269 A.3d 400
Md. Ct. Spec. App.2022Background
- On Sept. 17, 2019 Strothers, a UPS employee, experienced right‑side abdominal pain after using a power jack and was diagnosed with a 3.3 cm right paraumbilical hernia; he had two prior hernia repairs (2016 and ~20 years earlier).
- Strothers scheduled surgery for Sept. 30, 2019, but UPS/LMI contested the claim, refused authorization, and the surgery was postponed; Dr. Kravitz ultimately performed repair on Nov. 14, 2019.
- Medical reports (Dr. Macht and Dr. Kravitz) opined the umbilical hernia was a new onset from the Sept. 2019 accident and required urgent surgery; those reports were admitted without objection.
- The Maryland Workers’ Compensation Commission found the hernia compensable, ruled it arose out of employment, awarded temporary total disability and ordered authorization/payment of surgery and related medical expenses.
- UPS/LMI requested rehearing (denied), sought judicial review in Howard County Circuit Court (on‑the‑record hearing), which affirmed the Commission; UPS/LMI appealed to the Court of Special Appeals.
- The appeal raised three questions: whether “definite proof” in LE § 9‑504 requires a heightened (clear and convincing) standard; whether Strothers met the “definite proof” requirement given the medical opinions; and whether the surgery was performed “immediately.”
Issues
| Issue | Strothers' Argument | UPS/LMI's Argument | Held |
|---|---|---|---|
| Whether “definite proof” in LE § 9‑504 requires a heightened standard of proof | "Definite proof" refers to the quality of evidence and the Act should be liberally construed in favor of claimants; preponderance applied | "Definite proof" means a higher standard (clear and convincing); Commission erred by applying preponderance | Court: “definite proof” describes the required quality of evidence, not a separate burden; statute does not import clear and convincing; preponderance standard appropriate |
| Whether Strothers' medical opinions satisfied § 9‑504’s “definite proof” requirement | Medical opinions (Drs. Macht and Kravitz) to reasonable degree/"more likely than not" establish causation and absence/recurrence facts | The experts’ phrasing only meets preponderance, not "definite proof"; evidence insufficient | Court: Commission reasonably credited the medical evidence; where defendants offered no contrary medical testimony, the experts sufficed to meet the statute’s definite‑proof quality requirement |
| Whether the required operation was performed “immediately” after aggravation/strangulation | Surgery was urgently needed; delay resulted from defendants’ contesting the claim and scheduling/authorization problems, so operation was effectively immediate/urgent under circumstances | 59‑day gap shows surgery was not “immediate” as construed in prior cases | Court: "immediate" not synonymous with emergency; given prompt medical care, scheduling/authorization delays caused by defendants, and medical records showing urgency, requirement satisfied |
Key Cases Cited
- Long v. Injured Workers’ Ins. Fund, 448 Md. 253 (2016) (standard of review for judicial appeals of Commission decisions)
- Bethlehem Steel Co. v. Ziegenfuss, 187 Md. 283 (1946) (rejecting lay hearsay as meeting "definite proof" for medical condition)
- Lloyd v. Webster, 165 Md. 574 (1933) (legislative purpose for special hernia rules: guard against after‑the‑fact attributions)
- Greer v. Montgomery Cnty., 246 Md. App. 245 (2020) (hernia claims are a distinct subset with stricter statutory requirements)
- Hicks v. Georgia Cas. Co., 63 F.2d 157 (5th Cir. 1933) ("definite proof" refers to quality/force of evidence, not a formal heightened standard)
- Washington Metro. Area Transit Auth. v. Hewitt, 153 Md. App. 42 (2003) (construction of "immediately" in compensation context)