ANTONIO PEREIRA VS. OASIS FOODS (DEPARTMENT OF LABOR AND WORKFORCE DEVELOPMENT, DIVISION OF WORKERS' COMPENSATION)
A-0405-15T2
| N.J. Super. Ct. App. Div. | Jun 13, 2017Background
- Pereira injured his back in a July 10, 2013 work-related automobile accident and received treatment, including physical therapy, under a workers' compensation claim.
- On January 27, 2014 Pereira developed an umbilical hernia and sought medical benefits under a new workers' compensation claim alleging it arose from work (lifting) or from physical therapy related to the earlier compensable injury.
- Medical records and PT notes indicated a preexisting diastasis recti and earlier abdominal bulge dating to a 2011 fall; treating physicians and records suggested the hernia likely developed over time due to that condition and obesity.
- At the plenary hearing Pereira testified the hernia appeared during an exercise in his auto-accident physical therapy; his earlier filings and some medical reports, however, attributed the hernia to repetitive work strain or a long-term condition.
- The judge of compensation found Pereira’s testimony inconsistent with medical records and expert opinions, concluded the hernia was more likely caused over time by diastasis recti (a preexisting condition) and denied compensable medical benefits; Pereira appealed, raising evidentiary, procedural, and interpreter/due-process claims.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Compensability / causation (medical & legal) | Pereira: hernia caused by PT exercise tied to prior compensable injury or by work lifting; therefore compensable | Oasis: hernia resulted from preexisting diastasis recti and obesity, not work or PT; not compensable | Held: Judge’s credibility findings supported; Pereira failed to prove work/PT caused the hernia; claim denied |
| Aggravation vs. sole cause from preexisting condition | Pereira: even if preexisting, PT/work aggravated it | Oasis: preexisting condition was sole cause, not an aggravation from employment | Held: Evidence showed long-term causation from diastasis recti; preexisting condition was the likely cause, so not compensable |
| Consideration of post-hearing/new evidence | Pereira: court should consider additional medical and ambulance records obtained after decision | Oasis: review limited to record before the WC court; new evidence must be presented below first | Held: Appellate court refused to reopen record; new evidence must be raised in trial court first |
| Right to interpreter / due process | Pereira: was entitled to a Brazilian-Portuguese interpreter and was denied due process | Oasis: no request for interpreter was made at hearing; record shows Pereira testified at length without impediment | Held: Issue raised for first time on appeal; not considered; record supports no language barrier |
Key Cases Cited
- Hersh v. Cty. of Morris, 217 N.J. 236 (discusses deference to administrative factfinding and remedial purpose of Workers' Compensation Act)
- Coleman v. Cycle Transformer Corp., 105 N.J. 285 (establishes test for causation: employment must be a contributing cause and the risk reasonably incident to employment)
- Lindquist v. City of Jersey City Fire Dep't, 175 N.J. 244 (distinguishes medical and legal causation and outlines burden when causation is contested)
- Sexton v. Cty. of Cumberland/Cumberland Manor, 404 N.J. Super. 542 (discusses disqualification when preexisting condition is sole cause and burden on claimant)
- Perez v. Monmouth Cable Vision, 278 N.J. Super. 275 (standard for overturning agency findings: must be manifestly unsupported by competent, credible evidence)