Certified Building Maintenance v. Labor Commission, Appeals Board of the Labor Commission
2012 UT App 240
| Utah Ct. App. | 2012Background
- Antonio injured his left knee in a January 20, 2008 work fall for CBM; underwent arthroscopic surgery and later returned to work with ongoing knee pain.
- A February 9, 2009 steroid injection temporarily relieved pain; two days later, on February 12, 2009, he had a second work-related fall.
- Both falls were work-related; the 2009 fall prompted questions whether it caused a new injury or merely aggravated the prior injury.
- State Farm (CBM’s insurer at the time) declined the 2009 claim as a new injury; Workers Compensation Fund also declined as an aggravation of the 2008 injury.
- Antonio filed a Labor Commission claim on October 5, 2009; an ALJ’s Interim Findings triggered a medical panel review.
- The medical panel concluded a causal connection between the 2008 fall and the current injury, and no causal connection between the 2009 fall and the injury; ALJ admitted the panel’s Report over objections; the Board affirmed the ALJ’s decision except for attorney fees; State Farm challenged the ALJ’s findings and procedures, leading to appellate review.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Adequacy of Interim Findings for medical panel review | State Farm argues Interim Findings lacked detail (pain level before 2009 fall) and were inadequate | Antonio argues Interim Findings sufficiently reflect chronic pain, relief, and return to baseline; panel relied on overall history | Harmless error; Interim Findings adequate for medical panel review |
| Whether ALJ properly delegated fact-finding to the medical panel | State Farm contends ALJ delegated too much to the panel based on Price River Coal Co. | No factual dispute about duties; medical panel may review records and conduct examination under statute | ALJ did not improperly delegate; panel review appropriate |
| Admissibility of the medical panel Report | State Farm claims ALJ should have held a hearing or admitted new evidence; due process concerns | Discretionary procedures allowed; hearing unnecessary as no new information; due process not violated | ALJ acted within discretion; due process not violated; Report admitted and relied upon |
| Whether the medical panel's conclusion that the 2008 fall caused the injury was supported | State Farm disputes causation based on the panel’s evaluation | Panel reviewed extensive records and found 2008 fall causally related and 2009 fall not causative | Board affirmed ALJ; medical panel’s causation finding supported |
Key Cases Cited
- Adams v. Board of Review of the Industrial Commission, 821 P.2d 1 (Utah Ct. App. 1991) (requires detailed findings for appellate review; not controlling here for interim findings)
- Blair v. Labor Comm’n, 2011 UT App 248, 262 P.3d 456 (Utah Ct. App. 2011) (discusses limits of detailed requirements for interim findings)
- Speirs v. Southern Utah Univ., 60 P.3d 42 (2002 UT App 389) (medical panel may conduct its own examination and review of records)
- Price River Coal Co. v. Industrial Commission, 731 P.2d 1079 (Utah 1986) (recognizes ALJ may not abdicate fact-finding; inapplicable where no job duties dispute)
- Lander v. Industrial Commission, 894 P.2d 552 (Utah Ct. App. 1995) (board may decide whether to hold a hearing on objections to a medical panel report; due process analysis)