Krause v. Five Star Quality Care
919 N.W.2d 514
Neb.2018Background
- Linda Carlson fractured her right femur in a work-related slip-and-fall on February 17, 2013; she underwent surgical fixation and later a total hip arthroplasty and continued to report significant pain and limitations.
- Carlson filed a workers’ compensation petition in September 2015; on October 14, 2015 she suffered a catastrophic, nonwork-related stroke that left her largely incapacitated.
- Medical exams occurred in Sept. 2014, Apr. 2015, Oct. 8, 2015 (Dr. LaHolt), and treating-surgeon reports through Oct. 24, 2014; LaHolt opined Carlson reached maximum medical improvement (MMI) on Oct. 8, 2015 and noted significant permanent restrictions.
- Treating physician Dr. Reckmeyer later (July 2017) reported Carlson had been medically stable as of Oct. 24, 2014 and would have lifelong restrictions; Dr. Diamant earlier assessed a 30% whole-body impairment.
- The Workers’ Compensation Court found MMI on Oct. 8, 2015, awarded temporary benefits through that date, and concluded Carlson was permanently and totally disabled from that date forward due to the work injury; it also held the subsequent stroke did not terminate her entitlement.
Issues
| Issue | Plaintiff's Argument (Carlson) | Defendant's Argument (Five Star) | Held |
|---|---|---|---|
| Date of MMI | MMI occurred Oct. 8, 2015 (LaHolt IME) | Oct. 8, 2015 not MMI because psychological/neurocognitive issues went unaddressed | Court held MMI = Oct. 8, 2015 (no proof psychological conditions were work-caused) |
| Permanent total disability as of MMI | Carlson: medical evidence + vocational history show permanent total disability as of MMI | Five Star: insufficient evidence to establish loss of earning capacity (no post-MMI assessments; timing defeats finding) | Court held evidence (impairment ratings, lifelong restrictions, work history, education, IQ) supports permanent total disability as of Oct. 8, 2015 |
| Effect of subsequent nonwork-related stroke on benefits | Carlson: stroke does not negate preexisting compensable permanent total disability | Five Star: stroke ‘cut off’ or subsumed the work-related disability, so obligation to pay should end | Court held stroke did not terminate or displace entitlement; employer remains liable for work-caused permanent total disability |
| Burden to prove psychological injury | N/A (procedural legal point) | Five Star: contends MMI requires resolution of psychological injuries too | Court: claimant bears burden to prove psychological conditions are work-caused; no such proof here, so psychological issues did not delay MMI |
Key Cases Cited
- Wynne v. Menard, Inc., 299 Neb. 710 (discusses standards for reviewing workers’ compensation awards)
- Kohout v. Bennett Constr., 296 Neb. 608 (appellate obligation to determine questions of law in workers’ compensation cases)
- Gardner v. International Paper Destr. & Recycl., 291 Neb. 415 (distinguishes temporary vs. permanent disability and MMI concepts)
- Money v. Tyrrell Flowers, 275 Neb. 602 (disability vs. impairment; economic nature of disability)
- Beth-Elkhorn Corp. v. Dotson, 428 S.W.2d 32 (Kentucky case holding unrelated subsequent disability does not cancel compensable work-caused disability)
- Daugherty v. Watts, 419 S.W.2d 137 (authority that compensable injury is not defeated by independent concurrent causes of disability)