OPINION
1 1 Pеtitioner Linda Acosta seeks review of a Labor Commission order reversing an Administrative Law Judge's (ALJ) order awarding her workers' compensation benefits. The Commission ruled that because Acosta has a preexisting condition that contributed to her injury, she was subject to the legal causation test enunciated in Allen v. Industrial Commission,
BACKGROUND
12 Acosta was injured on December 20, 1998, while employed as a licensed practical nurse at Salt Lake Regional Medical Center. Acosta was working in the maternity unit, and aftеr she bent down to lift an eight pound infant out of an isolette, which is similar to a crib, she felt pain in her back as she turned to hand the child to its mother. Acosta's pain grew worse, she was eventually diagnosed with degenerative conditions of the spine, including spinal stenosis, and she required surgery. Acosta had no history of prior back pain.
T8 Acosta filed for workers' compensation benefits, and Respondents Salt Lake Regional Medical Center and Liberty Mutual Insurance Company denied her claim. Acosta filed an application for a hearing in March 1999, and Respondents, in their answer, alleged that Acosta suffered from a preexisting condition and that she failed to satisfy the Allen test for legal causation. A formal hearing was held before an ALJ on September 1, 1999.
T4 In an October 1999 order, the ALJ found that Acosta had preexisting but asymptomatic conditions that were discovered after December 20, 1998, that she had never received any treatment for the preexisting back problems, and that, despite the preexisting condition, she had worked continuously for the hospital since 1980. The ALJ cоncluded that medical causation had been shown by a preponderance of the evidence. The ALJ also concluded that because Acosta's injury was enhanced by the workplace, she did not have to meet the Allen test. The ALJ went on though, to conclude that if the Allen test were applicable, Acosta had met it. In doing so, the ALJ relied on a cumulative trauma theory that he raised sua sponte. The ALJ awarded temporary total disability benefits from April 1999 through the time in August 1999 when Acosta returned to work part time and temporary рartial disability until such time as maximum medical improvement was reached.
T5 Respondents filed a motion for review with the Commission, and the Commission reversed the ALJ in a January 2000 order, ruling that Allen applied and that Acosta had failed to meet the Allen test for legal causation. In doing so, the Commission noted that the preexisting condition contributed to the injury for which Acosta was seeking benefits. The Commission, quoting from Allen,
T 6 Acosta filed a timely petition for review in this court. Subsequently, Respondents filed a motion to dismiss the appeal because Acosta's brief was past due. In an August 30, 2000 order, this court, citing Acosta's failure to timely file her brief, ordered the apрeal dismissed unless Acosta filed her brief within ten days. During this time period, Acosta was in the process of dismissing her attorney of record and was seeking new counsel. She later filed a pro se motion to
ISSUES AND STANDARD OF REVIEW
T7 Respondents argue that: (1) this court lacks subject matter jurisdiction because of the October 18, 2000 remittitur, and (2) because the court committed manifest error in reinstating the appeal, the appeal should be dismissed.
T8 Acosta argues that: (1) the Allen test is inapplicable in cases of asymptomatic preexisting conditions, and (2) if the Allen test is applicable, the ALJ correctly ruled that Acosta met the legal causation standard for preexisting conditions.
19 "Whether appellate jurisdiction exists is a question of law which [is] reviewed for correctness." Pledger v. Gillespie,
110 " Judicial review of final agency actions is governed by the Utah Administrative Procedures Act'" Color Country Mgmt. v. Labor Comm'n,
111 Whether the Commission erroneously appliеd the Allen test is a mixed question of law and fact reviewed for reasonableness and rationality. See AE Clevite, Inc. v. Labor Comm'n,
ANALYSIS
$12 Respondents argue we are without jurisdiction to hear this appeal because we dismissed the appeal and the October 18, 2000 remittitur divested us of jurisdiction and returned jurisdiction to the Commission. - Resрondents cite State v. Clark,
1 13 This case is controlled by Hi-Country Estates v. Foothills Water Co.,
114 Thus, not only was it error to remit the case on October 18, 2000, before the time had run for Acosta to file her brief, but it also would have been error not to recall the remittitur and reinstate the appeal as contemplated by Rule 238A of the Utah Rules of Appellate Procedure.
15 Respondents contend that it was "manifest error" to reinstate Acosta's appeal based "solely upon [Acosta's] January 12, 2001 ex parte communication." Respondents argue that this court violated their due process rights because they were not notified of Acosta's motion to reinstate nor were they given an opportunity to file a responsive pleading, and they ask that the appeal be dismissed.
116 We decline to dismiss the appeal on this basis. We can reinstate an appeal "upon motion of the appellant" for any "failure to take a step other than the timely filing of a notice of appeal ... for ... mistake, inadvertence, surprise, or excusable neglect." Utah R.App. P. 28A. Because the remittitur was premature, and in light of our analysis above under Hi-Country Estates, we fail to see what possible impact any responsive pleаding filed by the Respondents could have had on our decision to reinstate the appeal-which we would readily have done sua sponte had we been the first to discover the error.
§17 We turn to the merits of Acosta's appeal. In order to recover workers' compensation benefits, an employee must prove she was injured "by accident arising out of and in the course of the employee's employment." Utah Code Ann. § 34A-2-401 (1997). Allen requires: (1) that the injury be " 'by accident," and (2) that " 'there be a causal connection between the injury аnd the employment'" Nyrehn,
T18 Acosta first challenges the Commission's decision that the Allen test for proving legal causation where an employee has a preexisting condition applies to asymptomatic preexisting conditions. Acosta urges us to treat claimаnts with. asymptomatic preexisting conditions differently than those claimants with preexisting conditions that were apparent before an industrial accident. Acosta's argument turns primarily on her reading of the words "suffers from" in Allen,
[ 19 Based on this language, Acosta argues that asymptomatic preexisting conditions do not trigger the Allen test because the claimant does not really suffer from any symptoms. Acosta relies on a narrow definition of the word "suffer" that includes to experiеnce or to endure pain or affliction. She argues that the word suffer, in the workers' compensation context, refers to "one who has had prior injuries or complaints in the same low back area and has received treatment for that injury or complaint." Acosta then argues that because the word asymptomatic means symptomless, a claimant with an asymptomatic preexisting condition cannot be "suffering from" a preexisting condition when there have been no prior symptoms, treatment or loss of employment. Acоsta then concludes from this that if a claimant is not "suffering from" the preexisting condition as she defines it, "then that condition cannot be found to contribute to her injury."
420 Although this argument is superficial ly appealing, it must fail for a number of reasons. First, Acosta misreads Nyrehn to support her position that asymptomatic preexisting conditions are outside the scope of the Allen test. She concludes that because we reversed the Commission in Ny-rehn and the claimant's preexisting condition was asymptomatic, we must have ruled as we did because the preexisting condition was asymptomatic. This is not so. The fact that the preexisting condition was asymptomatic was immaterial to the Nyrehn decision. In Nyrehn, the Commission had failed to make a required finding of fact-that the preexisting condition contributed to the injury. See Nyrehn,
{21 Second, Acosta's argument that asymptomatic preexisting conditions are outside the Allen test depends on her narrow definition of the verb "suffer." In contrast, Respondents maintain that "suffers from" means merely "to have." Respondents point to the context and purpose of the use of the language "suffers from" in Allen as supporting their interpretation.
7° & 4 22 Webster's offеrs "experience," "undergo," and "bear" as synonyms for "suffer." Webster's Third New International Dictionary 2284 (1986). It also defines "suffer" as "to submit to or endure death, affliction, penalty, or pain or distress"; "to be in a state of disability"; to "be subject to something disabling"; and "to be at a disadvantage." Id. These alternative meanings support Respondents' broader reading of the phrase "suffers from" as used by the Allen court.
T23 The purpose behind the legal causation test for preexisting conditions announced in Allen was to distinguish between injuries that
eoincidentally occur at work because a preexisting condition results in symptoms which appear during work hours without any enhancement from the workplace, and . those injuries which occur because some condition or exertion required by the employment increases the risk of injury which the worker normally faces in ... everyday life.
Allen,
T 24 In further describing preexisting conditions, Larson speaks of "having a ... personal disease," and not necessarily of enduring the pain or symptoms associated with a preexisting - condition. Larson, _ supra § 46.083[2], at 46-7 (emphasis added). Larson also notes a distinction between a "prior heart weakness" as opposed to a heart that is "previously healthy." Id. § 46.03[2], at 46-10. The use of this objective language supports Respondents' position that the Allen court, which cited Larson extensively in formulating the legal causation test, did not mean to limit the meaning of the phrase "suffers from" to claimants who subjectively experience pain or symptoms prior to their workplace injury. Instead, this language supports an interpretation of "suffers from" that includes those claimants who simply have the preexisting condition-whether or not they experience pain or symptoms.
125 The concurring opinion of Justice Zimmerman in Holloway v. Industrial Commission,
I would observe that the preexisting condition of which Allen speaks need not be patent; in fact, it need not have been known or knowable to anyone before the injury. The sole question is whether the worker came to the workplace with a condition that increased his risk of injury. If he did and that condition contributed to the injury, then Allen's higher standard of legal causation comes into play so as to рlace that worker on the same footing as one who did not come to work with a preexisting condition. To rule otherwise would create the strong likelihood that a worker who has a preexisting condition and whose virtually inevitable injury simply happens to occur at work will be able to foist the cost of that injury on his employer when the workplace had little to do with causing the injury.
Id. (citation omitted). We believe Justice Zimmerman's concurrence correctly states the law in Utah.
126 Other jurisdictions have applied a test for legal cаusation similar to our Allen test in cases where the preexisting condition was asymptomatic. See, eg., Market Food Distribs., Inc. v. Levenson,
127 The real issue in cases of preexisting conditions is not whether the claimant has suffered pain, nor is it a problem of proof,
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it is quite simply a problem of causation. When analyzing whether an injury arose out of and in the course of employment, it matters not at all, from the standpoint of legal causation, whether the preexisting condition was symptomatic or asymptomatic. Once
128 Finally, Acosta's conclusion, that if a claimant is not "suffering from" actual pain and symptoms of a preexisting condition then the condition cannot contribute to the injury, is fallacious. It assumes as a medical necessity that any preexisting condition that could possibly contribute to an injury must be knowable before the injury occurs. The facts of this very case prove the assumption incorrect. Both the ALJ and the Commission found that Acosta had a preexisting condition consisting of spinal stenosis, or narrowing of the spinal canal, and the Commission determined that, "[the medicаl record establishes that this preexisting condition actually contributed to the injury for which she now seeks compensation."
129 Under the Utah Administrative Procedures Act, we review the Commission's factual determinations to see whether they are "supported by substantial evidence when viewed in the light of the whole record" before us. Utah Code Ann. § 63-46b-l6(4)(g) (1997). Substantial evidence has been defined as " 'that quantum and quality of relevant evidence that is adequate to convince a reasonable mind to support a conclusion" U.S. West Communications, Inc. v. Public Serv. Comm'n,
130 Here, the medical evidence in the record, expressly relied upon by the Commis-gion, consists of a March 1999 report by Acosta's surgeon, Dr. Robert Hood. Dr. Hood writes: "I do not think there is any question that the severe stenosis seen on [the] MRI is the cause of her symptoms and that it first became symptomatic as a result of the work injury even though she clearly had some pre-existing disease." In addition, a report by Dr. Bart Fotheringham, who examined Acosta in February 1999-prior to her surgery-indicates that
thesе degenerative changes [in Acosta's spine] are clearly pre-existing with this having been gradually increasing over multiple years. I suspect, though, that there has been some type of slight disk herniation that then sort of set the patient into her current symptoms. I do not think it would have to be much ... due to the significant stenosis.
These medical reports are adequate to convince us that the Commission's finding that the preexisting condition contributed to the injury is supported by substantial evidence.
T381 Acosta next argues that, even if the Allen test applies to her сase, the Commission applied the test incorrectly when it reversed the ALJ's ruling. The ALJ, in ruling Acosta had satisfied Allen, relied on a cumulative trauma theory. The ALJ, in his order, wrote:
The single lift of an eight pound baby, turning and handing it to the mother, considered alone, would not constitute an extraordinary exertion under the Allen test of legal causation.... The totality of the circumstances in Acosta's case include much more than this single event for she had five babies and their respective mothers to care for. That uncontradicted testimony is supplemented by her deposition which indicates ... that if the mother was breastfeeding, the lifting of a child would be repeated about every two hours, or four times in an eight-hour shift, Of course there would be a second lift from the mother back to the isolette. For five mothers, that would be 40 lifts for feeding alone, and certainly there would be many other lifts for changing, bathing and visitors, probably doubling that number. But even that was only a portion of petitioners [sic] work.... Acosta testified that she had to assist the patients in their total care and activities of daily living, e.g. [but not limited tol, helping patients with a C-section up and to the bathroom. Petitioner also testified that she often had to pickthings up from the floor in assisting the mothers.
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... [EJven if legal causation is required ..., Acosta has shown by a preponderance of the evidence that her aggregated workplace duties caused her injury and exceeded the Allen test.
The Commission, in reversing the award of benefits, cited Hilton Hotel v. Industrial Commission,
132 Respondents argue that the Commission was correct to reverse the award of benefits because Acosta never raised a cumulative trauma theory, it was improper for the ALJ to do so sua sponte, and the single lifting of a small child to chest height is not an unusual or extraordinary exertion under Allen.
133 We agree with Respondents that the Commission acted reasonably and rationally in its application of the law to the facts of this case in reversing the ALJ's award of benefits. First, as noted by the Commission, under Hilton Hotel, it was improper for the ALJ to raise the cumulative trauma theory on his own because doing so denied Respondents "the opportunity to present evidence and challenge this type of claim."
1 34 Hence, because Acosta cannot rely on a cumulative trauma theory, and the Allen court itself specifically rejected lifting a smаll child to chest height as an unusual or extraordinary exertion, the Commission acted reasonably and rationally in denying her claim for workers' compensation benefits.
CONCLUSION
"[ 35 We conclude that we have jurisdiction to consider the merits of Acosta's appeal. We conclude that the Commission was correct in ruling that the Allen test for legal causation for preexisting conditions does apply to Acosta's asymptomatic preexisting condition. We also conclude that the Commission's ruling that Acosta did not meet the Allen test was reasonable.
[ 36 Affirmed.
137 WE CONCUR: PAMELA T. GREENWOOD and GREGORY K. ORME, JJ.
Notes
. Acosta also argues that Crosland v. Board of Review,
. The parties dispute how Acosta's approach would affect proceedings before the Commission. Respondents argue Acosta's interpretation of the word "suffer" would "wreak evidentiary havoc" before the Commission, while Acosta argues this would simply not be the case. Neither party makes a convincing argument on this issue, and we decline to give this issue much weight.
. In her "First Report of Injury," filеd with the Commission, Acosta, in answering how the injury occurred, replied: "Lifting a baby to crib, twisted back." (Emphasis added.) She also named a specific date, December 20, 1998, and a specific time of the occurrence, 10:00 a.m. In the ''Physician's Initial Report," also filed with the Commission, under the section captioned "Employee's Statement of Cause of Injury," is written: "Lifting an infant from an isolette." (Emphasis added.) In her application for hearing, Acosta described the accident occurring as follows: "I was lifting a baby out of an isolet [sic] to hand to its mother."
Just as in Hilton Hotel v. Industrial Comm'n,
