Provo City v. Utah Labor Commission
2015 UT 32
Utah2015Background
- Duane Serrano, a Provo City facility service technician, was injured in a work-related car accident and alleged aggravation of a congenital spine condition causing chronic pain.
- Serrano continued working for several years but quit after Provo City declined to reassign him to lighter duties; he then applied for permanent total disability (PTD) benefits under Utah Code § 34A-2-413.
- The ALJ initially denied PTD after hearing >20 medical evaluations that conflicted on severity and malingering; Serrano sought review before the Utah Labor Commission.
- The Labor Commission vacated and remanded, directing appointment of a medical panel; on remand the medical panel and ALJ found Serrano permanently and totally disabled and awarded benefits.
- The Labor Commission affirmed; WCF (employer/insurer) appealed, arguing failure to prove PTD elements, ALJ abuse for changing result after remand, and that delay should alter benefit onset. Utah Supreme Court affirmed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Serrano sustained a "significant impairment" from the accident | Serrano: medical panel and his testimony show limitations (no lifting >25 lbs, no heights) and a 6% whole-person impairment | WCF: evidence does not support a significant impairment | Affirmed—substantial evidence (medical panel report) supports the finding |
| Whether Serrano was not gainfully employed when benefits were awarded | Serrano: WCF conceded unemployment at hearing; no new evidence presented on remand | WCF: concession lapsed because remand required reconsideration as of the later decision date | Not considered on appeal—issue not preserved; WCF failed to raise below |
| Whether Serrano’s impairments limited basic work activities / ability to perform prior or reasonably available work | Serrano: testimony and experts show nausea, limited sitting, inability to climb/lift, limiting most jobs including clerical tasks | WCF: vocational testimony suggested available supervisor/office work Serrano could perform | Affirmed—substantial evidence (Serrano testimony + experts) supports limitations for basic activities, former work, and other available work |
| Whether ALJ abused discretion by reaching a different outcome after remand | Serrano: remand produced a medical panel report that was new evidence warranting reevaluation | WCF: ALJ improperly reversed prior denial and changed result after remand | Rejected—no legal bar to changing outcome on remand where new evidence (medical panel) could reasonably lead to different result |
| Whether the work accident was the direct/legal cause of PTD given a preexisting condition | Serrano: accident aggravated congenital spine condition; aggravation is compensable | WCF: aggravation of preexisting condition cannot be the direct cause | Rejected—aggravation of preexisting conditions can be compensable; legal causation was satisfied |
| Whether administrative delay should alter benefit onset | Serrano: delay attributable to system, not claimant; should not penalize claimant | WCF: seeks equitable modification of benefit onset to mitigate prejudice from long adjudication delay | Rejected—prior case limiting awards for claimant delay (Employers’ Reinsurance Fund) inapplicable; delay was administrative, so claimant not penalized |
Key Cases Cited
- Murray v. Utah Labor Comm’n, 308 P.3d 461 (Utah 2013) (standard for administrative-reviewable errors and causation principles)
- Becker v. Sunset City, 309 P.3d 223 (Utah 2013) (substantial evidence review and deference to agency factfinding)
- Martinez v. Media-Paymaster Plus, 164 P.3d 384 (Utah 2007) (elements of PTD and factual nature of ability-to-work inquiries)
- Allen v. Industrial Comm’n, 729 P.2d 15 (Utah 1986) (preexisting-condition aggravation compensable; legal causation test)
- Employers’ Reinsurance Fund v. Labor Commission, 289 P.3d 572 (Utah 2012) (equitable limitation on benefit onset where claimant’s delay caused prejudice)
- Ivory Homes, Ltd. v. Utah State Tax Comm’n, 266 P.3d 751 (Utah 2011) (definition of substantial evidence)
- In re Adoption of Baby B. (Manzanares v. Byington), 308 P.3d 382 (Utah 2012) (mixed question analysis for legal standards applied to facts)