Moffett Paving & Excavating & United Contractors of Virginia v. Donald Kelly
0198172
| Va. Ct. App. | Oct 24, 2017Background
- Claimant (Donald Kelly) suffered a compensable work injury on December 12, 2013 (fall from a backhoe) and was awarded medical and temporary total disability benefits by the Commission.
- Claimant has an extensive pre-2013 history of back, neck, and head complaints and prior injuries (1991 fall, 1995 car accident, 2000 dump truck rollover, 2010 deck fall), plus degenerative spine disease on imaging.
- Treating physicians (Dr. Pollard, Dr. Helm, Dr. Leone) linked claimant’s post-December-2013 symptoms (concussion/post-concussive headaches, neck pain/radiculopathy, chronic neck/back pain) to the December 2013 accident; Dr. Helm opined the need for further testing and related it to the work injury.
- Employer obtained two independent medical evaluations (Dr. Hereford and Dr. Wilson) concluding claimant’s current conditions were attributable to preexisting degenerative disease and not the December 2013 accident; Dr. Hereford cleared claimant for pre-injury work, Dr. Wilson limited claimant to sedentary work.
- A deputy commissioner granted employer’s applications to terminate benefits based on the IMEs, but the full Commission reversed, finding employer failed to show claimant’s disability had dissipated or was caused by another condition; employer appealed to the Court of Appeals.
Issues
| Issue | Kelly's Argument | Moffett Paving (Employer) Argument | Held |
|---|---|---|---|
| Whether claimant’s ongoing disability is causally related to the Dec. 12, 2013 work accident | Disability and ongoing symptoms (headache, neck, radicular pain, back pain) are causally related to the work accident; treating doctors support causation | IME doctors show disability is due to preexisting degenerative conditions, not the 2013 accident | Commission credited Dr. Helm and claimant’s ongoing symptoms; employer failed to prove loss of causal connection — claimant remains disabled due to the work accident |
| Whether employer proved claimant can return to pre-injury work | Claimant testified he was not released to return; treating opinions recommended further testing and restrictions | IME (Hereford) released claimant to pre-injury work; (Wilson) limited to sedentary work and attributed restrictions to preexisting condition | Commission found employer did not prove claimant could return to pre-injury work; credited evidence showing continued disability |
| Whether medical opinions lacking full prior history are inherently unreliable | Treating physician’s opinion based on exam, chart review, and imaging is reliable even if not all prior records were known | Employer argues treating opinions (Dr. Helm) lack probative value because he didn’t know claimant’s full medical history | Court held Clinchfield Coal is distinguishable; Commission may credit treating opinion despite incomplete history if not based on a revised/faulty premise |
| Standard and burden for terminating benefits on change-in-condition grounds | Award established causal connection; claimant need not reprove causation | Employer must prove by preponderance that effects dissipated or disability caused by another condition | Employer bore burden and failed to meet it; Commission’s factual credibility determinations stand on appeal |
Key Cases Cited
- Artis v. Ottenberg’s Bakers, Inc., 45 Va. App. 72, 608 S.E.2d 512 (Va. Ct. App. 2005) (on appeal, evidence viewed in light most favorable to prevailing party below)
- Clinchfield Coal Co. v. Bowman, 229 Va. 249, 329 S.E.2d 15 (Va. 1985) (medical opinion based on incomplete/inaccurate history may be of little probative value)
- Caskey v. Dan River Mills, Inc., 225 Va. 405, 302 S.E.2d 507 (Va. 1983) (appellate courts do not retry facts or reweigh credibility of Commission)
- Celanese Fibers Co. v. Johnson, 229 Va. 117, 326 S.E.2d 687 (Va. 1985) (employer may seek termination of benefits by proving effects of injury have dissipated)
- Pilot Freight Carriers, Inc. v. Reeves, 1 Va. App. 435, 339 S.E.2d 570 (Va. Ct. App. 1986) (burden on party alleging change in condition to prove it by preponderance)
- Kim v. Sportswear, 10 Va. App. 460, 393 S.E.2d 418 (Va. Ct. App. 1990) (weight and resolution of conflicting evidence are within Commission’s prerogative)
- Amelia Sand Co. v. Ellyson, 43 Va. App. 406, 598 S.E.2d 750 (Va. Ct. App. 2004) (Clinchfield Coal does not require doctors to have entire medical history before offering a valid causation opinion)