was out of work and receiving temporary total disability benefits when she was separated from her employment due to reasons unrelated to her injury.  Subsequently, the claimant was cleared to return to work.  Id.  At that point, the defendants unilaterally discontinued the claimant's disability benefits without filing any forms with the Commission.  Id.  On review, the Fonville Court found that the employer failed to follow the proper procedures under the Workers' Compensation Act and held that, because the claimant had not actually returned to work, the defendants could not terminate benefits pursuant to N.C. Gen. Stat. § 97-18.1(b) and rather had to follow the procedures set forth in N.C. Gen. Stat. § 97-18.1(c).  Id.. at 271-272, 683 S.E.2d at 448.  The Full Commission concludes that Fonville is not applicable to the case at bar.  
  Although the Full Commission concludes that, in this case, Defendant should have filed a Form 24 under N.C. Gen. Stat. § 97-18.1(c), the Full Commission, given the unique facts of this case, applies equitable estoppel to grant Defendant a credit/offset such that Defendant is not obligated to pay disability benefits to Plaintiff beyond 27 February 2024.  The Full Commission is careful to note, however, that the application of equitable principles which led to this holding is extraordinarily specific to this set of circumstances, and that the language in N.C. Gen. Stat. § 97-18.1(c) to the effect that the Form 24 process shall be used by employers seeking to terminate or suspend compensation in all situations "other than those specified" in N.C. Gen. Stat. § 97-18.1(b) provides the dominant guidance for employers in this area of the law. 
Though the facts of Fonville are inapposite, the court's discussion of the termination of compensation paid pursuant to an award of the Commission and the procedural safeguards required for that termination is instructive.  In the instant case, the Full Commission notes, as the Court did in Fonville, that Defendant's desired outcome could have easily been obtained by simply following the procedures delineated by the Act and the rules of the Commission (to wit, N.C. Gen. Stat. § 97-18.1(c) and Rule 404).  Absent the unique facts before us and the application of equitable principles, Plaintiff in the case at bar may have been entitled to compensation payments during the disputed period in addition to the applicable 10 percent late penalty.  Defendant in the case at bar, like the Fonville defendant, felt it could unilaterally suspend payments without regard to the Act.  The Full Commission restates the Fonville Court's admonition that defendants cannot use a later determination that plaintiff was not disabled to justify its clear circumvention of established Commission procedures. Fonville, 200 N.C. App. at 273, 683 S.E.2d at 449. 
It is well-established North Carolina law that principles of equity can apply to workers' compensation cases.  Carroll v. Daniels and Daniels Constr. Co., Inc., 327 N.C. 616, 620, 398 S.E.2d 325, 328 (1990).  In general, "[e]quitable estoppel . . .'is an equitable doctrine designed to protect the integrity of the courts and the judicial process.'" State v. Taylor, 128 N.C. App. 394, 400, 496 S.E.2d 811, 815, aff'd per curiam, 349 N.C. 219, 504 S.E.2d 785 (1998) (citation omitted).  In a workers' compensation context, the North Carolina Court of Appeals has articulated the traditional requirements of estoppel:
The essential elements of estoppel are (1) conduct on the part of the party sought to be estopped which amounts to a false representation or concealment of material facts; (2) the intention that such conduct will be acted on by the other party; and (3) knowledge, actual or constructive, of the real facts.  The party asserting the defense must have (1) a lack of knowledge and the means of knowledge as to the real facts in question; and (2) relied upon the conduct of the party sought to be estopped to his prejudice.

Parker v. Thompson-Arthur Paving Co., 100 N.C. App. 367, 370, 369 S.E.2d 626, 628-29 (1990).  Furthermore, in Gore v. Myrtle/Mueller, the North Carolina Supreme Court quoted Watkins v. Central Motor Lines, Inc., 279 N.C. 132, 139, 181 S.E.2d 588, 593 (1971) in holding that "actual fraud, bad faith, or an intent to mislead or deceive is not essential to invoke the equitable doctrine of Estoppel." Gore v. Myrtle/Mueller, 362 N.C. 27, 40, 653 S.E.2d 400, 409 (2007).   The Full Commission concludes that, in the case at bar, in not responding to the Form 90 Report of Earnings sent to her in November of 2023, in not telling her doctors or nurse case manager that she was working a second job as she was being written out of work, in not providing an accurate account of her work hours with Optum when she was asked directly during her 10 November 2023 recorded statement, and in refusing to respond to Defendant regarding her employment status in March and April 2024, Plaintiff concealed material facts with the intention that it would be acted on while she had actual knowledge of the real facts.  Additionally, because of the nature of Plaintiff's concealment, Defendant lacked knowledge of the real facts, did not have timely access to the real facts in question, and relied upon Plaintiff's concealment to their detriment. Given the foregoing, in this case the doctrine of equitable estoppel is applicable to prevent Plaintiff from asserting the rights and presumptions that she would normally enjoy under N.C. Gen. Stat. § 97-18.1(c).  Id.; Parker, 100 N.C. App. at 370, 369 S.E.2d at 628-29.  In reaching this conclusion, the Full Commission further notes that Plaintiff was released to return to work by her treating physician on 31 January 2024 following an FCE which showed inconsistent effort, that Plaintiff never contacted Defendant-Employer about returning to work after she was released without restrictions, and that Plaintiff waited 285 days after Defendant terminated her benefits to file a motion to reinstate compensation.  
The burden of proving ongoing compensable disability remains with Plaintiff.  Sims v. Charmes/Arby's Roast Beef, 142 N.C. App. 154, 160, 542 S.E.2d 277, 282 (2001), disc. review denied, 353 N.C. 729, 550 S.E.2d 782 (2001) (citing Olivares-Juarez v. Showell Farms, 138 N.C. App. 663, 532 S.E.2d 198 (2000)).  To meet this burden, Plaintiff must produce evidence that (1) she is incapable after her injury of earning the same wages she had earned before his injury in the same employment; (2) she is incapable after her injury of earning the same wages she had earned before her injury in any other employment; and (3) that her incapacity to earn was caused by her injury.  Hilliard v. Apex Cabinet Co., 305 N.C. 593, 290 S.E.2d 682 (1982).  See Medlin v. Weaver Cooke Constr., LLC, 367 N.C. 414, 760 S.E.2d 732 (2014).  In the present case, given that Plaintiff was released to return to work without restrictions on 31 January 2024, was working full time with a different employer, and thereafter expressed an unwillingness to return to work with Defendant-Employer, she has failed to meet her burden of proving ongoing compensable disability, consequent of the 3 July 2023 compensable injury, subsequent to 27 February 2024 and continuing.  Harrington v. Adams-Robinson Enters., 349 N.C. 218, 504 S.E.2d 786, rev'g Harrington v. Adams-Robinson Enters., 128 N.C. App. 496, 495 S.E.2d 377 (1998).  
"Maximum medical improvement" refers to the point at which a claimant's injury has stabilized and the healing period has ended and is the first point at which an injured worker can elect to receive payment for permanent partial disability benefits pursuant to N.C. Gen. Stat. § 97-31 for a scheduled body part.  Knight v. Wal-Mart Stores, Inc., 149 N.C. App. 1, 12-13, 562 S.E.2d 434, 443-444, aff'd per curiam, 357 N.C. 44, 577 S.E.2d 620 (2003).  In the present matter, the Full Commission concludes that Plaintiff reached maximum medical improvement for her compensable back injury on 31 January 2024. 
As a result of the 3 July 2023 compensable injury, Plaintiff sustained a 2% permanent partial disability to her back, for which Plaintiff is entitled to compensation at a rate of $388.54 per week for a period of 6 weeks, for a total of $2,331.24, less the amount Plaintiff received in temporary total disability benefits subsequent to 31 January 2024.  N.C. Gen. Stat. § 97-31(23) (2025); Collins v. Speedway, 165 N.C. App. 113, 120, 598 S.E.2d 185, 190 (2004). 
Subject to the provisions of N.C. Gen. Stat. § 97-25.1, Plaintiff is entitled to have Defendant provide all medical treatment, incurred or to be incurred, necessitated by Plaintiff's compensable back injury when bills for the same have been approved pursuant to Industrial Commission procedures.  N.C. Gen. Stat. §§ 97-2(19); 97- 25; 97-25.1 (2025).  The Full Commission concludes that Dr. Dresser's medical treatment and associated scans and tests are unrelated to Plaintiff's compensable back injury.
* * * * * * * * * * *
Based upon the foregoing Stipulations, Findings of Fact and Conclusions of Law, the Full Commission makes the following: 
				        AWARD
Plaintiff is not entitled to temporary total disability benefits beyond 27 February 2024.
For the 2% permanent partial disability rating to Plaintiff's back, Defendant shall pay Plaintiff permanent partial disability compensation at the rate of $388.54 per week for a period of 6 weeks, for a total of $2,331.24.  This shall be paid in a lump sum, less the amount Plaintiff received in temporary total disability benefits subsequent to 31 January 2024 and less the stipulated credit for Plaintiff's half of the mediator's fee and half of the report of mediator's fee.
A reasonable attorney fee of twenty-five percent (25%) of the compensation due Plaintiff under Paragraph 2 is approved for Plaintiff's counsel.  This fee shall be paid as follows: twenty-five percent (25%) of the sum due Plaintiff shall be deducted and paid directly to Plaintiff's counsel.
Subject to the limitations set forth in N.C. Gen. Stat. § 97-25.1, Defendant shall continue to provide all medical care reasonably intended to effect a cure, provide relief, or lessen the period of disability for Plaintiff's compensable back condition. 
Plaintiff's request for Defendant to pay for her neurological evaluation and associated treatments is hereby DENIED. 
Commissioners TAYLOR and PHILLIPS concur. 

 Landmark was purchased by Optum and became a branch of Optum Healthcare.  Although much of the testimony and evidence refers to "Landmark," this entity will be referred to as "Optum" in this decision.
 Calculated using the wage records found in Stip. 2.  Note for pre-injury wage calculations, Plaintiff received multiple non-taxable income payments-likely expense reimbursements-that while paid to Plaintiff should not be considered as a part of her income.  

I.C. NO. 23-027392		Page 2