Tompkin v. RTG Medical
A-16-045
| Neb. Ct. App. | Oct 18, 2016Background
- On Jan. 21, 2012, Janet Tompkins slipped on ice while working as a traveling nurse for RTG Medical, fracturing her left distal radius; she underwent surgical fixation and occupational therapy and reported severe, persistent left-arm pain.
- Over 2012–2015 multiple treating physicians (orthopedist, neurologist, pain specialists) documented autonomic signs, severe pain, limited motion, and diagnosed or suspected complex regional pain syndrome (CRPS); some recommended further interventions including removal of hardware and spinal cord stimulation.
- Janet developed worsening depression and panic symptoms after the injury; treating providers linked her psychiatric condition (aggravation of preexisting depression) to the injury and recommended psychiatric treatment, which RTG initially declined to authorize.
- The Workers’ Compensation Court (Nov. 2012) awarded temporary disability and future medical care; RTG petitioned to modify in Dec. 2013 asserting changed condition and employability.
- After trial (July 2015) the court (Sept. 2015) found CRPS and compensable psychiatric injury causally related to the work accident, ordered ongoing temporary total disability and medical treatment (including spinal cord stimulator and mental health care), and later awarded penalties, interest, and attorney fees for late/denied payments and failure to authorize mental health treatment.
- RTG appealed; the Nebraska Court of Appeals affirmed, finding sufficient evidence to support causation, ongoing disability, and the awards of penalties, interest, and attorney fees.
Issues
| Issue | Plaintiff's Argument (Tompkins) | Defendant's Argument (RTG) | Held |
|---|---|---|---|
| Whether Tompkins suffered CRPS causally related to the Jan. 2012 fall | Treating physicians’ findings (Soliman, Colon, Shah, others) show CRPS caused by the fracture/surgeries | Bone scan and some physician opinions disputed CRPS and causation; pain subjective | Court credited treating specialists and rejected equivocal/brief contrary opinions — CRPS found causally connected to the accident |
| Whether Tompkins’ depression is compensable and causally related to the accident | Treating PCP and psychiatrist tied aggravation of preexisting depression to physical injury, disability, and loss of work role | RTG argued depression stemmed from prior life events (deaths of husband/daughter) independent of the accident | Court found depression aggravated by the work injury (physical disability and pain were primary contributors) — psychiatric injury compensable |
| Whether ongoing temporary total disability is warranted given attempts to work | Tompkins: brief, accommodated, unsuccessful returns do not show ability to sustain work; treating restrictions limit left-hand use | RTG: she attempted work and has no permanent restrictions, so disability should be reduced/terminated | Court held disability continues because she hasn’t reached maximum medical improvement and cannot sustain regular employment; affirmed on appeal |
| Whether penalties, interest, and attorney fees for late/denied payments/denial of mental-health authorization were proper | RTG’s delayed payments and refusal to authorize psychiatric care were without reasonable controversy and thus triggered penalties, interest, and fees | RTG argued reasonable controversy existed (employability, causation) justifying delays/denials | Court found no reasonable controversy before Feb. 2015 regarding psychiatric causation and liability; awarded waiting-time penalty, interest, and attorney fees — affirmed |
Key Cases Cited
- Hynes v. Good Samaritan Hosp., 285 Neb. 985 (standard for appellate modification of Workers’ Comp Court decisions)
- Armstrong v. State, 290 Neb. 205 (deference to factual findings in Workers’ Compensation Court)
- Davis v. Goodyear Tire & Rubber Co., 269 Neb. 683 (appellate limits on substituting factual findings)
- Manchester v. Drivers Mgmt., 278 Neb. 776 (causation and burden in workers’ compensation cases)
- Olivotto v. DeMarco Bros. Co., 273 Neb. 672 (evaluating sufficiency of evidence in favor of successful party)
- Money v. Tyrrell Flowers, 275 Neb. 602 (medical testimony required to establish causal connection)
- Visoso v. Cargill Meat Solutions, 285 Neb. 272 (award cannot be based on speculation)
- Green v. Box Butte General Hosp., 284 Neb. 243 (trier of fact may accept or reject expert opinions)
- Worline v. ABB/Alstom Power Int. CE Servs., 272 Neb. 797 (psychological injuries compensable when related to employment)
- Heiliger v. Walters & Heiliger Electric, Inc., 236 Neb. 459 (preexisting condition aggravated by work injury can be compensable)
- Lagemann v. Nebraska Methodist Hosp., 277 Neb. 335 (when 50% waiting-time penalty applies)
- VanKirk v. Cent. Cmty. College, 285 Neb. 231 (attorney fees for employer delinquency in medical payments)
- Beavers v. IBP, Inc., 222 Neb. 647 (attorney fees not authorized where reasonable controversy exists)
- Godsey v. Casey’s Gen. Stores, Inc., 15 Neb. App. 854 (return to work does not automatically terminate total disability)