Molinar v. Larry Reetz Constr., Ltd.
35,219
| N.M. Ct. App. | Aug 17, 2017Background
- Jaime Molinar had a 2002 nonwork femoral neck fracture with hip hardware and later developed posttraumatic degenerative joint disease/avascular necrosis (AVN); he continued working despite intermittent pain and recommendations for total hip replacement.
- On March 11, 2014 Molinar fell from a ladder at work, complaining of severe right-hip/thigh pain; he initially was diagnosed with a contusion, returned to modified duty, but became unable to work by July 2014.
- Dr. Joshua Carothers (orthopaedic surgeon) testified that AVN preexisted the fall but the March 2014 fall aggravated the hip, worsening pain and prompting pursuit of hip replacement.
- Employer/Insurer disputed causation and sought to depose Carothers and later obtained an IME panel (Drs. Ross and Legant), whose report concluded Worker’s current condition arose from preexisting disease, not the March 2014 work injury.
- The WCJ found Molinar suffered a compensable contusion from the fall but concluded the AVN and need for total hip arthroplasty were unrelated to the workplace incident and denied PPD and medical benefits tied to the AVN; Molinar appealed.
Issues
| Issue | Molinar's Argument | Employer/Insurer's Argument | Held |
|---|---|---|---|
| Whether WCJ applied correct causation standard under §52-1-28 for PPD/medical benefits | Molinar: accident aggravated preexisting AVN, causing disability and entitling him to PPD and medical benefits | Employer: worker must show causal connection between accident and overall AVN/need for replacement; Carothers’ opinion is unreliable | Court: WCJ applied wrong focus (need for surgery). Worker’s burden on PPD/medical is to show accident caused an injury (aggravation) and resulting disability; Carothers’ testimony sufficiently established aggravation + causation; reverse and remand for benefits calculation. |
| Admissibility/weight of Carothers’ opinion (Niederstadt challenge) | Molinar: Carothers had pertinent prior-injury information and radiographs; his aggravation opinion is competent | Employer: Carothers lacked review of prior records; under Niederstadt his opinion is unreliable | Held: Niederstadt distinguishable; Carothers had been informed of prior injury and affirmed opinion after reviewing records; WCJ erred to discount opinion on that basis. |
| Sufficiency of IME panel (Ross/Legant) to rebut aggravation causation | Molinar: IME applied wrong legal standard (medical impossibility of aggravation at end-stage) and their concessions showed change in course/treatment after fall | Employer: IME showed no aggravation — end-stage disease cannot be aggravated | Held: IME testimony applied incorrect standard; increased pain, changed treatment and loss of ability to cope post-fall constitute aggravation under NM law; IME did not supply substantial evidence to overcome Carothers. |
| Mileage / bad-faith / premature attorney-fee payments under §52-1-54(M) | Molinar: seeks mileage and argues Employer/Insurer received attorney fees before adjudication in violation of statute; requested bad-faith hearing | Employer: (position contested below) | Held: Court remanded on injury/benefits and declined to address bad-faith/fee-payment issue for lack of jurisdiction because no final order on that claim; mileage not resolved on appeal and should be considered on remand. |
Key Cases Cited
- Smith v. Arizona Pub. Serv. Co., 75 P.3d 418 (N.M. Ct. App. 2003) (statutory interpretation of workers’ compensation provisions reviewed de novo)
- Edmiston v. City of Hobbs, 944 P.2d 883 (N.M. Ct. App. 1997) (preexisting disease does not bar compensation when aggravated by work)
- Tom Growney Equip. Co. v. Jouett, 113 P.3d 320 (N.M. 2005) (aggravation of preexisting infirmity by employment activity can be compensable even without discrete accident)
- Buchanan v. Kerr-McGee Corp., 908 P.2d 242 (N.M. Ct. App. 1995) (causation standard: contributing factor need not be major cause; medical probability standard)
- Banks v. IMC Kalium Carlsbad Potash Co., 77 P.3d 1014 (N.M. 2003) (uncontradicted medical evidence rule; certain expert medical proof can bind the trier of fact)
- Zanio’s Foods, Inc. v. Sanchez, 123 P.3d 788 (N.M. Ct. App. 2005) (Niederstadt principle: experts must be informed of pertinent prior injuries to render reliable causation opinions)
- Niederstadt v. Ancho Rico Consol. Mines, 536 P.2d 1104 (N.M. Ct. App. 1975) (expert opinion may be invalid where the expert lacked knowledge of a pertinent prior injury)