The North Carolina Court of Appeals issued an opinion in Miller v. Mission Hospital, Inc.last week, which addressed the shifting burden of proof structure in regards to theParsonspresumption.

Parsons presumption holds that where a plaintiff’s injury has been proven to be compensable, there is a presumption that the additional medical treatment is directly related to the compensable injury. The employer may rebut the presumption with evidence that the medical treatment is not directly related to the compensable injury. If the employer is able to rebut the Parsons presumption, the burden of proof shifts back to the plaintiff.

The Plaintiff in Miller was diagnosed with and treated for a degenerative spinal condition in 2003. In the summer of 2009 plaintiff suffered a compensable injury at work compensable injury at work that aggravated her pre-existing back condition. Defendant filed a Form 60 admitting the compensability of plaintiff’s claim for worker’s compensation benefits and describing her injury.

In February of 20110 plaintiff had a functional capacity evaluation and the examining doctor determined that plaintiff had reached maximum medical improvement and could return to work full time, with restrictions. However, a few weeks later, plaintiff reported to her doctor that her symptoms had gotten worse. In January of 2011 an orthopedic surgeon examined plaintiff and saw no reason why she could not return to work without restriction, and opined that the consequences of her work injury had resolved and no further treatment was needed.

Plaintiff requested that her claim for further compensation be heard before the Industrial Commission. The commission concluded that the plaintiff regained the capacity to earn the same wages she was earning at the time of the injury in the same employment, and therefore, is not disabled and there was no need for ongoing medical treatment related to the injury by accident.

The Court of Appeals held that plaintiff failed to meet her burden to produce competent medical evidence that her claim for ongoing medical benefits was related to her work accident in June of 2009. The Court further held that the Commission did not err in concluding that plaintiff was not entitled to further medical benefits arising from this claim.