Brown v. W.T. Martin Plumbing & Heating, Inc.
72 A.3d 346
Vt.2013Background
- Claimant sustained a work-related shoulder injury in 2006 with CRPS appearing post-injury.
- Treating doctors diagnosed CRPS; Lefkoe assigned a 46% whole-person impairment under AMA Guides Chapter 16.
- Employer’s expert Wieneke later concluded CRPS had resolved and assigned 3% impairment for ROM/pain, but did not attribute CRPS impairment if Chapter 16 criteria were not met.
- DOL Commissioner ruled that 21 V.S.A. § 648(b) requires impairment determinations to follow AMA Guides, effectively denying CRPS impairment unless diagnosed under AMA Chapter 16 criteria; adopted 3% impairment.
- Superior court conducted de novo review, ultimately agreeing with the statutory constraint and increasing ROM impairment to 6%, but still rejecting CRPS impairment under Chapter 16.
- The Vermont Supreme Court reversed and remanded, holding that § 648(b) permits impairment ratings for CRPS using methods in the Guides other than the strict Chapter 16 diagnosis criteria, and that the factfinder may weigh competing expert opinions to determine impairment.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does § 648(b) require denial of CRPS impairment if diagnosis fails AMA Chapter 16 criteria? | Lefkoe’s CRPS rating should be admissible under AMA Guides; diagnosis need not meet Chapter 16. | impairment must be diagnosed under AMA Chapter 16 criteria to support CRPS impairment. | No; § 648(b) allows impairment rating using Guides methods beyond Chapter 16 diagnosis. |
| Can an impairment rating for CRPS be supported when Chapter 16 criteria are not met for diagnosis? | Yes, the rating can be based on objective impairment evidence and alternative Guide sections. | No, impairment for CRPS requires Chapter 16 diagnostic conformity. | Yes; rating may be derived from Chapter 16 or other Guide sections with objective support. |
| Is diagnosis of CRPS a prerequisite for impairment rating under § 648(b)? | Diagnosis is not strictly necessary if there is objective impairment evidence and appropriate rating method. | Diagnosis under the Guides is required to anchor impairment. | Diagnosis is not strictly necessary; impairment can be rated using alternative Guide-based methodologies with objective findings. |
Key Cases Cited
- Tokico (USA), Inc. v. Kelly, 281 S.W.3d 771 (Ky. 2009) (diagnosing and impairment rating are different matters; impairment can follow different Guide-based methods)
- Westmoreland Reg'l Hosp. v. Workers' Comp. Appeal Bd., 29 A.3d 120 (Pa. Commw. Ct. 2011) (CRPS impairment rating requires objective findings; zero impairment if none present at rating time)
- Rainville v. In re Rainville, 732 A.2d 406 (N.H. 1999) (physician can use alternative methods not prohibited by AMA Guides when Guides are inapplicable)
- Montgomery v. Brinver Corp., 142 Vt. 461, 457 A.2d 644 (1983) (remedial construction of workers' compensation; liberal interpretation for employee benefits)