Oliver v. Labor Commission & Employers' Reinsurance Fund
2013 UT App 301
| Utah Ct. App. | 2013Background
- Employee (Angela K. Oliver) sustained a compensable back injury at Safeway in March 1987 and received benefits and restrictions; she later retrained and worked as a nurse beginning in 1991.
- In April 2004 Employee again injured her back at work; fusion surgery followed and she was assigned restrictions that prevented nursing work.
- A one-doctor medical panel (Dr. Alan Goldman) first concluded the 2004 condition was attributable to preexisting degenerative disease with some relation to the 1987 injury; the 2004 claim was denied.
- Employee then pursued a claim that her current disability was caused by the 1987 injury. The ALJ referred the medical issues to a panel (initially Dr. Goldman alone; later Dr. Goldman plus a pain-management anesthesiologist) which found at least some causal connection between the 1987 accident and the later condition.
- The ALJ denied permanent total disability (PTD). The Board reversed and remanded for a new medical panel, then later applied an older Prescott standard (focusing on ability to do or learn other work) to deny PTD, concluding return to nursing and vocational rehabilitation barred relief.
- Employee sought review, arguing the Board applied the wrong legal standard; the appellate court set aside the Board's order and directed reconsideration under the correct causation test.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Board applied the correct legal standard for permanent total disability based on an earlier compensable injury | Oliver: The relevant test is whether the 2004 aggravation was the "natural result" of the 1987 compensable injury; return-to-work does not forever bar a later claim | Safeway: Under Prescott, ability to perform or learn other work after the 1987 injury precludes PTD based on that injury | Court: Board applied the wrong standard; must evaluate whether the 2004 injury was the "natural result" of the 1987 injury (causal connection) |
| Whether Employee's prior return to work permanently precludes a subsequent PTD claim | Oliver: Return to work and rehabilitation do not permanently bar a later claim if a subsequent aggravation is causally related | Safeway: Prior successful vocational rehabilitation and long employment as a nurse indicate no PTD from the 1987 injury | Court: Return to work does not automatically preclude a later claim; causation (natural result test) controls |
| Whether the ALJ/Board should have appointed a new, impartial medical panel | Oliver: (Implicit) claims panel should be impartial and newly constituted as directed | Safeway: Dr. Goldman’s prior involvement compromised impartiality; panel was not "new" when he chaired again | Court: Did not decide on this issue but noted Board may prudently appoint a new unbiased panel on remand given possible compromise of Dr. Goldman’s objectivity |
| Standard of review for Board's legal standard choice | Oliver: Question of law reviewed for correctness | Safeway: (implicit) Board's application of precedent appropriate | Court: Reviewed de novo and found Board erred in legal standard application |
Key Cases Cited
- United Park City Mines Co. v. Prescott, 393 P.2d 800 (Utah 1964) (articulates the "cannot perform work of the general character" Prescott test for total disability)
- Intermountain Health Care, Inc. v. Board of Review, 839 P.2d 841 (Utah Ct. App. 1992) (return to work does not bar later claim if subsequent aggravation is the natural result of the original compensable injury)
- Mountain States Casing Servs. v. McKean, 706 P.2d 601 (Utah 1985) (defines the necessity of showing subsequent injury is the natural result of primary injury)
- McKesson Corp. v. Labor Comm'n, 41 P.3d 468 (Utah Ct. App. 2002) (employer remains responsible for medical costs of subsequent aggravations when causal link to compensable injury is shown)
- Allen v. Industrial Comm'n, 729 P.2d 15 (Utah 1986) (preponderance of the evidence standard for causal connection)
- Large v. Industrial Comm'n, 758 P.2d 954 (Utah Ct. App. 1988) (same standard for proving causal link)