dissenting.
The majority’s opinion holds that Dr. Kritzer’s testimony sufficiently established causation to affirm the Commission’s award. I respectfully dissent.
“Plaintiff has the burden to prove each element of compensability.” Holley v. ACTS, Inc., 357 N.C. 228, 234, 581 S.E.2d 750, 754 (2003) (citing Harvey v. Raleigh Police Dep’t, 96 N.C. App. 28, 35, 384 S.E.2d 549, 553, disc. rev. denied, 325 N.C. 706, 388 S.E.2d 454 (1989); Taylor v. Twin City Club, 260 N.C. 435, 437, 132 S.E.2d 865, 867 (1963)). “[T]he plaintiff must prove that the accident was a causal factor by a ‘preponderance of the evidence.’ ” Holley, 357 N.C. at 232, 581 S.E.2d at 752 (quoting Ballenger v. ITT Grinnell Indus. Piping, Inc., 320 N.C. 155, 158-59, 357 S.E.2d 683, 685 (1987), and citing 1 Kenneth S. Broun, Brandis and Broun on North Carolina Evidence § 41, at 137 (5th ed. 1998)). With injuries involving complex medical questions:
“only an expert can give competent opinion evidence as to the cause of the injury.” Click v. Pilot Freight Carriers, Inc., 300 N.C. 164, 167, 265 S.E.2d 389, 391 (1980). “However, when such expert opinion testimony is based merely upon speculation and conjecture, ... it is not sufficiently reliable to qualify as competent evidence on issues of medical causation.” Young v. Hickory Bus. Furn., 353 N.C. 227, 230, 538 S.E.2d 912, 915 (2000). “The evidence must be such as to take the case out of the realm of conjecture and remote possibility, that is, there must be sufficient competent evidence tending to show a proximate causal relation.” Gilmore v. Hoke Cty. Bd. of Educ., 222 N.C. 358, 365, 23 S.E.2d 292, 296 (1942)....
Holley, 357 N.C. at 232, 581 S.E.2d at 753.
In Holley, our Supreme Court clarified the employee’s burden and the required standard of proof to establish causation and stated, “[although expert testimony as to the possible cause of a medical condition is.admissible if helpful to the jury, it is insufficient to prove causation, particularly ‘when there is additional evidence or testimony showing the expert’s opinion to be a guess or mere speculation.’ ” 357 N.C. at 233, 581 S.E.2d at 753 (quoting Young, 353 N.C. at 233, 538 S.E.2d at 916) (internal citation omitted). In reversing this Court’s majority opinion, which had affirmed the Commission’s finding of compensability, our Supreme Court held, “the entirety of causation evidence before the Commission failed to meet the reason*486able degree of medical certainty standard necessary to establish a causal link between plaintiff’s . . . injury and her [disease].” Holley, 357 N.C. at 234, 581 S.E.2d at 754.
Here, Dr. Kritzer was the only medical expert whose testimony was considered by the Commission. He testified that plaintiff’s injury could have been caused by “emptying a dishwasher,” “in [his] sleep,” or “coughing and sneezing.” Dr. Kritzer also stated he could not testify to a “reasonable degree of medical certainty” that plaintiff’s “falling a couple of feet from the ladder caused the herniated disk.” Further, Dr. Kritzer did not review “any previous medical history” from plaintiff, other than plaintiff’s “account” of the accident and an MRI film. Dr. Kritzer’s only basis for causation was admittedly based on “the temporal nature of the pain and the fall.” The “entirety of causation evidence” fails to establish plaintiff’s fall off the ladder caused his back injury. Id.
Dr. Kritzer’s deposition and testimony show that numerous possible causes of plaintiff’s injury exist. His opinion regarding the cause of plaintiff’s injury was based on the “history” given to him regarding plaintiff’s injury and the “temporal nature of the complaint and the fall.” Although Dr. Kritzer’s testimony may be admissible, it was based on “mere speculation” and is “insufficient to prove causation.” Id. at 233, 581 S.E.2d at 753.
To support its holding that plaintiff presented sufficient evidence regarding causation, the majority’s opinion relies in part on Johnson v. Piggly Wiggly of Pinetops, Inc., 156 N.C. App. 42, 575 S.E.2d 797 (2003), which was decided by this Court prior to the Supreme Court’s decision in Holley. Further, this Court’s majority opinion in Holley v. ACTS, Inc., relied on Johnson and was reversed by our Supreme Court. See Holley v. ACTS, Inc., 152 N.C. App. 369, 567 S.E.2d 457 (2002), rev’d, 357 N.C. 228, 581 S.E.2d 750 (2003). Reliance on this case as precedential authority was rejected by the Supreme Court in Holley and the majority’s opinion fails to apply the proper standard. Id. We are bound by the decisions of our Supreme Court. See Dunn v. Pate, 334 N.C. 115, 118, 431 S.E.2d 178, 180 (1993) (noting the Court of Appeals is bound by decisions of the Supreme Court).
Even accepting the majority’s interpretation of Holley that expert testimony to a “reasonable degree of medical certainty” is not required to prove causation, no competent evidence exists to support the Commission’s finding that “plaintiff’s [injury] was causally related to liis October 1, 2000[,] fall from the ladder.” Dr. Kritzer, the sole *487expert, testified to numerous possible causes of plaintiffs injury. Dr. Kritzer’s opinion, based solely on temporal proximity and “plaintiffs account,” does not constitute competent evidence of causation. His opinion is speculation and conjecture, which we all agree is insufficient under Holley. 357 N.C. at 232, 581 S.E.2d at 752.
Without competent evidence to support a finding of fact to prove the required element of causation, the Commission’s conclusion of law that “Plaintiff suffered a compensable injury” cannot be supported. The Opinion and Award should be reversed. I respectfully dissent.