John G Gehman, App v. Department Of Labor And Industries Of The State Of Washington, Resp
75409-2
| Wash. Ct. App. | Oct 9, 2017Background
- John G. Gehman injured his right wrist and developed a psychological condition after a workplace incident on December 29, 2005.
- The Department of Labor and Industries closed the claim in September 2012, awarding a permanent partial disability for the right arm and a category 2 permanent mental-health impairment.
- Gehman appealed the closing order to the Board of Industrial Insurance Appeals, disputing the Department’s medical determinations and arguing the record contained contradictory medical opinions.
- The industrial appeals judge (IAJ) and Board told Gehman he needed a medical expert witness to prove entitlement to additional treatment, time-loss, or increased permanent disability; they excluded medical reports offered by Gehman as hearsay.
- Gehman presented no medical witness at the Board hearing; the Board and superior court affirmed the Department’s closing order for lack of admissible medical evidence supporting his claims.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Board/superior court erred by excluding medical reports and finding insufficient evidence for additional benefits | Gehman argued the medical records in the Department’s file (including billing/diagnostic codes) showed errors and supported his claims; RCW 51.52.080 permits reliance on the department record | Department/Board argued the IAJ must apply rules of evidence; medical records offered for their truth are hearsay and inadmissible absent an exception or sponsoring medical witness | The courts correctly excluded the records as hearsay; without medical witness testimony there was insufficient evidence to award additional treatment, time-loss, or increased permanent disability |
| Whether billing-code discrepancies in Department-paid records relieved Gehman of the obligation to present medical expert testimony | Gehman claimed billing codes proved the Department relied on inconsistent diagnoses, so his exhibits alone should sustain the appeal | Department argued (and authorities require) that extent of disability and need for treatment are medical questions requiring expert testimony | Held that billing discrepancies do not replace the claimant’s burden to produce medical expert testimony; medical testimony is necessary to establish extent of disability or entitlement to further benefits |
Key Cases Cited
- Fochtman v. Dep't of Labor & Indus., 7 Wn. App. 286 (medical testimony is necessary to establish permanent partial disability)
- Jackson v. Dep't of Labor & Indus., 54 Wn.2d 643 (extent of disability is a medical question requiring expert proof)
- Ruse v. Dep't of Labor & Indus., 138 Wn.2d 1 (standard of review for findings of fact in industrial appeals)
- Sunnyside Valley Irrig. Dist. v. Dickie, 149 Wn.2d 873 (definition of substantial evidence)