Cox v. Labor Commission
2017 UT App 175
Utah Ct. App.2017Background
- In May–August 2013 Cox (a maintenance mechanic) experienced back incidents at work, reported increasing pain, and ultimately underwent lumbar surgery after MRIs showed severe spinal canal stenosis and multilevel disc bulging.
- Cox had prior back injuries (1977 car crash; 2009 ATV accident) with some chronic back complaints but had continued working until 2013; he stopped working after the surgery.
- Workers Compensation Fund (WCF) denied Cox’s claim, citing preexisting severe degenerative disc disease and asserting no acute findings tied to the claim; WCF’s medical examiner said the 5/7/13 accident did not cause or aggravate Cox’s condition.
- Cox’s treating surgeon and physician assistant opined the work events worsened symptoms and likely precipitated the need for surgery; an ALJ ordered a medical panel which concluded the May 2013 injury did not cause Cox’s substantial spinal problems though it ‘‘worsened’’ an already developed condition.
- The ALJ and Labor Commission denied benefits, holding the work incidents were not the medical cause of Cox’s need for surgery; Cox sought judicial review alleging the Commission applied the wrong legal standard for medical causation.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Medical causation standard when an industrial accident aggravates a preexisting condition | Cox: causation requires only that the industrial accident be a cause in any degree (de minimis/but-for-type showing); cumulative trauma or minor contribution satisfies medical causation | WCF: must show permanent aggravation; temporary exacerbations that return to baseline are insufficient; medical cause must be more than a minimal contribution | Court: A claimant must show the industrial accident contributed in any degree, but the aggravation must be permanent (did not return to baseline) |
| Whether the medical panel and Commission applied correct causation question | Cox: panel/Commission focused on whether accident was the (substantial) medical cause of surgery, not whether it contributed in any degree | WCF: relied on panel finding that work injuries did not medically cause current condition | Court: The ALJ’s panel question and the Commission’s framing were ambiguous/incorrect; panel appears to have required greater-than-de-minimis causation, and Commission applied that incorrect standard |
| Whether Commission addressed permanence of aggravation | Cox: Commission failed to determine if aggravation was permanent or temporary | WCF: Commission referenced brief negative effects and concluded no causal relationship | Court: Commission’s cursory references were insufficient; it did not clearly decide permanence, so must reconsider under correct standard |
Key Cases Cited
- Allen v. Industrial Commission, 729 P.2d 15 (Utah 1986) (defines medical cause test and asks whether work exertion contributed to injury)
- Zimmerman v. Industrial Commission, 785 P.2d 1127 (Utah Ct. App. 1989) (distinguishes compensable permanent aggravation from temporary aggravation)
- Virgin v. Board of Review of Industrial Commission, 803 P.2d 1284 (Utah Ct. App. 1990) (holds temporary aggravation insufficient for permanent disability claims)
- Provo City v. Utah Labor Commission, 345 P.3d 1242 (Utah 2015) (states general rule that accident must be but-for cause under medical causation test)
- Washington County School Dist. v. Labor Commission, 358 P.3d 1091 (Utah 2015) (distinguishes issues involving subsequent non-workplace injuries)
- Covington v. Board of Review of Industrial Commission, 737 P.2d 207 (Utah 1987) (directs remand to Commission to redetermine claim under proper legal standard)
Summary of holding: The court set aside the Commission’s denial, holding the Commission applied an incorrect medical-causation standard (requiring the accident to be the medical cause rather than a contributing cause) and failed to address whether any aggravation was permanent; the case is remanded for reconsideration under the correct standard.