Trujillo v. Los Alamos Nat'l Lab
2016 NMCA 41
N.M. Ct. App.2016Background
- Eric Trujillo (Worker) fell ~6 feet from scaffolding at Los Alamos National Laboratory on Nov. 30, 2012 while carrying a 25-lb chipping hammer; he sought treatment at Employer’s Occupational Medicine (Occ Med) and later at the hospital.
- Occ Med diagnoses included contusions, cervical/thoracic/lumbar strains, concussion and chronic pain; Worker was initially returned to work but later experienced worsening symptoms and additional visits, referrals to a chronic pain specialist (Dr. Elliott), and physical therapy.
- Worker was ultimately cleared to return with restrictions on Feb. 6, 2013 but was terminated after failing to complete an allegedly improper drug test; Employer terminated TTD and medical benefits.
- Depositions of three doctors were submitted: Dr. Elliott (opined, to a reasonable medical probability, that the Nov. 30 fall caused cervical, thoracic, lumbar and bilateral elbow strains), Dr. Pasqualoni (treated Worker but did not state a causation opinion to a reasonable medical probability), and Dr. Schwartz (initially attributed low-back strain/likely aggravation of degenerative disease to the fall but later equivocated when confronted with prior medical history).
- The Workers’ Compensation Judge (WCJ) denied benefits, finding Worker failed to prove causation to a reasonable medical probability; the Court of Appeals reversed and remanded, holding the WCJ’s order lacked substantial evidentiary support given Dr. Elliott’s testimony.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Worker proved causation (accident → disability/injuries) to a reasonable medical probability under § 52-1-28 | Trujillo: Dr. Elliott’s deposition and form letter establish causation for cervical, thoracic, lumbar, and bilateral elbow strains | LANL: medical testimony equivocal; preexisting conditions and later equivocations by doctors undermine causation | Court: Reversed WCJ. Dr. Elliott’s unequivocal causation testimony is substantial evidence; WCJ’s denial not supported by whole-record review. Case remanded for further evaluation of TTD/medical benefits |
| Whether reopening discovery and admitting later medical evidence was an abuse of discretion | Trujillo: Reopening was appropriate in interests of justice to admit later medical report | LANL: Admission of documents after trial amounted to new trial and improper reopening | Held: WCJ did not abuse discretion in reopening under applicable rules and precedent |
| How to treat equivocal medical testimony in whole-record review | Trujillo: Equivocations on some diagnoses do not negate clear causation opinions for others | LANL: Equivocal language and concessions ("possible," "could have," "it's possible") render causation unproven | Held: Court must balance testimony; equivocation on some issues does not nullify unambiguous causation opinions on other diagnoses (McMillian analogy) |
| Whether expert testimony that fails to address the ultimate issue may carry substantial weight | Trujillo: Nonresponsive testimony should not outweigh a clear affirmative causation opinion | LANL: Ambiguity in treating doctors supports denial | Held: Testimony that does not opine on ultimate issue has little weight; WCJ erred in relying on such gaps over Dr. Elliott’s affirmative opinions |
Key Cases Cited
- Archuleta v. Safeway Stores, Inc., 104 N.M. 769, 727 P.2d 77 (N.M. Ct. App.) (expert must establish causation to a reasonable medical probability)
- Gammon v. Ebasco Corp., 74 N.M. 789, 399 P.2d 279 (N.M.) (medical testimony must permit a reasonable inference that disability is natural and direct result of accident)
- McMillian v. Schweiker, 697 F.2d 215 (8th Cir.) (administrative decision unsupported where equivocal medical reports were improperly weighed against more definitive opinions)
- Tallman v. ABF (Arkansas Best Freight), 108 N.M. 124, 767 P.2d 363 (N.M. Ct. App.) (whole-record review: disregard testimony of little or no worth and decide if substantial evidence supports agency finding)
- White v. Land Valley Co., 64 N.M. 9, 322 P.2d 707 (N.M.) (factfinder must base verdict on probabilities, not mere possibilities)
- Montano v. Saavedra, 70 N.M. 332, 373 P.2d 824 (N.M.) (compensation denial affirmed where expert admitted difficulty saying causation to any degree of probability)
- Renfro v. San Juan Hosp., Inc., 75 N.M. 235, 403 P.2d 681 (N.M.) (affirming denial where expert testimony established possibility but not medical probability)
- Tom Growney Equipment Co. v. Jouett, 137 N.M. 497, 113 P.3d 320 (N.M.) (compensation triggers require a disabling work-related injury)