Case Information
*1 IN THE UTAH COURT OF APPEALS
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Certified Building Maintenance and ) MEMORANDUM DECISION Fire Casualty Co., )
) Case No. Petitioners, )
)
v. ) F I L E D
) (August 2012) Labor Commission, Appeals Board ) Labor Commission; Enrique )
Antonio; Workers Compensation )
Fund, )
)
Respondents. )
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Original Proceeding Court
Attorneys: Jeff Francis, Grand Junction, Colorado, for Petitioners
Ryan L. Andrus, Murray, Respondent Workers Compensation Fund Alan L. Hennebold, Salt Lake City, Respondent Labor Commission Mark J. Sanchez, Salt Lake City, Respondent Enrique Antonio ‐‐‐‐‐
Before Judges McHugh, Davis, Christiansen.
McHUGH, Presiding Judge: Fire Casualty Co. (State Farm) seeks judicial order Appeals (the Board) must pay benefits Enrique Antonio. We disturb Board’s decision.
¶2 Antonio injured his left knee on January 20, 2008, he slipped on ice (the fall) while working for Certified Building Maintenance (CBM) as a commercial building cleaner. Following MRI, Antonio was diagnosed with a “[l]eft knee medial meniscus tear” and underwent arthroscopic surgery on September 4, 2008. Antonio’s claims arising out fall insured by Farm, which CBM’s insurer time. After surgery and six weeks physical therapy, Antonio returned work on November but continued suffer knee pain and swelling.
¶3 On February 9, 2009, doctor gave him steroid injection temporarily relieve his pain. The injection alleviated pain until February 12, 2009, when Antonio slipped on ice fell onto his back while carrying chemicals CBM (the fall). pain his left knee spiked after eventually subsided preinjection chronic level. There no dispute both falls were work related.
¶4 On March doctor recommended MRI determine whether Antonio had retorn his meniscus. Farm, no longer insured CBM, declined claim on ground fall had resulted injury. CBM’s current insurance carrier, Workers Compensation Fund, refused cover Antonio’s expenses, asserting fall merely aggravated underlying injury by fall. Antonio filed claim Commission (the Commission) October 2009.
¶5 After evidence, Administrative Law Judge (ALJ) entered Fact, Conclusions Law & Order (the Findings). Because competing about injury, however, requested panel. report (the Report) concluded that “there medically demonstrable causal connection between” and current injury was causal connection between injury. objected admission his expected pain relief somewhat contradictory in he testified doctor informed him both “in two weeks [he] not going feel pain” “the pain going go away two weeks.” The treating doctor’s indicates “worked about week.” The Administrative Law Judge found day after injection.
ground that the Interim Findings on which the Report based were inadequate. In addition, State Farm argued that Report ignored some the evidence. ¶6 The ALJ rejected State Farm’s objection to Report, noting that “objection goes weight should be given rather than admission into record.” After reviewing Report determining that it “supported by preponderance evidence,” concluded that Antonio’s knee injury after “arose out the” which had medically caused his injuries. concluded that State Farm liable for expenses. State Farm appealed Board, affirmed ALJ’s decision in all respects, except award attorney fees. State Farm argues Board erred affirming ALJ’s conclusion knee injury, thus making State Farm responsible for
coverage expenses. Specifically, State challenges ALJ’s finding Antonio “had no pain his day following [February steroid] although he continued use brace work.” State Farm contends this finding rendered Interim Findings insufficient panel injuries because does indicate Antonio pain free immediately before fall. According State Farm, this omission rendered so unreliable by considering it, abused her discretion, abdicated duty, violated Farm’s process rights. ¶8 We first evaluate claim Findings inadequately detailed, as matter law, because they include level immediately before fall. adequacy administrative agency’s factual “a legal determination requires deference.” See Olsen Labor 2. reversed award attorney fees remanded that issue further findings. Attorney fees issue appeal.
3. challenges as insufficient evidence. However, because fails marshal evidence, required challenge a factual ground, consider claim insufficient evidence support factual findings. Martinez Media Paymaster Plus/Church Jesus Christ Latter day Saints See generally id. ¶¶ (distinguishing between inadequate those are unsupported by substantial evidence warning parties risk summary dismissal declining marshal raising challenges sufficiency evidence).
Comm ʹ n , 2011 UT App 70, ¶ 10, 249 P.3d 586 (internal quotation marks omitted). To support claim, State Farm cites Adams v. of Review of the Industrial , 821 P.2d 1 (Utah Ct. App. 1991). Adams requires that an agency’s findings “‘be sufficiently detailed disclose the steps the ultimate factual conclusions, or conclusions mixed law, reached’” so that this court may conduct appellate review. Id. at 5 (quoting Milne Truck Lines, Inc. v. Public Serv. Comm ʹ n P.2d 1373, 1378 (Utah 1986)). However, Adams did not involve challenge the interim ALJ, State Farm cites no decision requiring findings to meet the standards designed facilitate appellate review. See Blair Comm’n , 2011 UT App 248, ¶ 15 & n.1, 262 P.3d 456 (mem.) (indicating that court would not apply the standards discussed in Adams interim absent any supporting authority), cert. denied 268 P.3d 192 (Utah 2011). Even if consider State Farm’s challenge adequacy Interim
Findings merits, any presumed error was harmless. Smith Department Workforce Servs., 382, 17, 245 758 (applying harmless error to agency actions). State Farm complains that that Antonio “had pain in his knee day following [February steroid] injection” was inadequate because it did not specifically state “level pain zero leading up moment February incident significant increase in pain time February incident.” argues panel know Antonio pain free from February until fall, which occurred two days later, fall resulted spike knee pain. ¶10 Contrary assertions, accurately reflect that suffered chronic pain after pain subsided after injection, pain returned after fall. indicated how specific regarding level pain immediately before would aided panel’s review. Indeed, conclusion primarily evaluation chronic pain over time, on specific pain level immediately before fall. While panel acknowledged “increased pain,” it determined increase “temporary aggravation[]” “returned baseline” “[i]t baseline causally related [2008] work accident.” further alleges apparent discrepancies over exact duration relief after steroid rendered Findings inadequate, does indicate how resolution these discrepancies would change evaluation injury.
¶11 Further, record as whole supports Board’s observation that Report “persuasive because panel is impartial in this matter and has benefit collegial review Mr. relevant medical history . . . [and] panel included an orthopedic expert who examined Mr. left before panel reached conclusion.” medical panel reviewed “[i]ndexed medical records . . . providers medical facilities comprising 109 pages.” Those reports included two medical opinions—including that treating physician—indicating that the merely exacerbated existing injury. panel also considered one physician’s opinion that injury, found opinion unpersuasive. we do agree “the left out key piece evidence, thereby rendering her [Interim Findings] insufficient [medical panel’s] review.” Cf. Blair UT App (“[W]e agree . . . because interim were more detailed ‘the [medical panel] left guess what injuries [the claimant] sustained or aggravated in accident.”). next asserts because specifically state in her free leading up she inappropriately
delegated fact finding duty medical panel. In support, cites Price River Coal Co. Industrial Commission P.2d (Utah 1986), which held an improperly delegated its duty conflicting about employee’s job description left medical panel “confused some basic [job] duties,” leading make “assumptions . . . [were] unsupported the evidence.” Id. 1084. Price River Coal Co. is inapplicable, however, because there is no factual dispute about job duties facts either or falls. We previously indicated panel may conduct own medical examination record. Speirs Southern Univ ., ¶¶ 42.
[T]o award compensation, must determine accident occurred causal connection between accident injury claimed.
For same reasons we find any presumed error Findings be harmless, reject assertion ultimate Findings Fact, Conclusions Law, Order incorrectly stated “had all factual finding[s] consider rendering [its] opinion so [it] could consider mechanism injury all accidents render [its] opinion.” Because comprehensive nature panel’s review, any presumed error ALJ’s ultimate adequate review harmless.
This requires the Commission make findings fact and draw conclusions law. In difficult cases, the opinions a medical panel may be assistance to the Commission in determining whether benefits should be awarded because medical panel provides the the benefit its medical expertise. medical panel is empowered to study, take X ‐ rays, and perform tests may determine necessary or desirable rendering its opinion.
Id. ¶ (citations and internal quotation marks omitted). However, ALJ “may not abdicate its fact ‐ responsibility to medical panel.” See id. (citing Price River Coal Co. 1084).
¶13 Here there is indication fact inadequate medical panel’s review. As stated above, relief, and temporary nature thereof, expected result steroid and particularly relevant to ultimate conclusion medical injuries. Furthermore, medical panel provided medical record and permitted conduct its own physical examination interview Antonio. See Utah Code Ann. § 34A ‐ ‐ 601(2)(a) (2011) (allowing panel “conduct a study” if “necessary or desirable”). Under these circumstances, improperly delegate her ‐ duty panel.
¶14 Finally, challenges admission Report over objections, arguing first exceeded her discretion admitting Report, alternatively admission violated procedural process rights. first claims exceeded discretion declining hold a
hearing provide additional panel upon objection to Report. However, statutory administrative code provisions State relies expressly permissive. Code Ann. § 34A ‐ 601(2)(f)(i) (2011) (“If written objection report filed . . . administrative law judge may set case hearing determine facts issues involved.” (emphasis added)); Utah Admin. Code R602 2(B) (“A objections panel report may be scheduled if proffer conflicting showing need clarify panel . . . . [The ALJ] may lieu hearing, re submit new consideration clarification.” (emphasis added)). *7 ¶16 The ALJ determined an additional hearing necessary because “[t]here nothing contained within [State Farm’s] objection would prevent . . . [R]eport from being entered into evidentiary record.” ALJ noted considered, rejected, State Farm’s proffered opinion. Additionally, State Farm afforded an opportunity examine at hearing elicit any alleged inconsistent prior deposition. Yet State asserts decision hold another hearing “exceeded bounds reasonableness rationality.” We cannot conclude acted unreasonably or irrationally where State identified any information could been presented hearing or would have altered medical analysis. we reject Farm’s claim decision consider without holding an additional hearing an abuse discretion. alternatively asserts violated constitutional right to procedural due process she exercised discretion hold hearing or take additional evidence based Farm’s objections Report. U.S. Const. amend. V (“No person shall . . . be deprived life, liberty or property, without due process law.”); Utah Const. art. I, § (same). “Due process challenges questions law applying correction error standard.” Auto Auction v. Comm ʹ n , UT App 293, ¶ 9, P.3d (internal quotation marks omitted). procedural due process challenge, like abuse discretion challenge, is premise discretionary procedures available an take additional or hold response objection are constitutionally required. level procedure any legal setting dependent upon number factors:
First, private interest will be affected official action; second, risk erroneous deprivation such interest through procedures used, probable value, if any, additional or substitute procedural safeguards; finally, Government’s interest, including function involved fiscal administrative burdens additional substitute procedural requirement would entail.
Mathews Eldridge , U.S. 319, (1976); see Color Country Mgmt. v. Labor Comm ʹ n UT P.3d (quoting Mathews U.S. 335), aff ʹ d sub nom. Thomas Color Country Mgmt ., 1201. In Lander Industrial (Utah Ct. App. 1995), we applied
those factors determined Board has “the discretion whether not hold a objections panel” discretion “is a violation due process guaranteed Fourteenth Amendment United States Constitution Article I, Section Utah Constitution.” id. ‐ (citing Code Ann. § (Supp. 1994) (current version id. § 34A (2011))). makes attempt distinguish Lander identified any information would been helpful panel. Accordingly, we conclude violate process rights.
¶19 For reasons indicated, disturb Board’s decision. ____________________________________
Carolyn B. McHugh,
Presiding Judge
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¶20 WE CONCUR:
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James Z. Davis, Judge
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Michele M. Christiansen, Judge