## Facts

- Stevie Johnson worked about 15 years for the City of Winston-Salem as a recreational center custodian performing repetitive cleaning tasks.
- His duties included operating mechanized stripping/buffing and carpet-shampooing equipment requiring frequent gripping, twisting, and exposure to vibration.
- Johnson developed bilateral carpal tunnel syndrome and also had other medical conditions including gout and arthritis; the claim focused on work-related disability.
- A treating hand surgeon diagnosed bilateral carpal tunnel syndrome and opined that Johnson’s repetitive, forceful, vibrating work activities significantly contributed to the condition, despite other risk factors (including diabetes and obesity).
- The City denied the workers’ compensation claim.
- Johnson left work in 2003 and later stopped medical treatment after losing health insurance; evidence indicated he intended to resume treatment when financially able.

## Issues

1. Whether competent evidence supported finding bilateral carpal tunnel syndrome a compensable occupational disease under N.C. Gen. Stat. § 97-53(13).
2. Whether competent evidence supported awarding temporary total disability benefits under N.C. Gen. Stat. § 97-29.
3. Whether disability benefits had to be apportioned between compensable carpal tunnel syndrome and non-compensable conditions.
4. Whether the Commission erred by finding Johnson had not reached maximum medical improvement (MMI) despite discontinuing treatment.

## Decision

- The Court of Appeals affirmed the Full Commission’s Opinion and Award.
- Competent evidence supported that Johnson’s employment significantly contributed to his bilateral carpal tunnel syndrome, satisfying occupational disease requirements.
- Competent evidence supported the finding of temporary total disability based on Johnson’s reduced earning capacity in light of his injury and circumstances.
- The Commission properly declined to apportion benefits because the record did not provide a non-speculative basis to allocate disability between compensable and non-compensable causes.
- The Commission properly found Johnson had not reached MMI where treatment stopped for financial reasons rather than medical stability.

## Legal Principles

- An occupational disease under N.C. Gen. Stat. § 97-53(13) is compensable when it is characteristic of the employment, not an ordinary disease of life to which the public is equally exposed, and is causally connected to the work.
- For occupational disease causation, employment need not be the sole cause; it is sufficient that work significantly contributed to the disease’s development.
- Appellate review is limited: the Commission’s findings are binding if supported by competent evidence, even if contrary evidence exists.
- Disability may be proven by showing inability to earn the same wages in the same or other employment because of the compensable condition; the Commission may consider the worker’s education, training, work history, and health in assessing employability.
- Apportionment between compensable and non-compensable causes is improper where the evidence does not permit a rational allocation without speculation.
- Discontinuation of medical treatment due to loss of insurance or financial inability may support a finding that MMI has not been reached.

## Conclusion

The court upheld an award of workers’ compensation benefits, holding that competent medical and factual evidence supported treating Johnson’s bilateral carpal tunnel syndrome as a compensable occupational disease causing temporary total disability, that apportionment was not permitted absent evidence allowing a reasoned division of causes, and that stopping treatment for financial reasons did not establish MMI.


Johnson v. City of Winston-Salem, 188 N.C. App. 383, 656 S.E.2d 608 (2008)