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Industrial Reports
2002
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Al Evans vs. Woodland Park Care Center and Workers' Compensation Fund
Case Number --2000816
Court/Judge --Eblen
Verdict/Settlement --Order, 11/01
Amount --The ALJ ordered employer/carrier to pay claimant accrued temporary total disability benefits of $4,560 for the period running from 6/16/2000 through 10/13/2000, plus interest. Employer/carrier must also continue to pay claimant's related medical expenses. The claim for additional permanent partial disability benefits was denied, since claimant did not present any evidence to prove he suffered additional impairment.
Injuries --Claimant suffered a right hip injury which caused him ongoing pain, weakness and difficulty ascending stairs. He was diagnosed with a bulged disc at L5/S1. Dr. Chung gave claimant a 3% related whole person impairment rating.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Hans M. Scheffler
Damages --Employer/carrier paid claimant temporary total disability benefits for three weeks at $266 per week, as well as $3,200 in medical expenses. Employer/carrier paid claimant for his 3% permanent partial impairment.
Facts/Contentions --Claimant was injured while assisting a patient weighing over 300 pounds in the transfer from her wheelchair to her bed. He later aggravated this injury at work and sought additional temporary total disability compensation for the times he was unable to work. He also sought additional permanent partial disability benefits.
Employer/carrier admitted the accident occurred and accepted liability, but argued that it had already paid claimant all the benefits to which he was entitled.
WORK INJURY
Case Type --WA; BT; Work-related assault
Case Name --Garlyn W. Davis vs. L. W. Miller Transportation and/or Workers' Compensation Fund
Court/Judge --Hann
Verdict/Settlement --Order, 11/01
Amount --The ALJ stated that she found claimant's account credible; she therefore ordered employer/carrier to pay claimant's related medical expenses.
Injuries --Claimant suffered two smooth fractures of the jaw, with fracturing in teeth numbers 2, 3, 19 and 30.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Eugene W. Miller Jr.
Expert Witness(es) - Plaintiff --Dr. Gary W. Lowder
Damages --Employer reimbursed claimant for $300 of the $600 that was stolen and paid $133 of his medical expenses.
Facts/Contentions --Claimant was injured during a robbery while he was driving a truck for employer. He had a load to deliver at a Jack in the Box in Phoenix and drove down from Logan. Arriving the night before the delivery was scheduled to be made, he discovered he could not park his truck in the customer's lot because the lot only held three trucks and was already occupied by the first three trucks scheduled to make deliveries the next morning. Claimant therefore drove to a nearby truck stop, but found its parking lot was also full. He said he parked the truck on a side street and sat in the cab for a while to make sure the neighborhood looked safe, after which he locked all the doors, crawled into the sleeper, and fell asleep.
At 7:00 the next morning, claimant stated, two young men broke into the cab, pushed claimant down onto his face in the sleeper, trained a gun on him and demanded his wallet. Claimant said he believed they reached through the window, which claimant had left open a bit for air, and unlocked the door. Claimant gave the men his wallet, and they took $600 out of it and demanded more. Claimant told the men that was all the money he had, but added that the men found some dollar bills which had fallen into his boots while he was getting out his wallet. The robbers became enraged, accused claimant of lying, pulled him up by his hair and struck him in the side of the face with the gun. They then fled. Claimant said he blew the truck's air horn as the robbers were running away, but no one responded.
Claimant said he drove to the truck stop after the robbery and told a policeman there what had happened, but added that he made no formal report because the officer "didn't seem interested." Claimant made his delivery, picked up his return load and drove back to Logan.
Claimant said he believed he suffered no ill effects from being hit with the gun beyond some transitory pain. Two years after the incident, however, he began experiencing pain and felt tooth slivers in his mouth. He consulted Dr. Lowder, who discovered the healed fractures and also found several of claimant's teeth were beginning to break up. Dr. Lowder said he was quite sure the injuries stemmed from the assault.
Employer/carrier at first paid some of claimant's expenses, but contended that his story of pain and tooth fractures beginning two years after the accident was not credible. Claimant alleged that he filed his claim as soon as he realized his problems were caused by being hit with the gun.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Jeff D. Hofhine vs. Schuff Steel Company and Lumbermen's Mutual Casualty Insurance
Case Number --99573
Court/Judge --Eblen
Verdict/Settlement --Order, 12/01
Amount --The ALJ ordered employer/carrier to pay claimant's related medical expenses through 4/21/99 and also to pay for a three-month trial of Depakote or a calcium channel blocker to prevent claimant's migraine headaches. Employer/carrier must also pay claimant accrued temporary total disability compensation of $138.80 and accrued temporary partial disability benefits of $290.64; both payments are due in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Attorney's fees are to include 20% of the accrued interest on this award.
Injuries --Claimant contended that he suffered a brain injury; employer/carrier disputed this claim.
Attorney(s) - Plaintiff --Timothy C. Allen
Attorney(s) - Defense --S. Brook Millard of Dunn & Dunn
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Thomas Schenkenberg; Dr. George Smith; Dr. John Foley; and Dr. John Hylen.
Facts/Contentions --Claimant, an iron worker, hit his head on one of the boards holding a handrail around the upper level of a work area while climbing a ladder to get to the work area at a construction site. Claimant fell four feet off the ladder, striking his chest and elbow, and lost consciousness for a few seconds. He revived, complained of dizziness and blurred vision, and then passed out again, after which his foreman called an ambulance. An accident report filled out by a former certified EMT said claimant was shaking violently, although he said he was not cold, and he appeared pale and was breathing in a "ragged" manner. Cervical spine X-rays and a cranial CT scan were normal. After the accident claimant complained for some time of continuing headaches and vertigo which he felt made it unsafe for him to work. He eventually returned to his job as an iron worker.
Claimant had a prior history of head trauma with headaches. Because of this fact, and because most of claimant's diagnostic tests, both organic and cognitive, were normal, employer/carrier denied liability. However, electronystagmography confirmed claimant's complaint of vertigo and revealed hyperactive caloric responses.
The medical panel found the treatment claimant received was medically necessitated by his work injury until he stabilized three months and two days after the accident. The panel also recommended workers' compensation coverage for a three-month trial of Depakote or a calcium channel blocker to prevent claimant's migraine headaches.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Dan R. McKenzie vs. Southern Utah Fuel Company and Workers' Compensation Fund
Case Number --991158
Court/Judge --Poelman
Verdict/Settlement --Order, 12/01
Amount --The ALJ found claimant made reasonable efforts to fulfill his obligations under the terms of the return-to-work plan, and employer/carrier should have modified the plan when it became obvious that claimant was not going to be able to comply with it. The ALJ ordered employer/carrier to pay for an updated functional capacity evaluation and review the return-to-work plan in light of the results, modifying it if needed. Claimant must continue to cooperate fully with the plan, and employer/carrier must pay claimant accrued subsistence benefits of $365 per week from 5/3/01 until the date of payment in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Regular payment of subsistence benefits must then continue until claimant completes the return-to-work plan or it is abandoned.
Injuries --Claimant suffered a back injury.
Attorney(s) - Plaintiff --Wayne A. Freestone of Freestone & Angerhofer
Attorney(s) - Defense --Barbara W. Sharp
Expert Witness(es) - Plaintiff --Dr. Gaufin
Facts/Contentions --After claimant was injured, he and his employer reached a return-to-work agreement whereby employer/carrier was to pay claimant subsistence benefits while claimant was attending school to obtain his associate's degree and a bachelor's degree in accounting. However, though claimant registered for 12 credit hours in the fall semester, he stated that he had to discontinue a 3-hour evening class because of pain. After he realized that he was not going to be able to complete his course work in the time allotted by the plan, he spoke with his vocational rehabilitation counselor and offered to take summer classes to make up the required credit hours, but employer/carrier terminated his subsistence benefits on grounds that claimant was not cooperating fully with the return-to-work plan. Claimant produced a statement from Dr. Gaufin's office in which the doctor opined that claimant was unable to maintain a 12-hour class schedule because of his work-related low back pain, mid-back pain, neck pain and numbness of the hands, and would have to take a reduced number of hours each semester.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Gil C. Sorensen vs. Ascend H R Solutions and Workers' Compensation Fund
Case Number --2000738
Court/Judge --Eblen
Verdict/Settlement --Order, 12/01
Amount --The ALJ found that since claimant's physician documented the inappropriateness of the work offered in that it aggravated claimant's pre-existing symptoms, light duty work suitable to claimant's limitations was not really available to him. The ALJ therefore ordered employer/carrier to pay claimant additional accrued temporary total disability benefits of $1,272.65 in a lump sum plus interest.
Injuries --Claimant suffered a fractured fifth right metacarpal.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Lori Hansen
Expert Witness(es) - Plaintiff --Dr. Robert Horne
Facts/Contentions --After claimant broke his finger, he was offered light duty work by his employer and accepted it. However, he claimed the sitting involved in the light duty work aggravated his low back pain from a pre-existing vertebral compression fracture; he discontinued the light duty work and sought additional temporary total disability benefits.
Employer/carrier said no restrictions were placed on claimant, who could stand up or sit down at will while doing the light duty work. Employer/carrier contended that since light duty work was available and claimant refused to perform it, employer/carrier was not liable for any further disability benefits.
Claimant's doctor wrote a note stating that claimant could not perform the duties involved in the light duty work because they aggravated his low back pain.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury
Case Name --Juana Tellez vs. Artex International, Incorporated
Case Number --99556
Court/Judge --Eblen
Verdict/Settlement --Order, 12/01
Amount --The ALJ accepted the medical panel's findings and dismissed the claims for benefits related to the carpal tunnel syndrome, cubital tunnel syndrome, and cervical spinal injuries; however, the ALJ reserved the issue of claimant's possible entitlement to permanent partial impairment benefits related to the shoulder injury pending submission of a permanent impairment rating.
Injuries --Claimant suffered a right shoulder injury and also claimed she developed carpal tunnel syndrome, cubital tunnel syndrome and degenerative spondylolysis at C6/7.
Attorney(s) - Plaintiff --Virginius Dabney of Dabney & Dabney, St. George
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll (Brad C. Betebenner of Richards, Brandt, Miller & Nelson substituted during the pendency of this claim before the Labor Commission)
Expert Witness(es) - Plaintiff --Because of conflicting medical testimony, this case was referred to a medical panel.
Facts/Contentions --Plaintiff worked for self-insured employer as an apron-folder, inspecting aprons, fold them and stacking them. She claimed the repetitive actions involved in this work caused all her symptoms, which came on suddenly one day after she placed the last bundle of aprons on top of a stack above shoulder height. Claimant said she felt a pain as if something had burst in her shoulder, accompanied by a burning sensation in her face, neck and arm.
Employer accepted liability for the shoulder injury, but denied that claimant's carpal tunnel syndrome, cubital tunnel syndrome and cervical spine injuries were work-related.
The medical panel found claimant's shoulder symptoms were related to her work activities, but her other problems were not.
OCCUPATIONAL DISEASE
Case Type --OD; Occupational disease claim
Case Name --Gary D. Harris vs. Battelle Memorial Institute/CNA Casualty of California; and EG&G/Liberty Mutual Insurance
Case Number --99332, 99334
Court/Judge --Eblen
Verdict/Settlement --Order, 11/01
Amount --The ALJ granted Battelle's motion to dismiss under the Last Injurious Exposure Rule, finding that EG&G was claimant's employer of record for at least 12 months before this claim was filed and would therefore be the only party liable if claimant suffered from occupational disease. The ALJ found, however, that claimant did not produce sufficient evidence to support his claim of disability caused by chemical poisoning on the job at EG&G. The ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant alleged that he suffered neurotoxic poisoning from his chemical exposures. Tests did not show any abnormalities which could stem from chemical poisoning from mustard gas, organophosphates or heavy metals.
Attorney(s) - Plaintiff --Kenneth E. Atkin of Atkin & Associates
Attorney(s) - Defense --For Battelle/CNA: Theodore E. Kanell of Plant, Wallace, Christensen & Kanell; for EG&G: Doug Owens; for Liberty Mutual: Michael E. Dyer of Blackburn & Stoll
Facts/Contentions --Claimant alleged that he suffered toxic chemical exposures during the time he worked for both Battelle and EG&G which left him permanently and totally disabled.
Battelle argued that it should be dismissed from the claim under the Last Injurious Exposure Rule, since claimant was employed by EG&G for more than twelve months after leaving Battelle. Battelle also claimed there were no hazardous waste spills recorded at its incinerator during the time claimant worked there. Records indicated that claimant was not involved in cleaning up any hazardous spills at Battelle.
Liberty Mutual denied that claimant suffered chemical exposures at its facility and also contended that the permanent total disability claim was premature, since claimant did not have a permanent partial impairment rating. Records at both facilities indicated that claimant was not exposed to any dangerous chemicals in the course of his employment at either one.
OCCUPATIONAL DISEASE
Case Type --OD; Occupational disease
Case Name --Sheree Fontenot vs. University of Utah and/or Workers' Compensation Fund; Utah Valley State College and/or Workers' Compensation Fund; and Salt Lake Community College and/or Workers' Compensation Fund
Case Number --991233, 991234, 2000520
Court/Judge --Hann
Verdict/Settlement --Order, 12/01
Amount --The ALJ found employers/WCF do not owe claimant any further temporary total disability benefits. However, the ALJ ordered employers/WCF to pay claimant accrued permanent partial disability benefits of $5,513.84 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Of this award, SLCC must pay 50%, the U of U must pay 30%, and UVSC must pay 20%. The ALJ also ruled SLCC must reimburse the U of U for 50% of the benefits it has already paid claimant, and UVSC must reimburse the U of U for 20% of the benefits it has already paid claimant.
Injuries --Claimant developed bilateral CTS and shoulder impingement. Dr. Holmes gave her a 6% upper extremity rating for the loss of function in the right shoulder and a 3% upper extremity rating for loss of function in the elbow, forearm, wrist and hand. Of this total impairment, Dr. Holmes found 50% was due to claimant's work at SLCC, 30% was due to her exposure at the U of U, and 20% resulted from her activities at UVSC.
Attorney(s) - Plaintiff --Phillip B. Shell of Day, Shell & Liljenquist
Attorney(s) - Defense --For University of Utah/WCF: Barbara W. Sharp; for Utah Valley State College/WCF: Lori Hansen; for SLCC: Eugene Miller Jr.
Expert Witness(es) --Because of the great quantity of conflicting medical testimony, this case was referred to Dr. Edward B. Holmes, a specialist in occupational medicine.
Facts/Contentions --Claimant, a state-certified Level III American Sign Language (ASL) interpreter, stated she developed her occupational disease while interpreting ASL for all three employers. ASL employs extensive movements of the arms. Claimant contended that employers should have provided team interpreters when several back-to-back one-hour classes were scheduled instead of just for two-hour classes. Claimant often interpreted from 7 AM to 3 or 4 PM daily with only one hour off for lunch.
Utah Valley State College denied liability and contended that claimant failed to prove medical causation. The University of Utah denied liability for the shoulder injuries, but accepted liability for a previous right wrist/thumb injury. SLCC denied liability due to intervening exposure.
Dr. Holmes found a medical causal connection between claimant's work activities and her symptoms.
FALL
Case Type --WA, SF; Work-related fall
Case Name --Kevin Graves vs. Ballard Medical Products, a wholly-owned subsidiary of Kimberly-Clark Corporation
Case Number --2000665
Court/Judge --Eblen
Verdict/Settlement --Order, 12/01
Amount --Because claimant was symptomatic before he fell, the ALJ ruled the hip replacement surgery was not necessitated by the work injury; the ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant underwent total hip arthroplasty.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Carrie T. Taylor of Richards, Brandt, Miller & Nelson
Expert Witness(es) - Plaintiff --Dr. Lynn Rasmussen
Expert Witness(es) - Defense --Dr. Richard Knoebel--Independent Medical Examination
Facts/Contentions --Claimant fell while lifting a 65-pound box down from a shelf at work after he caught his foot in a pallet. He contended that the surgery he later needed was necessitated by the work injury.
Self-insured employer denied liability for claimant's surgery and associated temporary total and permanent partial disability.
Dr. Rasmussen felt the fall caused further collapse and aggravation with acute symptoms of a pre-existing avascular necrosis of the left femoral head. Dr. Rasmussen opined that while claimant would eventually have needed a total hip replacement, the fall at work caused the collapse and fracture of the femoral head, necessitating the replacement sooner than it would otherwise have been needed. Dr. Knoebel found the avascular necrosis was not caused by or aggravated by the fall. Claimant's medical history indicated the avascular necrosis was already symptomatic before he fell.
FALL
Case Type --WA, SF; Work-related fall
Case Name --(Name of case withheld)
Case Number --200022
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 12/01
Amount --Notwithstanding claimant's loss of credibility, the ALJ accepted the medical panel's findings and found claimant did actually suffer the failed surgery and attendant impairment. The ALJ found that self-insured employer overpaid claimant's temporary total disability benefits by $1,598.03. This figure was offset against the additional permanent partial disability benefits employer still owes claimant for her further 15% related whole person impairment, leaving a total balance owing of $2,608.51. This amount is due and payable in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer must also pay claimant's related medical expenses.
Injuries --Claimant suffered a knee injury which resulted in a failed total right knee arthroplasty. Claimant was left with a pronounced limp and a halting, lordotic gait. The medical panel gave claimant a 25% related whole person permanent impairment. Employer previously paid claimant for a 10% impairment.
Attorney(s) - Plaintiff --James C. Haskins of Haskins & Associates
Attorney(s) - Defense --Henry K. Chai II of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Alvin Wirthlin--neurologist; and Dr. Glen Momberger--orthopedic surgeon.
Facts/Contentions --Claimant fell down some stairs at a junior high school while picking up some supplies in the course of her employment. Claimant had pre-existing polio in the affected leg, contracted when she was five years old, but the fall caused a new right tibial plateau fracture which necessitated a total right knee arthroplasty. This surgery ultimately failed.
Self-insured employer contended that some of claimant's problems resulted from the earlier polio; however, the medical panel found the surgery was necessitated by the industrial fracture. The ALJ noted, however, that claimant impaired her credibility by embellishing the circumstances surrounding her disability with regard to non-significant details, even though a surveillance video refuted her claims.
DISCRIMINATION
Case Type --DS; Discrimination claim
Case Name --Cindy Kobbs vs. Crossroads Travel nka C R Affiliates
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 12/01
Amount --The ALJ ordered employer/carrier to pay claimant $10,800 in lost back wages dating from her termination, as well as $3,925.15 in accrued interest and another $3,000 in attorney's fees. Interest will continue to accrue on the balance due at 8% per annum until the award is paid in full. However, the ALJ said there is no provision in Utah workers' compensation law for compensatory damages in the form of emotional distress. ALJ La Jeunesse therefore denied the $50,000 claim.
Attorney(s) - Plaintiff --Stephen W. Cook
Attorney(s) - Defense --Catherine S. Conklin, Ogden
Facts/Contentions --Claimant contended that her employer fired her because she was pregnant. She sought back pay, accrued interest and attorney's fees, as well as $50,000 for intentional infliction of emotional distress.
When it received notice of the claim and the scheduled hearing, C R sent a letter by its attorney stating that it would not be present at the hearing. The letter said C R understood its non-appearance would result in its being declared in default, and C R had no objections. The default was duly entered at the hearing.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Linda Acosta vs. IASAIS/Salt Lake Regional Medical Center
Case Number --20001139
Court/Judge --Hann
Verdict/Settlement --Order, 12/01
Amount --The ALJ noted that at the time of this incident, claimant had still not stabilized from her earlier surgery and was therefore required to meet the Allen test for extraordinary exertion in order to prove a new injury occurred. The ALJ found claimant's fall did not meet the Allen test, since anyone might have the same thing happen while assisting an elderly or ill relative in everyday life; the injury was therefore an exacerbation of her previous injury, and the ALJ dismissed this claim with prejudice.
Injuries --Claimant was diagnosed with multi-level lumbar spondylosis with stenosis and failed lumbar surgery syndrome with epidural fibrosis causing left and right lumbar radiculopathy.
Attorney(s) - Plaintiff --Phillip B. Shell of Day, Shell & Liljenquist
Attorney(s) - Defense --Theodore E. Kanell of Plant, Wallace, Christensen & Kanell
Expert Witness(es) - Defense --Dr. Robert Hood, Dr. Joel Dahl, Dr. Gerald Moress
Facts/Contentions --Claimant is an LPN who works on the maternity ward. She first injured her low back while working at the same hospital, then known as Holy Cross, under a different owner, at which time she was found to have some pre-existing spinal stenosis. Surgery was performed for that injury, but claimant had not yet been able to return to working a regular twelve-hour shift when this injury occurred. Claimant was assisting a patient who had to go to the bathroom. Claimant said she asked the patient to wait for the arrival of an assistant, who was on the way, but the patient got up and started to head for the bathroom anyway, and claimant walked beside her to support her. The patient's legs buckled and she fell, pulling claimant down with her so that claimant landed on her right knee and right leg. Claimant said she felt as if her leg was jammed into her spine, but she took some Motrin and finished her shift. She went to the emergency room the next day because of pain. Almost two months after this incident, claimant was at home when her right leg buckled and she fell. She said she had not experienced numbness in her leg before this incident, and claimed the incident amounted to a new injury caused by her fall at work two months earlier.
Employer/carrier contended that claimant's injury was not new and that her symptoms were brought on by activities which did not meet the Allen test for extraordinary exertion as required in cases of pre-existing injury.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Rich Cunningham vs. Highland Farms and/or Workers' Compensation Fund
Case Number --2000716
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 12/01
Amount --The ALJ found that claimant was self-employed; the ALJ therefore found Highland Farms was not liable because claimant was not working for them at the time of his injury. The ALJ dismissed this claim with prejudice.
Injuries --Claimant suffered a cut on his left foot.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Eugene C. Miller Jr.
Facts/Contentions --Claimant cuts wood for a living. He said he had a single conversation with Ken Stratton of Highland Farms, who arranged for claimant and a co-worker to cut some wood in an orchard owned by Highland Farms, after which claimant and his co-worker could sell the wood for whatever price they pleased and keep the money. Claimant and his co-worker eventually sold the wood for $100 per truck-load and split the money, with half going to each man. The co-worker owned the truck and the chainsaws and wood-splitters the men used. Claimant was injured when the chainsaw he was using slipped off a log and cut into his foot. He claimed he was employed by Highland Farms at the time.
Highland Farms denied that an employment relationship existed between it and claimant, contending that claimant was self-employed.
FALL
Case Type --WA, SF; Work-related slip/fall
Case Name --Peter J. Handleson vs. Dick Simon Trucking and Fremont Comp
Case Number --99664
Court/Judge --Eblen
Verdict/Settlement --Order, 12/01
Amount --The ALJ found claimant's fall met the Allen test for extraordinary exertion. The ALJ accepted the medical panel's finding that the industrial fall caused claimant's shoulder injury. The ALJ therefore ordered employer/carrier to pay claimant's related medical expenses, as well as accrued temporary total disability benefits of $21,428 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorneys. Employer/carrier must also pay claimant accrued permanent partial disability benefits of $5.469.75 plus interest and less attorney's fees.
Injuries --Claimant was diagnosed with a right shoulder injury. but doctors disagreed about whether it was a full rotator cuff tear. The medical panel felt the rotator cuff was most likely torn and gave claimant a 5% related whole person impairment rating for his industrial injury, with another 3% whole person impairment due to pre-existing cervical spinal conditions.
Attorney(s) - Plaintiff --Loren M. Lambert of Arrow Legal
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) - Plaintiff --Dr. Sorsby, Washington; Dr. Ricketson, Hawaii--orthopedist; Dr. Terry Smith, Hawaii
Expert Witness(es) - Defense --Dell Felix, PT--functional capacity evaluation; Dr. Gerald Moress and Dr. Gary Zeluff--IMEs; this case was referred to a medical panel consisting of Dr. Richard Bromley--orthopedic surgeon and Dr. John Hylen--internist and cardiologist.
Facts/Contentions --Claimant was working as a driver-trainer for employer. He had climbed into a trailer to inspect it for cleanliness, and as he was leaving the trailer, his foot slipped out from under him and he fell about three feet onto the ground, landing on his right shoulder just above the shoulder-blade. He did not lose consciousness and continued working, but one and a half or two weeks later he noticed he was unable to shift the truck's gears and was experiencing pain while trying to sleep.
Employer/carrier noted that X-rays showed degenerative changes of the acromioclavicular joint, and employer's evaluating physicians felt the shoulder pain was pre-existing and was caused not by the industrial fall, but by an automobile accident in which claimant was involved six years earlier. Claimant stated his injuries from the automobile accident had completely resolved; he maintained he was not experiencing symptoms prior to his industrial fall.
The medical panel found claimant did suffer an industrial injury which caused his shoulder problems. The panel found claimant stabilized medically eleven months after he was injured.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Sergio Gonzalez Pena vs. Carlos Leblanc (uninsured) and Uninsured Employer's Fund
Case Number --20001202
Court/Judge --Eblen
Verdict/Settlement --Order, 12/01
Amount --The ALJ concluded that employer was insolvent or otherwise unable to pay claimant's benefits. The ALJ therefore ordered the ERF to pay claimant accrued temporary total disability benefits of $2,748 plus interest; accrued temporary partial disability benefits of $110.58 plus interest; and accrued permanent partial disability benefits of $3,206 plus interest. The ERF was also ordered to pay claimant's related medical expenses. The ERF retains full rights of subrogation and has the right to seek repayment in full from Carlos Leblanc, and may also impose on Leblanc a 15% penalty for failure to maintain workers' compensation insurance coverage on his employees.
Injuries --Claimant's left ring finger was amputated at the distal interphalangeal joint and his left little finger was amputated at the proximal interphalangeal joint. Revision of the stump of one finger has been recommended by claimant's treating physician.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Employer failed to file an answer to this complaint and did not appear at the scheduled hearing. For UEF: Sherrie Hayashi
Expert Witness(es) - Plaintiff --Claimant's treating physician
Facts/Contentions --Claimant was injured while using a table saw to install hardwood floors in a home near Park City. Claimant's fingers were caught in the saw and severed.
Employer apparently did not maintain worker's compensation insurance coverage on his employees. Claimant said he tried without success to get employer to pay his medical expenses and reimburse him for the time he was off work.
WORK INJURY
Case Type --WA: Work-related injury
Case Name --Angel M. Wyant vs. Okland Construction and Workers' Compensation Fund
Case Number --991026
Court/Judge --Eblen
Verdict/Settlement --Order, 12/01
Amount --The ALJ ordered employer/carrier to pay claimant accrued temporary total disability benefits of $7,863.51 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant accrued permanent partial disability benefits of $5,070 plus interest and less attorney's fees. Attorney's fees shall include 20% of the accrued interest. Employer/carrier was also ordered to pay claimant's related medical expenses through the date when she stabilized medically, but employer/carrier was not required to pay for any future treatment, including the recommended epidural injections or any future surgery.
Injuries --Claimant was diagnosed with a protruding disc at L4/5 with right radiculopathy. The medical panel concluded that claimant suffered a permanent industrially-caused aggravation of pre-existing degenerative spinal disc and joint disease and has permanent light duty work restrictions. The panel gave claimant a 5% related whole person impairment rating and found no further treatment is necessary.
Attorney(s) - Plaintiff --Bradford D. Myler of Myler Law Office, Orem
Attorney(s) - Defense --Mark D. Dean
Expert Witness(es) --This case was referred to a medical panel consisting of Dr. Richard Bromley--orthopedic surgeon, and Dr. john Hylen--internist and cardiologist.
Facts/Contentions --Claimant, who operated a forklift and did general labor for Okland, injured her low back while lifting and moving concrete forms weighing 50 to 60 pounds each.
Employer/carrier disputed the need for the medical treatment claimant received and also for the epidural injections recommended by Dr. Horne. Dr. Horne also said claimant might need surgery if the epidural injections were unsuccessful.
WORK INJURY
Case Type --WA: Work-related injury
Case Name --(Name of case withheld)
Case Number --97583
Court/Judge --Eblen
Verdict/Settlement --Final order, 12/01
Amount --The ALJ found claimant could not be successfully rehabilitated and employer's re-employment plan was not reasonable or workable, never having been approved by the Labor Commission. The ALJ ordered employer/carrier to pay claimant permanent total disability benefits of $354 per week for life. Employer/carrier must also pay for claimant's recommended lumbar spinal MRI.
Injuries --Claimant suffered multiple serious injuries, including lumbar spinal injuries, and takes methadone for pain.
Attorney(s) - Plaintiff --David W. Parker
Attorney(s) - Defense --Carrie T. Taylor of Richards, Brandt, Miller & Nelson
Facts/Contentions --Claimant was injured in the course and scope of his employment on 9/8/94. His claim was thereafter transferred between several ALJs, who afterward left the Labor Commission; during this time an order was issued awarding claimant temporary subsistence benefits pending a determination of permanent total disability. Employer/carrier, however, contended that claimant was capable of working and submitted a re-employment plan. The case was then assigned to ALJ Eblen. Claimant saw five separate vocational rehabilitation counselors at employer/carrier's behest and underwent surveillance and extensive testing and multiple evaluations. He claimed the counselors did not listen to him, did not make an effort to comprehend his situation or his limitations, and "treated [him] like a criminal." Claimant, who suffers from anxiety, depression and dyslexia, said he received no feedback or assistance with his job applications from his counselors and was severely stressed by the continued evaluation and testing he was forced to undergo on top of his continuing pain. His psychologist had not been paid but continued to treat him because he did not feel claimant should be abandoned. Claimant said he was unable to rely on his subsistence benefit checks, because on two occasions they simply stopped without notice. Employer/carrier stated that the payment problems were caused by a computer "glitch," but ALJ Eblen noted that the computer and its programming were under employer's control and suggested that employer change its programming in order to avoid this type of unnecessary and stressful situation. Claimant was never placed in any job as a result of the alleged re-employment plan.
Employer/carrier argued that claimant did not cooperate with the re-employment plan because his cooperation was "passive" rather than "active."
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Daniel Hone vs. Geneva Rock and/or Royal & Sun Alliance
Case Number --20001061
Court/Judge --Hann
Verdict/Settlement --Order, 12/01
Amount --The ALJ found there was no medical evidence indicating the 1995 injury was the cause of claimant's current back condition. Since claimant failed to prove his back pain arose from a work injury, the ALJ therefore dismissed his claim for permanent total disability benefits with prejudice.
Injuries --Claimant suffered bulged discs with some desiccation at L2/3 and L3/4. He has a history of lower back pain and has undergone prior back surgery. He underwent a second failed lumbar fusion surgery after the 1995 injury. Claimant has not worked since his injury in 1995 because he cannot sit for any length of time. Dr. Root gave claimant a 12% related whole person impairment rating. Dr. Reichman, however, found little difference in claimant's condition after the 1995 aggravation when compared with his earlier back problems.
Attorney(s) - Plaintiff --Virginius Dabney of Dabney & Dabney, St. George
Attorney(s) - Defense --Brad C. Betebenner of Richards, Brandt, Miller & Nelson
Expert Witness(es) - Defense --Dr. Reichman
Facts/Contentions --Claimant was injured in 1995. He had been changing the screens in a rock crusher, which required him to crawl into the crusher with only thirty inches' clearance; unbolt the screens while lying down; and push and pull the 80-to-100-pound screens from awkward positions. He said he took a break and then went into the yard to begin loading 20-pound metal strips about 20 feet long into a front-end loader. He said as he twisted back from throwing the second strip into the loader, he felt a sudden sharp pain in his back. He finished his shift, but was unable to continue working past noon of the following day because of pain. He was unable to work thereafter, even after his second back surgery, because he cannot tolerate sitting for any sustained length of time.
Employer/carrier accepted liability and paid temporary total disability, permanent partial disability and medical benefits, accepting that the work activities which aggravated claimant's prior back condition were beyond those required in everyday life. However, employer/carrier contended that claimant's permanent total disability was caused by his previous back problems, not by the re-aggravation at work.
WORK INJURY
Case Type --WA: Work-related injury
Case Name --Jeannie Jackson vs. Rivers West Apparel and/or Workers' Compensation Fund
Case Number --20001103
Court/Judge --Hann
Verdict/Settlement --Order, 12/01
Amount --The ALJ found that once confusion arose over the light duty work release, claimant should not have been required to return to work or penalized for not doing so until the confusion was resolved. The ALJ therefore ordered employer/carrier to pay claimant accrued temporary total disability benefits of $1,019.92 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney.
Injuries --Claimant suffered a right knee injury. Dr. Brady restricted her to no more than 4 hours at work, and Dr. Kimball gave her a light duty release. He later clarified this to mean claimant could operate her sewing machine with her other foot.
Attorney(s) - Plaintiff --Bruce J. Wilson, Orem
Attorney(s) - Defense --Barbara W. Sharp
Expert Witness(es) - Plaintiff --Dr. Kirt Kimball; Dr. William Brady
Facts/Contentions --Claimant was injured 3/26/99. Employer/carrier accepted liability, but denied further temporary total disability compensation on grounds that claimant was released to light duty and was offered light duty work, but refused it. Employer understood the release to mean claimant could return to sitting at her sewing machine. Claimant stated she could not sit for hours without breaks to stand up, as operation of the sewing machine required; she stated she understood the light duty release to mean she could do office work so she could get up and walk around from time to time. Claimant was listed as a voluntary termination when she did not show up for work after this dispute arose. She acted promptly to clarify the release from Dr. Kimball, but the doctor was out of the office when she called, and by the time he returned, claimant had been terminated.
WORK INJURIES
Case Type --WA, MA, TA; Work-related motorcycle-truck accident
Case Name --Timmy Sheets vs. City of Moab and/or Workers' Compensation Fund
Case Number --94851, 2000326
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 12/01
Amount --The ALJ wrote that under Utah law, there are no time limits on an employer/carrier's right to reimbursement from third-party settlement money for expenses and/or benefits paid to an injured worker. The ALJ ruled employer/carrier was liable to claimant for permanent total disability benefits of $304 per week for the period running from 7/21/94 through 7/21/2000, and must then pay claimant $304 per week or 36% of the current state average weekly wage, whichever is greater, for the rest of his life. These benefits are reducible by 50% of any Social Security retirement benefits claimant receives. The ALJ ordered that the $100,000 received from the third-party settlement must be offset against employer/carrier's liability to claimant, but claimant may first deduct the reasonable expenses of the civil action, including reasonable attorney's fees. The ALJ also ordered employer/carrier to pay claimant's related medical expenses.
Injuries --Claimant sustained massive head trauma in the accident, and the ALJ who handled the case before ALJ La Jeunesse tentatively found claimant to be permanently and totally disabled.
Attorney(s) - Plaintiff --H. Deloyd Bailey, Provo
Attorney(s) - Defense --Elliot Morris
Facts/Contentions --Claimant was riding his motorcycle north on Main Street in Moab, in the course and scope of his employment, when a pick-up truck driven by a third party pulled in front of him and caused a collision. Employer/carrier admitted claimant was permanently and totally disabled, but reserved the right to submit a re-employment plan. Employer/carrier never submitted such a plan, and the parties eventually stipulated that the sole remaining issue disputed in the case was whether employer/carrier was entitled to an offset for the $100,000 in settlement money claimant recovered from the third party who caused the accident; claimant sued the third party in district court. Claimant contended in a motion for summary judgment that employer/carrier failed to take the necessary steps to recover their share of the money in a timely fashion. Employer/carrier claimed their right to the offset was absolute and not subject to a time limit.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Jeff D. Hofhine vs. Schuff Steel Company and Lumbermen's Mutual Casualty Insurance
Case Number --99573
Court/Judge --Eblen
Verdict/Settlement --Order, 1/02
Amount --The ALJ ordered employer/carrier to pay claimant's related medical expenses through 4/21/99 and also to pay for a three-month trial of Depakote or a calcium channel blocker to prevent claimant's migraine headaches. Employer/carrier must also pay claimant accrued temporary total disability compensation of $138.80 and accrued temporary partial disability benefits of $290.64; both payments are due in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Attorney's fees are to include 20% of the accrued interest on this award.
Injuries --Claimant contended that he suffered a brain injury; employer/carrier disputed this claim.
Attorney(s) - Plaintiff --Timothy C. Allen
Attorney(s) - Defense --S. Brook Millard of Dunn & Dunn
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Thomas Schenkenberg; Dr. George Smith; Dr. John Foley; and Dr. John Hylen.
Facts/Contentions --Claimant, an iron worker, hit his head on one of the boards holding a handrail around the upper level of a work area while climbing a ladder to get to the work area at a construction site. Claimant fell four feet off the ladder, striking his chest and elbow, and lost consciousness for a few seconds. He revived, complained of dizziness and blurred vision, and then passed out again, after which his foreman called an ambulance. An accident report filled out by a former certified EMT said claimant was shaking violently, although he said he was not cold, and he appeared pale and was breathing in a "ragged" manner. Cervical spinal X-rays and a cranial CT scan were normal. After the accident claimant complained for some time of continuing headaches and vertigo which he felt made it unsafe for him to work. He eventually returned to his job as an iron worker.
Claimant had a prior history of head trauma with headaches. Because of this fact, and because most of claimant's diagnostic tests, both organic and cognitive, were normal, employer/carrier denied liability. However, electronystagmography confirmed claimant's complaint of vertigo and revealed hyperactive caloric responses.
The medical panel found the treatment claimant received was medically necessitated by his work injury until he stabilized three months and two days after the accident. The panel also recommended workers' compensation coverage for a three-month trial of Depakote or a calcium channel blocker to prevent claimant's migraine headaches.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Dan R. McKenzie vs. Southern Utah Fuel Company and Workers' Compensation Fund
Case Number --991158
Court/Judge --Poelman
Verdict/Settlement --Order, 1/02
Amount --The ALJ found claimant made reasonable efforts to fulfill his obligations under the terms of the return-to-work plan, and employer/carrier should have modified the plan when it became obvious that claimant was not going to be able to comply with it. The ALJ ordered employer/carrier to pay for an updated functional capacity evaluation and review the return-to-work plan in light of the results, modifying it if needed. Claimant must continue to cooperate fully with the plan, and employer/carrier must pay claimant accrued subsistence benefits of $365 per week from 5/3/01 until the date of this order; accrued benefits are to be paid in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Regular payment of subsistence benefits must then continue until claimant completes the return-to-work plan or it is abandoned.
Injuries --Claimant suffered a back injury.
Attorney(s) - Plaintiff --Wayne A. Freestone of Freestone & Angerhofer
Attorney(s) - Defense --Barbara W. Sharp
Expert Witness(es) - Plaintiff --Dr. Gaufin
Facts/Contentions --After claimant was injured, he and his employer reached a return-to-work agreement whereby employer/carrier was to pay claimant subsistence benefits while claimant was attending school to obtain his associate's degree and a bachelor's degree in accounting. However, though claimant registered for 12 credit hours in the fall semester, he stated that he had to discontinue a 3-hour evening class because of pain. After he realized that he was not going to be able to complete his course work in the time allotted by the plan, he spoke with his vocational rehabilitation counselor and offered to take summer classes to make up the required credit hours, but employer/carrier terminated his subsistence benefits on grounds that claimant was not cooperating fully with the return-to-work plan. Claimant produced a statement from Dr. Gaufin's office in which the doctor opined that claimant was unable to maintain a 12-hour class schedule because of his work-related low back pain, mid-back pain, neck pain and numbness of the hands, and would have to take a reduced number of hours each semester in order to satisfy the requirements for his degrees.
FALL
Case Type --WA, SF; Work-related fall
Case Name --(Name of case withheld)
Case Number --200022
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 1/02
Amount --Notwithstanding claimant's lack of credibility, the ALJ accepted the medical panel's findings and found claimant did actually suffer the failed surgery and attendant impairment. The ALJ found that self-insured employer overpaid claimant's temporary total disability benefits by $1,598.03. This figure was offset against the additional permanent partial disability benefits employer still owes claimant for her further 15% related whole person impairment, leaving a total balance owing of $2,608.51. This amount is due and payable in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer must also pay claimant's related medical expenses.
Injuries --Claimant suffered a knee injury which resulted in a failed total right knee arthroplasty. Claimant was left with a pronounced limp and a halting, lordotic gait. The medical panel gave claimant a 25% related whole person permanent impairment. Employer previously paid claimant for a 10% impairment.
Attorney(s) - Plaintiff --James C. Haskins of Haskins & Associates
Attorney(s) - Defense --Henry K. Chai II of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Alvin Wirthlin--neurologist; and Dr. Glen Momberger--orthopedic surgeon.
Facts/Contentions --Claimant fell down some stairs at a junior high school while picking up some supplies in the course of her employment. Claimant had pre-existing polio in the affected leg, contracted when she was five years old, but the fall caused a new right tibial plateau fracture which necessitated a total right knee arthroplasty. This surgery ultimately failed.
Self-insured employer contended that some of claimant's problems resulted from the earlier polio; however, the medical panel found the surgery was necessitated by the industrial fracture. The ALJ noted, however, that claimant impaired her credibility by embellishing the circumstances surrounding her disability with regard to non-significant details, even though a surveillance video refuted her claims.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Gil C. Sorensen vs. Ascend H R Solutions and Workers' Compensation Fund
Case Number --2000738
Court/Judge --Eblen
Verdict/Settlement --Order, 1/02
Amount --The ALJ found that since claimant's physician documented the inappropriateness of the work offered in that it aggravated claimant's pre-existing symptoms, light duty work suitable to claimant's limitations was not really available to him. The ALJ therefore ordered employer/carrier to pay claimant additional accrued temporary total disability benefits of $1,272.65 in a lump sum plus interest.
Injuries --Claimant suffered a fractured fifth right metacarpal.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Lori Hansen
Expert Witness(es) - Plaintiff --Dr. Robert Horne
Facts/Contentions --After claimant broke his finger, he was offered light duty work by his employer and accepted it. However, he claimed the sitting involved in the light duty work aggravated his low back pain from a pre-existing vertebral compression fracture; he discontinued the light duty work and sought additional temporary total disability benefits.
Employer/carrier said no restrictions were placed on claimant, who could stand up or sit down at will while doing the light duty work. Employer/carrier contended that since light duty work was available and claimant refused to perform it, employer/carrier was not liable for any further disability benefits.
Claimant's doctor wrote a note stating that claimant could not perform the duties involved in the light duty work because they aggravated his low back pain.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury
Case Name --Juana Tellez vs. Artex International, Incorporated
Case Number --99556
Court/Judge --Eblen
Verdict/Settlement --Order, 1/02
Amount --The ALJ accepted the medical panel's findings and dismissed the claims for benefits related to the carpal tunnel syndrome, cubital tunnel syndrome, and cervical spinal injuries; however, the ALJ reserved the issue of claimant's possible entitlement to permanent partial impairment benefits related to the shoulder injury pending submission of a permanent impairment rating.
Injuries --Claimant suffered a right shoulder injury and also claimed she developed carpal tunnel syndrome, cubital tunnel syndrome and degenerative spondylolysis at C6/7.
Attorney(s) - Plaintiff --Virginius Dabney of Dabney & Dabney, St. George
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll (Brad C. Betebenner of Richards, Brandt, Miller & Nelson substituted during the pendency of this claim before the Labor Commission)
Expert Witness(es) - Plaintiff --Because of conflicting medical testimony, this case was referred to a medical panel.
Facts/Contentions --Plaintiff worked for self-insured employer as an apron-folder, inspecting aprons, fold them and stacking them. She claimed the repetitive actions involved in this work caused all her symptoms, which came on suddenly one day after she placed the last bundle of aprons on top of a stack above shoulder-height. Claimant said she felt a pain as if something had burst in her shoulder, accompanied by a burning sensation in her face, neck and arm.
Employer accepted liability for the shoulder injury, but denied that claimant's carpal tunnel syndrome, cubital tunnel syndrome and cervical spine injuries were work-related.
The medical panel found claimant's shoulder symptoms were related to her work activities, but her other problems were not.
WORK INJURY
Case Type --WA: Work-related injury
Case Name --(Name of case withheld)
Case Number --97583
Court/Judge --Eblen
Verdict/Settlement --Final order, 1/02
Amount --The ALJ found claimant could not be successfully rehabilitated and employer's re-employment plan was not reasonable or workable, never having been approved by the Labor Commission. The ALJ ordered employer/carrier to pay claimant permanent total disability benefits of $354 per week for life. Employer/carrier must also pay for claimant's recommended lumbar spinal MRI.
Injuries --Claimant suffered multiple serious injuries, including lumbar spinal injuries, and takes methadone for pain.
Attorney(s) - Plaintiff --David W. Parker
Attorney(s) - Defense --Carrie T. Taylor of Richards, Brandt, Miller & Nelson
Facts/Contentions --Claimant was injured in the course and scope of his employment on 9/8/94. His claim was thereafter transferred between several ALJs, who afterward left the Labor Commission; during this time an order was issued awarding claimant temporary subsistence benefits pending a determination of permanent total disability. Employer/carrier, however, contended that claimant was capable of working and submitted a re-employment plan. The case was then assigned to ALJ Eblen. Claimant saw five separate vocational rehabilitation counselors at employer/carrier's behest and underwent surveillance and extensive testing and multiple evaluations. He claimed the counselors did not listen to him, did not make an effort to comprehend his situation or his limitations, and "treated [him] like a criminal." Claimant, who suffers from anxiety, depression and dyslexia, said he received no feedback or assistance with his job applications from his counselors and was severely stressed by the interminable evaluation and testing he was forced to undergo on top of his continuing pain. His psychologist had not been paid but continued to treat him because he did not feel claimant should be abandoned. Claimant said he was unable to rely on his subsistence benefit checks, because on two occasions they simply stopped without notice. Employer/carrier stated that the payment problems were caused by a computer "glitch," but ALJ Eblen noted that the computer and its programming were under employer's control and suggested that employer change its programming in order to avoid this type of unnecessary and stressful situation. Claimant was never placed in any job as a result of the alleged re-employment plan.
Employer/carrier argued that claimant did not cooperate with the re-employment plan because his cooperation was "passive" rather than "active."
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Daniel Hone vs. Geneva Rock and/or Royal & Sun Alliance
Case Number --20001061
Court/Judge --Hann
Verdict/Settlement --Order, 1/02
Amount --The ALJ found there was no medical evidence indicating the 1995 injury was the cause of claimant's current back condition. Since claimant failed to prove his back pain arose from a work injury, the ALJ therefore dismissed his claim for permanent total disability benefits with prejudice.
Injuries --Claimant suffered bulged discs with some desiccation at L2/3 and L3/4. He has a history of lower back pain and has undergone prior back surgery. He underwent a second failed lumbar fusion surgery after the 1995 injury. Claimant has not worked since his injury in 1995 because he cannot tolerate sitting for any length of time. Dr. Root gave claimant a 12% related whole person impairment rating. Dr. Reichman, however, found little difference in claimant's condition after the 1995 aggravation when compared with his earlier back problems.
Attorney(s) - Plaintiff --Virginius Dabney of Dabney & Dabney, St. George
Attorney(s) - Defense --Brad C. Betebenner of Richards, Brandt, Miller & Nelson
Expert Witness(es) - Defense --Dr. Reichman
Facts/Contentions --Claimant was injured in 1995. He had been changing the screens in a rock crusher, which required him to crawl into the crusher with only thirty inches' clearance; unbolt the screens while lying down; and push and pull the 80-to-100-pound screens from awkward positions. He said he took a break and then went into the yard to begin loading 20-pound metal strips about 20 feet long into a front-end loader. He said as he twisted back from throwing the second strip into the loader, he felt a sudden sharp pain in his back. He finished his shift, but was unable to continue working past noon of the following day because of pain. He was unable to work thereafter, even after his second back surgery, because he experiences pain upon sitting for any sustained length of time.
Employer/carrier accepted liability and paid temporary total disability, permanent partial disability and medical benefits, accepting that the work activities which aggravated claimant's prior back condition were beyond those required in everyday life. However, employer/carrier contended that claimant's permanent total disability was caused by his previous back problems, not by the re-aggravation at work.
WORK INJURY
Case Type --WA: Work-related injury
Case Name --Jeannie Jackson vs. Rivers West Apparel and/or Workers' Compensation Fund
Case Number --20001103
Court/Judge --Hann
Verdict/Settlement --Order, 1/02
Amount --The ALJ found that once confusion arose over the light duty work release, claimant should not have been required to return to work or penalized for not doing so until the confusion was resolved. The ALJ therefore ordered employer/carrier to pay claimant accrued temporary total disability benefits of $1,019.92 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney.
Injuries --Claimant suffered a right knee injury. Dr. Brady restricted her to no more than 4 hours at work, and Dr. Kimball gave her a light duty release. He later clarified this to mean claimant could operate her sewing machine with her other foot.
Attorney(s) - Plaintiff --Bruce J. Wilson, Orem
Attorney(s) - Defense --Barbara W. Sharp
Expert Witness(es) - Plaintiff --Dr. Kirt Kimball; Dr. William Brady
Facts/Contentions --Claimant was injured 3/26/99. Employer/carrier accepted liability, but denied further temporary total disability compensation on grounds that claimant was released to light duty and was offered light duty work, but refused it. Employer understood the release to mean claimant could return to sitting at her sewing machine. Claimant stated she could not sit for hours without breaks to stand up, as operation of the sewing machine required; she stated she understood the light duty release to mean she could do office work so she could get up and walk around from time to time. Claimant was listed as a voluntary termination when she did not show up for work after this dispute arose. She acted promptly to clarify the release from Dr. Kimball, but the doctor was out of the office when she called, and by the time he returned, claimant had been terminated.
WORK INJURIES
Case Type --WA, MA, TA; Work-related motorcycle-truck accident
Case Name --Timmy Sheets vs. City of Moab and/or Workers' Compensation Fund
Case Number --94851, 2000326
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 1/02
Amount --The ALJ wrote that under Utah law, there are no time limits on an employer/carrier's right to reimbursement from third-party settlement money for expenses and/or benefits paid to an injured worker. The ALJ ruled employer/carrier was liable to claimant for permanent total disability benefits of $304 per week for the period running from 7/21/94 through 7/21/2000, and must then pay claimant $304 per week or 36% of the current state average weekly wage, whichever is greater, for the rest of his life. These benefits are reducible by 50% of any Social Security retirement benefits claimant receives. The ALJ ordered that the $100,000 received from the third-party settlement must be offset against employer/carrier's liability to claimant, but claimant may first deduct the reasonable expenses of the civil action, including reasonable attorney's fees. The ALJ also ordered employer/carrier to pay claimant's related medical expenses.
Injuries --Claimant sustained massive head trauma in the accident, and the ALJ who handled the case before ALJ La Jeunesse tentatively found claimant to be permanently and totally disabled.
Attorney(s) - Plaintiff --H. Deloyd Bailey, Provo
Attorney(s) - Defense --Elliot Morris
Facts/Contentions --Claimant was riding his motorcycle north on Main Street in Moab, in the course and scope of his employment, when a pick-up truck driven by a third party pulled in front of him and caused a collision. Employer/carrier admitted claimant was permanently and totally disabled, but reserved the right to submit a re-employment plan. Employer/carrier never submitted such a plan, and the parties eventually stipulated that the sole remaining issue disputed in the case was whether employer/carrier was entitled to an offset for the $100,000 in settlement money claimant recovered from the third party who caused the accident; claimant sued the third party in district court. Claimant contended in a motion for summary judgment that employer/carrier failed to take the necessary steps to recover their share of the money in a timely fashion. Employer/carrier claimed their right to the offset was absolute and not subject to a time limit.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury
Case Name --Hussain Al-Malaki vs. LSG Sky Chefs and/or Lumberman's Mutual Casualty
Case Number --2000843
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 1/02
Amount --The ALJ dismissed this claim with prejudice for claimant's failure to prove medical causation on either of his problems.
Injuries --Claimant was diagnosed with knee and ankle tendinitis, plantar fascitis, and bilateral enthesopathy of the tibia (shin splints). However, his doctors failed to connect these problems with his work duties and were unsure what caused them. Claimant also claimed he suffered industrially caused hearing loss, but he failed to produce any evidence of the decibel level at his workplace.
Attorney(s) - Plaintiff --David K. Smith
Attorney(s) - Defense --Theodore E. Kanell of Plant, Wallace, Christensen & Kanell
Expert Witness(es) - Defense --Charles Canfield, MD; Letitia Archuleta, MD; Richard Gremillion, MD
Facts/Contentions --Claimant loaded food and culinary water aboard airplanes in the course of his employment. He stated that his leg problems were caused by the repetitive pulling, lifting and pushing involved in this process. Claimant loaded food on 17 airplanes a day, and water on four. The items he lifted weighed between 25 and 40 pounds, and he pulled them out of the cargo box and pushed them into the plane. He also jumped 2 or 3 feet to the ground off the back of the truck that took him to each plane. He also claimed the noise level at work caused his ears to hurt.
Employer/carrier contended that claimant failed to prove medical causation on any of his claims, His ear pain subsided when he took his medicine for infection, and the leg pain did not improve with rest.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Diane Brock Williams Dyer vs. Creekside Care Center and/or Utah Property and Casualty Insurance Guaranty Associations and Employers' Reinsurance Fund
Case Number --99624
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 1/02
Amount --The ALJ found claimant did not present any medical evidence to prove she needed a fourth surgery or that a fourth surgery had been recommended. Claimant also did not state that she wanted a fourth surgery. The ALJ therefore denied claimant's application for future medical care. As to the claims for temporary total disability compensation, the ALJ said the Utah Supreme Court has ruled that once an injured worker begins receiving permanent total disability benefits, that worker is held to have reached medical stability and is therefore no longer eligible for temporary total disability benefits. The ALJ therefore denied this claim with prejudice. The ALJ also denied the claim for unpaid medical expenses previously incurred for lack of evidentiary support.
Injuries --Claimant suffered a low back injury and underwent spinal fusion surgery at L4/5 and L5/S1. The L4/5 junction fused, but the L5/S1 fusion failed. Claimant subsequently underwent two further surgeries in an attempt to get the L5/S1 junction to fuse, but both surgeries failed.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --For Creekside/Utah Property: Henry K. Chai II of Blackburn & Stoll; for ERF: Deidre Marlowe
Facts/Contentions --Claimant was injured 9/7/84, and began receiving permanent total disability benefits pursuant to a stipulation between the parties on 3/4/91. She later filed this claim for additional temporary total disability benefits, incurred but unpaid medical expenses and recommended medical care, notably a fourth fusion surgery. The ALJ noted that although he gave claimant additional time to marshal her evidence after she appeared at the hearing with no support for her claims, she still had not produced any evidence to verify or support her claims at a second hearing. Claimant stated that the Utah Pain Management Clinic declined to see her further unless she had a fourth back surgery, but did not produce any evidence to support this claim. She has declined a fourth back surgery on previous occasions. Medical records from the Pain Management Clinic did not indicate that surgery had been recommended.
HARASSMENT
Case Type --SH; Sexual harassment
Case Name --(Name of case withheld)
Case Number --8000447
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 1/02
Amount --The ALJ dismissed the request for an evidentiary hearing on the presumption that this claim has been withdrawn. Given the circumstances, the ALJ did not feel it appropriate to instigate any sanctions, such as awarding costs.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Kathleen W. Toth of Manning, Curtis, Bradshaw & Bednar
Facts/Contentions --Claimant originally filed this claim for sexual harassment with the Utah Antidiscrimination and Labor Division (UALD), and UALD issued a determination and order based on a finding of no reasonable cause. Claimant thereupon filed a formal request for an evidentiary hearing. Employer filed a motion for sanctions based on claimant's failure to appear at a scheduled deposition. Two weeks after this motion was filed, claimant filed a letter stating that she thought she had withdrawn her complaint some time ago. The letter indicated claimant no longer intended to pursue action on this complaint.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Samuel James Smith vs. Donald W. Nelson; Janette J. Nelson; Jay Hites; Tennessee Log Homes; and Uninsured Employers' Fund
Case Number --2000574
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 1/02
Amount --The ALJ determined that Utah law does not specifically exclude a person from being considered an employer simply because he or she is working on his or her own residence. However, the ALJ also found that to be considered an employer, a person must employ one or more workers pursuant to the regular practice of a trade, business, profession or occupation. The building of a single residence does not constitute such a practice; the ALJ therefore dismissed the claim against the Nelsons on grounds that they were indeed owner/builders and were therefore not claimant's employers. The ALJ also dismissed the claim against Hites on grounds that he was a co-worker, not an employer. Claimant originally named Tennessee Log Homes as a dba of the Nelsons, but this claim was never substantiated by any evidence, or even referred to seriously at the hearing, and the ALJ dismissed it as well.
Injuries --Claimant suffered a knee injury and underwent an anterior cruciate ligament reconstruction with patellar tendon autograft, partial medial meniscectomy, and limited synovectomy.
Attorney(s) - Plaintiff --Daniel F. Bertch of Bertch Robson
Attorney(s) - Defense --The Nelsons were represented pro se; Hites was also represented pro se; for UEF: Sheryl Hayashi
Facts/Contentions --The Nelsons were building a log home in Heber after moving to Utah from California. They were issued an owner/builder certificate by the Utah Department of Commerce, and did not have a general contractor's license. The Nelsons used the general contractor's license of a third party and occasionally relied on the third party's advice. The Nelsons bought their home as a kit from Tennessee Log Homes, and no evidence was ever presented that Tennessee Log Homes had any more involvement than that in this claim. The Nelsons hired Hites, who was also not a contractor, to help with the roofing and framing. Claimant was asked by Hites to help him with this job. Claimant was injured while standing on a ladder and assisting Hites, who was working on the roof of the home. The ladder slipped, and claimant caught his knee in a rung. He hung upside-down with his left knee caught in the ladder rung until Hites helped him to get free. He sought medical care next day after his knee swelled and became painful. He claimed Hites or the Nelsons or both were his employers and sought workers' compensation benefits.
Hites denied that he ever worked as a contractor or owned his own business. Hites also claimed that he hired claimant at Donald Nelson's behest, and did not have authority to hire or fire anyone on the site. Donald Nelson paid claimant's wages in cash through Hites and provided al the power tools used on the construction, and Hites provided his own hand tools. Neither Hites nor the Nelsons had workers' compensation insurance. Hites and claimant negotiated claimant's hourly wage. Donald Nelson lived in a trailer on the site and gave day-to-day instruction to Hites, who in turn supervised claimant.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Paul White vs. Taylor Hunt Electric, Incorporated and/or Liberty Mutual Insurance and Ohio Casualty Company
Case Number --2001106
Court/Judge --Hann
Verdict/Settlement --Order, 1/02
Amount --The ALJ entered the default of Liberty Mutual after they failed to answer or appear at the hearing on this claim. The ALJ ordered Liberty Mutual to pay claimant accrued temporary total disability benefits of $3,344.84, accrued temporary partial disability benefits in the amount of $779.43, and $5,288.40 in permanent partial disability benefits for his permanent impairment. All these awards shall be paid in a lump sum plus interest and less attorney's fees, which are to be deducted from this amount and paid directly to claimant's attorney. Liberty Mutual must also pay claimant's related medical expenses, including the outstanding bills.
Injuries --Claimant suffered a left shoulder subacromial impingement and underwent a left shoulder subacromial decompression with arthroscopy. He suffered a previous work-related shoulder injury in 1997, and Dr. Hansen felt this incident was an aggravation of the pre-existing condition rather than a new occurrence. Dr. Zeluff gave claimant a 5% related whole person permanent impairment rating.
Attorney(s) - Plaintiff --Ross E. McPhail, Bountiful
Attorney(s) - Defense --For Taylor Hunt/Ohio Casualty: Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) - Plaintiff --Dr. Robert P. Hansen--treating physician; Dr. Gary Zeluff--treating physician
Damages --Claimant produced evidence to substantiate $10,130.63 in unpaid medical bills.
Facts/Contentions --Claimant was working for Taylor Hunt on construction of the Grand America Hotel. He was installing the hotel's security system, adding conduit to existing racks. To do this, he had to lift the conduit and hold the entire weight with his left hand while adding a strip with his other hand and screwing the new conduit onto the strip. The weight of each assembly was around 100 pounds and took all of claimant's strength to lift, and claimant testified that he attached extensions to each side of 20 assemblies that day, for a total of 40 lifts, each over 100 pounds. Claimant sought medical care the day after these exertions; he experienced pain the same evening, but found it did not respond to ibuprofen.
The ALJ found that claimant's activities in adding the conduit extensions met the Allen standard for extraordinary exertion, as is required by law in cases of re-injury or aggravation of a pre-existing condition.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Russell Love vs. Dixie Woodworks and Workers' Compensation Fund
Case Number --99554
Court/Judge --Eblen
Verdict/Settlement --Order, 1/02
Amount --The ALJ found claimant suffered the industrial injury that led to the filing of this claim, and also found employer/carrier failed to prove claimant's pre-existing condition contributed to this injury. The actions which caused this injury therefore did not have to meet the Allen standard for extraordinary exertion. The ALJ accepted the medical panel's report and ordered employer/carrier to pay claimant $2,022.39 in accrued temporary partial disability benefits; $5,758.60 in accrued temporary total disability benefits; and $8,723.52 in permanent partial disability benefits for his 12% whole person permanent industrial impairment. All benefits are due and payable in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant's related medical expenses. The ALJ noted that though the medical panel felt no additional treatment is necessary at this time, a change in claimant's condition could trigger a need for additional care under the Commission's continuing jurisdiction.
Injuries --Claimant suffered bulged discs at L4/5 and L5/S1. He had a prior healed stress fracture at L4 from 1992 and also had some existing degenerative joint and disc disease. After this incident, claimant underwent two back surgeries.
Attorney(s) - Plaintiff --Bruce J. Wilson, Orem
Attorney(s) - Defense --Mark D. Dean; later Floyd Holm
Expert Witness(es) --This case was referred to a medical panel consisting of Dr. John Hylen; Dr. John Smith; and Dr; Richard Bromley.
Facts/Contentions --Claimant worked as a carpenter, making stair treads, risers and handrails. He noticed an onset of pain in his back and numbness in his legs while lifting a board for a bending rail onto a planer. He did not notice a specific incident. After work, he went to his other job, coaching high school wrestling practice. Because he did not feel well, so he did not wrestle himself, but merely coached the young people. Next day, he was supposed to help his family move, but he was in so much pain that his family insisted he seek medical attention before starting, and when he did, his doctor placed him on light duty restrictions. Claimant thereafter had to leave his job with Dixie as they had no work for him to do which did not involve lifting at least 45 pounds. Claimant went to work at an oil-change shop; he is still sore, but says the numbness in his legs is gone. He now cannot play sports, bend over, or stand or sit in certain positions for long periods, and he cannot always pick up and carry his child. At the time he was injured, claimant was assistant wrestling coach for the Jordan School District, and regularly worked out and wrestled with students during practice.
Employer/carrier did not attack claimant's credibility, but contended that at least part of his injury came from his wrestling activities or was an aggravation of the pre-existing injury from 1992.
The medical panel concluded that claimant's joint occupational exposure at Dixie and Jordan School District permanently re-aggravated his degenerative spinal disease. The panel also felt, however, that claimant suffered a separate industrial injury in the incident mentioned in this claim, and gave claimant a 12% whole person impairment rating, entirely attributable to the two surgeries following this incident, which the panel found were medically necessary to treat claimant's industrial injury. The panel concluded that of claimant's permanent partial impairment resulting from the permanent aggravation of his pre-existing degenerative disease, 50% resulted from his work at Dixie and 50% from his work at Jordan School District. However, the panel also found claimant had no ratable impairment due to pre-existing conditions prior to the industrial injury concerned in this claim. The panel found no future care is necessary to treat claimant's industrial injury.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Michael A. Smullin vs. Cogolink Wireless, Incorporated (uninsured) and Uninsured Employers' Fund
Case Number --2001575
Court/Judge --Hann
Verdict/Settlement --Order, 1/02
Amount --The ALJ found Cogolink Wireless was in default, insolvent, and in violation of Utah law because of its failure to maintain workers' compensation insurance on its employees. The ALJ ordered UEF to pay claimant's related medical expenses for this injury. The UEF retains the right to seek reimbursement of these expenses in full from Cogolink Wireless, and also has the right to impose a 15% penalty for Cogolink's failure to insure its employees as required by Utah statute.
Injuries --Claimant suffered a broken and lacerated finger.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Uninsured employer failed to answer or appear. For UEF: Sheryl Hayashi
Facts/Contentions --Claimant was injured 12/11/00 and did not lose more than three days from work. His employer failed to answer or appear at the hearing on his claim, and did not maintain workers' compensation insurance on its employees.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Kimberly Anderson vs. Big K Vending (uninsured) and Uninsured Employers' Fund
Case Number --2000834
Court/Judge --Eblen
Verdict/Settlement --Order, 1/02
Amount --The ALJ found claimant's employer was uninsured, but not insolvent, at the time claimant was injured. The ALJ ordered employer to pay claimant $2,063.68 in accrued temporary total disability benefits and $4,792.81 in accrued permanent partial disability benefits for her 7% permanent impairment. All benefits are due and payable in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer must also pay claimant's related medical expenses, with the exception of the treatments with Dr. Hanson; employer must further pay claimant's expenses for travel to medical appointments at 31 cents per mile.
Injuries --Claimant suffered a sprained right wrist. When her pain failed to resolve, she sought further care and was diagnosed at various times by different health care providers as having possible lateral epicondylitis, radial runnel syndrome, Wartenberg's syndrome, carpal tunnel syndrome, DeQuervain's tenosynovitis, extensor tendinitis of the dorsal right wrist, or interarticular pathology at wrist level (interosseus ligament or TFCC). Dr. Burrows recommended an MRI and electrodiagnostic studies by way of further evaluation, and the MRI indicated a TFCC ligament tear. Claimant failed to keep two of her physical therapy appointments; she said this fact was due to transportation problems. Dr. Colledge gave claimant a 7% related whole person impairment rating due to lack of decreased range of motion in the wrist, but felt that the sessions with Dr. Hanson were not medically necessary to treat claimant's industrial injury.
Attorney(s) - Plaintiff --David W. Parker
Attorney(s) - Defense --For Big K: Marci Rechtenbach of Jones, Waldo, Holbrook & McDonough; for UEF: Sheryl Hayashi
Expert Witness(es) - Plaintiff --Dr. Douglas Burrows; Dr. Houts; Keith Hanson, DC
Expert Witness(es) - Defense --Dr. Alan Colledge--independent medical examination
Facts/Contentions --Claimant was employed as a route driver, loading the truck, driving it to the various vending machines on the route, loading product into the machines, and removing the money. As she was carrying wight cases of soft drinks, weighing a total of about 100 pounds, on a hand-truck to load into a machine, the hand-truck hit a dip and snapped claimant's wrist back. She reported the injury that evening, took two days off and sought medical care three days after she was injured. After she was injured, she was fired for inability to perform her job duties.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Brad Bailey vs. Menlove Construction and Workers' Compensation Fund
Case Number --20001140
Court/Judge --Eblen
Verdict/Settlement --Order, 1/02
Amount --The ALJ accepted the medical panel's report and concluded that claimant is not medically stable and needs further diagnostic evaluations as outlined by the medical panel. Employer/carrier must pay for these tests, and must also pay claimant $37,884.36 in accrued temporary total disability benefits plus interest. These benefits must continue at $509 per week until claimant reaches medical stability.
Injuries --Claimant was first diagnosed with right ulnar nerve entrapment and right rotator cuff tendinitis. Later nerve conduction studies indicated a demyelinating left ulnar neuropathy at the elbow and a possible soft disc herniation at C6/7. Dr. Muir recommended anterior cervical discectomy and fusion.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Hans M. Scheffler
Expert Witness(es) --Because of a large amount of conflicting medical testimony, this case was referred to a medical panel
Facts/Contentions --Claimant was injured while pulling a skylight into the roof of a commercial building being constructed by Menlove. One of the clamps holding the skylight broke, and claimant was left with the weight of the skylight suspended by a rope and a single clamp. The skylight measured 44 x 70 inches and weighed between 160 and 180 pounds, and a co-worker was pushing up on it when the clamp broke. Claimant reached out and grabbed the skylight with one hand while holding on to the rope in order to keep the skylight from knocking his co-worker off the ladder. Claimant was fired after he was injured for inability to perform his duties as working supervisor.
Employer/carrier admitted the accident occurred, but disputed the need for cervical fusion surgery.
The medical panel concluded that the recommended surgery may be reasonably necessary to treat claimant's industrial injury. The panel recommended that claimant receive a discogram or selective nerve root blocks and an MRI for diagnostic purposes. If these tests indicate surgery is not appropriate, the panel recommended limited physical therapy focusing on neck posture.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --James D. Henson Jr. vs. Geneva Steel and/or Workers' Compensation Fund
Case Number --2001409
Court/Judge --Poelman
Verdict/Settlement --Order, 1/02
Amount --The ALJ dismissed this claim without prejudice after claimant failed to appear at the scheduled pre-hearing conference.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Floyd W. Holm
Facts/Contentions --After claimant filed his request for a hearing on his claim, his employer filed a motion to dismiss, and the ALJ scheduled a pre-hearing conference to address the motion. Claimant failed to respond to the motion or appear at the pre-hearing conference.
SLIP
Case Type --WA, SF; Work-related slip
Case Name --Warren T. Jolley vs. A Plus Benefits; Credit General Insurance and Utah Property & Casualty Insurance Guaranty Association
Case Number --99842
Court/Judge --Eblen
Verdict/Settlement --Order, 1/02
Amount --The ALJ found the medical record indicated claimant had pre-existing degenerative joint disease in his foot. The ALJ found his credibility was questionable and his actions leading to injury did not meet the Allen standard; the ALJ therefore dismissed his claim with prejudice.
Injuries --Claimant suffered an injury to his left foot and a sprained left ankle. He was eventually diagnosed with cellulitis of the left foot; an MRI revealed Charcot's joint, a cuboid stress fracture and a Type I partial tear of the posterior tibialis. He was also diagnosed with severe degenerative changes and deterioration of the joint, possibly as the result of a prior trauma.
Attorney(s) - Plaintiff --David J. Holdsworth
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) - Defense --Dr. Cortese; Dr. Knoebel--independent medical examination
Facts/Contentions --Claimant was a leased employee from A Plus Benefits who was working at Nelson Trucking. As he was climbing into the cab of his 35-foot end-dump truck after refueling it, he stated, his foot slipped off the step and he twisted his ankle. He was limping when he got home and later called Ask A Nurse, who advised him to rest, ice and elevate the foot and ankle. He felt extreme pain in the foot next morning when he tried to get out of bed, and sought medical attention. He said he did not report the injury when it occurred because there was no one there for him to report it to, but he stopped by work to report it on the way to the emergency room.
Employer/carriers denied that the incident occurred and argued that claimant's foot problems stemmed from pre-existing injuries. Employer/carriers further contended that claimant's actions which led to his injury did not meet the Allen test for extraordinary exertion, as is required in cases of pre-existing injury. Employer/carriers also pointed out that hospital records showed claimant first stated he was injured while jumping on a trampoline with his grandchildren and only later changed his story to reflect an industrial cause for his injury.
WORK INJURIES
Case Type --WA, MA, TA; Work-related motorcycle-truck accident
Case Name --Timmy Sheets vs. City of Moab and/or Workers' Compensation Fund
Case Number --94851, 2000326
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 1/02
Amount --The ALJ wrote that under Utah law, there are no time limits on an employer/carrier's right to reimbursement from third-party settlement money for expenses and/or benefits paid to an injured worker. The ALJ ruled employer/carrier was liable to claimant for permanent total disability benefits of $304 per week for the period running from 7/21/94 through 7/21/2000, and must then pay claimant $304 per week or 36% of the current state average weekly wage, whichever is greater, for the rest of his life. These benefits are reducible by 50% of any Social Security retirement benefits claimant receives. The ALJ ordered that the $100,000 received from the third-party settlement must be offset against employer/carrier's liability to claimant, but claimant may first deduct the reasonable expenses of the civil action, including reasonable attorney's fees. The ALJ also ordered employer/carrier to pay claimant's related medical expenses.
Injuries --Claimant sustained massive head trauma in the accident, and the ALJ who handled the case before ALJ La Jeunesse tentatively found claimant to be permanently and totally disabled.
Attorney(s) - Plaintiff --H. Deloyd Bailey, Provo
Attorney(s) - Defense --Elliot Morris
Facts/Contentions --Claimant was riding his motorcycle north on Main Street in Moab, in the course and scope of his employment, when a pick-up truck driven by a third party pulled in front of him and caused a collision. Employer/carrier admitted claimant was permanently and totally disabled, but reserved the right to submit a re-employment plan. Employer/carrier never submitted such a plan, and the parties eventually stipulated that the sole remaining issue disputed in the case was whether employer/carrier was entitled to an offset for the $100,000 in settlement money claimant recovered in a district court action from the third party who caused the accident. Claimant contended in a motion for summary judgment that employer/carrier failed to take the necessary steps to recover their share of the money in a timely fashion. Employer/carrier claimed their right to the offset was absolute and not subject to a time limit.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury
Case Name --Hussain Al-Malaki vs. LSG Sky Chefs and/or Lumberman's Mutual Casualty
Case Number --2000843
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 1/02
Amount --The ALJ dismissed this claim with prejudice for claimant's failure to prove medical causation on either of his problems.
Injuries --Claimant was diagnosed with knee and ankle tendinitis, plantar fascitis, and bilateral enthesopathy of the tibia (shin splints). However, his doctors failed to connect these problems with his work duties and were unsure what caused them. Claimant also claimed he suffered industrially caused hearing loss, but he failed to produce any evidence verifying the decibel level at his workplace.
Attorney(s) - Plaintiff --David K. Smith
Attorney(s) - Defense --Theodore E. Kanell of Plant, Wallace, Christensen & Kanell
Expert Witness(es) - Defense --Charles Canfield, MD; Letitia Archuleta, MD; Richard Gremillion, MD
Facts/Contentions --Claimant loaded food and culinary water aboard airplanes in the course of his employment. He stated that his leg problems were caused by the repetitive pulling, lifting and pushing involved in this process. Claimant loaded food on 17 airplanes a day, and water on four. The items he lifted weighed between 25 and 40 pounds, and he pulled them out of the cargo box and pushed them into the plane. He also jumped 2 or 3 feet to the ground off the back of the truck that took him to each plane. He also claimed the noise level at work caused his ears to hurt.
Employer/carrier contended that claimant failed to prove medical causation on any of his claims. His ear pain subsided when he took his medicine for infection, and the leg pain did not improve with rest.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Morris Carter vs. Sportform Health and Fitness (self-insured)
Case Number --2000675
Court/Judge --Eblen
Verdict/Settlement --Order, 1/01
Amount --The ALJ found claimant suffered a compensable industrial injury; however, since his treatment provider failed to file the Restorative Services Authorization forms with the Commission, the ALJ denied payment of those bills dated after the date of submission of the last form as mandated by law. Under the law, the treatment provider also cannot require the injured worker to pay these bills.
Injuries --Claimant suffered a back injury.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Mark R. Sumsion and Brad C. Betebenner of Richards, Brandt, Miller & Nelson
Expert Witness(es) - Plaintiff --Dan George, DC
Expert Witness(es) - Defense --Brian Morgan, MD
Facts/Contentions --Claimant was injured while lifting concrete at work. Dr. Morgan released him to full-time sedentary work with no lifting over 10 pounds and found that all the chiropractic treatment he had received up to that point was medically necessary to treat his injury, but he also opined that claimant would be medically stable in six weeks after completing an aggressive physical therapy program of three treatments per week over four weeks. Claimant's chiropractor did not file Restorative Services Authorization (RSA) forms with the Labor Commission after claimant saw Dr. Morgan, but the chiropractor continued to treat claimant, giving him 19 more sessions. The RSA forms are required by the Commission, which made sure the chiropractor was aware of the Commission rule stating that if the forms are not filed, a treatment provider is not entitled to payment under workers' compensation law from the employer and cannot seek payment from the injured worker.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Dennis Christiansen vs. Robinson Transport and Industrial Indemnity
Case Number --98243
Court/Judge --Eblen
Verdict/Settlement --Order, 1/02
Amount --The ALJ found that claimant was permanently and totally disabled from the date of his work injury. The ALJ ordered employer/carrier to pay claimant permanent total disability benefits of $240 per week beginning 12/4/99 and continuing until claimant's death or until further order of the Commission. Employer/carrier must also continue to pay all related medical expenses. Attorney's fees are to be deducted from the weekly disability payments, up to the maximum legal limit of $9,100, and sent directly to claimant's attorney.
Attorney(s) - Plaintiff --Wayne Freestone of Freestone Angerhofer
Attorney(s) - Defense --Kendall P. Hatch and Mark A. Riekhof of Dunn & Dunn
Expert Witness(es) --Because of conflicting medical testimony, this matter was referred to a medical panel.
Facts/Contentions --Claimant was injured at work on 1/16/98, and the parties disputed the treatment medically necessary and the question of claimant's alleged permanent total disability. Findings of fact, conclusions of law and an order for subsistence benefits were issued on 2/5/01, and employer/carrier were given 30 days to indicate whether they intended to file a re-employment plan. Employer/carrier originally indicated that they intended to file such a plan, but then in September of 2001 they withdrew their request to submit the plan and agreed that a final award for permanent total disability should be made.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Ellie Gibbons vs. J. C. Penney and Liberty Mutual Insurance
Case Number --2000534
Court/Judge --Eblen
Verdict/Settlement --Order, 1/02
Amount --The ALJ found that since claimant had a pre-existing meniscal tear, the Allen standard requiring proof of extraordinary exertion as the cause of injury would apply. Squatting and then standing up, the ALJ wrote, does not meet this test, since these activities might well be performed in the course of everyday life. The ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant was diagnosed with acute rupture of some portions of the gastrocnemius muscle and a suspected recurrent meniscal tear. Dr. Bean suspected a Grade I collateral ligament injury as well. Claimant had a pre-existing torn cartilage in the same knee and underwent previous arthroscopic surgery, but Dr. Bean indicated he did not think the earlier injury contributed to the current injury. Dr. Bean performed arthroscopic repair of a posterior bucket-handle tear of the lateral meniscus. At that time, claimant was also diagnosed with Grade III chondromalacia of the left knee and lateral tibial plateau, and Dr. Bean gave her an additional 3% related whole person impairment rating, as well as an additional 2% related whole person impairment rating for a total, as opposed to a partial, lateral meniscectomy.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Michael E. Dyer of Blackburn & Stoll
Expert Witness(es) - Plaintiff --Dr. Charles Bean--orthopedist
Expert Witness(es) - Defense --Dr. Kudrewicz--medical record review
Facts/Contentions --Claimant, who worked for employer as a hair stylist, stated she was squatting down to get something from a cabinet. When she stood up, she experienced pain down the outside of her left knee to the Achilles tendon. She sought medical treatment after getting home from work.
WORK STRESS CLAIM
Case Type --WA, ED; Work-related mental illness claim
Case Name --(Name of case withheld)
Case Number --991128
Court/Judge --Eblen
Verdict/Settlement --Order, 1/0
Amount --The ALJ noted that in order to prove entitlement to benefits for stress-related disorders caused by work activities, a claimant must prove she suffered an extraordinary stress from a sudden stimulus arising predominantly and directly from employment. Finding the dead man, the ALJ wrote, would fall outside the everyday experience of most Americans and could qualify as a trigger for such extraordinary stress. The requirements for legal causation were therefore met. The ALJ accepted the medical panel's finding of a medical causal link between the discovery of the body and claimant's depression, and ordered employer/carrier to pay claimant accrued temporary total disability benefits of $538.53, plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay all related medical expenses, including those for counseling, plus accrued mileage expenses of $173.60 an additional mileage expenses as accrued at 31 cents per mile. The ALJ reserved the issue of permanent partial disability, as claimant has not stabilized medically.
Injuries --Claimant contended that she suffered from post-traumatic stress disorder (PTSD), but the medical panel found she suffered from industrially caused depression.
Attorney(s) - Plaintiff --Marsha S. Atkin of Atkin & Atkin
Attorney(s) - Defense --Brad C. Betebenner of Richards, Brandt, Miller & Nelson
Expert Witness(es) --This case was referred to a medical panel consisting of Dr. Robert Burgoyne--psychiatrist; Dr. Thomas Schenkenberg--neuropsychiatrist; and Dr. Madison Thomas--neurologist.
Expert Witness(es) - Defense --Dr. Michael Smith; Dr. David McCann--psychiatrist; independent medical evaluation
Facts/Contentions --Claimant worked at respondent county jail as a corrections officer, supervising inmate workers and also serving meals and distributing medications to inmates. Claimant said she went to go call an inmate who had been assigned to a work project but did not respond when paged three times. Claimant found the inmate on his bed, with a blanket covering him to his chin, a grimace on his open mouth and a greenish-grey color on his skin. Claimant did not touch the body, but called a co-worker and immediately left the room. The inmate was determined to have died of a heroin overdose. Claimant stated that after she found the dead man, who was "a real person" to her rather than just an inmate, she felt guilty because the man apparently obtained the heroin while he was outside the jail with an earlier work party for which claimant selected him. Claimant knew the dead man's girlfriend and family. Claimant was off work on administrative leave for two weeks and received 14 counseling sessions, but later sought further help because she said she kept seeing images of the dead man in her mind during the day and in nightmares while sleeping. She had extreme difficulty continuing in her job, but continued to try to come to work.
Employer contended that claimant suffered from non-industrial depression rather than PTSD, and two physicians supported this diagnosis. A supervisor wrote the insurance adjuster that claimant did not show any signs of stress or depression before she discovered the dead man.
The medical panel found there was a medically demonstrable causal connection between claimant's symptoms and her discovery of the dead man at work. However, the panel found, this discovery caused depression, not PTSD. The panel found that past medical care was necessary, and future medical care would also be necessary, to treat claimant's condition. It was suggested that claimant receive another three months of medication and counseling to focus on the anger generated by the circumstances surrounding her discovery of the body.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Scott Roy vs. Iasis Health Care/Davis Hospital and Kemper Insurance Company
Case Number --2000680
Court/Judge --Eblen
Verdict/Settlement --Order, 1/02
Amount --The ALJ found that the incident that caused claimant's pain satisfied the Allen requirement for extraordinary exertion as is required in cases involving pre-existing injury. The ALJ found that the only medical opinion that the surgery was not necessary to treat claimants industrial injury came from Dr. Marble, who merely conducted a record review and did not examine claimant. The therefore found Dr. Marble's opinion was not sufficient to create a medical controversy requiring referral to a medical panel. Since the surgery was necessary to treat claimant's industrial injury, the ALJ ordered employer/carrier to pay claimant's medical expenses, including the costs of the surgery. Employer/carrier must also pay claimant accrued temporary total disability benefits of $10,695.35 and accrued permanent partial disability benefits of $15,865.20 for his 15% related whole person impairment. All benefits are to be paid in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney.
Injuries --Claimant suffered a herniated disc at C5/6 which was surgically repaired. Dr. Hood, the treating surgeon, noted degenerative changes in claimant's cervical vertebrae, but added that these conditions did not require surgery. The operation was performed solely to correct the industrial injury. Claimant was given a 15% related whole person impairment rating by Dr. Hood.
Attorney(s) - Plaintiff --W. Scott Lithgoe, Ogden
Attorney(s) - Defense --Mark A. Riekhof of Dunn & Dunn
Expert Witness(es) - Plaintiff --Dr. Hood--treating surgeon; Dr. Chowdhury--neurologist
Expert Witness(es) - Defense --Dr. Stephen Marble--independent medical record review
Facts/Contentions --Claimant, who works as an RN, was assigned to the ICU at Davis Hospital. He said he heard a thud from one of the rooms and found an ambulance crew had dropped a 6-foot, 219-pound patient on the floor while transferring the patient from the ambulance gurney to a hospital bed. Claimant, who is 5' 7" and weighs 185 pounds, got behind the patient, lifted him under the arms to a standing position at about shoulder height, and got him onto the gurney, which was 2 feet off the floor. Claimant did not experience an immediate onset of pain or file an accident report, but instead finished his 12-hour shift. Claimant was working on remodeling his house, but could not use the industrial sander due to his neck pain. Claimant reported the accident a week to 10 days after the incident after he slept on a couch and woke with a kink in his neck, which persisted and finally became excruciating. Electrodiagnostic tests were abnormal, and claimant was referred to Dr. Hood, who diagnosed a disc herniation on top of an osteophyte and performed surgery. Dr. Hood opined that the surgery was medically necessitated by the industrial lifting incident. Claimant was unable to work for one month before and four months after the surgery.
Employer/carrier contended that claimant's neck condition was pre-existing and claimed the surgery was performed to repair degenerative osteophytic ridging at C5/6.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury
Case Name --James F. Sevy vs. ZCMI nka May Company (self-insured) and/or Fireman's Fund Insurance Company and/or Workers' Compensation Fund
Case Number --2000530
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 1/02
Amount --The ALJ found that the treatment claimant received was medically necessitated by his industrial injury and ordered ZCMI/May to pay claimant accrued temporary total disability benefits of $7,111.02; WCF is at least partially liable for $5,641.02 of these benefits. ZCMI/May/WCF must also pay claimant accrued permanent partial disability benefits of $19,651.83 for his 31% industrial upper extremity impairment. All benefits are to be paid in a lump sum plus interest. ZCMI/May/WCF must also pay claimant's related medical expenses.
Injuries --Claimant suffered bilateral cubital and carpal tunnel syndrome and underwent corrective surgery.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --For ZCMI/May: Henry K. Chai II of Blackburn & Stoll; for Workers' Compensation Fund: Barbara W. Sharp
Expert Witness(es) - Plaintiff --Dr. Provost
Expert Witness(es) - Defense --Dr. Dall
Facts/Contentions --Claimant worked for ZCMI, which was later acquired by May, for ten years as a fabric cutter and thirteen years as an upholsterer in the store's furniture department. He complained of problems with his hands and arms and took sick leave for this pain as early as 1985, but did not undergo surgery until 2000. He was also diagnosed with Guyon's canal nerve root entrapment.
WCF contended that the statute of limitations for claimant's reporting of his industrial injury ran from 1988, when claimant requested but did not take leave of absence from his work due to pain in his hands and arms. WCF argued that it should thus be dismissed from the action. Employer contended that claimant's problems were due to an occupational disease rather than an industrial accident, but the ALJ noted that the Utah Supreme Court has classified repetitive traumas as injuries, not accidents. The ALJ also found that claimant met the reporting requirement of the Workers' Compensation Act as early as 1985 when he told ZCMI of his hand and arm pain, even though his employer talked him into taking sick leave rather than workers' compensation because the sick leave would pay 100% of his salary. No evidence indicated whether ZCMI filed the requisite report of work-related injury at that time, but the ALJ doubted that the form was filed because claimant did not seek benefits at that time.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Paula M. Thornton vs. Salt Lake Community College and Workers' Compensation Fund
Case Number --2000879
Court/Judge --Eblen
Verdict/Settlement --Order, 1/02
Amount --The ALJ ordered employer/carrier to pay claimant accrued temporary total disability benefits of $1,779.48 in a lump sum plus interest and less any temporary partial disability benefits already paid.
Injuries --Claimant suffered a severe impingement with a partial thickness rotator cuff tear in her right shoulder, with calcification of both the bursa and tendon and significant bursal effusion. She underwent arthroscopic anterior decompression surgery, and Dr. Berman gave her a related 5% whole person impairment rating.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Lori Hansen
Expert Witness(es) - Plaintiff --Dr. Berman
Facts/Contentions --Claimant, who worked in food preparation, was injured while delivering coffee and snacks to a conference on the second floor in a freight elevator. She was pulling the elevator doors closed, and they were very heavy and hard to move. Claimant experienced an immediate onset of shoulder pain.
Employer/carrier accepted liability for the injury and paid for the surgery and impairment, but claimed they were not liable for further temporary total disability benefits because claimant was offered light duty work and refused it. Employer/carrier terminated claimant when she did not return to work.
The ALJ found claimant was not aware of her release to light duty work because Dr. Berman's office never gave her a release form to take to her employer. Claimant was therefore understandably reluctant to take on the light duty work, and the ALJ found she was not really "offered" the light duty work under these circumstances, since claimant was never advised by anyone of her mandatory return-to-work date.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Beverly S. Workman vs. Intracorp and Ace USA
Case Number --2000917
Court/Judge --Eblen
Verdict/Settlement --Order, 1/02
Amount --The ALJ found that claimant's pregnancy and prior history of miscarriages constituted a pre-existing condition, but claimant's actions when she had the flat tire did not satisfy the Allen requirement for extraordinary exertion as is required in industrial injury claims where pre-existing conditions are present, since anyone might have a flat tire in the ordinary course of modern non-employment life. The ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant suffered a miscarriage and a uterine wall rupture and was hospitalized for six days.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Michael E. Dyer of Blackburn & Stoll
Facts/Contentions --Claimant was pregnant and had a history of multiple prior miscarriages. She was working a 20-hour week, driving on I-15 to see a patient in Payson during major road construction, when she had a flat tire. She had a difficult time finding a place to pull off the road, but finally managed it and was helped by another traveler who loaded claimant's car onto his tilt-trailer and took it and claimant to a garage and then to a tire shop. Claimant suffered an onset of pre-term labor and a uterine wall rupture.
Employer/carrier denied benefits, contending that claimant's actions in regard to the flat tire did not meet the Allen test for exertions beyond those required of people in the course of everyday non-employment life.
DISCRIMINATION
Case Type --DS, Discrimination claim
Case Name --Marion E. App vs. Mervyn's California
Case Number --8980674
Court/Judge --This order was issued by the Appeals Board of the Labor Commission.
Verdict/Settlement --Order, 3/02
Amount --The Board remanded this matter to the ALJ, reasoning that the Board does not yet have jurisdiction since it is for the ALJ to make the decision on whether a new hearing is warranted. If the ALJ denies Mervyn's request for a new hearing, Mervyn's may then seek review by the Board or the Labor Commissioner.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Mervyn's was represented by its in-house legal department.
Facts/Contentions --Claimant alleged that Mervyn's discriminated against claimant in the matter of claimant's employment. ALJ La Jeunesse conducted a hearing on the matter, at which Mervyn's did not appear. Relying on claimant's undisputed testimony, the ALJ found Mervyn's unlawfully discriminated against claimant in the terms and conditions of her employment. The ALJ ordered Mervyn's to cease the discriminatory practice, pay claimant's back wages, and reinstate claimant in a suitable employment position.
Mervyn's filed a motion for review, claiming it never received notice of the scheduled hearing and asking that a new hearing be rescheduled.
WORK-RELATED DEATH
Case Type --WD, WA; Work-related death benefits claim
Case Name --Clarice Brown, widow of Melvin Brown, vs. Sears Roebuck Company and Liberty Mutual Insurance Company
Case Number --2001953
Court/Judge --Eblen
Verdict/Settlement --Order, 3/02
Amount --Since claimant failed to respond to the ALJ's request for necessary medical documentation which would allow the claim to be adjudicated, the ALJ dismissed this claim.
Injuries --Claimant's husband died of congestive heart failure, acute-on-chronic renal failure and adult-onset-type diabetes mellitus. These causes were listed on the death certificate.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Theodore E. Kanell of Plant, Wallace, Christensen & Kanell
Facts/Contentions --Claimant filed this application for dependent benefits in connection with the death of her husband, who was injured March 17, 1980 and was receiving permanent total disability benefits at the time of his death. These benefits were paid by the Employers' Reinsurance Fund, which contended that it had no liability to pay death benefits under the law which was in effect on the date of Melvin Brown's death.
Sears filed a motion to dismiss based on lack of evidence supporting a causal connection between Melvin Brown's back injury in 1980 and the conditions that caused his death. In keeping with the Commission's rules the ALJ asked claimant to submit supporting medical evidence to prove her contention, and claimant failed to do so.
INDUSTRIAL INJURIES/FALL
Case Type --WA, SF; Work-related injuries, slip/fall
Case Name --Donald Clawson vs. Chums Ltd. and Liberty Mutual Insurance Company
Case Number --99950
Court/Judge --Eblen
Verdict/Settlement --Order, 3/02
Amount --The ALJ found that the second accident satisfied the Allen test for extraordinary exertion as is required in cases involving pre-existing injury. The ALJ therefore ordered employer/carrier to pay claimant accrued temporary total disability benefits of $4,158.63 and accrued permanent partial disability benefits of $9,481.25. These benefits are to be paid to claimant in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant's related medical expenses, including those for the knee replacement surgery.
Injuries --Claimant suffered left knee injuries and underwent two surgeries, including and arthroscopic meniscal repair and a total surgical knee replacement.
Attorney(s) - Plaintiff --Aaron J. Prisbrey, St. George
Attorney(s) - Defense --Dori K. Petersen of Blackburn & Stoll
Expert Witness(es) - Plaintiff -- Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Madison Thomas and Dr. Owen Smoot.
Facts/Contentions --Claimant stated he was injured twice while working in his employer's packing and shipping areas; he also supervised the knitting and invert room. The first time he was climbing stairs and his knee "went out" on him, so that he was unable to walk or bend the knee. The second time he tripped over the edge of a rubber mat and fell while carrying a 70-pound box, landing on a concrete floor. The box landed on his left leg and knee.
Employer/carrier contended that neither the first nor the second surgery was necessitated by industrial causes, instead arguing that the changes in claimant's knee were degenerative and pre-existing.
The medical panel found the surgeries--especially the second surgery--were necessitated by claimant's industrial injuries. The ALJ found that claimant did have a pre-existing condition, but also found that a fall while carrying a 70-pound box, which then struck claimant on the knee, could not be made to correspond to any normal activity a person might encounter in everyday life; this injury therefore satisfied the Allen test for extraordinary exertion.
WORK-RELATED DEATH
Case Type --WA, WD; Work-related death benefits claim
Case Name --Jessie B. Conover, widow of Donald L. Conover, vs. White Consolidated Industries and Reliance Insurance
Case Number --99995
Court/Judge --Eblen
Verdict/Settlement --Order, 3/02
Amount --The ALJ accepted the medical panel's finding and dismissed this claim with prejudice based on the panel's failure to find a causal connection between the treatment of decedent's industrial injury and the embolism that caused his death.
Injuries --Claimant's husband died of a pulmonary embolism; cause of the embolism was disputed.
Attorney(s) - Plaintiff --Virginia Curtis Lee
Attorney(s) - Defense --Dori K. Petersen of Blackburn & Stoll
Expert Witness(es) - Plaintiff --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. John Hylen--cardiologist and internist and Dr. Richard Bromley--orthopedist.
Facts/Contentions --Claimant's husband was receiving permanent total disability benefits and had both left and right prosthetic knee joints from an earlier work-related vehicular accident. He died suddenly on September 29, 1999, and the parties disputed the cause of his death. His widow claimed he died because of a "foreign body" embolism that resulted from the de-lamination of the polyethylene in his left knee prosthesis, part of which migrated through his veins to his lung and killed him; employer/carrier contended that the embolism occurred due to natural, non-industrial causes. The prosthesis was 12 years old at the time of decedent's death. The parties agreed by stipulation to the referral of the case to a medical panel.
The medical panel found no causal connection between the medical treatment necessitated by the decedent's industrial injury and the pulmonary embolism that caused his death.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Jill A. Jacobson vs. United Parcel Service and/or Liberty Mutual Insurance Company
Case Number --981015
Court/Judge --Eblen
Verdict/Settlement --Order, 3/02
Amount --The ALJ accepted the medical panel's report and ordered employer/carrier to pay claimant accrued temporary total disability benefits of $548.61 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant's medical expenses, including those for chiropractic treatment, incurred through September 1, 1998. Any expenses incurred after that date are claimant' responsibility.
Injuries --Claimant suffered a lower back injury.
Attorney(s) - Plaintiff --Stephen W. Cook
Attorney(s) - Defense --Dori K. Petersen of Blackburn & Stoll
Expert Witness(es) - Plaintiff --Because of conflicting medical testimony, this case was referred to a medical panel.
Damages --In addition to other benefits, claimant sought medical benefits in the amount of $1,674.40 for chiropractic treatment with Dr. Finsand.
Facts/Contentions --Claimant stated she injured her back while pulling very heavy packages from under trailer rollers on July 22, 1998, exacerbating a pre-existing non-industrial degenerative lower back condition. Employer/carrier initially accepted liability for the injury, but later denied the claim because of claimant's pre-existing back condition. Employer/carrier contended that claimant reached medical stability from the temporary exacerbation of this condition within two to three weeks of the accident. Employer/carrier also disputed the necessity for the chiropractic treatments claimant received. Claimant argued that she did not stabilize until January 11, 1999.
The medical panel found that claimant reached medical stability on September 1, 1998; however, the panel also found that the chiropractic treatment claimant received prior to this date was medically necessary to treat her industrial injury.
WORK INJURIES/TRUCK ACCIDENT
Case Type --WA, TA; Work-related injuries, truck accident
Case Name --Marshall J, Moore vs. Riverbend Express and/or Workers' Compensation Fund and/or BICO; Dat's Trucking and/or Transamerica Insurance and/or Workers' Compensation Fund; and Dalton Brothers Trucking and Wasatch Crest
Case Number --98967, 98968, 99035, 99036, 2000105
Court/Judge --Eblen
Verdict/Settlement --Order, 3/02
Amount --The ALJ accepted the medical panel's report and also found that claimant's aggregated activities exceeded the exertions of everyday life and thus met the Allen test for extraordinary exertion as is required in cases involving a pre-existing injury or condition. The ALJ reserved the issue of permanent partial impairment and dismissed Dat's/WCF and Dat's/Transamerica from the action on grounds that they bore no liability for the broken-air-ride-seat incident at Riverbend that exacerbated claimant's pre-existing back injury and also bore no liability for the roll-over at Dalton. The ALJ also dismissed BICO from the action, since it was not the workers' compensation coverage carrier of record for Riverbend at the time the air-ride-seat incident occurred. The ALJ ordered Riverbend/WCF to pay claimant accrued temporary total disability benefits of $8,000.92 in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Riverbend/WCF must also pay all medical expenses related to the air-ride-seat incident, including the costs of the recommended fusion surgery. The ALJ ordered Dalton/Wasatch Crest to pay claimant accrued temporary total disability benefits of $4,842.73 for the time he was off after the roll-over; benefits are payable in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Dalton/Wasatch Crest must also pay all medical expenses related to the necessary treatment of the reinjuries sustained in the roll-over.
Injuries --Claimant suffered several lumbar spinal injuries, and fusion surgery has been recommended.
Attorney(s) - Plaintiff --Aaron J. Prisbrey, St. George
Attorney(s) - Defense --For Riverbend/WCF: Elliot K. Morris; for Riverbend/BICO: Brad C. Betebenner of Richards, Brandt, Miller & Nelson; for Dat's/Transamerica: Theodore E. Kanell of Plant, Wallace, Christensen & Kanell; for Dat's/WCF: Mark D. Dean; for Dalton/Wasatch Crest: Carrie T. Taylor of Richards, Brandt, Miller & Nelson
Expert Witness(es) - Plaintiff --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Madison Thomas and Dr. Glenn Momberger.
Facts/Contentions --Claimant was first injured while working for Dat's as a local truck driver and dock assistant. He stated that after almost a full day of moving freight, he bent over to pick up a pallet and move it out of his way; he then fell to the floor due to the onset of severe low back pain. After recovering, he was changed to a job delivering freight which did not have to be unloaded by hand, but reinjured his back when he made a delivery of 220-pound hay bales to a Dat's customer who did not have a forklift. Claimant later went to work for Riverbend, first as a local driver and later as an over-the-road driver. He reinjured his back there while helping lift a plastic milk crate containing five chains and binders weighing 130 to 150 pounds. He recovered, returned to work for Riverbend as an over-the-road driver, and reinjured his back again when he had to drive nearly 1500 miles on a broken air-ride seat because no parts were available to repair it. He reinjured his back a final time while driving for Dalton, when he flipped his truck onto its side in an effort to avoid a deer that ran into the road. His passenger, another driver, was thrown onto claimant.
The employers/carriers involved were unable to apportion responsibility for claimant's back injuries and their required treatment; there was also some dispute as to how much of claimant's back condition was non-industrial.
The medical panel found the long trip on the broken air-ride seat was medically causally connected to the aggravation of claimant's low back condition; that the proposed fusion surgery is medically necessary to treat the injury caused by the broken air-ride seat; and that claimant is not yet medically stable, so that no permanent impairment rating can be assigned at this time.
DISCRIMINATION/DEATH
Case Type --SH, DS, WD; Discrimination/sexual harassment, wrongful death
Case Name --(Name of case withheld)
Case Number --8990538
Court/Judge --This order was issued by ALJ Stuart L. Poelman of the Labor Commission.
Verdict/Settlement --Order on appeal from UALD, 3/02
Amount --The ALJ ruled that a discrimination claim does not survive the death of the claimant, and also that the Utah Anti-Discrimination Act makes no provision for an award of wrongful death benefits. The ALJ therefore dismissed this claim with prejudice, declining to substitute claimant's personal representative as a party to the action or to amend the claim to one of wrongful death.
Attorney(s) - Plaintiff --Loren M. Lambert
Attorney(s) - Defense --Roger H. Hoole of Hoole & King
Facts/Contentions --Claimant filed this action with the Utah Anti-Discrimination and Labor Division (UALD) of the Labor Commission, which concluded that claimant was sexually harassed. The UALD ordered employer to pay claimant past lost wages and benefits plus attorney's fees. Claimant later died, and her personal representative sought to have himself named to continue and amend the action on behalf of himself and claimant's other heirs on grounds that employer's discriminatory behavior was the cause of claimant's death.
Employer moved to dismiss, contending that the action died with the claimant and was not transferrable.
REPETITIVE STRESS INJURY
Case Type --Repetitive stress injury claim
Case Name --Valerie G. Remels vs. Health South Rehabilitation Corporation and/or ACE USA/CIGNA
Case Number --2000977
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 3/02
Amount --The ALJ dismissed this claim with prejudice on grounds that claimant failed to prove her injuries were medically caused by her activities at work.
Injuries --Claimant suffered bilateral foot pain and right shoulder problems.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Dori K. Petersen of Blackburn & Stoll
Expert Witness(es) - Plaintiff --Dr. Gary Zeluff
Facts/Contentions --Claimant was diagnosed with bilateral plantar fascitis and tarsal tunnel syndrome; she claimed these problems stemmed from that fact that she was constantly standing on her feet in the course of her employment. She was also diagnosed with right shoulder impingement syndrome, which she claimed resulted from lifting heavy bags of laundry and supplies.
Employer/carrier contended that claimant failed to report her problems as industrial injuries and that her claim was thus barred by the statute of limitations.
The ALJ noted that a thorough search of claimant's medical records failed to reveal a single medical opinion as to the cause of her foot and shoulder problems.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Richard Hernandez vs. STS, Incorporated and/or Royal SunAlliance
Case Number --2001452
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 3/02
Amount --The ALJ ordered employer/carrier to pay for an MRI of claimant's right shoulder.
Injuries --Claimant suffered a right shoulder injury.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Mark D. Dean of Blackburn & Stoll
Facts/Contentions --Claimant stated that he was injured at work on June 12, 2000. Employer/carrier generally denied liability; however, the parties stipulated that the only issue to be determined by the ALJ at this hearing was whether employer/carrier must pay for an MRI of claimant's right shoulder. At the hearing, employer/carrier agreed that claimant is entitled to an MRI of his right shoulder.
DISCRIMINATION
Case Type --DS; Discrimination claim
Case Name --Roxanne Kresser vs. Utah Valley Regional Medical Center
Case Number --8990389
Court/Judge --This order was issued by ALJ Stuart L. Poelman of the Labor Commission.
Verdict/Settlement --Order on appeal from UALD, 3/02
Amount --The ALJ agreed that claimant failed to raise a genuine material issue of fact in her appeal; the ALJ therefore granted employer's motion for summary judgment, dismissing this claim with prejudice.
Attorney(s) - Plaintiff --Gordon W. Duval, Pleasant Grove
Attorney(s) - Defense --Steven C. Bednar of Manning, Curtis, Bradshaw & Bednar
Facts/Contentions --Claimant was employed at Utah Valley when she injured her back while moving a patient. She was placed on modified light duty restrictions, and her employer paid workers' compensation and long-term disability benefits for almost two years. In May of 1998, claimant received a permanent partial impairment rating and was placed on permanent work restrictions, including limitation to sedentary duties and no lifting over 10 or 15 pounds. Claimant's employer then informed her that with these restrictions, she was no longer qualified for a position as an LPN, and was no longer eligible to continue her temporary light-duty work assignment in the employee health office. Along with claimant's employment, her employer also terminated claimant's long-term disability benefits.
Claimant filed a charge of discrimination with the Utah Anti-Discrimination and Labor Division (UALD) of the Labor Commission on May 20, 1999, stating that the last incident of discrimination by her employer occurred on July 6, 1998, when she was terminated. The UALD dismissed her claim on grounds that it was not filed within the 180 days allowed for the filing of a state discrimination claim or within the 300 days allowed for the filing of a federal discrimination claim. Claimant appealed, alleging that she was led by conversations and correspondence with her employer's payroll and human resource personnel to believe that her termination would not become effective until February 1999.
Employer moved for summary judgment, arguing that the tolling of a statute of limitations should occur only if claimant could prove the delay in filing was caused by "active deception" on the part of the employer. Employer contended that claimant's delay in filing was caused by "a self-promoted misunderstanding" on claimant's part.
WORK INJURIES/TRUCK ACCIDENT
Case Type --WA, TA; Work-related injuries, truck accident
Case Name --Marshall J. Moore vs. Riverbend Express and/or Workers' Compensation Fund and/or BICO; Dat's Trucking and/or Transamerica Insurance and/or Workers' Compensation Fund; and Dalton Brothers Trucking and Wasatch Crest
Case Number --98967, 98968, 99035, 99036, 2000105
Court/Judge --Eblen
Verdict/Settlement --Order, 3/02
Amount --The ALJ accepted the medical panel's report and also found that claimant's aggregated work activities, which caused his injury, exceeded the exertions of everyday life. The claimant's work activities thus met the Allen test for extraordinary exertion, as is required in cases involving a pre-existing injury or condition. The ALJ reserved the issue of permanent partial impairment and dismissed Dat's/WCF and Dat's/Transamerica from the action on grounds that they bore no liability for the broken-air-ride-seat incident at Riverbend that exacerbated claimant's pre-existing back injury; the ALJ ruled that Dat's also bore no liability for the roll-over at Dalton. The ALJ also dismissed BICO from the action, since it was not the workers' compensation coverage carrier of record for Riverbend at the time the air-ride-seat incident occurred. The ALJ ordered Riverbend/WCF to pay claimant accrued temporary total disability benefits of $8,000.92 for the air-ride-seat incident; benefits are due and payable in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Riverbend/WCF must also pay all medical expenses related to the air-ride-seat incident, including the costs of the recommended fusion surgery. The ALJ ordered Dalton/Wasatch Crest to pay claimant accrued temporary total disability benefits of $4,842.73 for the time he was off after the roll-over; benefits are payable in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Dalton/Wasatch Crest must also pay all medical expenses related to the necessary treatment of the reinjuries sustained in the roll-over.
Injuries --Claimant suffered several lumbar spinal injuries, and fusion surgery has been recommended.
Attorney(s) - Plaintiff --Aaron J. Prisbrey, St. George
Attorney(s) - Defense --For Riverbend/WCF: Elliot K. Morris; for Riverbend/BICO: Brad C. Betebenner of Richards, Brandt, Miller & Nelson; for Dat's/Transamerica: Theodore E. Kanell of Plant, Wallace, Christensen & Kanell; for Dat's/WCF: Mark D. Dean; for Dalton/Wasatch Crest: Carrie T. Taylor of Richards, Brandt, Miller & Nelson
Expert Witness(es) - Plaintiff --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Madison Thomas and Dr. Glenn Momberger.
Facts/Contentions --Claimant was first injured while working for Dat's as a local truck driver and dock assistant. He stated that after almost a full day of moving freight, he bent over to pick up a pallet and move it out of his way; he then fell to the floor due to the onset of severe low back pain. After recovering, he was changed to a job delivering freight which did not have to be unloaded by hand, but reinjured his back when he made a delivery of 220-pound hay bales to a Dat's customer who did not have a forklift. Claimant later went to work for Riverbend, first as a local driver and later as an over-the-road driver. He reinjured his back there while helping lift a plastic milk crate containing five chains and binders weighing 130 to 150 pounds. He recovered, returned to work for Riverbend as an over-the-road driver, and reinjured his back again when he had to drive nearly 1500 miles on a broken air-ride seat because no parts were available to repair it. He reinjured his back a final time while driving for Dalton, when he flipped his truck onto its side in an effort to avoid a deer that ran into the road. His passenger, another driver, was thrown onto claimant.
The employers/carriers involved were unable to apportion responsibility for claimant's back injuries and their required treatment; there was also some dispute as to how much of claimant's back condition was non-industrial.
The medical panel found the long trip on the broken air-ride seat was medically causally connected to the aggravation of claimant's low back condition; that the proposed fusion surgery is medically necessary to treat the injury caused by the broken air-ride seat; and that claimant is not yet medically stable, so that no permanent impairment rating can be assigned at this time.
FALL
Case Type --WA, SF; Work-related slip/fall
Case Name --Rosario Linares vs. P.A.C.E. and Workers Compensation Fund
Case Number --2001651
Court/Judge --Poelman
Verdict/Settlement --Order, 3/02
Amount --Based on claimant's and employer's statements, the ALJ denied the claim for additional temporary total compensation. However, the ALJ felt the evidence preponderated in favor of claimant regarding the recommended MRI, and he ordered employer/carrier to pay all claimant's related medical expenses, including those for this diagnostic procedure.
Injuries --Claimant suffered injuries to her neck, shoulder (possibly a mild rotator cuff tear) and head.
Attorney(s) - Plaintiff --Raymond N. Malouf Jr., Logan
Attorney(s) - Defense --Hans M. Scheffler
Expert Witness(es) - Plaintiff --Dr. Keith J. Nelson--orthopedic surgeon
Facts/Contentions --Claimant stated she slipped and fell on ice in her employer's parking lot as she was walking from her car into the workplace. She reported the accident to her employer immediately, and the employer took her to Logan Regional Hospital for treatment. She continued receiving treatment for her injuries periodically until June 11, 2001.
The only parts of this claim disputed by employer/carrier involved the request for temporary total disability compensation for the period between May 31, 2001 and June 28, 2001 and the MRI recommended by Dr. Nelson to diagnose claimant's continuing shoulder pain. Claimant stated that she continued working from the time of the accident through May 30, 2001, when she was terminated. She stated that she did not work during the period in question because she had no job, but was looking for one; she never claimed she was unable to work during this period.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury
Case Name --Mericia Milligan vs. State of Utah Tax Commission and Workers Compensation Fund
Case Number --2000232
Court/Judge --Eblen
Verdict/Settlement --Order, 3/02
Amount --The ALJ found employer/carrier overpaid claimant $3,082.69 in temporary total compensation benefits, given her return to light duty work October 17, 2000. However, the ALJ also found employer/carrier owed claimant additional temporary total disability benefits for the time she was off work following the trigger finger release surgeries, leaving a balance due and owing to claimant after the overpayment was deducted of $11,276.80. The ALJ found employer/carrier also owes claimant $2,914.21 in permanent partial impairment benefits for her right arm impairment; the ALJ reserved the issue of impairment of the left arm. Payment of benefits awarded in this order is due in a lump sum plus interest and less attorney's fees, which are to be deducted from these awards and paid directly to claimant's attorney.
Injuries --Claimant was diagnosed with left carpal tunnel syndrome and possible bilateral DeQuervain's tenosynovitis; the carpal tunnel syndrome was surgically repaired, and claimant later underwent bilateral "trigger finger release" surgeries. The medical panel gave claimant a 14% whole person impairment rating, with 80% of this impairment industrially related. The panel found claimant's current impairment for the upper left arm is 20%; however, given the substantial improvement of the right arm after the trigger finger release surgery, the panel felt it is likely that the upper left arm will also improve with surgery; therefore, the ALJ felt an award for permanent total disability of the left arm would be premature at this time.
Attorney(s) - Plaintiff --Michael G. Belnap, Ogden
Attorney(s) - Defense --Barbara W. Sharp
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Edward B. Holmes, MD, MPH.
Damages --Employer/carrier paid claimant $11,683.65 in medical expenses and $15,160.29 in temporary total disability compensation.
Facts/Contentions --Claimant noticed that swelling developed in her left hand after she had been at work. She claimed her work activities in connection with her job as an investigator caused her carpal tunnel syndrome.
Employer/carrier paid for the carpal tunnel surgery, but disputed the date on which claimant attained medical stability on grounds that the trigger finger release surgeries were not medically necessary to treat claimant's work injury. Claimant sought payment for additional medical procedures, including the trigger finger releases, as well as permanent total disability benefits. Employer/carrier contended that claimant can return to gainful employment with accommodations, such as a "hands-free" computer system.
At first the evidence indicated that claimant first experienced symptoms just after she began working for employer; however, further investigation revealed that the record was mistaken, and claimant had been working for employer for nearly 12 years at the time she began experiencing pain in her hands, arms and wrists. The medical panel attributed 80% of her symptoms to her work activities and felt that all of the medical care claimant received to date was necessary to treat her work-related problems. The medical panel concluded that additional treatment was needed in the form of surgical release to treat flexion contractures of the left little and ring fingers; however, the panel assigned claimant an impairment rating nonetheless.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury
Case Name --Melissa Weight vs. Davis County School District
Case Number --98866
Court/Judge --Eblen
Verdict/Settlement --Order, 3/02
Amount --Since claimant already received benefits from her other employer for the time she was off work, the ALJ dismissed her claim for temporary total disability compensation for that time; the ALJ also found no evidence to prove claimant was off work at all during the later period in question and therefore dismissed her claim for temporary total disability benefits from this employer with prejudice. However, the ALJ ordered this employer to pay claimant's related medical expenses, both past and future, for her shoulder pain and biceps tendinitis.
Injuries --Claimant was diagnosed with bilateral DeQuervain's tenosynovitis, and her previous employer/carrier paid for its treatment; she filed this claim for continuing pain in her shoulders, possibly caused by overuse rotator cuff tendinitis. The medical panel gave claimant a 4% related whole person impairment rating for her bilateral elbow and wrist conditions, but no permanent partial impairment rating in connection with the shoulder pain because this was a temporary aggravation.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Henry K. Chai II of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel.
Facts/Contentions --Claimant worked as a secretary, helping with student registration, keyboarding on a computer and working with a 10-key adding machine. Claimant worked at a counter to help with student registration, and claimed her shoulder pain started when she had to hunch over to type on the computer situated on the counter.
A previous employer/carrier paid for claimant's DeQuervain's and carpal tunnel treatment. This self-insured employer disputed the claim for shoulder pain on grounds that claimant had a history of rotator cuff tendinitis and pre-existing degenerative shoulder disease.
The medical panel concluded that claimant's shoulder problems were 100% medically aggravated by her work activities and the treatment she received for this aggravation was medically necessary. The panel also found claimant suffered from undiagnosed biceps tendinitis which is not yet medically stable. The panel recommended steroid injections and two weeks of physical therapy to help claimant establish a home exercise program as treatment for this condition.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --David Wilkes vs. Utah Department of Corrections and/or Workers' Compensation Fund
Case Number --2001457
Court/Judge --Poelman
Verdict/Settlement --Order, 3/02
Amount --The ALJ found the evidence indicated that claimant's hernia was probably caused by the sit-ups. However, since there was no evidence to support claimant's statement that he told supervisors this was the case, the ALJ found claimant did not report the industrial injury within 180 days of its occurrence, as Utah law requires. The ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant suffered an incisional abdominal hernia.
Attorney(s) - Plaintiff --K. Dawn Atkin of Atkin & Associates
Attorney(s) - Defense --Floyd W. Holm
Expert Witness(es) - Plaintiff --Dr. Allred; Dr. Stephanie Fine--treating surgeon
Facts/Contentions --Claimant worked as a correctional psychological therapist, and was required to attend and pass the Department of Corrections Academy. Before entering the academy, he underwent fitness testing, which included sit-ups. He managed to complete the required sit-ups, but experienced pain and a bulge on his abdomen at a prior surgical site. His doctor told him abdominal strengthening exercises would worsen this condition, but when he took his doctor's note to his superiors, they told him there were no alternate exercises available and the sit-ups could not be waived. Claimant continued doing the sit-ups and passed the test performed about halfway through the academy program, after which he discontinued the sit-ups. Almost three years later he underwent abdominal surgery, at which time it was discovered that he suffered from multiple abdominal incision defects, known as "Swiss cheese." He and his doctor claimed these defects were caused by the continued sit-ups. Claimant said he talked the incisional hernia problem over with his employers before he entered the academy in connection with the possibility of waiving the sit-ups, but never filled out an industrial injury report; however, he said he told them the hernia was caused by the sit-ups.
Employer disputed causation and contended that claimant never reported his injury as industrial. Employer said claimant never told supervisors the hernia was caused by the sit-ups.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Tyren Willeto vs. Icon Health and/or Workers' Compensation Fund
Case Number --200171
Court/Judge --Poelman
Verdict/Settlement --Order, 3/02
Amount --The ALJ found claimant suffered an industrial injury and reported it properly and in a timely fashion. The ALJ therefore ordered employer/carrier to pay claimant $250.32 in accrued temporary total disability compensation benefits plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay all claimant's related medical expenses and travel costs for travel to treatment facilities at 31 cents per mile.
Injuries --Claimant suffered a cut on his right knee which became infected and had to be drained.
Attorney(s) - Plaintiff --Raymond N. Malouf, Logan
Attorney(s) - Defense --Barbara W. Sharp
Facts/Contentions --Claimant stated that he hit his knee on a metal bar at work. The metal shaft is part of the mechanism of a conveyor belt, and claimant was assembling exercise machines on the belt. Claimant said he mentioned the incident to a co-worker standing nearby, and told a supervisor within 10 minutes, but added that the supervisor didn't take claimant seriously. Claimant said he reported the accident to his shift supervisor the next day, and the man laughed as though it were a joke. Claimant said he told his wife, parents and a friend about the injury and sought medical care in 3 days, after his pain and swelling increased.
Employer/carrier contended that claimant actually injured his knee in an automobile accident 3 days before the date of his claim for this injury, but no evidence in the medical record supported this claim.
WORK INJURIES
Case Type --WA; Work-related injuries
Case Name --Kadim Al-Abboudy vs. Gerber Construction, Incorporated and/or Argonaut Insurance Company and Workers' Compensation Fund; and J. T. Thorpe and/or Lumbermens Mutual Casualty Company
Case Number --2000483, 2000484
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 3/02
Amount --The ALJ found claimant suffered a mild lumbar strain from the first injury and a lumbar sprain-strain from the second injury. However, since claimant failed to accept Thorpe's offer of light duty work the day after he was injured, the ALJ found Thorpe did not owe claimant any temporary total disability compensation. The ALJ therefore dismissed the claim against Thorpe with prejudice. The ALJ found Gerber/Argonaut owed claimant $1,000 in temporary total disability compensation, payable in a lump sum plus interest. The ALJ ordered Thorpe/Lumbermens to pay all related medical expenses for the first accident and Gerber/Argonaut to pay all related medical expenses for the second accident, but felt it would be inappropriate to order either employer/carrier to pay for an MRI without some medical opinion indicating that it was medically necessary to diagnose injuries from either industrial accident.
Injuries --Claimant suffered two lower back injuries, including a possible herniated disc.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --For Gerber/Argonaut: Dori K. Petersen of Blackburn & Stoll; for WCF: Elliot K. Morris; for Thorpe/Lumbermens: S. Brook Millard of Dunn & Dunn
Expert Witness(es) - Plaintiff --Dr. Robert Williams
Expert Witness(es) - Defense --Dr. Jeff Chung
Facts/Contentions --Claimant stated he injured his back while working for Thorpe when he was carrying some rock and brick debris in buckets up a ladder to throw them into a dumpster. Claimant said he twisted while on the ladder and felt pain in his low back. He said he injured his low back a second time while operating a 150-pound jackhammer for Gerber. On this occasion, he said, the pain was so intense he could not get out of bed the next day. Claimant had worked for Thorpe for seven days before the first injury, and had worked for Gerber for one day when he was injured the second time.
Employers/carriers contended that claimant had pre-existing low back injuries from an automobile accident in 1998. Thorpe personnel testified that claimant was offered light duty work after he was injured, but claimant never accepted it or returned to work; Thorpe therefore contended that it did not owe claimant any temporary total disability benefits for the period after it offered the light duty work to claimant when he was released to light duty the day after the accident. Dr. Chung concluded that claimant's temporary total disability from the second injury lasted two weeks maximum. Claimant contended that he needed back surgery as a result of his industrial injuries, but nothing in the medical records supported his contention. Both Dr. Chung and Dr. Williams recommended an MRI of the lower spine. The medical evidence indicated substantial pre-existing degenerative disc disease of the lower spine.
The parties stipulated to the dismissal of WCF from this action.
FALL
Case Type --WA, SF; Work-related fall
Case Name --Eric Barbeau vs. T K O Construction and Workers' Compensation Fund
Case Number --2000471
Court/Judge --Eblen
Verdict/Settlement --Order, 3/02
Amount --The ALJ declined to be bound by the provisions of the "high-low" agreement, since she was not notified of its existence in a timely fashion. She therefore ordered employer/carrier to pay claimant accrued permanent partial disability benefits of $20,826 for his 25% related whole person impairment, plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay all claimant's related medical expenses.
Injuries --Claimant shattered both heels (multiple calcaneus fractures). Dr. Colledge found claimant was medically stable, but his condition was very severe. The medical panel gave claimant an 18% related whole person impairment rating for the right foot and a 7% related whole person impairment rating for the left foot. Claimant may need ankle arthrodesis for both ankles at some time in the future.
Attorney(s) - Plaintiff --Aaron J. Prisbrey, St. George
Attorney(s) - Defense --Elliot K. Morris
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Alan Colledge and Dr. William Bacon.
Facts/Contentions --Claimant fell while setting trusses. Employer/carrier accepted liability, but disputed claimant's degree of impairment and some recommended medical care.
After the matter was referred to the medical panel, the parties informed the ALJ about the existence of a secret "high-low" agreement limiting employer's liability for permanent partial disability benefits to no more than 20% and no less than 12% impairment. However, the ALJ stated that since this fact was not included in the stipulated facts presented to her by the parties, she was not bound by it in making her determination, but instead was bound by the requirements of the Workers' Compensation Act.
FALL
Case Type --WA, SF; Work-related slip/fall
Case Name --Alberta Cartwright vs. Pictsweet and GAB Robbins
Case Number --9911092
Court/Judge --Eblen
Verdict/Settlement --Order, 3/02
Amount --The ALJ ordered employer/carrier to pay claimant accrued temporary total disability benefits of $388.10 to cover an additional 2.714 weeks, beginning after employer offered the light duty work and ending on the date when the medical panel found claimant attained medical stability. The ALJ also ordered employer/carrier to pay claimant $5,800.08 for her 13% related whole person impairment. All benefits are due and payable in a lump sum plus interest and less attorney's fees, which are to be deducted from these awards and paid directly to claimant's attorney.
Injuries --Claimant suffered a back injury and underwent a two-level discectomy, with her medical providers originally planning to release her to light duty work in three weeks. However, she did not do nearly as well as expected. Claimant terminated from this job voluntarily and has not yet returned to other work.
Attorney(s) - Plaintiff --Aaron J. Prisbrey
Attorney(s) - Defense --Carrie T. Taylor of Richards, Brandt, Miller & Nelson
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Madison Thomas and Dr. Glenn Momberger.
Facts/Contentions --Claimant worked as a packager at employer's mushroom farm, handling 2 1/2 to 3 pounds in weight and occasionally lifting 10-pound boxes after packaging. She was injured when she tangled her foot in an electrical cord and fell. Her employer accepted liability for the injury, but claimed it did not owe claimant any additional temporary total disability benefits because it offered her light duty work which she did not accept. Claimant contended that the light duty work was not appropriate because her medical provider had not yet released her to return to work.
The medical panel concluded that claimant attained medical stability nine months after the accident and has a 13% related whole person permanent partial impairment.
REPETITIVE STRESS INJURIES
Case Type --WA, SI; Work-related repetitive stress injuries
Case Name --Gloria Johnette Coe vs. Ajer's Investment Group and Workers' Compensation Fund; Fifth Avenue Ventures and Workers' Compensation Fund; Bradshaw Enterprises and Workers' Compensation Fund; and Sandpoint Management and Workers' Compensation Fund (Sandpoint was joined after the hearing)
Case Number --2000180, 2000181, 2000182, 2000163
Court/Judge --Eblen
Verdict/Settlement --Order, 3/02
Amount --The ALJ found this claim was timely filed after the cause of action arose, when claimant underwent surgery and therefore suffered disability, although she knew she suffered from carpal tunnel syndrome before that date. The ALJ found that the "Last Injurious Exposure Rule" did not apply in this case because claimant had not worked for her most recent employer (Sandpoint) for a full twelve months when she suffered her disability. Responsibility must therefore be apportioned among her previous employers. The ALJ accepted the medical panel's findings on this question and ordered Fifth Avenue/WCF to pay claimant $244.20 in accrued temporary total disability benefits and $761.91 in accrued permanent partial disability benefits; Ajer's/WCF to pay claimant $211.12 in accrued temporary total disability benefits and $658.94 in accrued permanent partial disability benefits; and Sandpoint/WCF to pay claimant $204.60 in accrued temporary total disability benefits and $638.35 in accrued permanent partial disability benefits. All these benefits are due and payable in a lump sum plus interest and less attorney's fees, which are to be deducted from these awards and paid directly to claimant's attorney. Fifth Avenue, Ajer's and Sandpoint must also pay all claimant's related medical expenses, including future expenses for follow-up and excepting those for the chiropractic treatment, with expenses to be apportioned according to the medical panel's finding of comparative liability. Fifth Avenue is entitled to an offset against the medical expenses it has already paid.
Injuries --Claimant suffered from bilateral carpal tunnel syndrome and underwent right-side surgical release. The medical panel gave claimant a 3% related whole person impairment rating and concluded that she suffers from painful organic syndrome due to her upper extremity overuse. The panel found specifically that claimant's martial arts activities in Hapkido did not cause any of her problems. The panel apportioned 31% of claimant's industrial injury to Sandpoint; 32% to Ajer's; 37% to Fifth Avenue and 0% to Bradshaw. The panel found all the treatment claimant received was medically necessary except for the chiropractic care. Future physician follow-up may be necessary to treat flare-ups.
Attorney(s) - Plaintiff --Phillip B. Shell of Day, Shell & Liljenquist
Attorney(s) - Defense --For Ajer's/WCF: Mark D. Dean; for Fifth Avenue/WCF: Barbara W. Sharp; for Bradshaw/WCF: Eugene C. Miller Jr.; for Sandpoint/WCF: Lori Hansen
Expert Witness(es) --This case was referred directly to a medical panel consisting of Edward Holmes, MD, MPH by agreement of the parties.
Facts/Contentions --Claimant worked as a hairstylist. She claimed her carpal tunnel syndrome was caused by her work activities for all of employers. The employers were unable to agree on apportionment of liability, and stipulated to referral of this claim to a medical panel.
REPETITIVE STRESS INJURIES
Case Type --WA, SI; Work-related repetitive stress injuries
Case Name --Gloria Johnette Coe vs. Ajer's Investment Group and Workers' Compensation Fund; Fifth Avenue Ventures and Workers' Compensation Fund; Bradshaw Enterprises and Workers' Compensation Fund; and Sandpoint Management and Workers' Compensation Fund (Sandpoint was joined after the hearing)
Case Number --2000180, 2000181, 2000182, 2000163
Court/Judge --Eblen
Verdict/Settlement --Order, 3/02
Amount --The ALJ found this claim was timely filed after the cause of action arose, when claimant underwent surgery and therefore suffered disability, although she knew she suffered from carpal tunnel syndrome before that date. The ALJ found that the "Last Injurious Exposure Rule" did not apply in this case because claimant had not worked for her most recent employer (Sandpoint) for a full twelve months when she suffered her disability. Responsibility must therefore be apportioned among her previous employers. The ALJ accepted the medical panel's findings on this question and ordered Fifth Avenue/WCF to pay claimant $244.20 in accrued temporary total disability benefits and $761.91 in accrued permanent partial disability benefits; Ajer's/WCF to pay claimant $211.12 in accrued temporary total disability benefits and $658.94 in accrued permanent partial disability benefits; and Sandpoint/WCF to pay claimant $204.60 in accrued temporary total disability benefits and $638.35 in accrued permanent partial disability benefits. All these benefits are due and payable in a lump sum plus interest and less attorney's fees, which are to be deducted from these awards and paid directly to claimant's attorney. Fifth Avenue, Ajer's and Sandpoint must also pay all claimant's related medical expenses, including future expenses for follow-up and excepting those for the chiropractic treatment, with expenses to be apportioned according to the medical panel's finding of comparative liability. Fifth Avenue is entitled to an offset against the medical expenses it has already paid.
Injuries --Claimant suffered from bilateral carpal tunnel syndrome and underwent right-side surgical release. The medical panel gave claimant a 3% related whole person impairment rating and concluded that she suffers from painful organic syndrome due to her upper extremity overuse. The panel found specifically that claimant's martial arts activities in Hapkido class did not cause any of her problems. The panel apportioned 31% of claimant's industrial injury to Sandpoint; 32% to Ajer's; 37% to Fifth Avenue and 0% to Bradshaw. The panel found all the treatment claimant received was medically necessary except for the chiropractic care. Future physician follow-up may be necessary to treat flare-ups.
Attorney(s) - Plaintiff --Phillip B. Shell of Day, Shell & Liljenquist
Attorney(s) - Defense --For Ajer's/WCF: Mark D. Dean; for Fifth Avenue/WCF: Barbara W. Sharp; for Bradshaw/WCF: Eugene C. Miller Jr.; for Sandpoint/WCF: Lori Hansen
Expert Witness(es) --This case was referred directly to a medical panel consisting of Edward Holmes, MD, MPH by agreement of the parties.
Facts/Contentions --Claimant worked as a hairstylist. She claimed her carpal tunnel syndrome was caused by her work activities for all of employers. The employers were unable to agree on apportionment of liability, and stipulated to referral of this claim to a medical panel.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Repetitive stress injury
Case Name --Richard Crossley vs. Barricks Resources USA, Incorporated and Workers' Compensation Fund; and Anderson Equipment Sales & Service and Argonaut Insurance Company
Case Number --200097
Court/Judge --Eblen
Verdict/Settlement --Order, 4/02
Amount --The ALJ accepted the medical panel's report and found that claimant suffered a pre-existing weakness in his right arm as a result of his work for Barricks. The ALJ further found claimant's actions while he was working for Anderson met the Allen test for extraordinary exertion, as is required by Utah law in cases of pre-existing injury. The ALJ stated that she could think of no typical activity of modern non-employment life which duplicates the exertions required by claimant's work at Anderson. The ALJ noted that under Utah law she is not allowed to give claimant an additional award for permanent partial impairment of his shoulders, since claimant has already been paid for this disability. The ALJ therefore found that Anderson/Argonaut is liable for benefits related to the right elbow injury, and Barricks/WCF is not. The ALJ ordered Anderson/Argonaut to pay claimant accrued temporary total disability benefits of $5,287.36 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Anderson/Argonaut must also pay all related medical expenses for treatment of the elbow injury. The ALJ reserved the issue of permanent partial impairment until claimant decides whether or not to have surgery.
Injuries --Claimant was diagnosed with work-related impingement syndromes in both shoulders and acute rotator cuff tendinitis and biceps tendinitis of the left shoulder only. He underwent surgery on each shoulder. The panel awarded claimant a 3% upper right extremity permanent partial impairment rating related to the original shoulder injury and found that he is medically stable unless he chooses to have surgery to treat his condition. If he chooses not to have surgery, he is entitled to a 5% upper extremity permanent partial impairment rating.
Attorney(s) - Plaintiff --Danny Quintana of Quintana & York
Attorney(s) - Defense --For Barricks/WCF: Barbara W. Sharp; for Anderson/Argonaut: Michael E. Dyer of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Edward B. Holmes, MD, MPH.
Damages --Barricks paid claimant for a 2% whole person permanent impairment stemming from the left shoulder injury and a 10% whole person permanent impairment due to loss of range of motion and arthroplasty.
The panel found claimant right arm and forearm problems are definitely related to his work at Anderson.
Facts/Contentions --Claimant worked for Barricks until the company closed in September of 1996, and was first diagnosed with shoulder problems while working for them. In April of 1998 he went to work for Anderson, doing the same kind of work he did for Barricks: operating a large drilling machine, pushing and pulling levers inside the cab and connecting drill bits and lines outside the cab. Claimant worked 10 to 11 hours a day five days a week plus some weekends. His right arm and elbow began to bother him after he had worked a couple of months at the new job.
Employers/carriers were unable to agree on the proper apportionment of liability and agreed to refer this matter to the medical panel.
FALL/CUT
Case Type --WA, SF, MS; Work-related fall/miscellaneous (cut)
Case Name --Robert J. Draper vs. Robert D. Draper dba Bob Draper Timber Company and Uninsured Employers' Fund
Case Number --2000770
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 4/02
Amount --The ALJ ordered the UEF to pay claimant accrued temporary total disability compensation of $1,178.75 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. The UEF must also pay all claimant's related medical expenses, including the cost of the recommended MRI. The UEF retains the right to seek reimbursement from Bob Draper and may further impose a penalty on Bob Draper of 15% of all the sums the UEF paid for Bob Draper's failure to maintain workers' compensation insurance coverage on his employees.
Injuries --Claimant suffered a cut on his knee which became infected and developed cellulitis. Claimant was off work for two months while his injury was being treated, and an MRI has been recommended.
Attorney(s) - Plaintiff --T. Jeffery Cottle, Orem
Attorney(s) - Defense --For Bob Draper: Paul K. Frischknecht, Manti; for UEF: Sheryl Hayashi
Expert Witness(es) - Plaintiff --Dr. Brace Burningham; Dr. DeVon Nelson
Facts/Contentions --Claimant worked at uninsured employer's logging operation. He was "bumping knots" (cutting limbs off trees with a chain-saw) when he fell out of the tree he was working in and the chain-saw lacerated his knee .
Bob Draper contended that claimant was an independent contractor, but the ALJ found the evidence indicated that Bob Draper told claimant when, where and how to work, held regular safety meetings for workers and corrected them when he saw them doing something wrong, oversaw the logging operation, and in all respects acted as claimant's employer.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Jose Alfonso Garcia vs. Agreserves, Incorporated--
West Hills Orchard dba Farm Management Corporation
Case Number --2000233
Court/Judge --Eblen
Verdict/Settlement --Order, 4/02
Amount --The ALJ accepted the medical panel's report and dismissed the claim for additional permanent partial disability and temporary total disability benefits with prejudice. However, the ALJ ordered employer/carrier to pay claimant's medical expenses, including those for the future treatment the medical panel found reasonable for continuing pain.
Injuries --Claimant was diagnosed with a disc bulge at C4/5, bulging and desiccation at C5/6, and desiccation at C6/7. The medical panel gave claimant a 3% related whole person permanent partial impairment rating.
Attorney(s) - Plaintiff --Michael Gary Belnap, Ogden
Attorney(s) - Defense --Stuart F. Weed of Kirton & McConkie
Expert Witness(es) --By stipulation of the parties, a hearing was waived and the matter was referred directly to a medical panel consisting of Edward Holmes, MD, MPH.
Facts/Contentions --Claimant was injured while walking around a cherry-shaker machine when he struck his head on the machine. Claimant's head was jerked backward.
Employer/carrier admitted that the accident occurred and accepted liability, but the parties could not agree on the degree of claimant's permanent impairment.
The medical panel found that claimant stabilized medically thirteen and a half months after he was injured, but that caring for his three young children was aggravating his industrial injury. The panel found that claimant does not need further chiropractic care for his industrial injury, and has not needed such care since twenty-three months after his accident. Claimant does not need further surgery or aggressive injection techniques to treat his industrial injury; the panel found his continuing problems are degenerative. The panel found, however, that occasional physical therapy and anti-inflammatory medication may be reasonable to treat pain from claimant's industrial injury.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Trent Orth vs. Anderson Lumber and Lumbermen's Mutual Casualty Company
Case Number --2000845
Court/Judge --Eblen
Verdict/Settlement --Order, 4/02
Amount --The ALJ accepted the medical panel's report and ordered employer/carrier to pay claimant accrued permanent partial disability benefits for his 24% upper extremity impairment; these benefits total $8,257.92 and are to be paid in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney.
Injuries --Claimant suffered a crush injury of the right hand. The medical panel gave claimant a 24% related upper extremity impairment rating.
Attorney(s) - Plaintiff --Sandra N. Dredge of Dredge Lallatin, Provo
Attorney(s) - Defense --Theodore E. Kanell of Plant, Wallace, Christensen & Kanell
Expert Witness(es) --By stipulation of the parties, this matter was referred directly to a medical panel.
Facts/Contentions --Claimant was driving a forklift around a corner while at work when the forklift slipped in the sand and tipped over, crushing claimant's right hand between the forklift and the ground.
Employer/carrier admitted that the accident occurred and accepted liability, but disputed the degree of impairment to the hand.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Thomas A. Rodgers vs. All Resort Express; Workers' Compensation Fund; and Employers' Reinsurance Fund
Case Number --991076
Court/Judge --This order was issued by Labor Commissioner R. Lee Ellertson.
Verdict/Settlement --Order on review, 4/02
Amount --The Commissioner found the conflict of interest did not apply to the ALJ, since she never represented the ERF as claimant stated she did. The Commissioner further stated that under Utah law, the fact that the Labor Commissioner has authority over the ERF and the ALJs of the Commission does not, standing alone, constitute grounds for a claim of conflict of interest--especially since claimant had the option of referring his request for review to the Appeals Board if he had concerns about the impartiality of Commissioner. The Commissioner reviewed case materials and found the ALJ fairly and fully set forth the findings from the hearing; the Commissioner further upheld the ALJ's determination that the earlier settlement was not voidable on grounds of duress or lack of an actual dispute. The Commissioner declined to comment or rule on the ALJ's dismissal, per the ERF's motion, of claimant's request for additional medical expenses; the Commissioner remanded this issue to the ALJ for such further proceedings as may be necessary to resolve the ERF's motion to dismiss the medical claim.
Attorney(s) - Plaintiff --Bruce Wilson, Orem
Attorney(s) - Defense --For employer/carrier: Floyd Holm; for ERF: Sheryl Hayashi
Facts/Contentions --Claimant was injured in a work-related accident, and he and his employer reached several settlement agreements. Claimant sought to set aside the last of these, a full and final settlement agreement, and ALJ Eblen ruled against him. Claimant applied for review by the Commissioner, who remanded the matter to the ALJ for further determination and application of the law that was in effect at the time of the settlement. The ALJ applied the law in effect at the time the settlement was reached, and claimant again applied for review by the Commissioner, contending that the ALJ and the Commissioner both should have been prevented by conflict of interest from ruling on his case. Claimant also argued that the ALJ did not fully and fairly set forth all the facts of his case; he claimed the settlement should be voidable on grounds of duress or lack of an actual dispute. Claimant's request for further medical benefits was denied without comment by the ALJ pursuant to a motion by the ERF.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury
Case Name --Gudrun Johnson vs. First Healthcare Corporation and CIGNA Property & Casualty Companies
Case Number --9950
Court/Judge --Eblen
Verdict/Settlement --Order, 4/02
Amount --The ALJ confirmed the tentative finding of permanent and total disability and ordered employer/carrier to pay claimant accrued permanent total disability benefits of $37,960 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant $365 in permanent total disability benefits for the period running from 11/29/01 through 10/06/03. Attorney's fees are to be deducted from these payments and paid directly to claimant's attorney up to $9,100, the maximum allowable by law, and employer/carrier has the right as of 10/7/03 to reduce benefits by 50% of claimant's Social Security retirement benefits, if any. Payment of benefits by employer/carrier at the new rate will continue from 10/7/03 for claimant's lifetime. Employer/carrier must also pay all claimant's related medical expenses.
Injuries --Claimant suffered upper extremity problems and underwent six surgeries; claimant had been given a 22% related whole person permanent partial impairment rating.
Attorney(s) - Plaintiff --Virginius C. Dabney of Dabney & Dabney, St. George
Attorney(s) - Defense --Michael E. Dyer of Blackburn & Stoll
Facts/Contentions --After claimant was tentatively found to be permanently and totally disabled, the ALJ gave employer/carrier the opportunity to submit a retraining and re-employment plan. The ALJ issued this order after no plan was submitted, when claimant told the ALJ First Healthcare had not paid her any benefits since the tentative finding was issued.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Keith R. Larsen vs. Garrett Freightlines and/or Truck Insurance Exchange; and Employers' Reinsurance Fund
Case Number --2001525
Court/Judge --Poelman
Verdict/Settlement --Order, 4/02
Amount --Because Utah law states clearly that acupuncturists, massage therapists and neuropathic providers may provide care only after such care has been pre-authorized by the payor, and because claimant admitted that he did not obtain such pre-authorization, the ALJ dismissed this claim with prejudice.
Injuries --Claimant suffered a back injury.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --For Employer/carrier: Carrie T. Taylor of Richards, Brandt, Miller & Nelson; for ERF: Sheryl Hayashi
Expert Witness(es) - Defense --Scott Knorpp, MD
Damages --The disputed bill was for $1,921.94.
Facts/Contentions --Claimant was injured at work, and his employer accepted liability and paid benefits, including medical expenses. The parties stipulated that the only matter at issue between them was a bill from an acupuncturist and herbal medicine specialist. Employer/carrier contended that claimant sought this treatment without pre-authorization, and claimant admitted that such was the case. However, claimant contended that the disputed treatment dramatically reduced his pain, enabling him to dispense with further pain medication or medical treatment.
Dr. Knorpp conducted a review of claimant's history and submitted a detailed analysis, in which he stated that there was no medical evidence supporting claimant's argument.
WORK INJURIES
Case Type --WA; Work-related injuries
Case Name --Ernest Bentley vs. Pacificorp dba Utah Power and/or Wasatch Crest Mutual Insurance Company
Case Number --2000459
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 4/02
Amount --The ALJ found that claimant's activities which led to his re-injury did not meet the Allen test (see employer's argument below) and dismissed this claim with prejudice.
Injuries --Claimant suffered low back injuries and was diagnosed with widespread spondylosis deformans and degenerative disc changes, including a Grade I spondylolisthesis at L3/4 and disc protrusions at L4/5 and L5/S1. A year after his re-injury while mopping, claimant underwent extensive surgery, including a laminectomy with decompression at L4/5 and L5/S1 and foraminotomies and partial facetectomies; a posterior lumbar interbody fusion at L4/5 and L5/S1 with autologous bone graft and tangent bone cages; a posterior spinal fusion of autologous bone mixed with AGF at L4/5; and posterior segmental instrumentation at L4-S1 with Sofamer Danek CDH instrumentation.
Attorney(s) - Plaintiff --Arthur F. Sandack
Attorney(s) - Defense --Brad C. Betebenner of Richards, Brandt, Miller & Nelson
Expert Witness(es) - Plaintiff --Dr. Darel Brodke
Facts/Contentions --Claimant worked for employer as a painter and sandblaster for over 20 years, until he retired in 2000. He admitted that he had pre-existing back problems which caused him pain; he stated that he was first injured at work in 1995, when a sander he was operating struck a piece of rebar embedded in the floor and whipped around, wrenching his back. He did not claim any permanent impairment from this injury, and the medical record did not support any finding of such impairment, according to the ALJ. Claimant stated that he was injured again in February of 2000 while mopping floors in the men's room.
Employer/carrier contended that claimant's actions in mopping the restroom did not meet the Allen test for extraordinary exertion, as Utah law requires in cases where pre-existing injury is present.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Maria Gil vs. Campfire Incorporated and/or Workers' Compensation Fund
Case Number --981030
Court/Judge --George
Verdict/Settlement --Order, 4/02
Amount --The ALJ found that based on the fact that Campfire failed to comply with its own safety program, thereby failing to maintain a safe workplace, claimant is entitled to a penalty of 15% of all benefits paid to her in connection with her injury, plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney.
Injuries --Claimant suffered a laceration injury to her hand.
Attorney(s) - Plaintiff --Ryan C. Shaw
Attorney(s) - Defense --Lori Hansen
Damages --Employer/carrier paid claimant $1,986.86 in temporary total disability compensation and $1,141.92 in permanent partial disability compensation, as well as all or her related medical expenses.
Facts/Contentions --Claimant was injured when she attempted to clean a marshmallow machine while it was running. Her employer accepted liability and paid benefits, but claimant contended that she was entitled to an additional 15% penalty as a result of Campfire's failure to maintain a safe working environment.
Claimant stated that her supervisors encouraged workers to clean the machine while it was running because the company's overall process depended on continuous 24-hour operation, and the machine had a long re-heat time which would have resulted in a considerable delay if it had been shut down. Claimant stated that the company had a policy whereby the machines were to be locked out and tagged out for cleaning, but she added that the company did not observe this policy.
Employer stated that it was proud of its safety record, but admitted when questioned that two accidents occurred with machines in operation after the lockout/tag-out policy was instituted, and after the second one the company was cited and fined $700 by UOSH. Records showed claimant received lockout/tag-out safety training four months after her accident.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Thomas A. Rodgers vs. All Resort Express; Workers' Compensation Fund; and Employers' Reinsurance Fund
Case Number --991076
Court/Judge --This order was issued by Labor Commissioner R. Lee Ellertson.
Verdict/Settlement --Order on review, 4/02
Amount --The Commissioner found the ALJ did not suffer a conflict of interest, since she never represented the ERF as claimant stated she did. The Commissioner further stated that under Utah law, the fact that the Labor Commissioner has authority over the ERF and the ALJs of the Commission does not, standing alone, constitute grounds for a claim of conflict of interest--especially since claimant had the option of referring his request for review to the Appeals Board if he had concerns about the impartiality of Commissioner. The Commissioner reviewed case materials and found the ALJ fairly and fully set forth the findings from the hearing; the Commissioner further upheld the ALJ's determination that the earlier settlement was not voidable on grounds of duress or lack of an actual dispute. The Commissioner declined to comment or rule on the ALJ's dismissal, per the ERF's motion, of claimant's request for additional medical expenses; the Commissioner remanded this issue to the ALJ for such further proceedings as may be necessary to resolve the ERF's motion to dismiss the medical claim.
Attorney(s) - Plaintiff --Bruce Wilson, Orem
Attorney(s) - Defense --For employer/carrier: Floyd Holm; for ERF: Sheryl Hayashi
Facts/Contentions --Claimant was injured in a work-related accident, and he and his employer reached several settlement agreements. Claimant sought to set aside the last of these, a full and final settlement agreement, and ALJ Eblen ruled against him. Claimant applied for review by the Commissioner, who remanded the matter to the ALJ for further determination and application of the law that was in effect at the time of the settlement. The ALJ applied the law in effect at the time the settlement was reached, and claimant again applied for review by the Commissioner, contending that the ALJ and the Commissioner both should have been prevented by conflict of interest from ruling on his case. Claimant also argued that the ALJ did not fully and fairly set forth all the facts of his case; he claimed the settlement should be voidable on grounds of duress or lack of an actual dispute. Claimant's request for further medical benefits was denied without comment by the ALJ pursuant to a motion by the ERF.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury
Case Name --Gudrun Johnson vs. First Healthcare Corporation and CIGNA Property & Casualty Companies
Case Number --9950
Court/Judge --Eblen
Verdict/Settlement --Order, 4/02
Amount --The ALJ confirmed the tentative finding of permanent and total disability and ordered employer/carrier to pay claimant accrued permanent total disability benefits of $37,960 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant $365 per week in permanent total disability benefits for the period running from 11/29/01 through 10/06/03. Attorney's fees are to be deducted from these payments and paid directly to claimant's attorney up to $9,100, the maximum allowable by law, and employer/carrier has the right as of 10/7/03 to reduce benefits by 50% of claimant's Social Security retirement benefits, if any. Payment of benefits by employer/carrier at the new rate will continue from 10/7/03 for claimant's lifetime. Employer/carrier must also pay all claimant's related medical expenses.
Injuries --Claimant suffered upper extremity problems and underwent six surgeries; claimant had been given a 22% related whole person permanent partial impairment rating.
Attorney(s) - Plaintiff --Virginius C. Dabney of Dabney & Dabney, St. George
Attorney(s) - Defense --Michael E. Dyer of Blackburn & Stoll
Facts/Contentions --After claimant was tentatively found to be permanently and totally disabled, the ALJ gave employer/carrier the opportunity to submit a retraining and re-employment plan. The ALJ issued this order after no plan was submitted, when claimant told the ALJ First Healthcare had not paid her any benefits since the tentative finding was issued.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Keith R. Larsen vs. Garrett Freightlines and/or Truck Insurance Exchange; and Employers' Reinsurance Fund
Case Number --2001525
Court/Judge --Poelman
Verdict/Settlement --Order, 4/02
Amount --Because Utah law states clearly that acupuncturists, massage therapists and neuropathic providers may provide care only after such care has been pre-authorized by the payor, and because claimant admitted that he did not obtain such pre-authorization, the ALJ dismissed this claim with prejudice.
Injuries --Claimant suffered a back injury.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --For employer/carrier: Carrie T. Taylor of Richards, Brandt, Miller & Nelson; for ERF: Sheryl Hayashi
Expert Witness(es) - Defense --Scott Knorpp, MD
Damages --The disputed bill was for $1,921.94.
Facts/Contentions --Claimant was injured at work, and his employer accepted liability and paid benefits, including medical expenses. The parties stipulated that the only matter at issue between them was a bill from an acupuncturist and herbal medicine specialist. Employer/carrier contended that claimant sought this treatment without pre-authorization, and claimant admitted that such was the case. However, claimant contended that the disputed treatment dramatically reduced his pain, enabling him to dispense with further pain medication or continued conventional medical treatment.
Dr. Knorpp conducted a review of claimant's history and submitted a detailed analysis, in which he stated that there was no medical evidence supporting claimant's argument.
WORK INJURIES
Case Type --WA; Work-related injuries
Case Name --Ernest Bentley vs. Pacificorp dba Utah Power and/or Wasatch Crest Mutual Insurance Company
Case Number --2000459
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 4/02
Amount --The ALJ found that claimant's work activities which led to his re-injury did not meet the Allen test (see employer's argument below) and dismissed this claim with prejudice.
Injuries --Claimant suffered low back injuries and was diagnosed with widespread spondylosis deformans and degenerative disc changes, including a Grade I spondylolisthesis at L3/4 and disc protrusions at L4/5 and L5/S1. A year after his re-injury while mopping, claimant underwent extensive surgery, including a laminectomy with decompression at L4/5 and L5/S1 and foraminotomies and partial facetectomies; a posterior lumbar interbody fusion at L4/5 and L5/S1 with autologous bone graft and tangent bone cages; a posterior spinal fusion of autologous bone mixed with AGF at L4/5; and posterior segmental instrumentation at L4-S1 with Sofamer Danek CDH instrumentation.
Attorney(s) - Plaintiff --Arthur F. Sandack
Attorney(s) - Defense --Brad C. Betebenner of Richards, Brandt, Miller & Nelson
Expert Witness(es) - Plaintiff --Dr. Darel Brodke
Facts/Contentions --Claimant worked for employer as a painter and sandblaster for over 20 years, until he retired in 2000. He admitted that he had pre-existing back problems which caused him pain; he stated that he was first injured at work in 1995, when a sander he was operating struck a piece of rebar embedded in the floor and whipped around, wrenching his back. He did not claim any permanent impairment from this injury, and the medical record did not support any finding of such impairment, according to the ALJ. Claimant stated that he was injured again in February of 2000 while mopping floors in the men's room.
Employer/carrier contended that claimant's actions in mopping the restroom did not meet the Allen test for extraordinary exertion, as Utah law requires in cases where pre-existing injury is present.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Maria Gil vs. Campfire Incorporated and/or Workers' Compensation Fund
Case Number --981030
Court/Judge --George
Verdict/Settlement --Order, 4/02
Amount --The ALJ found that based on the fact that Campfire failed to comply with its own safety program, thereby neglecting to maintain a safe workplace, claimant is entitled to a penalty of 15% of all benefits paid to her in connection with her injury, plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney.
Injuries --Claimant suffered a laceration injury to her hand.
Attorney(s) - Plaintiff --Ryan C. Shaw
Attorney(s) - Defense --Lori Hansen
Damages --Employer/carrier paid claimant $1,986.86 in temporary total disability compensation and $1,141.92 in permanent partial disability compensation, as well as all or her related medical expenses.
Facts/Contentions --Claimant was injured when she attempted to clean a marshmallow machine while it was running. Her employer accepted liability and paid benefits, but claimant contended that she was entitled to an additional 15% penalty as a result of Campfire's failure to maintain a safe working environment.
Claimant stated that her supervisors encouraged workers to clean the machine while it was running because the company's overall process depended on continuous 24-hour operation, and the machine had a long re-heat time which would have resulted in a considerable delay if it had been shut down. Claimant stated that the company had a policy whereby the machines were to be locked out and tagged out for cleaning, but she added that the company did not observe this policy.
Employer stated that it was proud of its safety record, but admitted when questioned that two accidents occurred with machines in operation after the lockout/tag-out policy was instituted, and after the second one the company was cited and fined $700 by UOSH. Records showed claimant received lockout/tag-out safety training four months after her accident.
WORK INJURIES
Case Type --WA, SF; Work-related injury, work-related fall
Case Name --Sidney Goddard vs. Price Framing & Concrete and/or Workers' Compensation Fund; and Beaver Dam Lodge and/or Workers' Compensation Fund
Case Number --2000682, 2000683
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 4/02
Amount --The ALJ found the first accident met the Allen test, since the trailer had three axles and was obviously heavier than normal. However, since claimant only missed two days of work, the ALJ found Beaver Dam Lodge did not owe claimant any temporary total compensation (these benefits are triggered after an injured worker misses three days of work).
The ALJ found the evidence indicated that Price offered claimant light duty work after claimant left the hospital, but claimant failed to accept it; however, because claimant was not yet medically stable, the ALJ found Price owes him temporary total compensation until he reaches maximum medical improvement. No evidence ever indicated that claimant had reached medical stability. Dr. Melling recommended epidural steroid injections to treat claimant's low back pain, and the ALJ found these injections were reasonably medically necessary given the nature of his industrial injury.
The ALJ ordered Beaver Dam Lodge to pay all claimant's medical expenses related to the first accident and Price to pay all medical expenses related to the second accident, including the cost of the recommended epidural injections. Price must also pay claimant accrued temporary total disability compensation from 4/16/01 and must continue such payments at the rate of $263 per week until claimant reaches medical stability. Accrued amounts are due and payable in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney; further attorney's fees are to be deducted from ongoing temporary total disability payments and paid directly to claimant's attorney.
Injuries --The ALJ found claimant suffered traumatized muscles, ligaments and nerves in his paraspinal area in the first accident. In the second accident, he suffered a broken ring finger on his right hand, a sprained left ankle, and a stretched nerve in his lumbar back.
Attorney(s) - Plaintiff --Aaron J. Prisbrey, St. George
Attorney(s) - Defense --For Price/WCF: Barbara W. Sharp; for Beaver Dam/WCF: Elliot K. Morris
Expert Witness(es) - Plaintiff --Dr. Mitch Melling; Dr. Randy Delcore; Dr. Ronald Thorpe; Dr. Roger Smith
Expert Witness(es) - Defense --Dr. Bruce McIff; Dr. Howard Reichman
Facts/Contentions --Claimant stated he first injured his back while attempting to hook a backhoe trailer onto the ball hitch of his pick-up truck. He jacked the three-axle trailer to within half an inch of the ball hitch, and as he lifted it the last half-inch onto the ball hitch, he experienced pain in his low back and tingling in his leg. He reported the incident to his employer, Beaver Dam Lodge, immediately.
Claimant was injured the second time when he fell ten feet to the ground while roofing a garage for Price. Claimant slipped on some roofing material and landed on his feet, rolling from there to the ground. Claimant worked the rest of the day after he fell because he said he did not feel he was seriously injured, but later sought medical care for continuing pain and was hospitalized. After leaving the hospital, claimant was released to light duty work with restrictions of no bending and no lifting over ten pounds.
Beaver Dam Lodge pointed out that claimant had a history of pre-existing back problems and disputed whether his actions leading up to the accident on their premises met the Allen test for exertions beyond those encountered in everyday life, as is required by Utah law in cases where pre-existing injury is present. Price argued that claimant did not return to light duty work after he was hospitalized, although such work was available. Claimant stated that Price told him he had no more light duty work available. Claimant did not return to work anywhere after he was released from the hospital.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --David M. Libby vs. Magna Garfield Trucklines and/or Fire & Casualty Insurance
Case Number --200179
Court/Judge --Poelman
Verdict/Settlement --Order, 4/02
Amount --The ALJ found the MRI and the epidural injections were reasonably necessary to treat claimant's industrial injury and ordered employer/carrier to pay these expenses. The ALJ noted that the chain of medical causation between the accident and claimant's need for additional treatment was not broken by the fact that he has experienced temporary episodes of increased pain due to his various non-industrial activities. The ALJ also ordered employer/carrier to pay add-on attorney's fees directly to claimant's attorney.
Injuries --Claimant suffered a low back injury and underwent a laminectomy/foraminotomy/medial facetectomy at L5/S1 bilaterally with a fusion at the same level. The surgery was not completed at the L4/5 level because of an anomalous nerve root configuration. Claimant has a 31% permanent whole person partial impairment, with 20% of that impairment due to his industrial accident.
Attorney(s) - Plaintiff --Michael E. Dyer of Blackburn & Stoll
Attorney(s) - Defense --Carrie T. Taylor of Richards, Brandt, Miller & Nelson
Expert Witness(es) - Plaintiff --Dr. Joel T. Dall
Expert Witness(es) - Defense --Dr. Richard Knoebel--medical record review
Facts/Contentions --Claimant had not incurred any medical expenses due to this industrial accident for 10 years when he sought these benefits for a recommended MRI and epidural steroid injections. Employer/carrier contended that in the interim claimant re-injured his back several times, but claimant argued that after these incidents, which included sleeping on the ground while camping, moving household goods, changing a tire on his car and the like, he returned to his prior baseline pain level within a few days. The MRI costs between $800 and $900, and the cost of the epidural injections is approximately $1,000. Dr. Fogg's records indicated that the earlier surgery left claimant with fragmented facets and associated scarring of the nerve root. Dr. Fogg's records also indicated that claimant may need additional surgery at some time in the future. Dr. Dall was concerned about possible new disc herniation and epidural scarring, indicating also that the prior surgery undoubtedly plays a role in claimant's current degree of spinal degeneration.
The ALJ noted that Dr. Knoebel did not address the specific question of whether the recommended treatment at issue was causally connected to claimant's industrial injury and if so, to what degree. Dr. Knoebel concluded only that any further impairment should be carefully considered for apportionment between industrial and non-industrial causes.
FALL
Case Type --WA, SF; Work-related fall
Case Name --Robert Lucas Jr. vs. Hoyle Construction, Incorporated and/or Workers' Compensation Fund
Case Number --9864
Court/Judge --Poelman
Verdict/Settlement --Order, 4/02
Amount --The ALJ ordered employer/carrier to pay claimant's related medical expenses from his industrial injury, as well as any temporary total disability compensation due if he was off work for any period of time over three days. Employer/carrier must also pay claimant for his 3% related whole person impairment. Attorney's fees are to be deducted from these awards and paid directly to claimant's attorney.
Injuries --The medical panel found claimant's industrial accident aggravated a pre-existing back condition and left him with an additional 3% related whole person impairment.
Attorney(s) - Plaintiff --K. Dawn Atkin of Atkin & Associates
Attorney(s) - Defense --Elliot K. Morris
Expert Witness(es) - Plaintiff --The parties waived a formal hearing and stipulated that this matter be referred directly to a medical panel
Facts/Contentions --Claimant tripped and fell while at work and sought medical expenses, temporary total disability benefits, and permanent partial impairment benefits.
Employer/carrier argued that claimant had a pre-existing back condition and did not suffer any further permanent impairment as a result of his industrial injury.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Clifton Van Valkenburg vs. FMH Material Handling Solutions and/or AIG
Case Number --2001150
Court/Judge --Poelman
Verdict/Settlement --Order, 4/02
Amount --The ALJ determined that under Utah law, claimant is entitled to compensation for a 12% industrial whole person impairment, due and payable in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney.
Injuries --Claimant was blinded in his right eye and underwent a surgical intra-ocular lens implant which restored his vision.
Attorney(s) - Plaintiff --Timothy C. Allen
Attorney(s) - Defense --Ramona E. Garcia of Richards, Brandt, Miller & Nelson
Expert Witness(es) - Plaintiff --Dr. Herbert J. Ungricht
Expert Witness(es) - Defense --Dr. N. Branson Call
Facts/Contentions --Claimant was totally blind in his right eye for some time after his industrial accident, but regained his vision after the surgery and now has a 12% impairment without glasses and no impairment with glasses. He and his employer disputed the amount of permanent partial impairment compensation to which he was entitled, given that the blindness was only temporary.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Salih Bajrovic vs. Sky Chefs, Incorporated and/or Kemper Insurance Company
Case Number --200150
Court/Judge --Poelman
Verdict/Settlement --Order, 4/02
Amount --The ALJ found claimant's account credible and ordered employer/carrier to pay his related medical expenses. Employer/carrier must also pay claimant $869.15 in temporary total disability benefits for the time he was off work following his industrial injury. These benefits are due and payable in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney.
Injuries --Claimant suffered a pulled groin muscle.
Attorney(s) - Plaintiff --Timothy C. Allen
Attorney(s) - Defense --Theodore E. Kanell of Plant, Wallace, Christensen & Kanell
Facts/Contentions --Claimant, who worked as a porter, stated that he was lifting boxes of alcoholic beverages from a cart to neck level in order to stack them elsewhere. Claimant stated that the cart moved forward while he was lifting a heavy box, and claimant experienced a sharp pain in the groin. He said he reported the injury to his supervisor but was told to continue working. He felt nauseated, went to the restroom and vomited, and was given an aspirin, but the pain continued to get worse, and eventually his supervisor gave him permission to leave work. Claimant said he vomited again in the car on the way home and ran off the side of the road, striking a stationary object. After going home, claimant said he went to a hospital emergency room with his son, who acted as his interpreter. He was released from the ER with instructions not to work for two days and to avoid heavy lifting thereafter at work, but he said when he returned to work, he was required to continue with his normal work assignments. He sought further treatment at WorkMed four days later and was told again not to do any lifting at work. Eight days after that, he took off work and did not return until three weeks later. Claimant testified at this hearing with the help of a translator.
Employer/carrier contended that claimant failed to report the industrial accident as he was trained to do. Employer/carrier also contended that claimant did not suffer a hernia and therefore would not have experienced the nausea he reported; his report of injury, employer/carrier argued, was merely subjective.
Claimant denied that he was ever given specific training in how to report an industrial injury. Claimant produced witness statements indicating that he reported the accident and stated that it occurred while claimant was at work. The ALJ found no evidence indicating the nausea claimant reported would be inconsistent with the musculoskeletal strain which claimant's medical records indicated he suffered.
FALL, WORK INJURY
Case Type --WA, SF; Work-related injury, slip/fall
Case Name --Bernard Kenneth Chatwin vs. Utah Transit Authority
Case Number --2000399, 2000400
Court/Judge --Hann
Verdict/Settlement --Order, 5/02
Amount --The ALJ found the evidence proved that claimant's ongoing problems resulted from his 1983 injury. The ALJ noted that the version of Utah Code Annotated in force in 1983, when claimant suffered the industrial injury that caused his continuing back problems, allowed an award of permanent partial disability to be made any time up to 8 years after the date of injury if the injury was not "finally healed and fixed" within that time; there was no statute of limitations on medical expenses related to a prior injury. The ALJ noted that the Allen case law standard, which requires that the exertions leading up to the injury must be beyond those a claimant would encounter in everyday life in order to qualify the injured worker for benefits, does not apply in cases where a pre-existing condition is caused by prior work-related injuries incurred in the same workplace. The ALJ therefore ordered self-insured employer to pay claimant's medical expenses for the 1983 surgery, as well as all related future medical expenses. Employer must also pay claimant accrued permanent partial impairment benefits for his 5% related whole person impairment from the 1998 surgery in the amount of $3,120, plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney.
Injuries --Claimant underwent surgical excision of a disc at L5/S1 in 1984, and was paid benefits for a work-related injury. His post-operative diagnosis was an extruded disc at L5/S1. Dr. Maschero diagnosed an unlevel pelvis with the left side higher, rotation of the right hip bone anteriorly, subluxations and reduced space between L5/S1 and mild degenerative changes of the lumbar spine with osteophytosis marginalis. Dr. Harrison found no fracture, thinning of the disc at L5 and right lateral bending of the lumbar spine, and an acute sacroiliac sprain associated with muscle splinting, complicated by L5 discogenic disease. He recommended 12 chiropractic treatments and a lumbar support to stabilize claimant's lower back. Dr. Henry found a disc protrusion at L4/5 with narrowing and desiccation, along with post-operative changes at L5/S1 and moderate epidural fibrosis surrounding the nerve root at S1. Dr. Fotheringham found claimant's continued problems to be an aggravation/degeneration of the area where claimant was previously injured. Dr. Macfarlane recommended a lumbar discectomy, but Dr. Fotheringham felt claimant was a good candidate for surgical fusion. By 1998, Dr. Warner found a nearly complete disc space collapse at L5/S1 and a large disc herniation at L4/5, which he felt was all connected to the original industrial injury. He performed a left L4/5 hemilaminotomy and L4/5 discectomy. Dr. Fotheringham gave claimant a 10% related whole person impairment rating in 1999, with an additional 5% related whole person impairment for the 1998 surgery.
Attorney(s) - Plaintiff --Bret A. Gardner of Crowther & Gardner
Attorney(s) - Defense --Theodore E. Kanell of Plant, Wallace, Christensen & Kanell
Expert Witness(es) - Plaintiff --Dr. Trent C. Harrison; Dr. Henry; Dr. John Macfarlane; Dr. Stephen J. Warner
Expert Witness(es) - Defense --Dr. Giovanni Maschero, Dr. Brent Fotheringham, Dr. Charles Rich--independent medical examinations
Facts/Contentions --Claimant worked as a mechanic repairing buses. He stated he was first injured in 1978 when he slipped and fell backwards while pulling a "dozer" out from under a bus. He struck a shelf with his back when he fell. He re-injured his back in 1983 while carrying wheelchair panels to a paint shop. At this hearing, the parties asked that the claim related to the 1978 injury be dismissed, since that injury had resolved without further symptoms; the parties also asked that the claim for the 1983 injury be amended to add a 1991 exacerbation, when claimant dropped a piece of aluminum he was carrying, bent over to pick it up, and felt excruciating pain in his lower back. He reported both injuries to his employer immediately.
As his condition continued to worsen over the years he worked for UTA, claimant underwent facet joint injections and physical therapy and consulted with several doctors, submitting the bills to his private health insurance; claimant stated he was not aware that he had been given a permanent impairment rating or that his continued back pain resulted from the surgery, which would be considered industrial.
When claimant found out about his permanent impairment ratings and presented them to UTA for payment, UTA offered to cover the costs of the 1998 surgery and any necessary future surgeries if claimant would agree that these payments constituted a full and final settlement, but UTA refused to pay any other benefits, claiming that the statute of limitations had expired and the case was closed. Claimant agreed that he did not submit any claims between the 1991 injury and the 1998 surgery, but stated that this was because he was not aware that his continuing problems were industrial. He said he submitted his claim to UTA as soon as he learned of his permanent industrial impairment rating.
WORK INJURIES
Case Type --WA; Work-related injuries
Case Name --Ursula Cruz vs. 7-11/Southland Corporation and/or American Motorists Insurance and/or American Protection Insurance (Kemper) and McLane Foods and/or Liberty Mutual Insurance Company and/or National Union Fire Insurance and/or American Home Assurance Company
Case Number --2000898, 2000899, 2000900, 2000901, 2000902, 2000903
Court/Judge --Eblen
Verdict/Settlement --Order, 5/02
Amount --The ALJ noted that the Allen case law standard, which requires that the exertions leading up to the injury must be beyond those a claimant would encounter in everyday life in order to qualify the injured worker for benefits, does not apply in cases where a pre-existing condition is caused by prior work-related injuries incurred in the same workplace. The ALJ found the medical record proved an industrial causal connection between claimant's first four back injuries, but not between those injuries and her current inability to work, since there was no record of treatment for an industrial injury when claimant reported a flare-up of her back pain in 1999. Prior to that incident, the last treatment claimant received for her industrial back injuries was in 1995, and no medical bills were submitted in the interim; the version of Utah Code Annotated in force at that time states that if no medical bills are submitted for an industrial injury over a period of three years, the employer's liability for that injury ceases. The ALJ therefore dismissed this claim for permanent total disability benefits with prejudice.
Injuries --Claimant suffered tendinitis, a finger injury, and multiple back injuries; she sought benefits for permanent and total disability.
Attorney(s) - Plaintiff --Bret A. Gardner of Crowther & Gardner
Attorney(s) - Defense --For 7-11: Theodore E. Kanell of Plant, Wallace, Christensen & Kanell; for McLane/National Union: Mark Sumsion; for Employers' Reinsurance Fund: Sherrie Hayashi; Liberty Mutual failed to file an answer or appear at the hearing.
Expert Witness(es) - Plaintiff --Dr. Bova
Expert Witness(es) - Defense --Dr. Moress
Facts/Contentions --Claimant worked at McLane's burrito factory, which was subsequently sold to 7-11. She suffered tendinitis in her hand while working in the slicing room, received therapy and returned to work. She next injured her low back while helping to change over the assembly line for the manufacture of tacos, when she lifted a box and turned to hand it to her supervisor. She re-injured her back when she lifted a tray of burritos weighing 25 to 35 pounds and turned to place it on a shelf. She received a 5% related whole person impairment rating after this incident. She returned to the same job and experienced renewed pain when she turned while moving burritos from the conveyor belt into the freezer. She re-injured her back again while lifting and opening 20-pound boxes of cheese on the assembly line. She underwent two MRIs; the first revealed degenerative disc disease, but the second showed a broad-based central disc herniation indenting the thecal sac at L3/4 as well. Claimant next injured her left middle finger at work, and two years later, she dropped burrito wrapping film on her knee and fell. When she experienced continuing back pain, she underwent a third MRI, which showed no herniation, bulge or protrusion, but did show desiccation at all levels. However, Dr. Bova read this same scan to show a small central protrusion at L4/5 and a small bulge at L5/S1. She underwent a rhizotomy with percutaneous stimulated ligamentous repair injection. Dr. Bova gave her a 10% related whole person impairment rating at this point. Dr. Moress gave claimant a 5% whole person impairment rating, but felt none of it was industrial.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Donovan T. Leach vs. Ready Made Trusses and/or Workers' Compensation Fund
Case Number --20001188
Court/Judge --Hann
Verdict/Settlement --Order, 5/02
Amount --Though the evidence indicated that the foreman made the maintenance man aware of a problem with the saw, the ALJ found the evidence presented was not sufficient to prove the employer acted willfully in failing to repair it ar attempted to bypass any safety equipment. The ALJ therefore dismissed the penalty claim with prejudice. However, the ALJ ordered employer/carrier to pay for the evaluation of claimant by Dr. States, though she ruled that his impairment rating was not admissible because Dr. States used the 5th Edition rather than the 4th Edition of the AMA guidelines. Should claimant obtain an admissible impairment rating, he is free to submit it for review.
Injuries --Claimant suffered a laceration of the right hand and received a 3% related whole person impairment rating, for which he received payment from employer/carrier. Dr. States gave claimant an 8% related whole person impairment rating.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Hans M. Scheffler
Expert Witness(es) - Plaintiff --Dr. Dan Hammond; Dr. Jeffrey States
Damages --Claimant sought a 15% penalty because he claimed employer failed to maintain a safe workplace.
Facts/Contentions --Claimant was running 16-foot 2 x 4s through the cord saw when wood began to pile up on the conveyor belt. Claimant pushed the stop button on the saw, picked up the safety cage, and was picking up the wood which was stacked up there when the wood pulled his hand into the free-spinning blade and lacerated his thumb and one finger. Claimant had only been working on this saw for a couple of days, and had previously been working on a saw which would stop immediately in such a situation. After the accident, the business owner had a mechanic examine the saw, and it was determined that an O-ring in the air cylinder of the brake had failed, causing the brake to be ineffective at stopping the free-spinning blade. The brake was repaired immediately.
Ready Made safety policy requires workers using saws to be responsible for the upkeep of their equipment. They do not have to make repairs themselves, but must notify the shop foreman in writing of any problems with the equipment. The maintenance man for the plant acknowledged the existence of the written report rule, but stated that he often waived it if workers reported equipment problems to him promptly. The foreman stated he notified the maintenance man of a problem with the saw.
ORDER ON REVIEW
Case Type --OD; Occupational disease claim
Case Name --Dwaine M. Johnson vs. USX/Geneva Steel and Employers' Reinsurance Fund
Case Number --990187
Court/Judge --This order was issued by Labor Commissioner R. Lee Ellertson.
Verdict/Settlement --Order on review, 5/02
Amount --The Commissioner adopted the medical panel's finding that claimant does not suffer from work-related disability; the Commissioner therefore set aside the ALJ's award of permanent total disability benefits.
Injuries --Claimant suffers from chronic obstructive pulmonary disease (COPD) and congestive heart failure.
Attorney(s) - Plaintiff --Philip B. Shell of Day, Shell & Liljenquist
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll; for ERF: Edwin Barnes of Clyde, Snow, Sessions & Swenson and Sherrie Hayashi
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel.
Facts/Contentions --Claimant contended that his COPD was caused by asbestosis, and the ALJ issued a tentative finding of permanent total disability pending completion of his rehabilitation/re-employment evaluation. Employer/carrier argued that claimant did not suffer from asbestosis, as his lungs did not show fibrosis. The medical panel determined that though claimant did exhibit asbestos-related neural plaques, he did not suffer from asbestosis. The ALJ found the panel's report contradictory, but when employer/carrier asked the Commissioner to review the panel's findings, he determined that the report was not contradictory.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Rita Wemberly vs. SOS Staffing
Case Number --2000929
Court/Judge --Hann
Verdict/Settlement --Order, 5/02
Amount --The ALJ found claimant's earlier episode of pain did not constitute a previous injury, since the pain was not localized in the same area and was not the same type of pain as the pain she experienced in the incident she claimed was a work injury. Claimant therefore did not have to meet the Allen case law standard, which requires that the exertions leading to injury in an employee with a pre-existing condition must exceed those found in everyday life in order for the employee to be eligible for benefits. (Even if claimant had a re-existing injury, the ALJ noted, her actions at work would have met the Allen standard, however, since she was lifting a total of over 1800 pounds every day.) The ALJ therefore found the incident of 9/11/00 qualified as a work injury and ordered self-insured employer to pay claimant accrued temporary total disability compensation of $416.05 plus interest; under Utah law, her first three days off work are exempted from reimbursement, since she was not off work more than 14 days in all. The ALJ also ordered employer to pay claimant's related medical expenses. However, the ALJ found claimant failed to prove the incidents of February and March 2001 were related to the earlier incident; employer therefore is not liable for medical treatment or disability compensation related to these incidents.
Injuries --Claimant suffered muscular strains.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Brad C. Betebenner of Richards, Brandt, Miller & Nelson
Expert Witness(es) - Plaintiff --Dr. Craig Marsden; Dr. Gary H. Lambert
Facts/Contentions --Claimant worked for SOS at Select Comfort, standing at a waist-high assembly line where she folded a box from a flat piece of cardboard, lifted a motor and wrapped it in packing material, and then placed it in the box. She then ran the box through a taping machine, placed a label on it, and carried it to a pallet, where she stacked it. The packaged motor weighed 7.1 pounds, and she packaged 254 of them on September 11, 2000 in a 9-hour shift with a half-hour lunch break. She sought medical treatment the next day and reported to her supervisor that she felt as if she had pulled something in her stomach. She experienced continuing pain the next day and was taken off work until September 25th, but her pain continued, and she went to the emergency room on September 21st and 22nd. She did not return to Select Comfort, but she experienced more pain and sought treatment again in February and March of 2001.
Employer's risk manager stated he felt claimant's job was light duty since she was lifting less than 10 pounds at a time. Employer contended that claimant suffered from a pre-existing injury.
FALL
Case Type --WA, SF; Work-related fall
Case Name --Kirk S. DeMille vs. Thurston Cable Construction and/or Fremont Comp
Case Number --20001059
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 5/02
Amount --The ALJ found that the opinions of Drs. Moress and Knorpp as to the date when claimant reached medical stability must be disregarded, since the previous ALJ ruled that claimant was not yet medically stable on the date they cited. Dr. Jonathan Horne and Dr. Jerold Hagen found claimant never achieved medical stability; however, both doctors also found claimant to be permanently and totally disabled. As a matter of law, the ALJ noted, this finding precludes an award of temporary benefits. The ALJ therefore dismissed this claim with prejudice, but stated that claimant is not barred from bringing another claim for permanent total disability benefits.
Injuries --Claimant injured his low back and left leg.
Attorney(s) - Plaintiff --Virginius C. Dabney of Dabney & Dabney, St. George
Attorney(s) - Defense --Henry K. Chai II of Blackburn & Stoll
Expert Witness(es) --At various times this case was referred to two separate medical panels.
Facts/Contentions --Claimant was injured when he fell off a front-end loader. A previous finding on the claim determined that he was injured in the course and scope of his employment; however, employer/carrier contended that he was medically stable, and claimant argued that he never reached medical stability and was therefore entitled to continuing temporary total disability benefits. Claimant has not been able to work since the accident, and he had a pre-existing 17% whole person impairment from low back injuries. The ALJ found that insurer's requirement of a two-step procedure for the surgical implantation of a stimulator caused claimant to develop spinal infections.
WORK INJURY
Case Type --WA: Work-related injury
Case Name --Manuel Guerrero vs. Allen Steel Company and/or Wasatch Crest Mutual Insurance Company
Case Number --99514
Court/Judge --George
Verdict/Settlement --Order, 5/02
Amount --The ALJ accepted the medical panel's findings and ordered employer/carrier to pay claimant additional accrued temporary total disability compensation of $1,374.84 plus interest and less attorney's fees, which are to be deducted from this award and sent directly to claimant's attorney. Employer/carrier has already paid claimant for a 16% whole person related impairment, but the ALJ accepted the panel's finding of 18% impairment and ordered employer/carrier to pay claimant accrued permanent partial disability benefits of $1,784.64 for the additional 2% impairment, plus interest and less attorney's fees, which are to be deducted from this award and sent directly to claimant's attorney. Employer/carrier must also pay claimant's future related medical expenses, as outlined in the panel's report.
Injuries --Claimant suffered a lower back injury with a herniated disc and nerve damage. He underwent a laminectomy/discectomy and a discectomy/fusion. Recommended treatment includes possible further surgery and prescription anti-inflammatory medication.
Attorney(s) - Plaintiff --Richard R. Burke of King & Isaacson
Attorney(s) - Defense --Brad C. Betebenner of Richards, Brandt, Miller & Nelson
Expert Witness(es) --By stipulation, the parties waived a hearing and referred this matter directly to a medical panel.
Facts/Contentions --Claimant stated that his back popped while he was lifting a piece of channel iron to position it for cutting.
Employer/carrier did not deny that the incident occurred, but the parties disputed the symptoms the injury caused, the medication and/or treatment necessary, and the issue of claimant's medical stability.
BUS/PEDESTRIAN ACCIDENT
Case Type --WA, BA, PA; Work-related bus/pedestrian accident
Case Name --Leroy Lovato vs. Kennecott Utah Copper
Case Number --2000532
Court/Judge --Eblen
Verdict/Settlement --Order, 5/02
Amount --The ALJ accepted the medical panel's findings over employer's objections and ordered self-insured employer to pay claimant accrued permanent partial disability benefits of $4,633.20 plus interest and less attorney's fees, which are to be deducted from this award and sent directly to claimant's attorney. In light of the panel's finding that ongoing medical treatment is reasonable, the ALJ also ordered employer to pay claimant's future related medical expenses.
Injuries --Claimant was diagnosed after the accident with a closed head injury with occipital scalp contusion; a right elbow contusion; and low back strain. Claimant contended that the accident caused a herniation at L4/5 and denervation in the middle lumbar region. The medical panel gave claimant an 8% related whole person impairment rating.
Attorney(s) - Plaintiff --Sandra N. Dredge of Dredge Lallatin, Provo
Attorney(s) - Defense --Henry K. Chai II of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Glenn Momberger and Dr. Madison Thomas.
Facts/Contentions --Claimant was hit by a bus at work. He sought treatment from various doctors and was evaluated at self-insured employer's request, but the parties could not agree on the extent of his injuries or his degree of impairment.
FALL
Case Type --WA, SF; Work-related slip/fall
Case Name --Albert Sivils vs. Painters Sun Country Chrysler and/or Agricultural Insurance Company
Case Number --991119
Court/Judge --George
Verdict/Settlement --Order, 5/02
Amount --The ALJ accepted the medical panel's finding that claimant has an 8% related whole person impairment and ordered employer/carrier to pay claimant accrued permanent partial disability benefits of $8,112 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Credit is to be given for any permanent partial disability benefits already paid.
Injuries --Claimant suffered injuries to his knees, with the degree of impairment being disputed. Claimant underwent bilateral partial medial meniscectomy surgeries.
Attorney(s) - Plaintiff --Aaron J. Prisbrey, St. George
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) --By stipulation, the parties waived a hearing and referred this matter directly to a medical panel.
Facts/Contentions --Claimant stated that he fell while mopping a floor at work, landing on both knees.
Employer/carrier accepted liability for the accident, but disputed claimant's degree of permanent impairment.
WORK INJURY
Case Type --WA: Work-related injury
Case Name --Ricky Arragon vs. Lowe's Home Improvement and Reliance Insurance Company (in liquidation) and Utah Property and Casualty Guaranty Association
Case Number --20001028
Court/Judge --Eblen
Verdict/Settlement --Order, 5/02
Amount --The ALJ determined that claimant was injured in the course and scope of his employment and ordered employer/carrier to pay him accrued temporary total disability benefits of $5,160 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant's related medical expenses.
Injuries --Claimant suffered a back strain.
Attorney(s) - Plaintiff --Maximo R. Guerra
Attorney(s) - Defense --Mark Riekhof of Dunn & Dunn
Facts/Contentions -- Claimant stated that he injured his back while helping a customer move a cabinet 8 feet by 3 feet by 1 foot. He stated that he reported his injury to his supervisor the same day it occurred.
Employer/carrier denied responsibility for the injury, contending that claimant was laid off on the date of the alleged injury and never notified his supervisor that he had been injured. The supervisor stated that he heard about the injury claim later from the personnel training coordinator, but did not think he needed to complete any paperwork at that time. The personnel training coordinator stated that she tried to contact claimant by phone following the lay-off, but the phone number on his application had been disconnected. The coordinator filled out an Employers' First Report of Injury form indicating that claimant told her about the injury the day it happened.
Claimant did not seek medical treatment for his injury until six weeks after it happened. He had a prior felony conviction that he did not disclose on his job application; he also failed to report that he filed a workers' compensation claim with a previous employer. All these facts, the ALJ noted, affected his credibility, but the preponderance of the evidence supported his claim that the injury in fact occurred.
BUS/PEDESTRIAN ACCIDENT
Case Type --WA, BA, PA; Work-related bus/pedestrian accident
Case Name --Leroy Lovato vs. Kennecott Utah Copper
Case Number --2000532
Court/Judge --Eblen
Verdict/Settlement --Order, 5/02
Amount --The ALJ accepted the medical panel's findings over employer's objections and ordered self-insured employer to pay claimant accrued permanent partial disability benefits of $4,633.20 plus interest and less attorney's fees, which are to be deducted from this award and sent directly to claimant's attorney. In light of the panel's finding that ongoing medical treatment is reasonable, the ALJ also ordered employer to pay claimant's future related medical expenses.
Injuries --Claimant was diagnosed after the accident with a closed head injury with occipital scalp contusion; a right elbow contusion; and low back strain. Claimant contended that the accident caused a herniation at L4/5 and denervation in the middle lumbar region. The medical panel gave claimant an 8% related whole person impairment rating.
Attorney(s) - Plaintiff --Sandra N. Dredge of Dredge Lallatin, Provo
Attorney(s) - Defense --Henry K. Chai II of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Glenn Momberger and Dr. Madison Thomas.
Facts/Contentions --Claimant was hit by a bus at work. He sought treatment from various doctors and was evaluated at self-insured employer's request, but the parties could not agree on the extent of his injuries or his degree of impairment.
FALL
Case Type --WA, SF; Work-related slip/fall
Case Name --Albert Sivils vs. Painters Sun Country Chrysler and/or Agricultural Insurance Company
Case Number --991119
Court/Judge --George
Verdict/Settlement --Order, 5/02
Amount --The ALJ accepted the medical panel's finding that claimant has an 8% related whole person impairment and ordered employer/carrier to pay claimant accrued permanent partial disability benefits of $8,112 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Credit is to be given for any permanent partial disability benefits already paid.
Injuries --Claimant suffered injuries to his knees, with the degree of impairment being disputed. Claimant underwent bilateral partial medial meniscectomy surgeries.
Attorney(s) - Plaintiff --Aaron J. Prisbrey, St. George
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) --By stipulation, the parties waived a hearing and referred this matter directly to a medical panel.
Facts/Contentions --Claimant stated that he fell while mopping a floor at work, landing on both knees.
Employer/carrier accepted liability for the accident, but disputed claimant's degree of permanent impairment.
WORK INJURY
Case Type --WA: Work-related injury
Case Name --Ricky Arragon vs. Lowe's Home Improvement and Reliance Insurance Company (in liquidation) and Utah Property and Casualty Guaranty Association
Case Number --20001028
Court/Judge --Eblen
Verdict/Settlement --Order, 5/02
Amount --The ALJ determined that claimant was injured in the course and scope of his employment and ordered employer/carrier to pay him accrued temporary total disability benefits of $5,160 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant's related medical expenses.
Injuries --Claimant suffered a back strain.
Attorney(s) - Plaintiff --Maximo R. Guerra
Attorney(s) - Defense --Mark Riekhof of Dunn & Dunn
Facts/Contentions -- Claimant stated that he injured his back while helping a customer move a cabinet measuring 8 feet by 3 feet by 1 foot. He stated that he reported his injury to his supervisor the same day it occurred.
Employer/carrier denied responsibility for the injury, contending that claimant was laid off on the date of the alleged injury and never notified his supervisor that he had been injured before leaving the store. The supervisor stated that he heard about the injury claim later from the personnel training coordinator, but did not think he needed to complete any paperwork at that time. The personnel training coordinator stated that she tried to contact claimant by phone following the lay-off, but the phone number on his application had been disconnected. The coordinator filled out an Employers' First Report of Injury form indicating that claimant told her about the injury the day it happened.
Claimant did not seek medical treatment for his injury until six weeks after it happened. He had a prior felony conviction that he did not disclose on his job application; he also failed to report that he filed a workers' compensation claim with a previous employer. All these facts, the ALJ noted, affected his credibility, but the preponderance of the evidence supported his claim that the injury in fact occurred.
FALL
Case Type --WA, SF; Work-related fall
Case Name --Daniel Draper vs. Cody Olsen dba Pace Roofing and Construction and/or Uninsured Employers' Fund; and Building Dynamics and/or Workers' Compensation Fund
Case Number --2001117
Court/Judge --George
Verdict/Settlement --Order, 5/02
Amount --The ALJ found that Utah law does not allow for apportionment of liability between the statutory employer and the UEF. The ALJ therefore found the WCF, as the carrier for the statutory employer, is totally responsible for claimant's benefits, and must reimburse the UEF for the $2,500 it advanced to claimant. The WCF shall be given credit against its obligation for the money it advanced to claimant and the sum it reimbursed to the UEF, and has full rights to pursue repayment from Pace and Cody Olsen for all benefits it pays to claimant. The WCF has no right to any repayment from the UEF. The ALJ ordered the WCF to pay claimant accrued temporary total disability benefits of $9,742 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. The WCF is also responsible for claimant's related medical bills.
Injuries --Claimant had six crushed vertebral levels in his mid-back region and other fractures, all of which required surgery with two rods and a six-level fusion. He is still undergoing rehabilitation and counseling and has significant permanent related whole person impairment, but has not stabilized medically and so has not yet received an impairment rating; the ALJ therefore did not address the issue of permanent impairment in this order.
Attorney(s) - Plaintiff --T. Jeffery Cottle, Orem
Attorney(s) - Defense --For UEF: Sheryl Hayashi; for Building Dynamics/WCF: Hans M. Scheffler
Damages --WCF advanced claimant $2,600, and the UEF advanced him $2,500.
Facts/Contentions --The parties stipulated to the fact that claimant was working for Pace when he fell 35 feet off a roof and landed on his feet. Pace did not maintain workers' compensation insurance, and this fact brought the UEF into the case. Pace did not file an answer to this claim. The parties stipulated that General Dynamics was claimant's statutory employer, and asked the ALJ to determine the apportionment of liability between General's carrier, WCF, and the UEF for Pace.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Vernon E. Kopps vs. Metro Group and Transcontinental Insurance
Case Number --20001068
Court/Judge --Eblen
Verdict/Settlement --Order, 5/02
Amount --The ALJ found a preponderance of the evidence indicated that claimant is capable of performing useful work for pay and is therefore not permanently and totally disabled. The ALJ thus dismissed the claim for permanent total disability benefits with prejudice.
Injuries --Claimant suffered a back injury and underwent a left hemilaminectomy and discectomy at L5/S1. Dr. Goldston gave claimant a 13% related whole person impairment rating. Dr. Chung agreed with the percentage of impairment, but found part of it was due to an earlier industrial accident.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) - Plaintiff --Dr. Peterson; Dr. Goldston
Expert Witness(es) - Defense --Dr. Jeff Chung; Felix, Dell, PT--functional capacity evaluation; Dirk Evertsen--vocational assessment
Facts/Contentions --Claimant worked as a truck driver for Metro Group, and noticed pain in his back after loading 80 empty barrels, weighing 30 pounds each, into his truck by throwing them over the side into the truck, about 6 feet over his head. He then climbed into the truck and stacked the barrels, and drove the load to Salt Lake City from Vernal. Claimant stated that he continued to work for the next five days, driving his truck, until the sixth morning, when he was unable to get out of bed. Claimant has qualified for Social Security disability benefits, and Dr. Goldston told him not to return to his work as a truck driver. Claimant is 58 years old and has completed tenth grade, but does not have a GED.
Claimant has not worked since his injury and sought permanent total disability benefits, but his employer contended that Dirk Evertsen's vocational evaluation showed claimant was capable of performing work as an appliance assembler, a parking lot attendant, a parking lot checker, or a security guard without violating his work restrictions. Dell Felix concluded that claimant could perform medium physical demand work. Claimant may earn up to $10,000 per year without jeopardizing his Social Security benefits.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury claim
Case Name --Betty Broadbent vs. Edo Western and/or Reliance Insurance Company and/or Travelers Insurance Company and/or Kempers Insurance Company and/or Workers' Compensation Fund
Case Number --9957, 9958
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 5/02
Amount --The ALJ dismissed Travelers and WCF as they were not the insurers of record during the time claimant contended that she was injured. Claimant settled with Kemper Insurance for an undisclosed amount. In this order, the ALJ accepted the medical panel's findings and dismissed the claim against Reliance Insurance with prejudice.
Injuries --Claimant maintained that she suffered stress injuries to her elbows; existence and causation of the injury was disputed.
Attorney(s) - Plaintiff --Timothy C. Allen
Attorney(s) - Defense --For Reliance: Dori K. Petersen of Blackburn & Stoll; for Travelers: Mark R. Sumsion of Richards, Brandt, Miller & Nelson; for Kemper: S. Brook Millard of Dunn & Dunn; for WCF: Mark D. Dean
Expert Witness(es) --The ALJ referred this case to a medical panel because of the dispute among the parties over causation.
Facts/Contentions --Claimant contended that her actions while working for Edo caused her elbow problems. Employer/carriers denied that her injuries existed and argued that any problems claimant suffered were not industrially caused.
The ALJ accepted the medical panel's report, which stated that the panel was unable to identify any elbow injuries.
ORDER ON REVIEW
Case Type --WA, MS; Work-related injury, miscellaneous (order on review)
Case Name --Becky Elwood vs. Pepperidge Farm, Incorporated and Travelers Insurance Company
Case Number --010679
Court/Judge --This order was issued by the Labor Commission Appeals Board, consisting of Colleen S. Colton, L. Zane Gill and Patricia S. Drawe.
Verdict/Settlement --Order, 5/02
Amount --The Appeals Board found that it is reasonable to expect an insurance company as large as Travelers to train its adjusters in proper procedures; also, the plain language of the request for answer stated that a reply was required within 30 days. The Appeals Board therefore declined to set aside the declaration of default and denied Travelers' motion for review.
Injuries --Claimant suffered spinal injuries.
Attorney(s) - Plaintiff --Sandra N. Dredge of Dredge Lallatin & Melendez, Provo
Attorney(s) - Defense --Carrie T. Taylor of Richards, Brandt, Miller & Nelson
Facts/Contentions --After claimant filed her request for a hearing and Travelers failed to answer, the ALJ declared Travelers in default.
Travelers asked the ALJ to set aside the declaration of default, claiming it never received its copy of the request for answer. But Pepperidge Farm stated that it forwarded its copy of the request to Travelers nine days after the ALJ sent it out, leaving Travelers over 20 days to respond. However, Travelers replied, because Travelers' claims adjuster was unfamiliar with Utah's workers' compensation system, the adjuster simply filed the request away without responding to it.
When Travelers' answer was past due, the Adjudication Division staff re-mailed the request for answer, but Travelers claimed it did not receive this "tracer" mailing until three weeks after it was mailed. There was no evidence that the inaction of Travelers' adjuster was affected in any way by the "tracer" or that the adjuster even knew of the "tracer"'s existence. The ALJ declined to set aside the declaration of default, and Travelers appealed for review by the Labor Commission Board of Appeals.
The Appeals Board noted that Utah workers' compensation law is set up to afford the quickest possible relief for injured workers at the time when they need it most. "Dilatory conduct," the Board stated, "should not be allowed to frustrate these objectives."
WORK INJURY
Case Type --WA; Work-related injury
Case Name --(Name of case withheld)
Case Number --991016
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 5/02
Amount --The ALJ accepted the medical panel's report and ordered self-insured employer to pay claimant accrued temporary total disability benefits of $7,880.37 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. The ALJ did not address the time period after 12/14/99 because the parties have not yet presented issues or evidence about the availability of light duty work for claimant after this date, when she would have been able to perform it. The ALJ ordered employer/carrier to pay all claimant's related medical expenses, including those for future treatment of the seizure disorder and the headaches. The ALJ did not make an award for permanent total disability because claimant has not stabilized medically and thus has no current whole person permanent impairment rating.
Injuries --The medical panel found claimant suffered the following injuries as a result of her exposure to the hydrogen sulfide: complex partial seizure disorder; headaches; eye irritation and spasm of the eyelid; nausea and vomiting; lethargy and weakness of extremities; and disorientation. The panel found the medical treatment claimant received for these conditions was reasonably necessary, and future medical treatment will be reasonably necessary for the complex partial seizures and the chronic headaches. The medical panel found claimant would have been able to do light duty work with seizure protection (no dangerous equipment; no heights, balancing or climbing) after 12/14/99.
Attorney(s) - Plaintiff --Timothy C. Allen
Attorney(s) - Defense --Henry K. Chai II of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel.
Facts/Contentions --Claimant, who worked as an operator in employer's plant alkylation unit, was ordered to neutralize spent caustic, which is used to scrub sulfur out of petroleum products. Claimant stated that the spent caustic was in an alkylation pit 12 by 6 feet, fifteen feet deep. Claimant tested the spent caustic with litmus paper and found it had a Ph level of over 14. She opened a valve, allowing sulfuring acid to flow into the pit at about three feet below the surface to neutralize the caustic. When she opened the valve, claimant was two to five feet away from the pit, wearing rubber gloves, a face shield, rubber boots, safety glasses and ear plugs, but she was not wearing a respirator, as this equipment was not required. Claimant said she saw black and purple fumes coming out of the pit immediately after she added the sulfuric acid; she immediately began choking, fell to her knees and vomited. When she told the unit operator over two-way radio what was happening, he instructed her to shut down the process, which she did. The emitted gas was determined to be hydrogen sulfide, and claimant was exposed to it for two to three minutes, after which she went to the control room and showered to get the smell off. She finished her shift in the control room, but did no further work that night. She left the next day on a scheduled leave for non-related surgery, but sought medical treatment within a week, reporting that she was having trouble concentrating.
Employer/carrier denied that claimant's symptoms were caused by her exposure to the hydrogen sulfide gas. An EEG revealed sharp transient waves, but an MRI was normal. Claimant underwent extensive further testing and continued to experience seizures; she reported to employer that she sustained a seizure disorder from the exposure as soon as she received a tentative diagnosis, one week less than six months after the incident. Several of her doctors and employer's independent medical examination physicians disagreed about what was causing her problems. One of her doctors indicated that though the exposure to hydrogen sulfide might have resolved, other harmful substances resent in the fumes, such as carbon disulfide, might have caused long-term problems.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Steven P. Hill vs. Granite School District
Case Number --20001077
Court/Judge --Eblen
Verdict/Settlement --Order, 5/02
Amount --The ALJ found that claimant's activities in playing volleyball for 40 minutes and leaping up to strike the ball did not exceed the exertions of everyday life. Claimant's activities thus did not meet the Allen test (see below), and this re-injury of the left knee was therefore not compensable. The ALJ dismissed this claim with prejudice.
Injuries --Claimant suffered an injury to his left knee. He had a pre-existing weakness from a prior industrial left knee injury for which he went surgery in 1994.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Facts/Contentions --Claimant stated he injured his knee while playing volleyball with students in the course and scope of his employment with Granite School District. He said he jumped up and forward to strike the ball, but his knee gave way when he landed and he fell. He had been playing for about 40 minutes at the time he was injured.
Self-insured employer argued that claimant's fall was caused by a pre-existing weakness and atrophy of the left quadriceps muscle following his 1994 left knee surgery. Employer argued that claimant's activities which led to this injury did not exceed the exertions one might encounter in everyday life and thus did not meet the Allen test for re-injury.
Legal Issues --Utah case law (Allen) states that in order for an injured worker with a pre-existing impairment to qualify for benefits, the work activities leading up to the re-injury must be extraordinary.
TRUCK ACCIDENT, REPETITIVE STRESS INJURY
Case Type --WA, TA, SI; Work-related truck accident, work-related repetitive stress injury
Case Name --Gregory Lawton vs. Interstate Rock Products and/or Workers' Compensation Fund
Case Number --200050, 2000222
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 5/02
Amount --The ALJ accepted the medical panel's report and ordered employer/carrier to pay claimant additional accrued temporary total disability benefits of $398.16 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay all claimant's related medical expenses for injuries to both shoulders, including the cost of the recommended surgery. The issue of permanent partial impairment from the truck accident was dismissed without prejudice pursuant to claimant's withdrawal of this issue as unripe, and employer/carrier must pay for the chiropractic visits and prescription medicine for the truck-accident-related injury as they have already agreed to do.
Injuries --Claimant suffered shoulder injuries caused by the repetitive stresses of his job; he hit his head in the truck accident, and the impact apparently caused neck problems.
Attorney(s) - Plaintiff --Aaron J. Prisbrey, St. George
Attorney(s) - Defense --Elliot K. Morris
Expert Witness(es) --The ALJ submitted the issue of the left shoulder injuries to a medical panel consisting of Laird Swenson, MD--orthopedic surgeon; and Alvin Wirthlin, MD--neurologist.
Damages --Employer/carrier paid claimant $6,354.57 in temporary total disability benefits for his right shoulder injuries.
Facts/Contentions --Claimant stated that he drove a cement-mixer truck for his employer. During the three months prior to the time he reported his stress injury, he drove truck R-7, which had four detachable metal chutes to help the driver dispense the wet cement from the permanently-attached main chute. The number-one chute had metal patches on it and weighed more than the other detachable chutes; the ALJ determined its weight was about 89 pounds. Claimant stated that he routinely lifted the number-one chute overhead with both hands to attach it to the main chute, adding the other chutes as needed if the main and number-one chutes did not reach the ground. Most jobs required that claimant at least use the number-one chute. Claimant worked six days per week from June of 1998 through September of 1998, when he reported his shoulder injuries, delivering five loads of pre-mixed concrete per day on weekdays and two to three loads on Saturdays.
Claimant was injured on April 30, 1999 when the truck he was driving was struck by an excavator and claimant hit his head on the driver's-side window.
Employer/carrier accepted liability for the stress-related injuries to claimant's right shoulder, but disputed liability for those to his left shoulder. Employer/carrier agreed to pay for 13 chiropractic visits in connection with the truck accident, where the impact to claimant's head appeared to have caused neck problems; employer/carrier will also pay for the medication prescribed for this injury by Dr. Gregory Last. Claimant withdrew his claim for permanent partial disability compensation in connection with this injury as unripe, since he has not yet received a related permanent whole person impairment rating.
Claimant had motor vehicle accidents in 1994 and 1996, but contended that he did not suffer shoulder injuries in either one. The 1996 accident caused neck and back injuries.
The medical panel found claimant suffered stress-related injuries to both shoulders as a result of his activities in dispensing cement from the chutes. The panel found arthroscopy and subacromial decompression surgery would be of benefit.
ORDER ON REVIEW
Case Type --WA, MS; Work-related injury, miscellaneous (order on review)
Case Name --Becky Elwood vs. Pepperidge Farm, Incorporated and Travelers Insurance Company
Case Number --010679
Court/Judge --This order was issued by the Labor Commission Appeals Board, consisting of Colleen S. Colton, L. Zane Gill and Patricia S. Drawe.
Verdict/Settlement --Order, 5/02
Amount --The Appeals Board found that it is reasonable to expect an insurance company as large as Travelers to train its adjusters in proper procedures; also, the plain language of the request for answer stated that a reply was required within 30 days. The Appeals Board therefore declined to set aside the declaration of default and denied Travelers' motion for review.
Injuries --Claimant suffered spinal injuries.
Attorney(s) - Plaintiff --Sandra N. Dredge of Dredge Lallatin & Melendez, Provo
Attorney(s) - Defense --Carrie T. Taylor of Richards, Brandt, Miller & Nelson
Facts/Contentions --After claimant filed her request for a hearing and Travelers failed to answer, the ALJ declared Travelers in default.
Travelers asked the ALJ to set aside the declaration of default, claiming it never received its copy of the request for answer. But Pepperidge Farm stated that it forwarded its copy of the request to Travelers nine days after the ALJ sent it out, leaving Travelers over 20 days to respond. However, Travelers replied, because Travelers' claims adjuster was unfamiliar with Utah's workers' compensation system, the adjuster simply filed the request away without responding to it.
When Travelers' answer was past due, the Adjudication Division staff re-mailed the request for answer, but Travelers claimed it did not receive this "tracer" mailing until three weeks after it was mailed. There was no evidence that the inaction of Travelers' adjuster was affected in any way by the "tracer" or that the adjuster even knew of the "tracer"'s existence. The ALJ declined to set aside the declaration of default, and Travelers appealed for review by the Labor Commission Board of Appeals.
The Appeals Board noted that Utah workers' compensation law is set up to afford the quickest possible relief for injured workers at the time when they need it most. "Dilatory conduct," the Board stated, "should not be allowed to frustrate these objectives."
WORK INJURY
Case Type --WA; Work-related injury
Case Name --(Name of case withheld)
Case Number --991016
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 5/02
Amount --The ALJ accepted the medical panel's report and ordered self-insured employer to pay claimant accrued temporary total disability benefits of $7,880.37 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. The ALJ did not address the time period after 12/14/99 because the parties have not yet presented issues or evidence about the availability of light duty work for claimant after this date, when she would have been able to perform it. The ALJ ordered employer/carrier to pay all claimant's related medical expenses, including those for future treatment of the seizure disorder and the headaches. The ALJ did not make an award for permanent total disability because claimant has not stabilized medically and thus has no current whole person permanent impairment rating.
Injuries --The medical panel found claimant suffered the following injuries as a result of her exposure to the hydrogen sulfide: complex partial seizure disorder; headaches; eye irritation and spasm of the eyelid; nausea and vomiting; lethargy and weakness of extremities; and disorientation. The panel found the medical treatment claimant received for these conditions was reasonable and necessary, and future medical treatment will be reasonable and necessary for her complex partial seizures and the chronic headaches. The medical panel found claimant would have been able to do light duty work with seizure protection (no dangerous equipment; no heights, balancing or climbing) after 12/14/99.
Attorney(s) - Plaintiff --Timothy C. Allen
Attorney(s) - Defense --Henry K. Chai II of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel.
Facts/Contentions --Claimant, who worked as an operator in employer's plant alkylation unit, was ordered to neutralize spent caustic, which is used to scrub sulfur out of petroleum products. Claimant stated that the spent caustic was in an alkylation pit 12 by 6 feet, and fifteen feet deep. Claimant tested the spent caustic with litmus paper and found it had a Ph level of over 14. She opened a valve, allowing sulfuring acid to flow into the pit at about three feet below the surface to neutralize the caustic. When she opened the valve, claimant estimated she was between two and five feet away from the pit. She was wearing rubber gloves, a face shield, rubber boots, safety glasses and ear plugs, but she was not wearing a respirator, as this equipment was not required. Claimant said she saw black and purple fumes coming out of the pit immediately after she added the sulfuric acid; she immediately began choking, fell to her knees and vomited. When she told the unit operator over two-way radio what was happening, he instructed her to shut down the process, which she did. The emitted gas was determined to be hydrogen sulfide, and claimant was exposed to it for two to three minutes, after which she went to the control room and showered to get the smell off. She finished her shift in the control room, but did no further work that night. She left the next day on a scheduled leave for non-related surgery, but sought medical treatment within a week, reporting that she was having trouble concentrating.
Employer/carrier denied that claimant's symptoms were caused by her exposure to the hydrogen sulfide gas. An EEG revealed sharp transient waves, but an MRI was normal. Claimant underwent extensive further testing and continued to experience seizures; she reported to employer that she sustained a seizure disorder from the exposure as soon as she received a tentative diagnosis, one week less than six months after the incident. Several of her doctors and employer's independent medical examination physicians disagreed about what was causing her problems. One of her doctors indicated that though the problems she experienced from the exposure to hydrogen sulfide might have resolved, other harmful substances present in the fumes, such as carbon disulfide, might have caused long-term problems.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Steven P. Hill vs. Granite School District
Case Number --20001077
Court/Judge --Eblen
Verdict/Settlement --Order, 5/02
Amount --The ALJ found that claimant's activities in playing volleyball for 40 minutes and leaping up to strike the ball did not exceed the exertions of everyday life. Claimant's activities thus did not meet the Allen test (see below), and this re-injury of his left knee was therefore not compensable. The ALJ dismissed this claim with prejudice.
Injuries --Claimant suffered an injury to his left knee. He had a pre-existing weakness from a prior industrial left knee injury for which he went surgery in 1994.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Facts/Contentions --Claimant stated he injured his knee while playing volleyball with students in the course and scope of his employment with Granite School District. He said he jumped up and forward to strike the ball, but his knee gave way when he landed and he fell. He had been playing for about 40 minutes at the time he was injured.
Self-insured employer argued that claimant's fall was caused by a pre-existing weakness and atrophy of the left quadriceps muscle following his 1994 left knee surgery. Employer argued that claimant's activities which led to this injury did not exceed the exertions one might encounter in everyday life and thus did not meet the Allen test for re-injury.
Legal Issues --Utah case law (Allen) states that in order for an injured worker with a pre-existing impairment to qualify for benefits, the work activities leading up to the re-injury must require exertions beyond those encountered in everyday life.
TRUCK ACCIDENT, REPETITIVE STRESS INJURY
Case Type --WA, TA, SI; Work-related truck accident, work-related repetitive stress injury
Case Name --Gregory Lawton vs. Interstate Rock Products and/or Workers' Compensation Fund
Case Number --200050, 2000222
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 5/02
Amount --The ALJ accepted the medical panel's report and ordered employer/carrier to pay claimant additional accrued temporary total disability benefits of $398.16 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay all claimant's related medical expenses for injuries to both shoulders, including the cost of the recommended surgery. The issue of permanent partial impairment from the truck accident was dismissed without prejudice pursuant to claimant's withdrawal of this issue as unripe, and employer/carrier must pay for the chiropractic visits and prescription medicine for the truck-accident-related injury as they have already agreed to do.
Injuries --Claimant suffered shoulder injuries caused by the repetitive stresses of his job; he hit his head in the truck accident, and the impact apparently caused neck problems.
Attorney(s) - Plaintiff --Aaron J. Prisbrey, St. George
Attorney(s) - Defense --Elliot K. Morris
Expert Witness(es) --The ALJ submitted the issue of the left shoulder injuries to a medical panel consisting of Laird Swenson, MD--orthopedic surgeon; and Alvin Wirthlin, MD--neurologist.
Damages --Employer/carrier paid claimant $6,354.57 in temporary total disability benefits for his right shoulder injuries.
Facts/Contentions --Claimant stated that he drove a cement-mixer truck for his employer. During the three months prior to the time he reported his stress injury, he drove truck R-7, which had four detachable metal chutes to help the driver dispense the wet cement from the permanently-attached main chute. The number-one chute had metal patches on it and weighed more than the other detachable chutes; the ALJ determined its weight was about 89 pounds. Claimant stated that he routinely lifted the number-one chute overhead with both hands to attach it to the main chute, adding the other chutes as needed if the main and number-one chutes did not reach the ground. Most jobs required that claimant at least use the number-one chute. Claimant worked six days per week from June of 1998 through September of 1998, when he reported his shoulder injuries, delivering five loads of pre-mixed concrete per day on weekdays and two to three loads on Saturdays. He claimed his shoulder injuries were caused by the repetitive stress of hoisting the chutes.
Claimant was injured again on April 30, 1999 when the truck he was driving was struck by an excavator and claimant hit his head on the driver's-side window.
Employer/carrier accepted liability for the stress-related injuries to claimant's right shoulder, but disputed liability for those to his left shoulder. Employer/carrier agreed to pay for 13 chiropractic visits in connection with the truck accident, when it became evident that the impact to claimant's head had caused neck problems; employer/carrier will also pay for the medication prescribed for this injury by Dr. Gregory Last. Claimant withdrew his claim for permanent partial disability compensation in connection with this injury as unripe, since he has not received a related permanent whole person impairment rating.
Claimant had motor vehicle accidents in 1994 and 1996, but contended that he did not suffer shoulder injuries in either one. The 1996 accident caused neck and back injuries.
The medical panel found claimant suffered stress-related injuries to both shoulders as a result of his activities in dispensing cement from the chutes. The panel found arthroscopy and subacromial decompression surgery would be of benefit.
AUTOMOBILE ACCIDENT
Case Type --AA, WA; Work-related automobile accident
Case Name --Howard Treft vs. Springhill Farms, Incorporated and Uninsured Employers' Fund
Case Number --2000309
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 5/02
Amount --The ALJ ruled that because claimant's employer did not maintain any workers' compensation, liability or health insurance covering job-related injuries to its employees, the employer did not qualify for the agricultural exemption from the Utah Code provisions on workers' compensation. The ALJ found claimant was acting as an employee of Springhill when he set out to deliver the rest of the shipment to the Salt Lake City shipping agent and pick up his employer, her life partner and their child at the Salt Lake City airport. The employer was therefore responsible for benefits connected with claimant's injury. The ALJ ordered the UEF to pay claimant accrued temporary total disability benefits of $3,600.88 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. The UEF must also pay claimant accrued permanent partial disability benefits of $4,305.60 for his 15% permanent partial impairment, plus interest and less attorney's fees as above. The UEF must also pay all of claimant' related medical expenses. The ALJ ordered Springhill Farms to repay the UEF for all these disbursements, plus interest, and also to pay the UEF a 15% penalty for its failure to maintain workers' compensation insurance on its non-immediate-family employees.
Injuries --Claimant suffered a posterior fracture and dislocation of his left hip and an extruded disc on the right side at C5/6. Both of these injuries were surgically repaired. Claimant also sustained injuries to his left ankle which did not require surgery. Dr. MacArthur gave claimant a 15% related whole person impairment rating.
Attorney(s) - Plaintiff --Chris L. Schmutz of Schmutz Mohlman
Attorney(s) - Defense --For Springhill: M. David Eckersley of Prince, Yeates & Geldzahler; for UEF: Sheryl Hayashi
Expert Witness(es) - Plaintiff --Dr. Creig MacArthur
Facts/Contentions --Claimant met Martina Gephardt, owner of Springhill Farms, in Germany as a friend of the family of Gephardt's life partner, and claimant came to this country and went to work at the Springhill farm near Boulder, Utah, 250 miles from Salt Lake City, at Gephardt's invitation in March of 1999. Claimant drove the tractor, mowed the willows, fed the livestock and performed general maintenance; he also gathered, dried, ground, and packaged various herbs that the farm shipped to Germany. Claimant returned to Germany in August 1999, but Gephardt contacted him later the same year to ask him to come back, as she was not satisfied with the performance of the employee who took his place. Claimant returned to the farm in November of 1999, with authority from Gephardt to oversee the other employees and sign salary checks. On February 26, 2000, Gephardt asked claimant to pick up herself, her life partner and their child at the Salt Lake City airport, and also to deliver the rest of a shipment which the other employee had mistakenly left half-filled to the farm's Salt Lake shipping agent. Gephardt gave claimant permission to use her Ford Explorer because it had a child safety seat for her son. Claimant was on the way to Salt Lake City when he hit a patch of black ice at 60 miles per hour in Highway 24 near the Fish Lake exit and rolled the Explorer into a clump of boulders. He was unconscious at the scene for about 15 minutes.
Gephardt argued that claimant was not an employee of the farm, but an independent contractor, or that if claimant was an employee, Gephardt qualified for the exemption from liability for workers' compensation provided by Utah law to some agricultural employers. The evidence indicated that Gephardt gave claimant weekly instructions regarding the running of the farm and allowed him to supervise other workers there. At one time during the hearing Gephardt stated that she told claimant to pay his own taxes, but later stated that her accountant erred in not withholding taxes from claimant's checks. Gephardt paid claimant over $9,000 during 1999.
Legal Issues --An agricultural employer is not responsible for workers' compensation as an employer of a non-immediate-family member if the employer's total annual payroll for all non-immediate-family employees was less than $8,000 for the previous calendar year; an agricultural employer whose total annual non-immediate-family-member payroll was between $8,000 and $50,000 for the previous calendar year may also qualify for this exemption if it maintains its own workers' compensation insurance coverage on its employees or at least $300,000 in liability insurance coverage or $5,000 health insurance coverage on non-family-members.
MOTOR VEHICLE ACCIDENT
Case Type --AA, WA; Work-related motor vehicle accident
Case Name --Troy Gren vs. Relms, Incorporated and/or Workers' Compensation Fund
Case Number --99321
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 5/02
Amount --The ALJ accepted the medical panel's findings and therefore dismissed the claim for additional temporary total compensation and the claim for permanent partial disability compensation with prejudice. The ALJ ordered employer/carrier to pay claimant's medical expenses incurred between the date of the accident and November 30, 1998, when the panel felt he attained medical stability and could have been released from all medical restrictions on his work.
Injuries --The medical panel found claimant suffered a temporary exacerbation of his pre-existing cervical spinal condition.
Attorney(s) - Plaintiff --W. Scott Lythgoe, Ogden
Attorney(s) - Defense --Mark D. Dean
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel.
Facts/Contentions --Claimant was injured in a work-related motor vehicle accident on August 18, 1998, when another vehicle rear-ended the vehicle he was driving while he was stopped. His employer accepted liability and paid him medical expenses and benefits through November 30, 1998. When claimant began experiencing further cervical spinal problems, he filed this claim seeking additional benefits.
Employer/carrier contended that claimant's additional cervical spinal problems resulted from his pre-existing condition and not from the accident.
The medical panel found claimant's work-related accident caused an exacerbation of his pre-existing cervical spinal condition which resolved completely by November 30, 1998, leaving him with no related whole person impairment.
FALL, STRESS INJURY
Case Type --WA, SF, SI; Work-related slip/fall and repetitive stress injury
Case Name --Carlene Kerr vs. O'Sullivan Industries, Incorporated and/or CNA Insurance
Case Number --99033, 99490
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 5/02
Amount --The ALJ ordered employer/carrier to pay claimant accrued permanent partial disability benefits of $6,396.00 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to attorney Holm. The ALJ ruled that no further benefits are due, as employer/carrier already paid claimant the rest of the benefits to which she was entitled. The ALJ dismissed the second repetitive-stress-related claim with prejudice, as medical causation was not proved.
Injuries --Claimant contended that she suffered injuries to her right shoulder, lower back, left elbow, right elbow, right hip and chin. The medical panel found she suffered an upper right shoulder injury and cervical spinal injuries in the fall; the panel gave her a 5% related whole person impairment for her cervical spinal problems and a 5% related whole person impairment for her right shoulder problems. No evidence proved that the alleged injuries to the elbows, hip, chin or lower back resulted in any temporary total disability or permanent impairment. Claimant stated that after the fall, she suffered repetitive stress-related injuries to her left arm, neck and lower back while performing light duty work, but the ALJ found that the medical evidence failed to prove these problems were caused by her work activities.
Attorney(s) - Plaintiff --Floyd Holm; then Virginius C. Dabney of Dabney & Dabney, St. George
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Alvin Wirthlin, MD--neurologist; and Laird Swensen, MD--orthopedic surgeon.
Facts/Contentions --Claimant was first injured when she lost her balance and fell at work while crossing some rollers. She struck a concrete floor on her right side. She stated that she was unable to use her right arm after the fall and was using her left arm to do ten-key work put labels on boxes, wipe small veneer-covered boards off with alcohol, and put small parts into boxes on the "pack line" as part of her light-duty assignments for her employer. She claimed that because of these actions, she suffered a repetitive stress injury to her left arm, neck and lower back.
OCCUPATIONAL DISEASE
Case Type --OD, WA, SI; Occupational disease claim, work-related repetitive stress injury
Case Name --Walter E. Roth vs. L. W. Miller and/or Workers' Compensation Fund
Case Number --2000919
Court/Judge --George
Verdict/Settlement --Order, 5/02
Amount --The ALJ found claimant's occupational disease was work-related and ordered employer/carrier to pay claimant temporary total disability benefits of $509 per week starting May 18, 2000, when claimant first reported problems, and continuing through the date when claimant reaches medical stability. Accrued amounts due are to include interest, and attorney's fees are to be deducted from these payments and paid directly to claimant's attorney. Employer/carrier must also pay all claimant's related medical expenses. The issue of permanent partial disability was reserved until claimant reaches medical stability.
Injuries --Claimant developed epicondylitis of the right elbow.
Attorney(s) - Plaintiff --Kristy Bertelsen and Michael E. Dyer of Blackburn & Stoll
Attorney(s) - Defense --Eugene C. Miller Jr.
Expert Witness(es) - Plaintiff --Dr. Stephen Cheyne; Dr. Michael Larsen--orthopedic surgeon
Expert Witness(es) - Defense --Dr. Richard Knoebel--independent medical examination
Facts/Contentions --Claimant contended that he developed his epicondylitis as a result of repetitive pounding and hammering in the course of his work while loosening wing nuts on a gravity drop semi truck and trailer. It took him an average of 30 minutes per load to open and close all the wing nuts on all the hatches on one load.
Employer/carrier denied that claimant's problems were caused by his work activities. No evidence was presented to indicate that claimant had any similar problems before coming to work for this employer.
Dr. Knoebel and Dr. Larsen both felt that all claimant's problems were work-related and he was not yet medically stable. Dr. Larsen released claimant to light duty work; employer admitted that it never offered claimant light duty work after this release.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury
Case Name --Arlene Andus vs. Granite School District
Case Number --20001016
Court/Judge --Eblen
Verdict/Settlement --Order, 5/02
Amount --The ALJ ruled that claimant's actions leading up to the exacerbation of her pre-existing injury failed to meet the Allen test (see below), since lifting a 50-pound box of soap is not beyond the exertions that might be required of a person in everyday life. Since the medical panel's findings indicated that claimant also failed to prove medical causation, the ALJ dismissed this claim with prejudice.
Injuries --Claimant suffered a left shoulder injury which caused her ongoing pain.
Attorney(s) - Plaintiff --David C. Cundick
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel chaired by Dr. Edward B. Holmes.
Facts/Contentions --Claimant works as a janitor for the district, cleaning three classrooms, the gymnasiums, a locker room and a set of boys' and girls' bathrooms. She also uses an "auto sweeper" to clean the halls after she sweeps them. She claimed these activities led up to her left shoulder problems in March of 2000, which developed the day after she lifted a 50-pound box of soap at work, when she hurt so badly she thought she was having a heart attack and sought medical care.
Self-insured employer contended that claimant's shoulder problems were pre-existing, and that her actions at work did not meet the Allen test. Allen case law says that in order for a previously injured worker to qualify for workers' compensation benefits, the work activities that led up to the injury must be beyond the scope of the actions a person might encounter in everyday life. Claimant's medical history showed she experienced herniated discs in her cervical spine and repetitive stress injuries to the rhomboid/levator scapula area in 1994 and has experienced periodic exacerbations of these injuries ever since then.
The medical panel found there was no medical causal connection between claimant's alleged injury in March of 2000 and her current problems. The panel gave claimant a 15% whole person impairment rating, with all of her impairment stemming from prior injuries incurred while she was working for a previous employer. The panel found that the medical treatment claimant has received so far to treat her cervical radiculopathy was reasonably necessary, but no further Lortab injections are needed, though surgery may be needed to treat the pre-existing industrial injury.
ORDER ON MOTION FOR REVIEW
Case Type --OD; Occupational disease
Case Name --Sherry Crane vs. Jordan School District (self-insured)
Case Number --20001076
Court/Judge --This order was issued by Labor Commissioner R. Lee Ellertson.
Verdict/Settlement --Order on review, 5/02
Amount --The Commissioner concluded that Dr. Robinson's report was sufficient to raise a genuine issue of material fact on the question of medical causation. The ALJ therefore set aside the summary judgment issued by the ALJ and remanded the case for further proceedings.
Injuries --Claimant suffered chronic asthma.
Attorney(s) - Plaintiff --David C. Cundick
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) - Plaintiff --Dr. Robinson
Facts/Contentions --Claimant contended that her exposure to chemical fumes at work caused her chronic asthma, and the ALJ dismissed her claim, issuing summary judgment in favor of her employer on the basis that she failed to prove medical causation. She filed this motion for review, claiming she submitted opinions from some of her physicians stating that her asthma was probably caused or severely exacerbated by the industrial chemical exposure. The Commissioner noted that Dr. Robinson's responses to the questions in the Summary of Medical Record form indicated that Dr. Robinson felt claimant suffered an 88% whole person impairment as a result of work-related exacerbation of her chronic asthma.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --(Name of case withheld)
Case Number --991016
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 5/02
Amount --The ALJ accepted the medical panel's report and ordered self-insured employer to pay claimant accrued temporary total disability benefits of $7,880.37 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. The ALJ did not address the time period after 12/14/99 because the parties have not yet presented issues or evidence about the availability of light duty work for claimant after this date, when she would have been able to perform it. The ALJ ordered employer/carrier to pay all claimant's related medical expenses, including those for future treatment of the seizure disorder and the headaches. The ALJ did not make an award for permanent total disability because claimant has not stabilized medically and thus has no current whole person permanent impairment rating.
Injuries --The medical panel found claimant suffered the following injuries as a result of her exposure to the hydrogen sulfide: complex partial seizure disorder; headaches; eye irritation and spasm of the eyelid; nausea and vomiting; lethargy and weakness of extremities; and disorientation. The panel found the medical treatment claimant received for these conditions was reasonable and necessary, and future medical treatment will be reasonable and necessary for her complex partial seizures and the chronic headaches. The medical panel found claimant would have been able to do light duty work with seizure protection (no dangerous equipment; no heights, balancing or climbing) after 12/14/99.
Attorney(s) - Plaintiff --Timothy C. Allen
Attorney(s) - Defense --Henry K. Chai II of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel.
Facts/Contentions --Claimant, who worked as an operator in employer's plant alkylation unit, was ordered to neutralize spent caustic, which is used to scrub sulfur out of petroleum products. Claimant stated that the spent caustic was in an alkylation pit 12 by 6 feet, and fifteen feet deep. Claimant tested the spent caustic with litmus paper and found it had a Ph level of over 14. She opened a valve, allowing sulfuring acid to flow into the pit at about three feet below the surface to neutralize the caustic. When she opened the valve, claimant estimated she was between two and five feet away from the pit. She was wearing rubber gloves, a face shield, rubber boots, safety glasses and ear plugs, but she was not wearing a respirator, as this equipment was not required. Claimant said she saw black and purple fumes coming out of the pit immediately after she added the sulfuric acid; she immediately began choking, fell to her knees and vomited. When she told the unit operator over two-way radio what was happening, he instructed her to shut down the process, which she did. The emitted gas was determined to be hydrogen sulfide, and claimant was exposed to it for two to three minutes, after which she went to the control room and showered to get the smell off. She finished her shift in the control room, but did no further work that night. She left the next day on a scheduled leave for non-related surgery, but sought medical treatment within a week, reporting that she was having trouble concentrating.
Employer/carrier denied that claimant's symptoms were caused by her exposure to the hydrogen sulfide gas. An EEG revealed sharp transient waves, but an MRI was normal. Claimant underwent extensive further testing and continued to experience seizures; she reported to employer that she sustained a seizure disorder from the exposure as soon as she received a tentative diagnosis, one week less than six months after the incident. Several of her doctors and employer's independent medical examination physicians disagreed about what was causing her problems. One of her doctors indicated that though the problems she experienced from the exposure to hydrogen sulfide might have resolved, other harmful substances present in the fumes, such as carbon disulfide, might have caused long-term problems.
TRUCK ACCIDENT, REPETITIVE STRESS INJURY
Case Type --WA, TA, SI; Work-related truck accident, work-related repetitive stress injury
Case Name --Gregory Lawton vs. Interstate Rock Products and/or Workers' Compensation Fund
Case Number --200050, 2000222
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 5/02
Amount --The ALJ accepted the medical panel's report and ordered employer/carrier to pay claimant additional accrued temporary total disability benefits of $398.16 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay all claimant's related medical expenses for injuries to both shoulders, including the cost of the recommended surgery. The issue of permanent partial impairment from the truck accident was dismissed without prejudice pursuant to claimant's withdrawal of this issue as unripe, and employer/carrier must pay for the chiropractic visits and prescription medicine for the truck-accident-related injury as they have already agreed to do.
Injuries --Claimant suffered shoulder injuries caused by the repetitive stresses of his job; he hit his head in the truck accident, and the impact apparently caused neck problems.
Attorney(s) - Plaintiff --Aaron J. Prisbrey, St. George
Attorney(s) - Defense --Elliot K. Morris
Expert Witness(es) --The ALJ submitted the issue of the left shoulder injuries to a medical panel consisting of Laird Swenson, MD--orthopedic surgeon; and Alvin Wirthlin, MD--neurologist.
Damages --Employer/carrier paid claimant $6,354.57 in temporary total disability benefits for his right shoulder injuries.
Facts/Contentions --Claimant stated that he drove a cement-mixer truck for his employer. During the three months prior to the time he reported his stress injury, he drove truck R-7, which had four detachable metal chutes to help the driver dispense the wet cement from the permanently-attached main chute. The number-one chute had metal patches on it and weighed more than the other detachable chutes; the ALJ determined its weight was about 89 pounds. Claimant stated that he routinely lifted the number-one chute overhead with both hands to attach it to the main chute, adding the other chutes as needed if the main and number-one chutes did not reach the ground. Most jobs required that claimant at least use the number-one chute. Claimant worked six days per week from June of 1998 through September of 1998, when he reported his shoulder injuries, delivering five loads of pre-mixed concrete per day on weekdays and two to three loads on Saturdays. He claimed his shoulder injuries were caused by the repetitive stress of hoisting the chutes.
Claimant was injured again on April 30, 1999 when the truck he was driving was struck by an excavator and claimant hit his head on the driver's-side window.
Employer/carrier accepted liability for the stress-related injuries to claimant's right shoulder, but disputed liability for those to his left shoulder. Employer/carrier agreed to pay for 13 chiropractic visits in connection with the truck accident, when it became evident that the impact to claimant's head had caused neck problems; employer/carrier will also pay for the medication prescribed for this injury by Dr. Gregory Last. Claimant withdrew his claim for permanent partial disability compensation in connection with this injury as unripe, since he has not received a related permanent whole person impairment rating.
Claimant had motor vehicle accidents in 1994 and 1996, but contended that he did not suffer shoulder injuries in either one. The 1996 accident caused neck and back injuries.
The medical panel found claimant suffered stress-related injuries to both shoulders as a result of his activities in dispensing cement from the chutes. The panel found arthroscopy and subacromial decompression surgery would be of benefit.
MOTOR VEHICLE ACCIDENT
Case Type --AA, WA; Work-related motor vehicle accident
Case Name --Troy Gren vs. Relms, Incorporated and/or Workers' Compensation Fund
Case Number --99321
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 5/02
Amount --The ALJ accepted the medical panel's findings and therefore dismissed the claim for additional temporary total compensation and the claim for permanent partial disability compensation with prejudice. The ALJ ordered employer/carrier to pay claimant's medical expenses incurred between the date of the accident and November 30, 1998, when the panel felt he attained medical stability and could have been released from all medical restrictions on his work.
Injuries --The medical panel found claimant suffered a temporary exacerbation of his pre-existing cervical spinal condition.
Attorney(s) - Plaintiff --W. Scott Lythgoe, Ogden
Attorney(s) - Defense --Mark D. Dean
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel.
Facts/Contentions --Claimant was injured in a work-related motor vehicle accident on August 18, 1998, when another vehicle rear-ended the vehicle he was driving while he was stopped. His employer accepted liability and paid him medical expenses and benefits through November 30, 1998. When claimant began experiencing further cervical spinal problems, he filed this claim seeking additional benefits.
Employer/carrier contended that claimant's additional cervical spinal problems resulted from his pre-existing condition and not from the accident.
The medical panel found claimant's work-related accident caused an exacerbation of his pre-existing cervical spinal condition which resolved completely by November 30, 1998, leaving him with no related whole person impairment.
FALL, STRESS INJURY
Case Type --WA, SF, SI; Work-related slip/fall and repetitive stress injury
Case Name --Carlene Kerr vs. O'Sullivan Industries, Incorporated and/or CNA Insurance
Case Number --99033, 99490
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 5/02
Amount --The ALJ ordered employer/carrier to pay claimant accrued permanent partial disability benefits of $6,396.00 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to attorney Holm. The ALJ ruled that no further benefits are due, as employer/carrier already paid claimant the rest of the benefits to which she was entitled. The ALJ dismissed the second repetitive-stress-related claim with prejudice, as medical causation was not proved.
Injuries --Claimant contended that she suffered injuries to her right shoulder, lower back, left elbow, right elbow, right hip and chin. The medical panel found she suffered an upper right shoulder injury and cervical spinal injuries in the fall; the panel gave her a 5% related whole person impairment for her cervical spinal problems and a 5% related whole person impairment for her right shoulder problems. No evidence proved that the alleged injuries to the elbows, hip, chin or lower back resulted in any temporary total disability or permanent impairment. Claimant stated that after the fall, she suffered repetitive stress-related injuries to her left arm, neck and lower back while performing light duty work, but the ALJ found that the medical evidence failed to prove these problems were caused by her work activities.
Attorney(s) - Plaintiff --Floyd Holm; then Virginius C. Dabney of Dabney & Dabney, St. George
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Alvin Wirthlin, MD--neurologist; and Laird Swensen, MD--orthopedic surgeon.
Facts/Contentions --Claimant was first injured when she lost her balance and fell at work while crossing some rollers. She struck a concrete floor on her right side. She stated that she was unable to use her right arm after the fall and was using her left arm to do ten-key work put labels on boxes, wipe small veneer-covered boards off with alcohol, and put small parts into boxes on the "pack line" as part of her light-duty assignments for her employer. She claimed that because of these actions, she suffered a repetitive stress injury to her left arm, neck and lower back.
OCCUPATIONAL DISEASE
Case Type --OD, WA, SI; Occupational disease claim, work-related repetitive stress injury
Case Name --Walter E. Roth vs. L. W. Miller and/or Workers' Compensation Fund
Case Number --2000919
Court/Judge --George
Verdict/Settlement --Order, 5/02
Amount --The ALJ found claimant's occupational disease was work-related and ordered employer/carrier to pay claimant temporary total disability benefits of $509 per week starting May 18, 2000, when claimant first reported problems, and continuing through the date when claimant reaches medical stability. Accrued amounts due are to include interest, and attorney's fees are to be deducted from these payments and paid directly to claimant's attorney. Employer/carrier must also pay all claimant's related medical expenses. The issue of permanent partial disability was reserved until claimant reaches medical stability.
Injuries --Claimant developed epicondylitis of the right elbow.
Attorney(s) - Plaintiff --Kristy Bertelsen and Michael E. Dyer of Blackburn & Stoll
Attorney(s) - Defense --Eugene C. Miller Jr.
Expert Witness(es) - Plaintiff --Dr. Stephen Cheyne; Dr. Michael Larsen--orthopedic surgeon
Expert Witness(es) - Defense --Dr. Richard Knoebel--independent medical examination
Facts/Contentions --Claimant contended that he developed his epicondylitis as a result of repetitive pounding and hammering in the course of his work while loosening wing nuts on a gravity drop semi truck and trailer. It took him an average of 30 minutes per load to open and close all the wing nuts on all the hatches on one load.
Employer/carrier denied that claimant's problems were caused by his work activities. No evidence was presented to indicate that claimant had any similar problems before coming to work for this employer.
Dr. Knoebel and Dr. Larsen both felt that all claimant's problems were work-related and he was not yet medically stable. Dr. Larsen released claimant to light duty work; employer admitted that it never offered claimant light duty work after this release.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury
Case Name --Arlene Andus vs. Granite School District
Case Number --20001016
Court/Judge --Eblen
Verdict/Settlement --Order, 5/02
Amount --The ALJ ruled that claimant's actions leading up to the exacerbation of her pre-existing injury failed to meet the Allen test (see below), since lifting a 50-pound box of soap is not beyond the exertions that might be required of a person in everyday life. Since the medical panel's findings indicated that claimant also failed to prove medical causation, the ALJ dismissed this claim with prejudice.
Injuries --Claimant suffered a left shoulder injury which caused her ongoing pain.
Attorney(s) - Plaintiff --David C. Cundick
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel chaired by Dr. Edward B. Holmes.
Facts/Contentions --Claimant works as a janitor for the district, cleaning three classrooms, the gymnasiums, a locker room and a set of boys' and girls' bathrooms. She also uses an "auto sweeper" to clean the halls after she sweeps them. She claimed these activities led up to her left shoulder problems in March of 2000, which developed the day after she lifted a 50-pound box of soap at work, when she hurt so badly she thought she was having a heart attack and sought medical care.
Self-insured employer contended that claimant's shoulder problems were pre-existing, and that her actions at work did not meet the Allen test. Allen case law says that in order for a previously injured worker to qualify for workers' compensation benefits, the work activities that led up to the injury must be beyond the scope of the actions a person might encounter in everyday life. Claimant's medical history showed she experienced herniated discs in her cervical spine and repetitive stress injuries to the rhomboid/levator scapula area in 1994 and has experienced periodic exacerbations of these injuries ever since then.
The medical panel found there was no medical causal connection between claimant's alleged injury in March of 2000 and her current problems. The panel gave claimant a 15% whole person impairment rating, with all of her impairment stemming from prior injuries incurred while she was working for a previous employer. The panel found that the medical treatment claimant has received so far to treat her cervical radiculopathy was reasonably necessary, but no further Lortab injections are needed, though surgery may be needed to treat the pre-existing industrial injury.
ORDER ON MOTION FOR REVIEW
Case Type --OD; Occupational disease
Case Name --Sherry Crane vs. Jordan School District (self-insured)
Case Number --20001076
Court/Judge --This order was issued by Labor Commissioner R. Lee Ellertson.
Verdict/Settlement --Order on review, 5/02
Amount --The Commissioner concluded that Dr. Robinson's report was sufficient to raise a genuine issue of material fact on the question of medical causation. The ALJ therefore set aside the summary judgment issued by the ALJ and remanded the case for further proceedings.
Injuries --Claimant suffered chronic asthma.
Attorney(s) - Plaintiff --David C. Cundick
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) - Plaintiff --Dr. Robinson
Facts/Contentions --Claimant contended that her exposure to chemical fumes at work caused her chronic asthma, and the ALJ dismissed her claim, issuing summary judgment in favor of her employer on the basis that she failed to prove medical causation. She filed this motion for review, claiming she submitted opinions from some of her physicians stating that her asthma was probably caused or severely exacerbated by the industrial chemical exposure. The Commissioner noted that Dr. Robinson's responses to the questions in the Summary of Medical Record form indicated that Dr. Robinson felt claimant suffered an 88% whole person impairment as a result of work-related exacerbation of her chronic asthma.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Casimira B. Diaz vs. Cafe Rio and/or Ohio Casualty (Great American Alliance)
Case Number --2001175
Court/Judge --George
Verdict/Settlement --Order, 6/02
Amount --The ALJ accepted Dr. Fotheringham's opinion and dismissed this claim for lack of medical causation.
Injuries --Claimant suffered back and shoulder pain and muscle spasms.
Attorney(s) - Plaintiff --Claimant was represented pro se and testified through an interpreter.
Attorney(s) - Defense --Dori K. Petersen of Blackburn & Stoll
Expert Witness(es) - Defense --Dr. McClain, American Fork; Dr. Fotheringham
Facts/Contentions --Claimant stated that her work clearing tables for employer caused her back and shoulder problems. At her hearing, she withdrew all her claims except the one for medical expenses, seeking additional physical therapy.
Dr. Fotheringham stated that he could not find a causal connection between claimant's work activities and her pain. Claimant admitted that employer paid her one week's worth of wages even though she did not work at all that week; employer also made claimant an unsecured personal loan. Claimant left this job to have an unrelated operation and later went to work for another restaurant.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --James W. Evans vs. Salt Lake City Fire Department #12
Case Number --2001717
Court/Judge --Poelman
Verdict/Settlement --Order, 6/02
Amount --The ALJ determined that claimant suffered a re-injury, not a new injury, and dismissed this claim with prejudice.
Injuries --Claimant suffered a hernia. He underwent three previous hernia repair surgeries on the same side.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Assistant Salt Lake City Attorney Martha S. Stonebrook
Expert Witness(es) - Defense --Dr. Stephen B. Smith
Facts/Contentions --Claimant stated that he coughed very hard as a result of his activities at work and developed a hernia. He claimed the incident constituted a new industrial injury.
Employer contended that claimant sustained an aggravation of a pre-existing injury for which it already paid claimant all the benefits to which he was entitled. Employer argued that claimant's activities leading up to his injury did not satisfy the Allen test. Under Utah case law (Allen) a previously injured worker is only entitled to additional benefits for a re-injury if the work activities leading up to the injury exceeded those a person might encounter in everyday modern life.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Ryan Larsen vs. Western States Mechanical and/or American Alliance Insurance Company and/or American Alliance Insurance Company/Ohio Casualty Group
Case Number --2000489
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 6/02
Amount --The ALJ accepted the medical panel's findings that surgery is not a reasonable and medically necessary treatment for his back problems at this time; the ALJ therefore dismissed this claim with prejudice. However, the ALJ noted that claimant is not barred from raising the issue of surgical treatment at a future date if such treatment should become medically necessary.
Injuries --Claimant suffered a back injury; surgery was recommended by his treating physician.
Attorney(s) - Plaintiff --E. Craig McAllister, Orem
Attorney(s) - Defense --Dori K. Petersen of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Charles Smith--orthopedic surgeon.
Damages --Employer paid claimant temporary total disability benefits of $360 and permanent partial impairment benefits for a 5% related whole person impairment totaling $4,728.
Facts/Contentions --Claimant was working for employer as a plumber, installing a large pump motor. He said he was attempting to align the motor by lifting it with a pry-bar when he heard a pop and felt immediate pain in his back, neck and both shoulders. He finished working his shift and went home as usual, but that night he developed severe muscle spasms and pain in his lumbar region. The next morning he sought treatment at a local emergency room. Claimant 's medical history showed he received treatment for mild back pain on and off for at least four years before this incident; however, he stated that he did not experience any previous radiating pain in his extremities like the pain he suffered from this incident.
Employer/carrier disputed the determination by claimant's treating physician that a discectomy and fusion would help relieve claimant's pain, pointing out that employer's independent medical examining physician indicated that surgery would probably not provide any relief. The parties agreed to refer the matter to a medical panel.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Jerry Butkovich vs. Ryan Smith dba Master Muffler and/or WCF
Case Number --2001937
Court/Judge --Poelman
Verdict/Settlement --Order, 6/02
Amount --The ALJ dismissed the claim for medical expenses related to the visit of August 10th, finding that claimant had stabilized medically from this injury by that time and his problems as of that date were caused by his pre-existing otitis media. Claimant was off work for seven days, and the first three are exempted from payment of benefits under Utah law because claimant was not off work for more than 14 consecutive workdays. The ALJ therefore ordered employer/carrier to pay claimant $316.60 in temporary total disability benefits for the remaining four days he was off work. These accrued benefits are due and payable plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney.
Injuries --Claimant suffered an ear injury.
Attorney(s) - Plaintiff --Loren M. Lambert
Attorney(s) - Defense --Elliot K. Morris
Expert Witness(es) - Plaintiff --Dr. Kottarathil, U of U Health Clinic
Expert Witness(es) - Defense --Dr. Clough Shelton
Facts/Contentions --Claimant was injured on July 6, 2001, while installing a muffler on a vehicle which backfired. The backfire propelled a piece of slag into claimant's right ear. He reported the accident at once and his employer sent him to the University of Utah Health Clinic the same day.
Employer/carrier admitted that the accident occurred and accepted liability for claimant's visits to his doctor on July 6 and 11, 2001, but disclaimed liability for the visit of August 10. Employer/carrier also argued that claimant should have told the doctor who treated his industrial injury that he has otitis media, a chronic right ear condition which caused him pain, hearing difficulties and ringing in the right ear.
When claimant was first treated for his injury, the doctor told him to stay home for two days. After two days, he was still having problems with his ear, so he went in again and the doctor told him to stay home for another week. However, the doctor's office did not fax this information to the employer until eight days later, when claimant had already been terminated for failing to show up at work. Claimant was told explicitly to contact his employer if he would not be in to work, but said he did not do so because the doctor's office personnel told him they would do it for him.
Claimant's treating physician, who did not know about claimant's otitis media, felt that his right ear problems resulted from the accident; however, he also speculated that infection could have spread from a case of otitis media. Dr. Clough Shelton, who performed a comprehensive independent medical examination, concluded that the accident did not permanently aggravate claimant's pre-existing right ear condition or cause any further hearing loss. He felt claimant did not suffer any permanent partial impairment as a result of the industrial accident, and stated that no further medical treatment is needed.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Eliseo Limones vs. Viliami Molisi dba SMK Construction and Uninsured Employers' Fund
Case Number --2000505
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 6/02
Amount --The ALJ found claimant sustained his hand and chest injuries in the course and scope of his employment because the fight was spontaneous and grew out of an argument over the performance of the work itself. Under Utah law, injuries sustained in such disputes are considered work-related. The ALJ therefore ordered uninsured employer to pay claimant accrued temporary total disability benefits of $197 for the week he was off work, plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer must also pay claimant's hospital bill of $682. Since no evidence was presented indicating employer is insolvent or otherwise unable to pay these expenses, the ALJ dismissed the UEF from the case.
Injuries --Claimant suffered injuries to his neck and a dislocated little finger on his left hand.
Attorney(s) - Plaintiff --Jose L. Trujillo
Attorney(s) - Defense --Uninsured employer was represented pro se; for UEF: Sheryl Hayashi
Expert Witness(es) - Plaintiff --Dr. Jeffrey Driscoll
Facts/Contentions --Claimant stated he was digging a hole with a shovel when another employee yelled at him, asking him to come and help with something the other worker was doing, but claimant could not hear the other worker because of the noise of a nearby backhoe. Claimant said the other worker threw a rock at him to get his attention, striking him in the chest, whereupon claimant went after the other worker with his shovel. The other worker picked up his own shovel and struck one blow, hitting claimant in the chest and hand; claimant went down, and the fight ended. Claimant rested for half an hour and then went back to work. He finally sought medical treatment four days after the incident. He was off work for one week at that time.
Uninsured employer contended that the fight was not work-related.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Scott L. Olsen vs. Boeing Company
Case Number --200133
Court/Judge --Poelman
Verdict/Settlement --Order, 6/02
Amount --The ALJ found that claimant suffered an aggravation of a pre-existing non-industrial injury, not a new work-related injury. The ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant suffered a lower back injury.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Henry K. Chai II of Blackburn & Stoll
Expert Witness(es) - Defense --Paul France, PhD--biomechanical expert
Facts/Contentions --Claimant was standing up, drilling holes through layered sheets of metal above his head. He said while he was engaged in this activity, he felt a popping sensation in his back and immediate pain extending down his leg. He had drilled 20 holes just prior to the onset of his pain, and the work was nothing he had not done many times before. He was drilling through one layer of steel, two of aluminum and one outer layer.
Self-insured employer contended that claimant had suffered a previous back injury for which he underwent surgery. They called Dr. France, who testified that the activity in which claimant was engaged placed the same force on his spine as would be placed on the spine of a person bending over to pick up a penny off the ground. Employer therefore argued that claimant's work activities leading up to his injury did not meet the Allen test. Under Utah case law (Allen) a previously injured worker is only entitled to additional benefits for a re-injury if the work activities leading up to the injury exceeded those a person might encounter in everyday modern life.
Claimant admitted he had prior low back surgery, but added that he felt he was completely healed at the time this incident occurred.
ORDER ON REVIEW
Case Type --WA; Work-related injury
Case Name --Donna M. Pond vs. La-Z-Boy Utah, Incorporated
Case Number --990700
Court/Judge --This order was issued by Labor Commissioner R. Lee Ellertson.
Verdict/Settlement --Order on review, 6/02
Amount --Since the results of the diagnostic arthroscopy were available at the time the ALJ issued her decision, but the ALJ was not advised of this fact, the Commissioner remanded the case to the ALJ so that she might consider all the relevant medical evidence before making her decision. The Commissioner suggested that the ALJ might ask the medical panel to reconsider its findings, taking into account the results of the diagnostic surgical procedure.
Injuries --Claimant suffered a shoulder injury.
Attorney(s) - Plaintiff --Randall G. Phillips, Ogden
Attorney(s) - Defense --Henry K, Chai II of Blackburn & Stoll
Expert Witness(es) --This case was originally referred to a medical panel.
Facts/Contentions --When this case was referred to the medical panel after the original hearing, the panel ordered an MRI, which showed torn shoulder ligaments and tendons. The panel found these injuries were caused by the work accident and also found claimant was not medically stable and needed surgery to repair her injuries. The ALJ issued her decision accordingly. However, La-Z-Boy moved for review, claimant that by the time the ALJ issued her decision, claimant had undergone diagnostic arthroscopy, but the results were not reflected in the ALJ's decision. La-Z-Boy contended that these results might conflict with the medical panel's findings.
FALL
Case Type --WA, SF; Work-related slip/fall
Case Name --Celestina Punzalan vs. Salt Lake Community College and/or Workers' Compensation fund
Case Number --2000533
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 6/02
Amount --The ALJ accepted the medical panel's findings and ordered employer/carrier to pay claimant accrued permanent partial disability benefits of $4,736.16 for her 6% impairment, less credit for any amounts already paid (employer/carrier contended that it paid claimant $4,212 in permanent partial disability benefits), plus interest, and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant's related medical expenses.
Injuries --Claimant was diagnosed with a contused coccyx and a right shoulder contusion after her fall. The medical panel gave claimant a related 6% whole person impairment rating.
Attorney(s) - Plaintiff --Marsha S. Atkin of Atkin & Associates
Attorney(s) - Defense --Lori Hansen
Expert Witness(es) --The parties agreed to waive a hearing and submit the stipulated facts of the case directly to a medical panel consisting of Dr. Alvin Wirthlin--neurologist; Dr. Glen Momberger--orthopedic surgeon; and Dr. Donald Stromquist--rheumatologist.
Facts/Contentions --Claimant is an adjunct professor of business mathematics. As she was leaving one of the buildings where she teaches, she slipped and fell on ice, landing on her back, buttocks and left hand and also hitting her head. She said she was rendered unconscious briefly and felt dazed; she returned to the building, and another employee drove her home. She sought medical care the next day, and X-rays revealed no fractures. The accident occurred at the end of the quarter; when claimant returned to work, her husband drove her to work, and she taught sitting down and used pain medication, but she did not take any time off. Claimant continued to experience pain after the incident; chiropractic referral and physical therapy helped only a little. Her treating physicians and employer's independent medical examination physicians disagreed over recommended medical treatment and claimant's degree of impairment.
The medical panel found claimant's ongoing cervical and lumbar pain resulted from her industrial slip/fall, but her shoulder, elbow, wrist, foot, chest and head pain did not. The panel suggested that some unknown inflammatory arthropathy might be responsible for these symptoms. The panel found all the medical treatment claimant received has been necessitated by her industrial injuries.
REPETITIVE STRESS INJURY
Case Type --OD, SI, WA; Occupational disease claim, work-related repetitive stress injury
Case Name --Janis Rasmussen vs. ACS Data Entry, Incorporated fka Unibase and/or Workers' Compensation Fund
Case Number --2000345
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 6/02
Amount --The ALJ accepted the medical panel's report and ordered employer/carrier to pay claimant $1,520 in accrued temporary total disability benefits and $4,511.75 in accrued temporary partial disability benefits, plus interest and less attorney's fees, which are to be deducted from these awards and paid directly to claimant's attorney. Employer/carrier must also pay claimant's related medical expenses. The ALJ dismissed the issue of permanent partial disability without prejudice as unripe.
Injuries --Claimant suffered upper right arm and shoulder impingement syndrome which required right shoulder acromioplasty and distal clavicle extension. She underwent prior surgical repair of a comminuted intra-articular fracture of the right wrist in 1994.
Attorney(s) - Plaintiff --Phillip B. Shell of Day, Shell & Liljenquist
Attorney(s) - Defense --Barbara W. Sharp
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel.
Facts/Contentions --Claimant stated that her activities as a ten-key data entry clerk caused her upper right arm and shoulder problems.
Employer/carrier contended that claimant's symptoms stemmed from a previous injury sustained in a fall while claimant was roller-skating at a company party.
The medical panel found that claimant's impingement syndrome was industrially caused and the treatment she received was reasonably necessary to treat her industrial problems. The parties agreed that the issue of claimant's permanent impairment, if any, was unripe at the time of this hearing.
REPETITIVE STRESS INJURY
Case Type --OD, SI, WA; Occupational disease claim, work-related repetitive stress injury
Case Name --Wayne A. Ross vs. Smith's Food & Drug and/or Pinnacle Risk Management
Case Number --991225, 2000306
Court/Judge --Hann
Verdict/Settlement --Order, 6/02
Amount --The ALJ accepted the medical panel's report and ordered employer/carrier to pay claimant accrued temporary partial disability benefits for the period running from 8/27/99 through 11/2/99, plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant accrued permanent partial disability benefits of $2,711.45 for his industrial impairment, plus interest and less attorney's fees as stated above. Employer/carrier was also ordered to pay claimant's related medical expenses, including surgery if it is deemed necessary in the future.
Injuries --Claimant suffered bilateral chronic tendinitis and mild bilateral medial and lateral epicondylitis. He later suffered a back injury.
Attorney(s) - Plaintiff --David W. Parker of Parker, Freestone & Angerhofer
Attorney(s) - Defense --Henry K. Chai II of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Edward Holmes.
Facts/Contentions --Claimant stated that he developed his tendinitis and epicondylitis from his work, locating and removing damaged goods from pallets loaded with cases of food. These duties entailed repetitive lifting, moving and re-stacking cases of food which were stacked 50 or 60 to a pallet. The cases weighed between 1 and 50 pounds each. Claimant said he injured his back in 1999 when removing a leaking case of spaghetti sauce from the bottom row of a pallet. As he lifted the case to waist height, he felt sharp pains in both elbows; as he twisted to throw the case onto a cart, he felt a muscle pull in his back and fell to the floor.
Claimant and employer reached a settlement regarding claimant's 1999 industrial accident, and claimant was released to light duty work. However, claimant's back and elbow pain continued, and he filed this claim for further benefits.
The medical panel found claimant suffered an industrial injury in 1999 and also suffers from an occupational disease. The panel gave claimant a 3% whole person impairment rating for his epicondylitis, of which 95% was industrial and 5% non-industrial. Of that 95%, only half is attributable to the 1999 incident; the rest is due to daily lifting and straining over time. Dr. Holmes found that surgery may be necessary if tennis elbow straps, duty modification and anti-inflammatory medication do not reduce claimant's pain.
OCCUPATIONAL DISEASE
Case Type --OD, WA, SI; Occupational disease claim, work-related repetitive stress injury
Case Name --Walter E. Roth vs. L. W. Miller and/or Workers' Compensation Fund
Case Number --2000919
Court/Judge --George
Verdict/Settlement --Order, 6/02
Amount --The ALJ found claimant's occupational disease was work-related and ordered employer/carrier to pay claimant temporary total disability benefits of $509 per week starting May 18, 2000, when claimant first reported problems, and continuing through the date when claimant reaches medical stability. Accrued amounts due are to include interest, and attorney's fees are to be deducted from these payments and paid directly to claimant's attorney. Employer/carrier must also pay all claimant's related medical expenses. The issue of permanent partial disability was reserved until claimant reaches medical stability.
Injuries --Claimant developed epicondylitis of the right elbow.
Attorney(s) - Plaintiff --Kristy Bertelsen and Michael E. Dyer of Blackburn & Stoll
Attorney(s) - Defense --Eugene C. Miller Jr.
Expert Witness(es) - Plaintiff --Dr. Stephen Cheyne; Dr. Michael Larsen--orthopedic surgeon
Expert Witness(es) - Defense --Dr. Richard Knoebel--independent medical examination
Facts/Contentions --Claimant contended that he developed his epicondylitis as a result of repetitive pounding and hammering in the course of his work, which required him to loosen and then tighten wing nuts on a gravity drop semi truck and trailer every time he delivered a load. It took him an average of 30 minutes per load to open and close all the wing nuts on all the hatches on one load, and he delivered several loads per shift.
Employer/carrier denied that claimant's problems were caused by his work activities. No evidence was presented to indicate that claimant had any similar problems before coming to work for this employer.
Dr. Knoebel and Dr. Larsen both felt that all claimant's problems were work-related and he was not yet medically stable. Dr. Larsen released claimant to light duty work; employer admitted that it never offered claimant light duty work after this release.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury
Case Name --Arlene Andus vs. Granite School District
Case Number --20001016
Court/Judge --Eblen
Verdict/Settlement --Order, 6/02
Amount --The ALJ ruled that claimant's actions leading up to the exacerbation of her pre-existing injury failed to meet the Allen test (see below), since lifting a 50-pound box of soap is not beyond the exertions that might be required of a person in everyday life. Since the medical panel's findings indicated that claimant also failed to prove medical causation, the ALJ dismissed this claim with prejudice.
Injuries --Claimant suffered a left shoulder injury which caused her ongoing pain.
Attorney(s) - Plaintiff --David C. Cundick
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel chaired by Dr. Edward B. Holmes.
Facts/Contentions --Claimant works as a janitor for the district; her duties include cleaning three classrooms, the gymnasiums, a locker room and a set of boys' and girls' bathrooms every day. She also uses an "auto sweeper" to clean the halls after she sweeps them. She claimed these activities led up to her left shoulder problems in March of 2000, which developed the day after she lifted a 50-pound box of soap at work. She said after she lifted the box of soap, she hurt so badly she thought she was having a heart attack and sought medical care.
Self-insured employer contended that claimant's shoulder problems were pre-existing, and that her actions at work did not meet the Allen test. Allen case law says that in order for a previously injured worker to qualify for workers' compensation benefits, the work activities that led up to the injury must be beyond the scope of the actions a person might encounter in everyday life. Claimant's medical history showed she experienced herniated discs in her cervical spine and repetitive stress injuries to the rhomboid/levator scapulae area in 1994 and has experienced periodic exacerbations of these injuries ever since then.
The medical panel found there was no medical causal connection between claimant's alleged injury in March of 2000 and her current problems. The panel gave claimant a 15% whole person impairment rating, with all of her impairment stemming from prior injuries incurred while she was working for a previous employer. The panel found that the medical treatment claimant has received so far to treat her cervical radiculopathy was reasonably necessary, but no further Lortab injections are needed, though surgery may be needed to treat the pre-existing industrial injury.
ORDER ON MOTION FOR REVIEW
Case Type --OD; Occupational disease
Case Name --Sherry Crane vs. Jordan School District (self-insured)
Case Number --20001076
Court/Judge --This order was issued by Labor Commissioner R. Lee Ellertson.
Verdict/Settlement --Order on review, 6/02
Amount --The Commissioner concluded that Dr. Robinson's report was sufficient to raise a genuine issue of material fact on the question of medical causation. The ALJ therefore set aside the summary judgment issued by the ALJ and remanded the case for further proceedings.
Injuries --Claimant suffered chronic asthma.
Attorney(s) - Plaintiff --David C. Cundick
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) - Plaintiff --Dr. Robinson
Facts/Contentions --Claimant contended that her exposure to chemical fumes at work caused her chronic asthma, and the ALJ dismissed her claim, issuing summary judgment in favor of her employer on the basis that she failed to prove medical causation. She filed this motion for review, claiming she submitted opinions from some of her physicians stating that her asthma was probably caused or severely exacerbated by the industrial chemical exposure. The Commissioner noted that Dr. Robinson's responses to the questions in the Summary of Medical Record form indicated that Dr. Robinson felt claimant suffered an 88% whole person impairment as a result of work-related exacerbation of her chronic asthma.
ORDER ON REVIEW
Case Type --WA; Work-related injury
Case Name --Donna M. Pond vs. La-Z-Boy Utah, Incorporated
Case Number --990700
Court/Judge --This order was issued by Labor Commissioner R. Lee Ellertson.
Verdict/Settlement --Order on review, 7/02
Amount --Since the results of the diagnostic arthroscopy were available at the time the ALJ issued her decision, but the ALJ was not advised of this fact, the Commissioner remanded the case to the ALJ so that she might consider all the relevant medical evidence before making her decision. The Commissioner suggested that the ALJ might ask the medical panel to reconsider its findings, taking into account the results of the diagnostic surgical procedure.
Injuries --Claimant suffered a shoulder injury.
Attorney(s) - Plaintiff --Randall G. Phillips, Ogden
Attorney(s) - Defense --Henry K, Chai II of Blackburn & Stoll
Expert Witness(es) --This case was originally referred to a medical panel.
Facts/Contentions --When this case was referred to the medical panel after the original hearing, the panel ordered an MRI, which showed torn shoulder ligaments and tendons. The panel found these injuries were caused by the work accident; the panel also found claimant was not medically stable and needed surgery to repair her injuries. The ALJ issued her decision accordingly. However, La-Z-Boy moved for review, claimant that by the time the ALJ issued her decision, claimant had undergone diagnostic arthroscopy, but the results were not reflected in the ALJ's decision. La-Z-Boy contended that these results might conflict with the medical panel's findings.
FALL
Case Type --WA, SF; Work-related slip/fall
Case Name --Celestina Punzalan vs. Salt Lake Community College and/or Workers' Compensation fund
Case Number --2000533
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 7/02
Amount --The ALJ accepted the medical panel's findings and ordered employer/carrier to pay claimant accrued permanent partial disability benefits of $4,736.16 for her 6% impairment, less credit for any amounts already paid (employer/carrier contended that it paid claimant $4,212 in permanent partial disability benefits), plus interest, and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant's related medical expenses.
Injuries --Claimant was diagnosed with a contused coccyx and a right shoulder contusion after her fall. The medical panel gave claimant a related 6% whole person impairment rating.
Attorney(s) - Plaintiff --Marsha S. Atkin of Atkin & Associates
Attorney(s) - Defense --Lori Hansen
Expert Witness(es) --The parties agreed to waive a hearing and submit the stipulated facts of the case directly to a medical panel consisting of Dr. Alvin Wirthlin--neurologist; Dr. Glen Momberger--orthopedic surgeon; and Dr. Donald Stromquist--rheumatologist.
Facts/Contentions --Claimant is an adjunct professor of business mathematics. As she was leaving one of the buildings where she teaches, she slipped and fell on ice, landing on her back, buttocks and left hand and also hitting her head. She said she was rendered unconscious briefly and felt dazed; she returned to the building, and another employee drove her home. She sought medical care the next day, and X-rays revealed no fractures. The accident occurred at the end of the quarter; when claimant returned to work, her husband drove her to work, and she taught sitting down and used pain medication, but did not take any time off. Claimant continued to experience pain after the incident; chiropractic referral and physical therapy helped only a little. Her treating physicians and employer's independent medical examination physicians disagreed over recommended medical treatment and claimant's degree of impairment.
The medical panel found claimant's ongoing cervical and lumbar pain resulted from her industrial slip/fall, but her shoulder, elbow, wrist, foot, chest and head pain did not. The panel suggested that some unknown inflammatory arthropathy might be responsible for these symptoms. The panel found all the medical treatment claimant received has been necessitated by her industrial injuries.
REPETITIVE STRESS INJURY
Case Type --OD, SI, WA; Occupational disease claim, work-related repetitive stress injury
Case Name --Janis Rasmussen vs. ACS Data Entry, Incorporated fka Unibase and/or Workers' Compensation Fund
Case Number --2000345
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 7/02
Amount --The ALJ accepted the medical panel's report and ordered employer/carrier to pay claimant $1,520 in accrued temporary total disability benefits and $4,511.75 in accrued temporary partial disability benefits, plus interest and less attorney's fees, which are to be deducted from these awards and paid directly to claimant's attorney. Employer/carrier must also pay claimant's related medical expenses. The ALJ dismissed the issue of permanent partial disability without prejudice as unripe.
Injuries --Claimant suffered upper right arm and shoulder impingement syndrome which required right shoulder acromioplasty and distal clavicle extension. She underwent prior surgical repair of a comminuted intra-articular fracture of the right wrist in 1994.
Attorney(s) - Plaintiff --Phillip B. Shell of Day, Shell & Liljenquist
Attorney(s) - Defense --Barbara W. Sharp
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel.
Facts/Contentions --Claimant stated that her activities as a ten-key data entry clerk caused her upper right arm and shoulder problems.
Employer/carrier contended that claimant's symptoms stemmed from a previous injury sustained in a fall while claimant was roller-skating at a company party.
The medical panel found that claimant's impingement syndrome was industrially caused and the treatment she received was reasonably necessary to treat her industrial problems. The parties agreed that the issue of claimant's permanent impairment, if any, was unripe at the time of this hearing.
REPETITIVE STRESS INJURY
Case Type --OD, SI, WA; Occupational disease claim, work-related repetitive stress injury
Case Name --Wayne A. Ross vs. Smith's Food & Drug and/or Pinnacle Risk Management
Case Number --991225, 2000306
Court/Judge --Hann
Verdict/Settlement --Order, 7/02
Amount --The ALJ accepted the medical panel's report and ordered employer/carrier to pay claimant accrued temporary partial disability benefits for the period running from 8/27/99 through 11/2/99, plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant accrued permanent partial disability benefits of $2,711.45 for his industrial impairment, plus interest and less attorney's fees as stated above. Employer/carrier was also ordered to pay claimant's related medical expenses, including surgery if it is deemed necessary in the future.
Injuries --Claimant suffered bilateral chronic tendinitis and mild bilateral medial and lateral epicondylitis. He later suffered a back injury.
Attorney(s) - Plaintiff --David W. Parker of Parker, Freestone & Angerhofer
Attorney(s) - Defense --Henry K. Chai II of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Edward Holmes.
Facts/Contentions --Claimant stated that he developed his tendinitis and epicondylitis from his work, locating and removing damaged goods from pallets loaded with cases of food. These duties entailed repetitive lifting, moving and re-stacking cases of food which were stacked 50 or 60 to a pallet. The cases weighed between 1 and 50 pounds each. Claimant said he injured his back in 1999 when removing a leaking case of spaghetti sauce from the bottom row of a pallet. As he lifted the case to waist height, he felt sharp pains in both elbows; as he twisted to throw the case onto a cart, he felt a muscle pull in his back and immediately experienced such pain that he fell to the floor.
Claimant and employer reached a settlement regarding claimant's 1999 industrial accident, and claimant was released to light duty work. However, claimant's back and elbow pain continued, and he filed this claim for further benefits.
The medical panel found claimant suffered an industrial injury in 1999 and also suffers from an occupational disease. The panel gave claimant a 3% whole person impairment rating for his epicondylitis, of which 95% was industrial and 5% non-industrial. Of that 95%, only half is attributable to the 1999 incident; the rest is due to daily lifting and straining over time. Dr. Holmes found that surgery may be necessary if tennis elbow straps, duty modification and anti-inflammatory medication do not reduce claimant's pain.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury
Case Name --Gudrun Johnson vs. First Healthcare Corporation and Cigna Property & Casualty Companies
Case Number --9950
Court/Judge --Eblen
Verdict/Settlement --Final order, 7/02
Amount --The ALJ found that, given employer/carrier's failure to submit a rehabilitation plan, claimant is permanently and totally disabled. The ALJ ordered employer/carrier to pay claimant accrued permanent total disability benefits of $37,960 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant permanent total disability benefits of $365 per week for the period running from 11/29/01 through 10/6/03, less 10% for attorney's fees, which are to be sent directly to claimant's attorney. Beginning 10/7/03, employer/carrier is entitled to a 50% offset for claimant's Social Security retirement benefits. Employer/carrier must continue to pay claimant's related medical expenses.
Injuries --Claimant suffered upper extremity problems and has qualified for Social Security disability benefits.
Attorney(s) - Plaintiff --Virginius C. Dabney of Dabney & Dabney, St. George
Attorney(s) - Defense --Michael E. Dyer of Blackburn & Stoll
Damages --Employer/carrier paid claimant $16,032 in temporary total disability benefits and $15,375.36 in permanent partial disability benefits.
Facts/Contentions --After claimant filed this request for permanent total disability benefits and a hearing was held, the ALJ issued a temporary finding that claimant was claimant permanently and totally disabled due to industrial causes, and ordered employer/carrier to pay claimant subsistence benefits pending a final finding. Employer/carrier had the opportunity to file a rehabilitation plan, but did not do so. Claimant reported that employer/carrier had not paid any subsistence benefits as ordered; claimant asked the ALJ to issue a final order awarding her permanent total disability benefits.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Jim Reiter vs. Lagoon Corporation and/or Workers' Compensation Fund
Case Number --2000937
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 7/02
Amount --The ALJ found that the effort claimant exerted in his attempt to get the bolt to come loose exceeded the exertions a person might encounter in everyday life. and thus met the Allen test. Utah case law (Allen) requires that for an injured employee with a pre-existing injury or condition to qualify for workers' compensation benefits, the activities leading up to the injury must exceed everyday exertions. The ALJ therefore found the work incident was both the medical and legal cause of claimant's injury. The ALJ ordered employer/carrier to pay claimant accrued temporary total disability benefits of $1,097.55 plus interest and accrued permanent partial disability benefits of $2,034 plus interest. Employer/carrier must also pay all claimant's related medical expenses.
Injuries --Claimant suffered two ruptured tendons in his right little finger, with a 2% or 3% attenuation of the sublimis tendon of his right ring finger. Claimant's right little finger was amputated at the proximal interphalangeal joint level.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Floyd Holm
Expert Witness(es) - Plaintiff --Dr. John Provost
Facts/Contentions --Claimant was performing mechanical repairs on a small go-cart-type car at Lagoon. He attempted to loosen a frozen 3/4" bolt on the car, set 4" above a concrete surface, with a 15" box wrench, but the bolt would not turn. Claimant said he exerted all the force he could muster on the wrench, and his right hand hit the concrete surface when the wrench slipped. The bolt on the car never came loose.
Employer/carrier did not dispute that the accident occurred and did not dispute medical causation, but claimed that the incident was not the legal cause of claimant's injury because claimant's physician found claimant had a pre-existing irregularity at the hook of the hamate which made rupture of the tendons in his little finger inevitable with time. Employer/carrier contended that claimant's actions leading up to the injury did not meet the Allen test (see above).
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Donald Sevey vs. Garff Enterprises and/or Industrial Indemnity Freemont Comp
Case Number --2000396
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 7/02
Amount --The ALJ accepted the medical panel's report and found claimant suffered an industrial injury which caused his back problems; claimant is not yet medically stable. The ALJ therefore ordered employer/carrier to pay claimant additional accrued temporary total disability benefits over and above those already paid of $27,395.94 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant $429 per week less attorney's fees until he reaches medical stability or until employer/carrier has paid 312 weeks of disability benefits. Employer/carrier must also continue to pay claimant's related medical expenses. The claims for permanent partial and permanent total disability benefits were dismissed without prejudice as unripe.
Injuries --Claimant suffered pain in his chest muscles, low back pain, and numbness of his arms and fingers. The chest and arm complaints resolved, but the back pain persisted. He was eventually diagnosed with a ruptured annular ligament at L4/5 and underwent fusion surgery, but has not yet stabilized.
Attorney(s) - Plaintiff --John L. McCoy
Attorney(s) - Defense --Kendall Hatch of Dunn & Dunn
Expert Witness(es) --Because of the great amount of conflicting medical testimony surrounding this claim, the case was referred to a medical panel.
Damages --Employer/carrier contended that they paid claimant $39,208.81 in temporary total disability benefits; claimant disputed this figure.
Facts/Contentions --Claimant was working as a sales manager for Garff when he noticed that a customer's driverless car had begun to roll toward the street from the Garff lot. Claimant stopped the car by personal physical force.
Employer/carrier contended that claimant's persistent back problems were not caused by his industrial accident.
The medical panel found claimant suffered a rupture of the annular ligament at L4/5 as a result of the industrial accident, which caused extensive continuing low back pain. The panel found claimant had not yet reached medical stability.
REPETITIVE STRESS INJURY
Case Type --OD, SI, WA; Occupational disease claim, work-related repetitive stress injury
Case Name --Wayne A. Ross vs. Smith's Food & Drug and/or Pinnacle Risk Management
Case Number --991225, 2000306
Court/Judge --Hann
Verdict/Settlement --Order, 7/02
Amount --The ALJ accepted the medical panel's report and ordered employer/carrier to pay claimant accrued temporary partial disability benefits for the period running from 8/27/99 through 11/2/99, plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant accrued permanent partial disability benefits of $2,711.45 for his industrial impairment, plus interest and less attorney's fees as stated above. Employer/carrier was also ordered to pay claimant's related medical expenses, including surgery if it is deemed necessary in the future.
Injuries --Claimant suffered bilateral chronic tendinitis and mild bilateral medial and lateral epicondylitis. He later suffered a back injury.
Attorney(s) - Plaintiff --David W. Parker of Parker, Freestone & Angerhofer
Attorney(s) - Defense --Henry K. Chai II of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Edward Holmes.
Facts/Contentions --Claimant stated that he developed his tendinitis and epicondylitis from his work, locating and removing damaged goods from pallets loaded with cases of food. These duties entailed repetitive lifting, moving and re-stacking cases of food which were stacked 50 or 60 to a pallet. The cases weighed between 1 and 50 pounds each. Claimant said he injured his back in 1999 when removing a leaking case of spaghetti sauce from the bottom row of a pallet. As he lifted the case to waist height, he felt sharp pains in both elbows; as he twisted to throw the case onto a cart, he felt a muscle pull in his back and immediately experienced such pain that he fell to the floor.
Claimant and employer reached a settlement regarding claimant's 1999 industrial accident, and claimant was released to light duty work. However, claimant's back and elbow pain continued, and he filed this claim for further benefits.
The medical panel found claimant suffered an industrial injury in 1999 and also suffers from an occupational disease. The panel gave claimant a 3% whole person impairment rating for his epicondylitis, of which 95% was industrial and 5% non-industrial. Of that 95%, only half is attributable to the 1999 incident; the rest is due to daily lifting and straining over time. Dr. Holmes found that surgery may be necessary if tennis elbow straps, duty modification and anti-inflammatory medication do not reduce claimant's pain.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury
Case Name --Gudrun Johnson vs. First Healthcare Corporation and Cigna Property & Casualty Companies
Case Number --9950
Court/Judge --Eblen
Verdict/Settlement --Final order, 7/02
Amount --The ALJ found that, given employer/carrier's failure to submit a rehabilitation plan, claimant is permanently and totally disabled. The ALJ ordered employer/carrier to pay claimant accrued permanent total disability benefits of $37,960 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant permanent total disability benefits of $365 per week for the period running from 11/29/01 through 10/6/03, less 10% for attorney's fees, which are to be sent directly to claimant's attorney. Beginning 10/7/03, employer/carrier is entitled to a 50% offset for claimant's Social Security retirement benefits. Employer/carrier must continue to pay claimant's related medical expenses.
Injuries --Claimant suffered upper extremity problems and has qualified for Social Security disability benefits.
Attorney(s) - Plaintiff --Virginius C. Dabney of Dabney & Dabney, St. George
Attorney(s) - Defense --Michael E. Dyer of Blackburn & Stoll
Damages --Employer/carrier paid claimant $16,032 in temporary total disability benefits and $15,375.36 in permanent partial disability benefits.
Facts/Contentions --After claimant filed this request for permanent total disability benefits and a hearing was held, the ALJ issued a temporary finding that claimant was claimant permanently and totally disabled due to industrial causes, and ordered employer/carrier to pay claimant subsistence benefits pending a final finding. Employer/carrier had the opportunity to file a rehabilitation plan, but did not do so. Claimant reported that employer/carrier had not paid any subsistence benefits as ordered; claimant asked the ALJ to issue a final order awarding her permanent total disability benefits.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Jim Reiter vs. Lagoon Corporation and/or Workers' Compensation Fund
Case Number --2000937
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 7/02
Amount --The ALJ found that the effort claimant exerted in his attempt to get the bolt to come loose exceeded the exertions a person might encounter in everyday life. and thus met the Allen test. Utah case law (Allen) requires that for an injured employee with a pre-existing injury or condition to qualify for workers' compensation benefits, the activities leading up to the injury must exceed everyday exertions. The ALJ therefore found the work incident was both the medical and legal cause of claimant's injury. The ALJ ordered employer/carrier to pay claimant accrued temporary total disability benefits of $1,097.55 plus interest and accrued permanent partial disability benefits of $2,034 plus interest. Employer/carrier must also pay all claimant's related medical expenses.
Injuries --Claimant suffered two ruptured tendons in his right little finger, with a 2% or 3% attenuation of the sublimis tendon of his right ring finger. Claimant's right little finger was amputated at the proximal interphalangeal joint level.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Floyd Holm
Expert Witness(es) - Plaintiff --Dr. John Provost
Facts/Contentions --Claimant was performing mechanical repairs on a small go-cart-type car at Lagoon. He attempted to loosen a frozen 3/4" bolt on the car, set 4" above a concrete surface, with a 15" box wrench, but the bolt would not turn. Claimant said he exerted all the force he could muster on the wrench, and his right hand hit the concrete surface when the wrench slipped. The bolt on the car never came loose.
Employer/carrier did not dispute that the accident occurred and did not dispute medical causation, but claimed that the incident was not the legal cause of claimant's injury because claimant's physician found claimant had a pre-existing irregularity at the hook of the hamate which made rupture of the tendons in his little finger inevitable with time. Employer/carrier contended that claimant's actions leading up to the injury did not meet the Allen test (see above).
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Donald Sevey vs. Garff Enterprises and/or Industrial Indemnity Freemont Comp
Case Number --2000396
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 7/02
Amount --The ALJ accepted the medical panel's report and found claimant suffered an industrial injury which caused his back problems; claimant is not yet medically stable. The ALJ therefore ordered employer/carrier to pay claimant additional accrued temporary total disability benefits of $27,395.94, over and above those already paid, plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay claimant $429 per week less attorney's fees until he reaches medical stability or until employer/carrier has paid 312 weeks of disability benefits. Employer/carrier must also continue to pay claimant's related medical expenses. The claims for permanent partial and permanent total disability benefits were dismissed without prejudice as unripe.
Injuries --Claimant suffered pain in his chest muscles, low back pain, and numbness of his arms and fingers. The chest and arm complaints resolved, but the back pain persisted. He was eventually diagnosed with a ruptured annular ligament at L4/5 and underwent fusion surgery, but has not yet stabilized.
Attorney(s) - Plaintiff --John L. McCoy
Attorney(s) - Defense --Kendall Hatch of Dunn & Dunn
Expert Witness(es) --Because of the great amount of conflicting medical testimony surrounding this claim, the case was referred to a medical panel.
Damages --Employer/carrier contended that they paid claimant $39,208.81 in temporary total disability benefits; claimant disputed this figure.
Facts/Contentions --Claimant was working as a sales manager for Garff when he noticed that a customer's driverless car had begun to roll toward the street from the Garff lot. Claimant stopped the car by personal physical force.
Employer/carrier contended that claimant's persistent back problems were not caused by his industrial accident.
The medical panel found claimant suffered a rupture of the annular ligament at L4/5 as a result of the industrial accident, which caused extensive continuing low back pain. The panel found claimant had not yet reached medical stability by the date of the hearing.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Paul M. Strevay vs. Mehrdad Najid dba Papiyon's and Uninsured Employers' Fund
Case Number --2001502
Court/Judge --Eblen
Verdict/Settlement --Order, 7/02
Amount --The ALJ found claimant suffered an industrial injury and ordered the UEF to pay claimant's medical expenses on behalf of uninsured employer. The UEF retains the right to seek reimbursement from uninsured employer, plus a 15% penalty for employer's failure to maintain workers' compensation insurance on his employees.
Injuries --Claimant suffered an injury to two fingers of his right hand.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Uninsured employer did not answer or appear at the hearing.
Facts/Contentions --Claimant worked as a bar-back for employer. He was bringing up some beer from the cooler to the bar when the cooler door slammed shut on his right hand. He sought medical care late the same night, and his hand was splinted. Claimant stated that he took the medical bills for treatment of the injury to his employer, who refused to pay them. Claimant quit his job because of non-payment of wages and of the medical bills.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Karla Gines vs. Duchesne County School District and/or School Boards Risk Management Mutual Assurance Association
Case Number --2001592
Court/Judge --Poelman
Verdict/Settlement --Order, 7/02
Amount --The ALJ found claimant was in the course and scope of her employment when the accident occurred and ordered employer/carrier to pay claimant's related medical expenses plus $91 in travel expenses incurred while obtaining medical treatment for the industrial injury. The ALJ noted that under Utah law, if an employee is traveling for an employer, injuries incurred while obtaining meals in the course of that travel do not constitute a departure from employment and thus are considered to have arisen in the course and scope of the employment.
Injuries --Claimant broke off a front tooth at the gum line.
Attorney(s) - Plaintiff --Geoffrey W. Leonard of the Utah Employees' Association
Attorney(s) - Defense --Stuart F. Weed of Kirton & McConkie
Expert Witness(es) - Plaintiff --John C. Prince, DDS
Facts/Contentions --Claimant worked as a bus driver for the Duchesne County School District. She was driving a busload of basketball team members on a two-day trip to Bryce Valley and Escalante. She stated that at about 4 PM, while the players were at the game at Escalante High School, claimant bought herself a package of chips at a convenience store across from the high school. She said she broke off her tooth when she attempted to open the package of chips. Claimant was on duty the entire trip and was required to maintain custody of the bus while the players were at the game, and she had not had anything to eat that day. Her wait at the high school was about eight hours long.
Employer/carrier contended that claimant's injury was the result of a pre-existing condition. Claimant had undergone dental treatment of her two front teeth which included the placement of a crown on them to close the gap between the two front teeth. After she broke off the tooth, her dentist extracted the root and installed a crown and bridge to replace the broken tooth. Claimant had to make a 70-mile round trip on four occasions for this treatment. Employer/carrier also contended that claimant was not in the course and scope of her employment at the time of the accident because she was not performing any specific duties.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury
Case Name --Jennifer Keoughan vs. Redwood Industries and/or Reliance National Indemnity
Case Number --2000799
Court/Judge --Poelman
Verdict/Settlement --Order, 7/02
Amount --The ALJ found that claimant failed to prove by a preponderance of the evidence that her carpal tunnel syndrome was caused by her work activities; the ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant developed bilateral carpal tunnel sundrome and underwent bilateral release surgery. Claimant stated that she still suffers from poor strength and dexterity in her hands and often drops things she picks up.
Attorney(s) - Plaintiff --Phillip B. Shell of Day, Shell & Liljenquist
Attorney(s) - Defense --Theodore E. Kanell of Plant, Wallace, Christensen & Kanell
Expert Witness(es) - Plaintiff --Dr. Mark C. Thomas; Dr. David Smith
Expert Witness(es) - Defense --Gerald Moress, MD
Facts/Contentions --Claimant stated she developed her carpal tunnel symptoms after she folded tousands of inserts and affixed stickers to mailings at work over a period of nine months. Dr. Thomas felt her problems were work-related.
Employer/carrier contended that claimant suffered a pre-existing injury to her hands and wrists when she fell on ice in 1996 while working for a previous employer. Employer/carrier contended that claimant's work activities which brought on her symptoms did not meet the Allen test. Utah case law (Allen) states that an injured worker with a pre-existing condition must prove that in order to qualfy for workers' compensation benefits, the activities which led up to the injury exceeded those which a person might encounter in everyday life. Claimant also admitted that shortly after this surgery, she re-injured her wrist by falling down some stairs. The person who held claimant's job after she left this employer testified that the process of folding inserts took only 45 minutes every Friday, and the process of folding, inserting, and sticking labels on letters occurred once monthly and took less than a day to complete. The folding, labeling and mailing of the company newsletter took less than a day to do and was done three times a year. The employee stated that she never experienced pain or fatigue in her wrists while she was engaged in these activities. Dr. Moress found that claimant's work activities could have caused her symptoms, but there was no evidence of a residual problem or permanent partial impairment.
WORK INJURY
Case Type --WA, OC; Work-related injury, ongoing case
Case Name --Maria Sandoval vs. Hexcel Corporation, self-insured
Case Number --20001402
Court/Judge --Eblen
Verdict/Settlement --Order, 7/02
Amount --The ALJ found the claim for additional medical expenses was barred by statute, since claimant had not submitted any related medical expenses to employer for over three years. However, the ALJ found the claim for additional temporary total and permanent partial compensation was not barred by the same statute.
Injuries --CLaimant suffered a knee injury and required total knee replacement surgery.
Attorney(s) - Plaintiff --Richard Burke of King, Burke & Schaap
Attorney(s) - Defense --Dori K. Petersen and Kristy Bertlesen of Blackburn & Stoll
Expert Witness(es) - Plaintiff --Dr. Catherine Allen; Dr. Dean Walker
Facts/Contentions --Claimant injured her knee in 1994, and her employer accepted liability and paid benefits. Claimant did not submit any related medical expenses to her employer for over five years, at which time she required a total knee replacement. Employer contended that the claim for additional medical benefits was barred by Utah statute because of that delay. Claimant also sought additional temporary total and permanent partial benefits for the knee injury, and employer contended that this claim was barred because no application for hearing was filed within six years of the date of the accident.
Dr. Walker noted that degenerative joint disease was present in the knee, relating back to original knee injury. The record did not show that claimant ever told her doctors to submit her expenses to her workers' compensation adjuster. The ALJ noted that though claimant was not responsible for personally submitting those bills to the adjuster, she was responsible for ensuring that the bills were submitted. However, the ALJ continued, regarding the claim for additional temporary total disability benefits and for permanent partial disability benefits, Utah law prohibits an employer who accepts liability for and pays benefits on a claim from later asserting statutory reasons such as failure to file an application for hearing when denying a claim for further benefits.
FALL
Case Type --WA, SF; Work-related slip/fall
Case Name --Joseph V. Smith vs. J-Mac Radiator Services and/or Insurance Company of the West
Case Number --2001758
Court/Judge --Poelman
Verdict/Settlement --Order, 7/02
Amount --The ALJ found claimant failed to prove medical or legal causation by a preponderance of the evidence. The ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant suffered a head injury. He has no related permanent partial impairment rating, and was told by his doctor that he could begin driving again in January of 2002.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Ford G. Scalley of Scalley & Reading
Expert Witness(es) - Plaintiff --Claimant's medical record was submitted.
Expert Witness(es) - Defense --Dr. John Barbuto--independent medical evaluation
Facts/Contentions --Claimant stated that he was injured when he slipped and fell in an Albertson's store in West Jordan in April of 2001 as he went in to get a snack after picking up a radiator for his employer.
Employer/carrier contended that claimant suffered from a pre-existing medical condition that caused him to black out and fall while leaving the store. Employer/carrier also denied that claimant slipped and fell at all, or that he was in the course and scope of his employment when he fell if the fall did occur. Claimant admitted that he suffered previous blackouts, but the cause was not clear. However, he said that he did not black out before falling, but slipped on something, though he was not sure what. An employee of Albertson's said he saw claimant walking towards him (the employee) when claimant suddenly stopped and put a hand against the wall as if to steady himself. The employee walked toward claimant, intending to assist him as it appeared claimant was going to fall, but claimant stepped away from the wall, closed his eyes and fell before the employee could get to him.
AUTOMOBILE ACCIDENT
Case Type --WA, AA: Work-related automobile accident
Case Name --Charles B. Sampson vs. Hills Brothers Coffee and/or Fireman's Fund Insurance Company
Case Number --2000976
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 7/02
Amount --Because the ALJ accepted the 18% finding of related permanent impairment, he found claimant was not entitled to any further permanent partial disability benefits beyond those which had already been paid. The ALJ therefore dismissed this claim with prejudice. On the claim for travel expenses, the ALJ found that while claimant lived in the Salt Lake Valley, employer/carrier remained liable for these expenses. However, the ALJ found, when claimant moved to Wyoming and sought care from a medical provider in a suburb of Denver, Colorado, he assumed liability for his own travel costs in the absence of an agreement from employer/carrier to pay them. The ALJ therefore dismissed this claim with prejudice as well.
Injuries --Claimant suffered a severe 40% compression fracture at L5. The ALJ accepted the various doctors' findings of an 18% related whole person impairment.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Henry K. Chai II of Blackburn & Stoll
Expert Witness(es) - Plaintiff --Dr. Robert Satovick; Brian Wilson, DC
Expert Witness(es) - Defense --Dr. Jeff Chung
Facts/Contentions --Claimant was injured when he rolled his company vehicle at SA 6 mile marker 256 in an attempt to avoid another vehicle. Employer/carrier accepted liability and paid benefits, but objected when claimant sought benefits for an additional 2% related whole person impairment based on Dr. Wilson's estimate of a 15-to-20% impairment. Drs. Satovick and Chung both rated impairment at 18%. Claimant also sought additional benefits for travel to obtain treatment, but employer/carrier objected to this claim on grounds that claimant moved to Wheatland, Wyoming and sought expenses for treatment in Englewood, Colorado.
ORDER ON REVIEW
Case Type --WA; Work-related injurya
Case Name --Paula M. Thornton vs. Salt Lake Commuity College and/or Workers' Compensation Fund
Case Number --00-0879
Court/Judge --This order was issued by Labor Commissioner R. Lee Ellertson.
Verdict/Settlement --Order, 7/02
Amount --The Commissioner issued his own findings to the effect that claimant received a letter from her employer informing her that she had been released to light duty work, that light duty work was available, and that claimant must report for this work or be terminated and lose her benefits. The Commissioner found claimant never telephoned or otherwise contact her employer to clarify the situation or suggest alternative arrangements, nor did she report for work. The Commissioner found the record indicated the work offered was within claimant's light duty restrictions. The Commissioner therefore ordered that claimant's temporary total disability compensation for the period 8/8/00 through 10/30/00 be reduced to reflect the $86 per week she would have earned had she accepted the legitimate offer of light duty work.
Injuries --Claimant suffered a shoulder injury.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Lori Hansen
Facts/Contentions --Claimant was injured 2/14/2000, and employer accepted liability and paid benefits. Employer contended that it offered light duty work as a cashier to claimant once she was released to light duty by her doctor, but claimant refused it; employer/carrier thus argued that it was no longer liable for temporary total disability benefits after these events occurred. Claimant stated that she was never advised clearly of the terms and conditions of the light duty assignment, and the ALJ concurred and continued temporary total disability benefits. Employer/carrier filed a motion for review.
OCCUPATIONAL DISEASE
Case Type --OD; Occupational disease claim
Case Name --Lisa Weakland vs. Autoliv and/or Travelers Property & Casualty
Case Number --2001119
Court/Judge --Poelman
Verdict/Settlement --Order, 8/02
Amount --The ALJ found claimant was unable to prove she suffered industrial disease caused by chemical exposure at work. The ALJ therefore dismissed this case with prejudice.
Injuries --Claimant stated she started experiencing breathing difficulties about six months after she started working at employer's plant.
Attorney(s) - Plaintiff --Michael Gary Belnap, Ogden
Attorney(s) - Defense --Brad C. Betebenner of Richards, Brandt, Miller & Nelson
Expert Witness(es) - Plaintiff --Dr. Jeff Abel; Dr. Schmitz; Heather Dove--speech-language pathologist
Expert Witness(es) - Defense --Dr. Dean R. Lillquist
Facts/Contentions --Claimant stated she was exposed to sodium azide at work, while sewing air bags at her employer's cushion plant in Ogden. She later underwent speech therapy for vocal cord dysfunction.
Employer/carrier denied that the industrial exposure occurred. Claimant admitted she never visited employer's Promontory plant, where the azide is used, nor the Brigham City plant, where the air bag inflators containing the azide are sealed. Claimant stated that she was undergoing significant stress in her life at the time she experienced breathing and speech problems. She was unable to produce evidence proving the plant where she worked was contaminated with azide.
WORK INJURIES
Case Type --WA; Work-related injuries
Case Name --Kathleen Ann Wyatt vs. Granite School District
Case Number --98386
Court/Judge --Eblen
Verdict/Settlement --Order, 8/02
Amount --The ALJ adopted the medical panel's findings. Since the panel found no residual impairment existed after the shoulder surgery, the ALJ found that claimant is not entitled to permanent partial disability benefits. The ALJ dismissed the claim for these benefits with prejudice.
Injuries --Claimant suffered three shoulder injuries and underwent corrective surgery. She was given a 4% related upper extremity impairment rating before the surgery, but the medical panel found she had no permanent impairment after the surgery.
Attorney(s) - Plaintiff --K. Dawn Atkin of Atkin & Associates
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) --This case was referred to a medical panel on the issues of permanent partial impairment and the question of whether medical expenses after 7/15/99 were industrially necessitated.
Damages --Self-insured employer paid claimant $1,494,75 in permanent total disability benefits, and also paid claimant's medical expenses through 7/15/99. The medical panel concluded that none of the medical care claimant received after that date was necessitated by her industrial injuries.
Facts/Contentions --Claimant was an instructional assistant helping to teach physically and mentally challenged children. She was injured the first time while transferring a 130-pound student from a wheelchair to a mat on the floor. The student suddenly transferred all her weight to claimant's left arm and fell onto the mat, pulling claimant down as well. Claimant began to have a headache about half an hour after the incident, and it became so severe that it impaired claimant's ability to see, eat, sleep and drive, and claimant sought medical care. Claimant re-injured her shoulder while transferring a child out of a wheelchair when the child fell. She was injured the third time while sitting at a desk in a classroom with a group of students who had behavioral problems. A large teenage boy hit claimant on the back of her head, re-injuring her neck, and claimant filed a police report related to this assault. Claimant underwent a surgical re-section of the superior medial border of the left scapula with a bursectomy. She sought permanent partial benefits after the surgery.
Self-insured employer produced a surveillance video showing claimant washing her car in a self-service car-wash, using both arms, and also driving a dump truck for her husband's business, using both arms. Employer contended that claimant had not suffered any permanent impairment from her injuries.
WORK INJURIES
Case Type --WA; Work-related injuries
Case Name --Jay Adams vs. Russ Necaise Masonry and/or Workers' Compensation Fund; Severson Construction, Incorporated and/or Zurich American Insurance; and Gold Medallion Homes and/or Liberty Mutual Insurance
Case Number --99047
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 8/02
Amount --The ALJ found Necaise/WCF and Severson/Zurich American were equally liable for all medical expenses, and ordered them to pay all such expenses connected with the accident of 3/24/98, including the costs of the surgery, which was necessitated by the industrial injury.
Injuries --Claimant suffered lumbar spinal injuries and had to have surgeries to implant hardware in and later to remove hardware from his back.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --For Necaise/WCF: Lori Hansen; for Severson/Zurich American: Thomas C. Sturdy of Blackburn & Stoll; for Gold Medallion/Liberty Mutual: Mark L. Anderson of Christensen & Jensen
Expert Witness(es) --This issue was referred to a medical panel.
Facts/Contentions --Claimant first sought benefits from Necaise/WCF and Severson/Zurich American for an accident that occurred March 24, 1998, when the brick facing of a chimney came loose and struck claimant as he was standing on a scaffold. That accident aggravated claimant's pre-existing lumbar spinal problems. ALJ Switzer ordered the employer/carriers to split the benefits owed to claimant equally, with each paying half. In November of 1999, Gold Medallion/Liberty Mutual filed the present action, seeking a determination of liability for the surgery performed 4/23/99. Gold Medallion argued that Necaise and Severson remained liable for the costs of this surgery; Necaise and Severson contended that a slip/fall which occurred on 1/26/99, while claimant was working for Gold Medallion, precipitated the need for surgery.
FALL, WORK INJURY
Case Type --WA, SF; Work-related slip/fall, work-related injury
Case Name --Doralee Boynton vs. Kennecott Utah Copper Corporation
Case Number --991209
Court/Judge --Eblen
Verdict/Settlement --Order, 8/02
Amount --The ALJ found the medical panel's findings were not supported by a preponderance of the medical evidence in the record. The ALJ therefore did not adopt the panel's findings. The ALJ found that because claimant had many opportunities for follow-up after the initial cervical injury, but claimant failed to seek further care until over a year and a half later when she sought the surgery, the surgery was not necessitated by claimant's industrial injury. The ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant suffered a cervical spinal injury and underwent fusion surgery at C5/6. She later suffered a left shoulder separation and underwent an arthroscopic acromioplasty. Claimant had a pre-existing medical history of cervical and lumbar injuries, and had been in three motor vehicle accidents.
Attorney(s) - Plaintiff --David Cundick
Attorney(s) - Defense --Dori K. Petersen of Blackburn & Stoll
Expert Witness(es) --The ALJ referred the stipulated facts to a medical panel for determination of medical causation and degree, if any, of permanent partial impairment.
Facts/Contentions --Claimant first injured her cervical spine when she slipped and fell on a graphite spill. She sought medical treatment the next day, as the incident occurred at the end of her shift. She injured her left shoulder when a co-worker unexpectedly handed her a 250-pound metal shaft; claimant suffered a left shoulder separation.
Self-insured employer accepted liability and paid for the shoulder injury and related surgery, but contended that claimant did not seek follow-up treatment for the initial cervical injury until a year and a half had gone by. Employer/carrier argued that claimant's need for surgery would have emerged sooner after her industrial accident, and the surgery was therefore not necessitated by the industrial injury.
The medical panel found the fusion surgery was necessitated by claimant's industrial cervical injury.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Becky Elwood vs. Pepperidge Farm and/or Travelers Insurance Company
Case Number --2001679
Court/Judge --Hann
Verdict/Settlement --Order, 8/02
Amount --The ALJ found claimant suffered an industrial injury; the ALJ further declared employer/carrier in default, since they failed to file a timely answer. The ALJ ordered employer/carrier to pay claimant $6,056.16 in accrued temporary total disability benefits, plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay all claimant's related medical expenses, including the unpaid bills for $3,958.46 and $567.69 in incurred travel expenses.
Injuries --Claimant suffered cervical injuries and underwent surgical fusions at C4/5, C5/6, and C6/7.
Attorney(s) - Plaintiff --Sandra N. Dredge of Dredge & Lallatin, Provo
Attorney(s) - Defense --Carrie T. Taylor of Richards, Brandt, Miller & Nelson
Damages --Claimant incurred $3,958.46 in unpaid medical bills and deductibles from her private health insurance, $103.61 in prescription expenses, and $567.69 in travel costs.
Facts/Contentions --Claimant stated she was injured while pushing a 700-pound slather mixing bowl across the floor when the mixer hit a hole in the floor and came to an abrupt halt. Claimant fell forward, jerked herself hard backwards to keep from falling, and injured her neck.
Employer/carrier did not file a timely answer, and the ALJ declared them in default. Employer/carrier appealed to the Appeals Board, which upheld the ALJ's ruling.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Alta Yergensen vs. Olsten Health Services nka Gentiva Health Services and/or Hartford Casualty Insurance Company
Case Number --200047
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 8/02
Amount --Given the severity of claimant's injuries and her limitations, as well as her credibility, the ALJ found she is permanently and totally disabled. The ALJ ordered employer/carrier to pay claimant permanent total disability benefits of $278 per week for the period running from 12/13/99, when claimant attained medical stability, through 2/25/02, with appropriate credit and offsets for benefits already paid. Thereafter, employer/carrier must pay claimant $278 per week for life, with offsets as allowed by law for any Social Security retirement benefits claimant receives. Accrued amounts are due and payable plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney; attorney's fees on continuing benefits are to be deducted and sent to claimant's attorney as benefits are paid. The ALJ reserved the issue of the right shoulder impingement syndrome and referred it to a medical panel. Employer/carrier must also pay claimant's related medical expenses for treatment of her neck injuries.
Injuries --Claimant suffered herniated discs at C5 through C7 and underwent anterior discectomy and fusion from C5 through C7 with Orion plating. She later developed right shoulder impingement syndrome, and an arthrogram has been recommended. Dr. Chung gave her a 15% related whole person impairment rating. Claimant has qualified for Social Security disability benefits. Several experts rated her functional capacity, and they concurred that claimant does not retain the ability to do anything more than sedentary work at most.
Attorney(s) - Plaintiff --Virginius C. Dabney of Dabney & Dabney, St. George
Attorney(s) - Defense --Carrie T. Taylor of Richards, Brandt, Miller & Nelson
Expert Witness(es) - Plaintiff --Dr. William Muir--orthopedic surgeon
Expert Witness(es) - Defense --Dr. Jeff Chung
Facts/Contentions --Claimant worked as a certified home health aide. She was injured while transferring a paraplegic patient from his water-bed to a low-chassis wheelchair. Claimant stated that she felt a pop and a searing pain in her back.
Employer/carrier admitted that the accident occurred, but disputed that it caused claimant to be permanently and totally disabled.
Claimant has tried a number of work options, but has not been able to tolerate any of them. She is limited in that she cannot bend her neck or use her right hand extensively. She can drive for short periods, but cannot remain sitting for more than 15 minutes at a time and must lie down several times per day. She is 62 years old and never graduated from high school.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --James Lynch vs. Smith's Food & Drug Centers, Incorporated (self-insured)
Case Number --2001602
Court/Judge --Poelman
Verdict/Settlement --Order, 8/02
Amount --The ALJ found claimant's activities at work which led to his re-injury did not meet the Allen test (see below); the ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant suffered a back injury. Dr. Chung gave him a related 4% whole person impairment rating, with another 4% for a non-industrial pre-existing condition.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Henry K. Chai II of Blackburn & Stoll
Expert Witness(es) - Plaintiff --Dr. Jeff Chung
Facts/Contentions --Claimant stated that he re-injured his back at his primary job with Smith's, while setting out produce on the "wet rack," where fruits and vegetables are kept moist with sprinklers, over a six-day period. Part of the merchandise displayed around the "wet rack" was bottled water, and the way the bottled water was arranged obliged claimant to stand six inches further away from the lower shelves while setting out the produce; he contended that this extra six-inch reach caused his back problems. Besides permanent partial compensation, claimant sought lost wages from his second job as a cashier at a 7-11, which he said he had to quit because of increased back pain. He said he did not consult Dr. Chung before quitting the second job, but added that he felt sure Dr. Chung would have approved.
Employer/carrier contended that claimant's back problems were pre-existing and further that his job activities leading up to his re-injury did not meet the Allen test. Utah case law (Allen) states that in order to qualify for workers' compensation benefits, an injured worker with a pre-existing condition must prove that the activities which led up to the injury exceeded those which a person might encounter in everyday life. Claimant contended that his low back pain prior to the alleged industrial injury was different from that which he suffered afterwards.
ORDER ON REVIEW
Case Type --WA; Work-related injury
Case Name --Alberta Cartwright vs. Pictsweet and GAB Robbins
Case Number --99-1092
Court/Judge --This order was issued by Labor Commissioner R. Lee Ellertson.
Verdict/Settlement --Order, 8/02
Amount --The Commissioner found that genuine issues of fact existed in the arguments presented by the parties. The Commissioner therefore remanded the case to the ALJ for further proceedings to determine the status of payment of claimant's benefits and attorney's fees.
Attorney(s) - Plaintiff --Aaron J. Prisbrey, St. George
Attorney(s) - Defense --Carrie T. Taylor of Richards, Brandt, Miller & Nelson
Facts/Contentions --This case was heard by an ALJ, who made a determination of benefits due claimant and fees due her attorney. Employer/carrier contended that it paid claimant the benefits due her and overpaid her attorney; claimant disputed these arguments. Both parties raised objections to the ALJ's findings, and employer/carrier filed this motion for review.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Janet Johnson vs. Quality Distribution, Incorporated and United Pacific Insurance
Case Number --00-0974
Court/Judge --This order was issued by Labor Commissioner R. Lee Ellertson.
Verdict/Settlement --Order, 8/02
Amount --The Commissioner denied employer/carrier's motion for review and affirmed the ALJ's decision with the exception of changing the date for commencement of subsistence payments from 9/18/99 to 10/3/99. The Commissioner remanded claimant's case to the ALJ for a final finding of permanent and total disability as required by Utah law.
Injuries --Claimant suffered wrist and pelvis injuries.
Attorney(s) - Plaintiff --Timothy C. Allen
Attorney(s) - Defense --Theodore E. Kanell of Plant, Wallace, Christensen & Kanell
Facts/Contentions --Claimant was injured on 10/27/98, and has not been able to work since. Employer/carrier accepted liability and paid benefits, including permanent partial disability compensation for a 1% related whole person impairment. The ALJ who heard the case issued a temporary finding of permanent and total disability as Utah law requires and ordered employer/carrier to pay subsistence benefits to claimant, beginning retro-actively, pending a final finding of permanent and total disability. Employer/carrier objected and filed this motion for review, claiming it could not be required to pay retro-active subsistence benefits.
WORK INJURIES
Case Type --WA; Work-related injuries
Case Name --Shane Johnson vs. Geneva Steel Company; Frontier Insurance Company; Uninsured Employers' Fund; and Workers' Compensation Fund
Case Number --9910, 99163, 99676
Court/Judge --Eblen
Verdict/Settlement --Order, 8/02
Amount --The ALJ accepted the medical panel's report and found that because the need for fusion surgery stemmed from the 1990 injury, WCF is responsible for payment, since it was the insurer of record for Geneva Steel at that time. The ALJ ordered WCF to pay the costs of claimant's surgery; WCF must also pay claimant temporary total disability benefits for the period running from 4/26/2000 until he reaches medical stability from the new surgery (estimated time six months). Accrued benefits are due and payable in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Since none of the parties submitted information on claimant's compensation rate at the time of the most recent re-injury on 3/5/90, the ALJ left it to the parties to determine the appropriate amount due.
Injuries --Claimant suffered multiple back injuries and underwent four surgeries--two on his thoracic spine and two on his lumbar spine. He also suffered a knee injury and underwent arthroscopic knee surgery.
Attorney(s) - Plaintiff --Sandra N. Dredge of Dredge Lallatin & Melendez, Provo
Attorney(s) - Defense --For WCF: Mark Dean, Janet Moffitt and Floyd Holm; for Frontier: Henry K. Chai II of Blackburn & Stoll; for UEF: Edwin C. Barnes of Clyde, Snow, Sessions & Swenson and Sheryl Hayashi
Expert Witness(es) --By stipulation of the parties, a hearing was waived and the case was referred directly to a medical panel chaired by Dr. Charles Smith--orthopedic surgeon.
Facts/Contentions --Claimant was injured five times while working for Geneva and one other steel company; the steel companies had various insurance carriers at the times of claimant's injuries. Claimant was also diagnosed with degenerative disc disease, but the parties could not agree on whether the degenerative changes were caused by the work injuries or not. They could not agree on which insurers, if any, were responsible for the ongoing benefits and treatment claimant needs.
The medical panel found claimant suffered an industrial injury in 1990 which required a fusion, but the surgery resulted in a non-union. The panel further found claimant suffered temporary aggravations of this original injury in 1998 and again in 2000, but these aggravations did not increase claimant's related whole person impairment, rated by his physician at 22%. The panel recommended lumbar fusion surgery to repair the non-union.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --William M. Avery vs. Craig F. Sorensen Construction and/or Workers' Compensation Fund
Case Number --2001178
Court/Judge --George
Verdict/Settlement --Order, 9/02
Amount --The ALJ found Drs. Burns and Barney were never authorized to provide ongoing treatment after the insurer denied further benefits. The ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant suffered spinal injuries which left him with neck pain and headaches.
Attorney(s) - Plaintiff --Russell T. Doncouse, Ogden
Attorney(s) - Defense --Lori Hansen
Expert Witness(es) --Brian Burns, DC; Dr. Barney; Dr. Schaelling
Damages --Pursuant to the previous order issued in this case, employer/carrier paid claimant $14,451.20 in medical benefits; $10,670.17 in temporary total disability benefits; $388 in temporary partial disability benefits; and $9,145.66 in permanent partial disability benefits.
Facts/Contentions --Claimant was first awarded benefits in 1997, after a hearing was held and his case was referred to a medical panel; employer/carrier paid as itemized above. Claimant later submitted a request for payment of medical expenses incurred after the order of 8/18/97, and employer/carrier contended that it denied authorization to treat claimant when Dr. Burns and Dr. Barney requested it. The 1997 order specified that physical therapist follow-up must be done by either an orthopedist or a physiatrist, and neither treatment provider is this type of physician. Dr. Schaelling, a family practitioner, prescribed therapy with Dr. Barney, but employer/carrier argued that this specification did not conform to the order either, since Dr. Schaelling was not an orthopedist or a physiatrist.
FALL
Case Type --WA, SF; Work-related fall
Case Name --Juan Geronimo vs. Monson & Monson Roofing and Wasatch Crest Insurance
Case Number --20006080
Court/Judge --Eblen
Verdict/Settlement --Order, 9/02
Amount --The ALJ accepted the medical panel's findings and ordered employer/carrier to pay claimant's related medical expenses, including the costs of the proposed surgery on the right wrist. Employer/carrier must also pay claimant temporary total disability compensation while he is recovering from the surgery and permanent partial disability compensation for any remaining impairment related to the right wrist injury. Attorney's fees are to be deducted from the disability compensation awards and paid directly to claimant's attorney.
Injuries --Claimant suffered a fractured left wrist and underwent open reduction internal fixation surgery, as well as physical therapy. His physician later proposed surgery to repair a ligament tear in the right wrist with associated scapholunate dissociation. Claimant has a 13% upper extremity impairment caused by the right wrist injury.
Attorney(s) - Plaintiff --Aaron J. Prisbrey, St. George
Attorney(s) - Defense --Brad C. Betebenner of Richards, Brandt, Miller & Nelson
Expert Witness(es) --The parties waived a hearing and stipulated to the forwarding of the undisputed facts and medical records to a medical panel consisting of Dr. Scott Smith, MD--orthopedic surgeon and Dr. Lawrence Chase--hand surgeon.
Damages --Employer/carrier paid claimant medical, temporary total impairment and permanent partial impairment benefits for his left wrist injury.
Facts/Contentions --Claimant was injured when he fell 14 to 20 feet from a ladder and landed on his hands and knees. His employer did not dispute liability for the left wrist injury, but contended that the right wrist injury was not medically causally related to the fall.
The medical panel found the right wrist injury was medically causally related to the industrial fall and will require further treatment in future.
WORK INJURY/FALLS
Case Type --WA, SF; Work-related injury and subsequent falls
Case Name --Elsie Merrill vs. Kelly Services and CNA Insurance Company
Case Number --2001692
Court/Judge --Eblen
Verdict/Settlement --Supplemental order, 9/02
Amount --The ALJ ruled that claimant's injuries sustained in the falls were the natural result of her original work injury and are therefore compensable. The ALJ ordered employer/carrier to pay claimant's related medical expenses for treatment of her injuries from the falls.
Injuries --Claimant injured her right knee, right ankle and low back in the falls.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Employer/carrier failed to answer or appear.
Facts/Contentions --Claimant stated that she fell at least three times after her original industrial injury because this original injury left her with weakness, numbness and muscle spasms in her left foot which were not present prior to the accident. Claimant stated that she talked to an adjuster at CNA about these injuries, but CNA refused to pay. The ALJ issued an order in May of 2002 directing CNA to pay for medically necessary treatment of her industrial injuries, but the order did not specifically address the secondary injuries from the falls, and claimant filed the request for clarification which led to this supplemental order.
WORK INJURY
Case Type --WA: Work-related injury
Case Name --(Name of case withheld)
Case Number --2001178
Court/Judge --George
Verdict/Settlement --Order, 9/02
Amount --The ALJ found claimant made false representations about the nature and extent of his injuries, his prior neck problems, and the circumstances surrounding the alleged injury. The ALJ therefore ruled that claimant failed to prove his case; the ALJ dismissed this claim with prejudice.
Injuries --Claimant said he experienced severe neck pain. He had several prior industrial injuries.
Attorney(s) - Plaintiff --Floyd Holm, Cedar City; then Rick Bonewell of Bonewell Morris, St. George
Attorney(s) - Defense --Elliot K. Morris
Facts/Contentions --Claimant said he and three co-workers were holding a 180-pound, 6" x 15' beam to be welded in place. Claimant was near the center of the beam, facing forward, with the beam resting on his right shoulder; he said there was a co-worker ahead of him on the other side of the center of the beam, and there were also co-workers at each end of the beam. The end of the beam claimant and the center co-worker were holding slipped off the pipe supporting it and came down about a foot. Claimant stated that when the beam came down, it struck a rocket fuel dryer tank and was deflected violently to one side, striking claimant in the neck. Claimant also contended that the beam weighed "at least" 300 pounds. The center co-worker stated that the beam did not strike the dryer tank, and this worker said he was not injured in the incident. Claimant said he felt no pain immediately after the beam shifted and thus did not report an injury at that time. After he finished his shift, he was laid off because the job was completed. He said he felt no discomfort that evening at home, but woke up the next morning in severe pain. Despite this pain, he said, he drove to a hunting area with his wife to fill his wife's elk-hunting permit. Claimant said his wife had to drive because his pain was so extreme, and after the truck broke down, they had to walk four miles for help.
Employer/carrier disputed that the alleged industrial accident occurred, contending that claimant's activities in gutting, skinning and butchering the elk, walking four miles, and working on the truck after the alleged industrial injury were inconsistent with his claim of severe and disabling pain. Claimant said he was unable to do heavy overhead work after the accident, but he continued to seek other work after being laid off. His medical records indicated that he experienced back pain after lying on concrete, working on the truck above him.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --(Name of case withheld)
Case Number --200185
Court/Judge --Eblen
Verdict/Settlement --Order, 9/02
Amount --The ALJ found there was insufficient evidence to prove claimant was injured in the course and scope of his employment. The ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant suffered severe back pain, at first believed to be musculoskeletal. Dr. Gardner diagnosed a right L4/5 herniated nucleus pulposus with degenerative disc disease, an annular tear reproducing back pain, and nerve root impingement to the right L5 nerve root causing leg pain.
Attorney(s) - Plaintiff --Sandra N. Dredge of Dredge Lallatin & Melendez, Provo
Attorney(s) - Defense --Carrie T. Taylor of Richards, Brandt, Miller & Nelson
Expert Witness(es) - Plaintiff --Dr. Gardner--neurosurgeon; Dr. King
Expert Witness(es) - Defense --Dr. Knoebel--independent medical examination
Facts/Contentions --Claimant stated he was injured October 22, 2000 in the course of his duties at Wal-Mart, while attempting to retrieve a large battery-powered toy car from a storage trailer for a customer. The car weighed about 60 pounds in the box, and claimant said he was unable to lift it; however, he dragged it out of the trailer to a shopping cart, after which he hugged the top of the box at chest level and put a foot under it, giving it a kick up so he could place it in the cart. He said when he did this he felt a sudden sharp pain above his beltline, and he dropped the box and walked around the trailer to "walk it off." He stated that he got the box into the shopping cart on his second try and took it to the customer. He said he was certain of the date because it was his mother-in-law's birthday, and he dropped his wife off at her parents' house on his way to work. He said he did not report the injury until the following day, when he came to work and experienced severe pain after getting out of his car in the parking lot.
Employer contended that claimant did not work on October 22, 2000, and the time sheets and payroll records substantiated this contention. Claimant's wife was unable to confirm that claimant actually went to work after he dropped her off. Wal-Mart management personnel testified that the storage trailers were always kept locked, and only management had the keys. Furthermore, management produced records indicating the merchandise in the storage trailers was inventoried three times in the fourth quarter and no merchandise was found to be missing, as it would have been had claimant removed the toy. Dr. Knoebel found claimant could have been injured as he claimed, but the injury could also have been caused by claimant's actions in getting out of his car in the parking lot. Claimant's medical records indicated he had a prior history of back pain.
WORK INJURY
Case Type --WA: Work-related injury
Case Name --Ronald K. Ahina vs. J P Realty and Liberty Mutual
Case Number --2002155
Court/Judge --Poelman
Verdict/Settlement --Order, 9/02
Amount --The ALJ found claimant was entitled to benefits for his work-related injury and ordered employer/carrier to pay claimant's accrued travel expenses of $210.76, as well as $32,072.48 in accrued temporary total disability benefits for the period running from 11/18/99 through 2/21/01. These benefits are due and payable in a lump sum plus interest.
Injuries --Claimant suffered a right knee injury. He stated that the physical therapy to which his doctor referred him made his pain worse. An MRI was performed after he moved to Seattle, and claimant eventually underwent surgery. He has a 10% related impairment of the lower extremity.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Employer/carrier was not represented and was initially declared in default, but Mr. Libby responded after the hearing, documenting payments made to claimant by insurer and indicating that respondents did not object to paying further benefits if ordered by the ALJ, as long as liability for these benefits was properly documented.
Expert Witness(es) - Plaintiff --Dr. Appell
Damages --Employer/carrier paid all claimant's related medical expenses, as well as $4,062.50 in permanent partial impairment benefits and approximately $18,000 in temporary total disability benefits for the period running from 2/22/01 through 11/07/01. Employer/carrier did not pay benefits for claimant's travel to obtain medical treatment.
Facts/Contentions --Claimant injured his knee when he bumped it at work. He reported the accident a week later, after the pain persisted and grew worse, and employer/carrier accepted liability, but did not pay some benefits, including those for claimant's initial period of temporary total disability.
FALL
Case Type --WA, SF; Work-related slip/fall
Case Name --(Name of case withheld)
Case Number --991037
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 9/02
Amount --The ALJ adopted the medical panel's findings and ruled that claimant's cervical spinal symptoms were not caused by his industrial fall. The ALJ therefore dismissed the claim for additional workers' compensation benefits with prejudice.
Injuries --Claimant suffered shoulder injuries and was diagnosed with a transverse comminuted fracture of the proximal left humeral diaphysis with mild apex anterior angulation. He said he was not conscious of having suffered any neck injury at the time he fell; however, he later developed cervical spinal problems and was diagnosed with very large grade III central and somewhat left posterolateral disc herniations at C4/5 and C5/6, with severe cord compression. Claimant underwent an anterior cervical C5 corpectomy and C4/5 and C5/6 discectomies with bone grafting and plating from C4 to C6.
Attorney(s) - Plaintiff --Danny Quintana of Quintana & York
Attorney(s) - Defense --Brad C. Betebenner of Richards, Brandt, Miller & Nelson
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel.
Facts/Contentions --Claimant speaks English as a second language, but testified without an interpreter. He said he was assigned to a metals company by his employer, a temporary staffing agency, and slipped on his way to work in the metals company's warehouse. He said he struck his left shoulder on some sheets of rebar when he fell. There were no witnesses to the accident, but claimant said he reported it to three co-workers and his supervisor.
Employer said claimant gave several differing accounts of how the accident occurred, and these different stories undermined claimant's credibility. Employer/carrier eventually accepted liability for the shoulder injury and paid temporary total and permanent partial disability benefits, but they disputed whether the accident caused claimant's cervical spinal problems, which did not develop until approximately a year and three months after he fell.
Claimant missed his appointment with the medical panel, and the ALJ dismissed his application for hearing; however, claimant later explained to the ALJ he missed the appointment because he was incarcerated in the Salt Lake County Jail, and the ALJ set aside the dismissal.
The medical panel found it was unlikely that claimant's neck problems were caused by his industrial fall.
FALL
Case Type --WA, SF; Work-related fall
Case Name --(Name of case withheld)
Case Number --2001264
Court/Judge --Hann
Verdict/Settlement --Order, 9/02
Amount --The ALJ found the medical evidence indicated claimant's fall was not caused by his multiple sclerosis or his diabetes, and therefore qualified as an industrial accident. However, the ALJ noted that claimant retired after his industrial accident without making any attempt to find other work he could do with his restrictions. Because of the lack of evidence proving that claimant cannot do other work reasonably available, and because he still does some work making keys on demand, the ALJ found claimant failed to prove he is permanently and totally disabled, and dismissed his claim for permanent total disability benefits with prejudice.
Injuries --Claimant hit and scraped his left shoulder and arm, twisted his left leg, and hit his back on the ground, twisting as he fell. He sought medical treatment for tingling and pain in his left leg, lower back, neck and shoulders about two months after he fell. He was diagnosed with a left posterolateral foraminal grade II disc herniation at L3/4. He was treated with physical therapy and injections and given a 4% related whole person impairment rating for his left shoulder injury and a 10% related whole person impairment rating for his lumbar spinal injury. He returned to his doctor six months later complaining of increasing lumbar pain with radiculopathy, and it was determined that the disc herniation had progressed, with significant nerve root compression at L3. Claimant underwent a laminectomy, foraminotomy and discectomy at L3/4. He was given an additional 3% related whole person impairment rating after the surgery, and was later diagnosed with a probable left rotator cuff tear in addition to his other injuries.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Theodore E. Kanell of Plant, Wallace, Christensen & Kanell
Expert Witness(es) - Plaintiff --Dr. Terry Sawchuk; Dr. Charles Beck; Dr. Reed Fogg
Expert Witness(es) - Defense --Dr. Gerald Moress--independent medical evaluation
Facts/Contentions --Claimant, who was 63 at the time of his accident, worked as a locksmith/mechanic at Dugway Proving Grounds. He was a civilian employee. He said he was injured when he fell off a two-foot cement landing as he was walking up some stairs to a building to work on a lock. Claimant, who suffers from non-industrial multiple sclerosis and diabetes, said he was carrying his cane and a 6-foot extension cord over his arm, and the stairs and the landing were outside the building. It had rained shortly before claimant fell. He landed on his shoulder, side and back, with his feet still up on the landing. He got up, went into the building and finished the work he had come to do, but then left work to seek medical treatment. He came back to work the next day and continued to try to work for about a week, but was sent home because his doctor had released him to light duty work only and there was no light duty work available. Claimant tried to go back to work after a month or two, but there was no job available that conformed with his permanent work restrictions. He began receiving Social Security benefits a couple of months later, and has not returned to full-time work since he fell. He sought permanent total disability benefits.
Claimant stated that his multiple sclerosis is under control and asymptomatic, as is his diabetes. A functional capacity evaluation revealed that he cannot stand for more than 20 to 30 minutes at a time. He cannot stand on a ladder or install a door and has lost feeling in his left hand since the accident; however, he can still make keys, and does so for people who call him because they know he is a locksmith.
Employer/carrier contended that claimant's fall was caused by his multiple sclerosis or by complications of his diabetes. Employer/carrier also argued that claimant is not permanently and totally disabled, and retired as a matter of choice after his accident.
OCCUPATIONAL DISEASE
Case Type --OD; Occupational disease
Case Name --Leroy W. Kell vs. Magcorp and CIGNA Insurance; AIG Claim Services; Wausau Insurance; Continental Insurance Company; Workers’ Compensation Fund; and Employers’ Reinsurance Fund
Case Number --99601
Court/Judge --Eblen
Verdict/Settlement --Order, 10/02
Amount --The ALJ accepted the medical panel’s report and ruled that claimant produced insufficient evidence to prove injurious exposure on the job. The ALJ therefore dismissed this claim for disability benefits with prejudice.
Injuries --Claimant suffers from chronic obstructive pulmonary disease (COPD). He has qualified for Social Security disability benefits.
Attorney(s) - Plaintiff --Phillip B. Shell of Day, Shell & Liljenquist
Attorney(s) - Defense --For Magcorp and AIG: Carrie T. Taylor of Richards, Brandt, Miller & Nelson; for Magcorp and CIGNA: Michael E. Dyer of Blackburn & Stoll; for Magcorp and Wausau: Brad C. Betebenner of Richards, Brandt, Miller & Nelson; for Magcorp and Continental: Theodore E. Kanell of Plant, Wallace, Christensen & Kanell; for Magcorp and WCF: Elliot K. Morris; and for ERF: Edwin C. Barnes of Clyde, Snow, Sessions & Swenson
Expert Witness(es) --This case was referred to a medical panel.
Facts/Contentions --Claimant worked at Magcorp’s chlorine plant as a crane operator, service and maintenance man, pot lines laborer, and electrode installer from 1973 to 1998, when his pulmonary disease forced him to stop working entirely. He smoked for fourteen years, but quit in 1988. Prior to 1973, claimant had a job at a smelter, where he was exposed to lead and zinc. Magcorp had several workers’ compensation insurers over the years claimant worked for them, and these carriers could not agree on when the illness began and which carrier(s), if any, are liable for claimant’s disability benefits.
Claimant’s own physician informed him directly that his chemical exposure on the job was contributing to his pulmonary disease and making it worse, and the medical staff at Magcorp was monitoring claimant’s condition through contact with his physician. Claimant stated that he thought he could not file a workers’ compensation claim at the time he learned he was disabled because of his smoking history. Employer/carriers failed to file required reports of occupational disease with the Labor Commission after claimant began to become disabled. ALJ Eblen noted that it appeared employer was well aware of its potential liability to claimant, but said nothing. Claimant filed his application for hearing within six years of the time his cause of action arose.
A previous ALJ issued an order in 2000 determining that claimant’s cause of action arose on June 2, 1998 and that liability was limited to CIGNA, the carrier on that date; the ALJ dismissed the other carriers at that time. The case was then referred to the medical panel, which found insufficient evidence to prove claimant was exposed to injurious vapors at his workplace. The panel therefore found no causal connection between claimant’s disease and his employment. The panel did note signs of early asbestosis, most likely caused by his work for another employer many years ago, but the panel concluded that claimant’s COPD was most likely caused by tobacco abuse.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --William M. Avery vs. Craig F. Sorensen Construction and/or Workers’ Compensation Fund
Case Number --2001178
Court/Judge --George
Verdict/Settlement --Order, 9/02
Amount --The ALJ found Drs. Burns and Barney were never authorized to provide ongoing treatment after the insurer denied further benefits. The ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant suffered spinal injuries which left him with neck pain and headaches.
Attorney(s) - Plaintiff --Russell T. Doncouse, Ogden
Attorney(s) - Defense --Lori Hansen
Expert Witness(es) --Brian Burns, DC; Dr. Barney; Dr. Schaelling
Damages --Pursuant to the previous order issued in this case, employer/carrier paid claimant $14,451.20 in medical benefits; $10,670.17 in temporary total disability benefits; $388 in temporary partial disability benefits; and $9,145.66 in permanent partial disability benefits.
Facts/Contentions --Claimant was first awarded benefits in 1997, after a hearing was held and his case was referred to a medical panel; employer/carrier paid as itemized above. Claimant later submitted a request for payment of medical expenses incurred after the order of 8/18/97, and employer/carrier contended that it denied authorization to treat claimant when Dr. Burns and Dr. Barney requested it. The 1997 order specified that physical therapist follow-up must be done by either an orthopedist or a physiatrist, and neither treatment provider is this type of physician. Dr. Schaelling, a family practitioner, prescribed therapy with Dr. Barney, but employer/carrier argued that this specification did not conform to the order either, since Dr. Schaelling was not an orthopedist or a physiatrist.
FALL
Case Type --WA, SF; Work-related fall
Case Name --Juan Geronimo vs. Monson & Monson Roofing and Wasatch Crest Insurance
Case Number --20006080
Court/Judge --Eblen
Verdict/Settlement --Order, 9/02
Amount --The ALJ accepted the medical panel’s findings and ordered employer/carrier to pay claimant’s related medical expenses, including the costs of the proposed surgery on the right wrist. Employer/carrier must also pay claimant temporary total disability compensation while he is recovering from the surgery and permanent partial disability compensation for any remaining impairment related to the right wrist injury. Attorney’s fees are to be deducted from the disability compensation awards and paid directly to claimant’s attorney.
Injuries --Claimant suffered a fractured left wrist and underwent open reduction internal fixation surgery, as well as physical therapy. His physician later proposed surgery to repair a ligament tear in the right wrist with associated scapholunate dissociation. Claimant has a 13% upper extremity impairment caused by the right wrist injury.
Attorney(s) - Plaintiff --Aaron J. Prisbrey, St. George
Attorney(s) - Defense --Brad C. Betebenner of Richards, Brandt, Miller & Nelson
Expert Witness(es) --The parties waived a hearing and stipulated to the forwarding of the undisputed facts and medical records to a medical panel consisting of Dr. Scott Smith, MD--orthopedic surgeon and Dr. Lawrence Chase--hand surgeon.
Damages --Employer/carrier paid claimant medical, temporary total impairment and permanent partial impairment benefits for his left wrist injury.
Facts/Contentions --Claimant was injured when he fell 14 to 20 feet from a ladder and landed on his hands and knees. His employer did not dispute liability for the left wrist injury, but contended that the right wrist injury was not medically causally related to the fall.
The medical panel found the right wrist injury was medically causally related to the industrial fall and will require further treatment in future.
WORK INJURY/FALLS
Case Type --WA, SF; Work-related injury and subsequent falls
Case Name --Elsie Merrill vs. Kelly Services and CNA Insurance Company
Case Number --2001692
Court/Judge --Eblen
Verdict/Settlement --Supplemental order, 9/02
Amount --The ALJ ruled that claimant’s injuries sustained in the falls were the natural result of her original work injury and are therefore compensable. The ALJ ordered employer/carrier to pay claimant’s related medical expenses for treatment of her injuries from the falls.
Injuries --Claimant injured her right knee, right ankle and low back in the falls.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Employer/carrier failed to answer or appear.
Facts/Contentions --Claimant stated that she fell at least three times after her original industrial injury because this original injury left her with weakness, numbness and muscle spasms in her left foot which were not present prior to the accident. Claimant stated that she talked to an adjuster at CNA about these injuries, but CNA refused to pay. The ALJ issued an order in May of 2002 directing CNA to pay for medically necessary treatment of her industrial injuries, but the order did not specifically address the secondary injuries from the falls, and claimant filed the request for clarification which led to this supplemental order.
WORK-RELATED DEATH
Case Type --WA, WD; Work-related death benefits claim
Case Name --RaNae Willard, widow of J. Scott Willard, vs. Giles & McFarland Excavating and/or Workers’ Compensation Fund
Case Number --20011036
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 9/02
Amount --The ALJ found the preponderance of the evidence, including the fact that RaNae and Scott Willard originally married and lived together for 23 years with the exception of a three-month separation following their divorce, indicated that they were capable of giving their consent to the bond between them and that they held the status of a married couple under Utah law. The ALJ therefore ordered employer/carrier to pay claimant death benefits of $333 per week beginning 9/19/01. Claimant must notify employer/carrier immediately if she remarries. Accrued benefits are due and payable in a lump sum plus interest and less attorney’s fees, which are to be deducted from this award and paid directly to claimant’s attorney.
Injuries --Scott Willard was killed in an industrial accident in September of 2001.
Attorney(s) - Plaintiff --Timothy C. Allen
Attorney(s) - Defense --Lori Hansen
Facts/Contentions --Claimant stated that she and decedent J. Scott Willard were married in a civil ceremony in 1978, but divorced in 1985. However, claimant stated, she and J. Scott Willard once again began living together as man and wife three months after the divorce; claimant contended that she and J. Scott Willard therefore had the status of common-law man and wife when he suffered an industrial accident that caused his death on September 19, 2001. The Willards shared responsibility for their bills and held a joint checking account and an account at R. C. Willey in common; they were raising a son together. RaNae Willard was carried as a dependent on Scott Willard’s employer-provided health insurance; she said she and Scott had talked about re-marrying formally, but never got around to it.
Employer/carrier admitted that the industrial accident occurred and that Scott Willard died, but disputed that RaNae Willard and Scott Willard were married at the time of his industrial accident and death. Employer/carrier pointed out that RaNae and Scott Willard filed separate income tax returns, and that RaNae did not name Scott on her employment-related health insurance. RaNae also kept the accounts for the car loan, utilities and credit card in her name alone; she stated that she did this because Scott had credit problems.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Brent Barton vs. Valley Electric & Engineering and/or Ohio Casualty
Case Number --2001855
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 9/02
Amount --The ALJ found the unrefuted evidence indicated that claimant suffered an infection that arose as a complication of the industrial wound on his leg. The ALJ therefore ordered employer/carrier to pay claimant $856 in accrued temporary total disability benefits plus interest, as well as all related medical expenses and any expenses for travel to seek treatment plus interest.
Injuries --Claimant suffered a left leg injury; the wound later developed cellulitis, which required aggressive antibiotic treatment.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) - Plaintiff --Dr. Elmo Gruwell; Dr. Craig Patten
Facts/Contentions --Claimant stated that he originally scraped his left shin while descending a ladder at work. He struck the same spot the next day with a hammer; at that time he told his foreman about the injury and sought medical treatment. He was off work for fourteen days while being treated.
Employer/carrier contended that the infection was not caused by the work injury.
DISCRIMINATION
Case Type --DS; Discrimination claim
Case Name --(Name of case withheld)
Case Number --8010140
Court/Judge --Eblen
Verdict/Settlement --Order, 10/02
Amount --The ALJ found there was no evidence in the record proving claimant was subjected to discrimination; rather, employer legitimately counseled claimant about poor job performance, and claimant resigned voluntarily. The ALJ therefore granted employer's motion for summary judgment and dismissed the discrimination claim with prejudice.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Russell K. Ryan, SLC, and Julie Mackoff, Seattle, Washington
Facts/Contentions --Claimant stated that her employer discriminated against her because she is African-American. She claimed she was refused a raise, denied lunch breaks and forced to work overtime without pay.
Claimant admitted that she signed forms at the time she was hired acknowledging her receipt and review of employer's attendance and dress code policies. Soon after she was hired, the evidence showed, employer counseled claimant about filing errors she had made, and shortly after that she was counseled about wearing inappropriate clothing to work, making too many personal phone calls, and being late and absent too many times. Claimant's phone was removed from her desk, and she did not receive a raise after 120 days of employment. Employer has not given raises to Caucasian employees after 120 days of employment; the company also removed the telephone from the desk of a Caucasian employee who was making too many personal phone calls. Records showed employers met with claimant to discuss her perception that she was not being treated with respect by other employees. Employer explained that claimant was required to finish her filing before she could leave work of go to lunch; this explanation addressed claimant's overtime and lunch grievances. Claimant left work one night without finishing her filing and without notifying her manager, and the next day, as employer was preparing written notice of her unsatisfactory performance, she called in sick. She called in the next day to tell employer she was not coming in to work, and after that she called again to say she was quitting. Company personnel testified that claimant was often rude and curt with other employees.
AUTOMOBILE ACCIDENT
Case Type --WA, AA; Work-related automobile accident
Case Name --Jeffrey States, DC, medical provider for Holly Erickson, vs. Markine Wright Graphic Arts and/or Workers' Compensation Fund
Case Number --99024
Court/Judge --George
Verdict/Settlement --Order, 10/02
Amount --The ALJ found that since WCF's letter failed to meet the criteria for Form 223, WCF was liable for 16 of the first 24 visits. However, since DC States began to treat Erickson again without pre-authorization, the ALJ found WCF was not liable for any further treatments or X-rays. DC States was paid for the first 24 visits, but since only 16 of those were allowed, the ALJ found DC States owes the WCF $406.37 for the 8 disallowed visits, due and payable in a lump sum plus interest. The ALJ dismissed the claim for payment for the other treatments with prejudice. The ALJ further ordered that DC States may not bill Erickson for the $406.37 DC States owes WCF.
Attorney(s) - Plaintiff --K. Dawn Atkin of Atkin & Associates
Attorney(s) - Defense --Lori Hansen
Damages --Employer/carrier paid Holly Erickson temporary total and permanent partial disability benefits.
Facts/Contentions --Holly Erickson was injured in a work-related car accident, and WCF accepted liability and paid benefits in full. Erickson was pregnant at the time of the accident, which caused some delays in treatment. DC States submitted to the Labor Commission a physician's first report of injury, which was filed 13 days late, and restorative services authorization forms for the first 20 visits Erickson made to his office for treatment, also filed late. WCF's review department authorized only 11 visits, but by then DC States had already treated claimant 16 times. DC States subsequently treated Erickson another 3 times. DC States filed Form 223 with WCF, disagreeing with WCF's review and requesting Level II reconsideration. WCF responded that its reviewing physician recommended a medical evaluation, but that this was not possible at that time due to Erickson's advanced pregnancy. However, WCF set up an appointment for Erickson for six weeks after her due date. DC States responded that because WCF failed to comply with the provisions of the request for review within five business days, the balance of his bill was due and payable. WCF responded that it had replied within five business days, and produced its letter as evidence. DC States argued that the letter did not comply with the rules for his Form 223, and the ALJ ruled that the letter did not state that it was a denial, was not issued on the Commission's Form 223, did not give the criteria for denial, did not give the name and specialty of the reviewing physician, and did not give any indication that the Commission was notified of the need for any further extension of time. DC States subsequently sought payment for additional X-rays, and in all he treated Erickson 39 times. Dr. Michael Chung performed an evaluation on Erickson, and gave her no impairment rating for her low back injury, but did give her a 3% impairment rating for her cervical strain/pain. Dr. Chung said he almost never recommended more than 12 physical therapy sessions, indicating that the Mercy Guidelines state that any passive modality treatment over 20 sessions is excessive. Chung opined that no further medical treatment was necessary. States then filed this application for hearing.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Sandra Daniels vs. St. Mark's Hospital/Columbia/HCA and/or Transportation Insurance Company
Case Number --99103
Court/Judge --George
Verdict/Settlement --Order, 10/02
Amount --The ALJ accepted the medical panel's findings and ordered employer/carrier to pay claimant $12,573.60 for her 13% related whole person impairment; this amount is due and payable in a lump sum plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must also pay all claimant's related medical expenses and expenses incurred in the course of travel to seek treatment.
Injuries --Claimant suffered a disc herniation at C5/6 with right C6 radiculopathy, cervicogenic headaches and cervical and shoulder girdle myofascial pain. She underwent surgery, but still has a 13% related whole person impairment.
Attorney(s) - Plaintiff --K. Dawn Atkin of Atkin & Associates
Attorney(s) - Defense --Mark Riekhof of Dunn & Dunn
Expert Witness(es) --The parties agreed to waive a hearing and refer the matter directly to a medical panel consisting of Dr. Madison Thomas--neurologist and chair; and Dr. Glenn Momberger--orthopedist.
Damages --Employer/carrier paid claimant temporary total disability benefits and temporary partial disability benefits.
Facts/Contentions --Claimant stated that she was injured when she caught an elderly patient who had slipped and was falling. She also suffers from non-industrial carpal tunnel syndrome. Employer/carrier disputed claimant's medical stability and permanent physical restrictions. Employer/carrier also sought a determination of whether claimant was capable of returning to work in any capacity and, if so, her job classification.
The medical panel found claimant has stabilized from her industrial injury and cannot use her right arm as she was doing at work prior to her injury. She is not capable of returning to work in any capacity because of her cervical spinal injury, and her related headaches preclude assigning her a job classification.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Joseph D. Fava vs. Osmose, Incorporated and/or Zurich Insurance
Case Number --20011293
Court/Judge --Poelman
Verdict/Settlement --Order, 10/02
Amount --The ALJ noted that even though contact with the drill might not have caused any damage to the boot itself, that fact would not preclude injury to the toe underneath, causing ulceration and infection, as often happens with diabetics who suffer foot injuries. The ALJ found claimant's testimony about co-worker witnesses, along with the fact that employer/carrier did not produce any testimony to refute this claim, to be persuasive. The ALJ therefore found the evidence preponderated in favor of claimant, and ordered employer/carrier to pay claimant's outstanding medical expenses of $6,390.22, as well as temporary total disability compensation in the amount of $1,073.48, due and payable in a lump sum plus interest.
Injuries --Claimant suffered a foot injury which developed an infection. He was under treatment for 10 days.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Facts/Contentions --Claimant stated he was drilling holes for the placement of telephone poles, and dropped the drill, which did not shut off as expected and struck him in the toe. The incident was witnessed by several co-workers. Claimant informed his supervisor and continued to work, but had to leave work early the following day because he developed nausea and started shaking. By the following Sunday, he noticed a red line extending up his leg from his toe, and he sought treatment at a hospital emergency room. He claimed he attempted to return to work after that time, but the employer would not take him back. Claimant is diabetic and has suffered from neuropathy for the past 4 years.
Cross=examination revealed that at the time of the accident, claimant was wearing a new pair of work boots, and he was not then aware of any damage done to his boots by the drill. Employer/carrier stated that claimant complained the morning of the accident that the boots were not smooth and were causing him pain. Claimant later took the boots back and received a refund. Employer/carrier contended that claimant's infection resulted from a blister caused by the new boots.
WORK INJURY
Case Type --WA: Work-related injury
Case Name --Clair Glenn vs. Cantwell Brothers Lumber Company, Incorporated and/or Fremont Compensation Insurance
Case Number --20011115
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 10/02
Amount --The ALJ noted that under Utah law, an injured worker receiving workers' compensation benefits has the right to make one change of doctor without the permission of the carrier, as long as the carrier is promptly notified of the change by the employee. The ALJ therefore ordered employer/carrier to pay all claimant's related medical expenses, including those for treatment with the new physician; the ALJ ordered claimant to notify employer/carrier as soon as he has chosen his new treating physician.
Injuries --Claimant suffered an injury to his left hand.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Mark D. Dean
Expert Witness(es) - Plaintiff --Dr. Blaine Anderson
Facts/Contentions --Claimant was injured 4/10/2000, and employer accepted liability and paid benefits. Claimant originally sought permanent total disability benefits, but withdrew that claim at his hearing. However, he claimed the right to obtain another treating physician, and employer objected.
WORK INJURY
Case Type --WA, MS, PA; Miscellaneous work-related injury (forklift/pedestrian accident)
Case Name --Monica Munoz vs. Smurfit Stone Container (self-insured)
Case Number --2001765
Court/Judge --Eblen
Verdict/Settlement --Order, 10/02
Amount --The ALJ noted that under Utah law, an injured employee is entitled to receive temporary total and/or temporary partial disability benefits as applicable until her medical condition has stabilized. As soon as a light duty work release is given and light duty work is made available by the employer, the employer is not required to continue to pay temporary total disability benefits. The ALJ also noted, however, that because claimant was terminated without a medical opinion regarding her medical stability, her employer is exposed to liability for continued compensation benefits under the plain language of the statute. The ALJ therefore ordered self-insured employer to pay claimant temporary total disability benefits for the period running from the time she was terminated until she found other light duty work on 6/14/2001, since no light duty work was made available to her by employer after she was terminated, but she was not yet medically stable. Of these accrued benefits, $3,672 shall be reimbursed directly to the Department of Workforce Services for the unemployment compensation claimant received from them. The other accrued benefits, totaling $3,707.92, shall be paid directly to claimant plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Attorney's fees are to include 20% of the interest generated on claimant's award. Employer must also pay all claimant's related medical expenses; however, the ALJ dismissed with prejudice claimant's request that employer pay for an MRI.
Injuries --Claimant was diagnosed with back contusions and sprain and a contusion on the back of her right leg.
Attorney(s) - Plaintiff --Maximo R. Guerra
Attorney(s) - Defense --Carrie T. Taylor of Richards, Brandt, Miller & Nelson
Expert Witness(es) - Plaintiff --Dr. Archuleta; Dr. Bart Fotheringham
Expert Witness(es) - Defense --Dr. Richard Knoebel--independent medical examination
Damages --Claimant received $3,672 in unemployment compensation benefits after she was terminated. The ALJ found no inconsistency between her report that she was able and willing to perform light duty work and her light duty work restrictions related to her injury.
Facts/Contentions --Claimant stated that she was squatting down and gluing some bags on a pallet at work when she was struck in the right leg and lower back by a pallet pushed by a forklift which was backing up. She immediately reported the incident to her supervisor, who applied ice to her back and leg. She returned to work later that morning to prepare a written report of the incident and receive a referral to a doctor. When claimant returned to work, employer provided her with light duty work until she was terminated on 12/15/2000. She complained of increased pain after she was terminated, but employer contended that her injuries had resolved before that time. Dr. Fotheringham found symptoms consistent with lumbosacral pain syndrome, which he felt was related to the work injury. He recommended physical therapy and opined that claimant was capable of light duty work. Claimant received physical therapy as per Dr. Fotheringham's recommendations, and self-insured employer refused to pay for it. Claimant later found light duty work with a temporary agency.
Dr. Knoebel found a medical causal relationship between claimant's pain and her industrial injury, but did not believe additional medical care was needed and declared claimant was medically stable as of 1/14/2002. Claimant returned to work on 6/14/2001.
Self-insured employer contended that claimant was not struck in the back, but the ALJ found the medical evidence (i.e., the contusion Dr. Archuleta found on her lower back) indicated that claimant's account was correct, and the forklift struck her in the leg and lower back.
FALL
Case Type --WA, SF; Work-related fall
Case Name --A. J. Smith vs. Holland Construction
Case Number --2002301
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 10/02
Amount --The ALJ found the undisputed medical evidence indicated that claimant was entitled to benefits for his 2% related whole person impairment. The ALJ therefore ordered employer/carrier to pay claimant accrued permanent partial disability benefits of $1,166.88 plus interest. The ALJ noted that employer/carrier is also required to continue to pay all of claimant's related medical expenses.
Injuries --Claimant suffered a fractured arm, a torn spleen, and a broken nose. Dr. Greene gave claimant a related 2% whole person impairment rating.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Charles T. Brown of Provident Management
Expert Witness(es) - Plaintiff --Dr. Mark Greene
Facts/Contentions --Claimant was injured when he fell through a stairwell at work, and his employer accepted liability and paid benefits. However, employer disputed his claim for permanent partial disability benefits and refused to pay an outstanding $30 bill for medical treatment. At the hearing, employer/carrier agreed to pay the $30 medical bill.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --(Name of case withheld)
Case Number --2000698
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 10/02
Amount --The ALJ accepted the medical panel's report and found employer/carrier is not liable for the costs of claimant's three surgeries. However, the ALJ found employer/carrier was liable for disability benefits. The ALJ ordered employer to pay claimant $21,213.34 in accrued temporary total disability benefits and $4,196.40 in accrued permanent partial disability benefits, with credit given for any benefits already paid. Both these awards are due and payable in lump sums plus interest and less attorney's fees, which are to be deducted from these awards and paid directly to claimant's attorney. Attorney's fees shall also include 15% of the interest generated by these awards. The ALJ ordered employer/carrier to pay those of claimant's related medical expenses which were found to be reasonably necessary by the medical panel.
Injuries --Claimant suffered an ankle injury and eventually underwent three surgeries because of continuing pain and disability. The medical panel found that her 5% whole person impairment was all related to her industrial injury.
Attorney(s) - Plaintiff --Aaron J. Prisbrey, St. George
Attorney(s) - Defense --Michael E. Dyer of Blackburn & Stoll
Expert Witness(es) --The parties agreed to waive a hearing and refer this matter directly to a medical panel consisting of Dr. Ross McNaught--orthopedist; and Dr. Robert Nakken--orthopedic surgeon. Because the parties failed to locate some related treatment records from claimant's treating physician which the ALJ asked them to submit, the panel reluctantly proceeded without some vital medical records.
Facts/Contentions --Claimant stated that she was loading packages on a pallet at work when she twisted and felt a pop in her right ankle. She received medical treatment the next day, and employer/carrier accepted liability and paid some benefits. Claimant contended that her ankle injury caused repeated falls and severe suicidal depression requiring medication that made it unsafe for her to work.
Claimant had a past history of multiple ankle sprains and a chip fracture, and employer/carrier disputed whether claimant's impairment and continuing problems were related to the ankle injury she sustained at work.
The medical panel found claimant's permanent impairment was all related to her industrial injury, and she reached medical stability six weeks after her third surgery (an ankle arthroscopy), on 1/30/2001. The panel found claimant remained unfit for work after that date. However, the panel found much of the treatment claimant received was not medically necessitated by her industrial injury, but resulted from the difficulty encountered by her physicians in reaching a clear diagnosis. The panel noted that though the surgeries claimant underwent never rose to the level of malpractice because they did not breach the standard of care, they were only marginally, if at all, justifiable under the circumstances.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --(Name of case withheld)
Case Number --2000169
Court/Judge --Eblen
Verdict/Settlement --Order, 10/02
Amount --The ALJ accepted the medical panel's report, found that claimant's continuing symptoms were not related to her 1997 industrial injury, and dismissed her claim for further benefits with prejudice.
Injuries --Claimant suffered a cervical and thoracic spinal strain.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Lori Hansen
Expert Witness(es) --Because of conflicting medical testimony, the ALJ referred this case to a medical panel consisting of Dr. Alvin Wirthlin--neurologist; and Dr. Glenn Momberger--orthopedist.
Damages --Employer/carrier paid claimant $244.28 in temporary total disability benefits and 4591.99 in medical benefits.
Facts/Contentions --Claimant worked as a dancer at employer's nightclub. She stated that she was injured on 1/20/97 while performing a backbend from a standing position in the course of her dance routine. Claimant stated that her vision went black for a short time after she returned to a standng position, and she felt pain along the entire length of her cervical, thoracic and lumbar spine. She left the stage and lay down for about an hour, and was later taken to a hospital. She said her neck continued to hurt after she returned to work, and she could dance for only about two or three two-hour shifts per week instead of her usual six seven-hour shifts. She was later terminated, and attempted to work at another club, where she could work for 15 minutes and then take a 15-minute break. She stated that the intensity of her back pain has not changed or abated since she was injured. She attended one physical therapy session, but experienced no relief. Claimant has passed out a couple of times since she was injured, and experienced tunnel vision, a numb right arm, and shakiness and tingling in both legs. One treating physician recommended that she be evaluated for seizure disorder, but another believed she was suffering from migraine headaches caused by the industrial injury. She had a prior history of treatment for acute cervical muscle and trapezius muscle sprain, also caused by her work as a dancer. An MRI performed after this work injury revealed mild desiccation at C2/3, C4/5 and C5/6, with mild broadbased disc bulging at C5/6, with no evidence of canal stenosis, foraminal encroachment or nerve root impingement. A second MRI was performed, and her treating physician opined that she was suffering the effects of an industrial injury. A cervical discography was normal. Claimant has continued to receive treatment through the present.
Employer paid some benefits, but contended that claimant's continuing problems stem from an emotional somatiform pain disorder and not from the after-effects of her industrial injury.
The medical panel found claimant's symptoms could not have resulted from her sprain injury; the panel concluded that claimant suffers from somatiform pain disorder with a background of social and emotional turmoil, substance abuse and anxiety and/or panic disorder. Claimant objected to the medical panel's report, but her objections were not filed within the time allowed by law.
REPETITIVE STRESS INJURY
Case Type --WA, SI; Work-related repetitive stress injury
Case Name --Beverly Workman vs. Intracorp and Ace, USA
Case Number --2001212
Court/Judge --Eblen
Verdict/Settlement --Order, 10/02
Amount --The ALJ accepted the medical panel's report and dismissed this claim with prejudice on grounds that claimant's symptoms are not causally related to her work activities.
Injuries --Claimant initially suffered pain and swelling of the extensor and flexor tendons of the index and middle fingers on her right hand with associated arm numbness. She was diagnosed with overuse syndrome related to her job--especially the repetitive use of her rather awkward computer mouse. Her doctors recommended a variety of treatments; none of them alleviated her symptoms, which grew steadily worse. Later tests indicated a high probability of thoracic outlet syndrome in her right arm and a moderate probability of thoracic outlet syndrome in her left arm. An electromyograph indicated the probability of severe neurovascular bundle irritation. She underwent a cortisone injection, but had a bad reaction to it, and this treatment was discontinued. A cervical MRI revealed disc protrusions at C4/5 and C5/6, with degenerative discs at both locations. A right shoulder MRI was normal. Claimant underwent a first rib re-section, but her symptoms continued to worsen.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Michael E. Dyer of Blackburn & Stoll
Expert Witness(es) --Because of the great volume of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Joseph Jarvis; Dr. Craig Wilkinson--vascular surgeon; and Dr. Dennis Gordon--orthopedic surgeon.
Facts/Contentions --Claimant argued that her continuing and worsening symptoms were brought on by the repetitive activities required by her work as a nurse case manager. Claimant worked from home and used the telephone, a laptop computer and a fax machine in the course of her duties. She also drove a car to visit the patients with whom she worked.
Employer/carrier disputed the allegation of industrial injury and contended that claimant's symptoms were unrelated to the industrial injury if it occurred, noting that Dr. Sellers, who performed an independent medical evaluation, found no causal connection.
The medical panel found claimant is medically stable, and she has no residual permanent impairment as a result of her industrial injury. The panel found no causal connection between claimant's thoracic outlet syndrome and her work duties.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Erin Gaudette vs. Stampin' Up and Zenith Insurance
Case Number --200167
Court/Judge --Eblen
Verdict/Settlement --Order, 10/02
Amount --The ALJ ruled that claimant's injury occurred within the course of her employment, because she was on her employer's premises and had been working. However, the ALJ ruled, the injury did not occur within the scope of claimant's employment, because she was on her way to clock out and took a personal deviation to pick up the box of firewood for her own use. The ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant suffered bilateral inguinal hernias which were laparoscopically repaired. Two years after the surgery, she was diagnosed with a right side pelvic mass which was caused by scarring from the earlier surgery, and claimant had to have another surgery to remove it.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Brad C. Betebenner of Richards, Brandt, Miller & Nelson
Damages --Claimant sought medical expenses and temporary total, permanent partial, and temporary partial disability benefits for both surgeries. Both surgeries were paid for by claimant's private health insurance.
Facts/Contentions --Claimant's work involved pulling orders to be mailed to customers. The items she pulled were mostly scissors and stamps, which were not heavy. Claimant stated that she had finished her shift and was on her way to the time-clock. On the way, she picked up a box of the scrap wood which her employer allowed employees to take home and use as firewood. The box weighed 15 to 20 pounds. After about ten steps, claimant felt abdominal pain and set the box down, and a friend carried it to her car. Claimant went to her other job at the IGA that afternoon and told her supervisor about the injury, and he suggested that she inform her supervisor at Stampin' Up. Claimant said she did so, but could not remember whether she told the Stampin' Up supervisor that her injury was industrial.
The Stampin' Up foreman did not remember claimant telling him she had suffered an industrial injury, and the human resource manager had no record of such a report in his files. Employer/carrier contended that the injury was not a work injury because claimant had finished her shift.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Bernard F. Dineen vs. Newport Holding, Incorporated (uninsured) and Uninsured Employers' Fund
Case Number --20021160
Court/Judge --Poelman
Verdict/Settlement --Order, 10/02
Amount --The ALJ ordered the ERF to pay claimant's related medical expenses and also to pay claimant accrued temporary total disability benefits of $2,432.32 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. The ERF retains full rights to seek repayment of these benefits from Newport, in addition to a 15% penalty for Newport's failure to maintain workers' compensation insurance on its employees.
Injuries --Claimant suffered a right leg injury.
Attorney(s) - Plaintiff --William R. Osmond
Attorney(s) - Defense --For ERF: Sherrie Hayashi
Damages --Claimant incurred $5,281.51 in medical expenses and was off work for 5 weeks and 6 days after his injury.
Facts/Contentions --Claimant was injured on 9/20/01. After he filed this claim for benefits, his employer did not answer or appear, and the ALJ determined that the employer was insolvent.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Jean Maddox vs. Jordan School District (self-insured)
Case Number --2001460
Court/Judge --Eblen
Verdict/Settlement --Order, 10/02
Amount --The ALJ found that claimant suffered a previous spinal injury. Therefore, in order to qualify for workers' compensation benefits under Utah case law, she had to prove that the actions which led up to this industrial exacerbation of her previous injury exceeded the exertions a person might encounter in everyday life, such as taking a turkey out of a shopping cart, lifting luggage onto an X-ray scanner or lifting a tire out of the trunk of a car (the Allen test). The ALJ found that claimant's activities which led to this re-injury were similar to those described in Utah case law and thus were not extraordinary. The ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant suffered a Grade III left posterolateral superiorly extruded recurrent disc herniation at L4/5 with associated compression and displacement at left L5 root. She had postoperative changes from a previous surgery at L5/S1 with moderate epidural fibrosis, and degenerative changes at L5/S1 and to a lesser extent at L3/4. She had a history of lumbar spinal problems prior to the industrial injury.
Attorney(s) - Plaintiff --David K. Smith
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Expert Witness(es) - Plaintiff --Dr. Thomas Bowman
Expert Witness(es) - Defense --Dr. Bart Fotheringham; Dr. Tim Grange; Dr. Gordon Kimball
Facts/Contentions --Claimant was helping to get the cafeteria ready for lunch by putting cases of single-serving milk cartons in the cooler. There were 50 half-pints of milk in each case, and the ALJ determined that each case weighed about 29 pounds. As claimant lifted the second case of milk from a stack of four or five cases and bent over to place it in the cooler, she felt a pop in her back. She immediately reported the injury and sought medical care, eventually undergoing an MRI. All of the doctors involved felt the re-injury was industrial and also noted claimant's past history of back problems.
Employer/carrier did not dispute that claimant re-injured herself as she claimed, but contended that her actions which led up to the re-injury did not meet the Allen test for legal causation (see Order above).
WORK INJURY
Case Type --WA: Work-related injury
Case Name --Ruben Miranda vs. Mountain States Supply and/or Reliance National
Case Number --20011054
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 10/02
Amount --The ALJ found employer/carrier paid claimant temporary total disability benefits until he attained medical stability. They therefore did not owe him any further benefits, and the ALJ dismissed this claim with prejudice.
Injuries --Claimant suffered a right lumbosacral sprain-strain. He had evidence of mild degenerative changes at L5/S1. Claimant was not given an impairment rating. He reached medical stability on 9/10/01, according to his doctors.
Attorney(s) - Plaintiff --Danny Quintana of Quintana & York
Attorney(s) - Defense --Theodore E. Kanell of Plant, Wallace, Christensen & Kanell
Expert Witness(es) - Plaintiff --Dr. Roger Stuart; Dr. Bart Fotheringham; Dr. Stephen Schultz
Facts/Contentions --Claimant drove a truck and delivered supplies to job sites for employer. He was delivering 3,000 feet of PVC pipe to a church, and put two bundles of the pipe, weighing 80 pounds apiece, on his shoulders to carry to the installers. While carrying the pipe, claimant stepped on another pipe and felt his back snap. He immediately reported the injury and sought medical care, eventually undergoing an MRI.
Employer/carrier accepted liability and paid benefits, but contended that claimant refused light duty work offered him after he had been released to return to light duty. Employer/carrier argued that they already paid claimant all the benefits to which he was entitled.
ASSAULT
Case Type --WA, BT; Work-related assault
Case Name --(Name of case withheld)
Case Number --2001338
Court/Judge --Hann
Verdict/Settlement --Order, 10/02
Amount --Without the videotape of the incident, the ALJ noted, this claim would probably have stood, and even on viewing the videotape at regular speed, the ALJ felt that claimant's version of events was correct. However, the ALJ added, when she viewed the tape several times in slow motion and at slow frame speed, it became evident that claimant's head, back and shoulders did not strike the door-frame or the railing. The ALJ therefore dismissed this claim with prejudice, noting that the Commission has no discretion to address issues not raised by the parties.
Injuries --Claimant suffered injuries to his left shoulder, mid- and lower back, and legs and head.
Attorney(s) - Plaintiff --Phillip B. Shell of Day, Shell & Liljenquist
Attorney(s) - Defense --Hans Scheffler
Facts/Contentions --Claimant was working for employer as an associate attorney, and on 1/11/01 he accompanied a client of the firm who wanted to videotape the contents of the building rented by the client and his business partners. The client was having a dispute with his partners and believed they were removing property from the premises in violation of a court order. Claimant met the client and the building's landlord at the building and entered with the understanding that no one else would be inside. Claimant waited in the lobby while his client and the landlord went further back into the building to videotape its contents. As it turned out, the client's other partners were in the back of the building, and they made the client and the landlord leave through a side entrance. The client continued videotaping as he and the landlord walked around the building to the front lobby door where claimant was waiting. As the client and the landlord came into the main lobby through the front door, with the client still filming, the partners came into the lobby from the back of the building. Claimant was standing facing the partners, with the landlord and the client behind him and to one side. Claimant told the partners that his and his client had a right to be on the property and a heated discussion ensued, at the end of which one of the partners bodily picked up the claimant, pinning his arms to his sides at waist-level, and carried claimant out the front door. After clearing the door, the partner was leaning forward, pushing claimant backwards; claimant then turned to go down the ramp and took a few steps forward, grabbing a railing with his right arm to stop his forward momentum. Claimant stated that he hit his head, shoulders and back on the door as he was carried through it. Claimant was terminated from his job the next day and has not worked since.
TRUCK ACCIDENT
Case Type --WA TA; Work-related semi truck accident
Case Name --William Blakely vs. GATX and/or American Insurance
Case Number --2000101
Court/Judge --Hann
Verdict/Settlement --Order, 11/02
Amount --The ALJ found employer/carrier has paid claimant all the benefits to which he is entitled until after he has reimbursed employer/carrier from the proceeds of the third party settlement for the benefits they have already paid him; the remaining proceeds of the settlement must also be offset against the balance of any workers' compensation benefits claimant is still owed. The ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant suffered unspecified injuries and sustained a 5% related whole person permanent partial impairment.
Attorney(s) - Plaintiff --J. Keith Henderson (withdrew); claimant was thereafter represented pro se.
Attorney(s) - Defense --Theodore E. Kanell of Plant, Wallace, Christensen & Kanell
Damages --Employer/carrier paid claimant $4,908.67 in medical expenses, $4,248 in temporary total disability benefits, and $4,336 in permanent partial disability benefits for his 5% related impairment.
Facts/Contentions --Claimant was injured September 10, 1994, and employer/carrier accepted liability and paid benefits. On December 21, 1999, claimant received $63,897.53 from the mediated settlement of a third-party suit he filed against Unit Transportation. After he paid attorney's fees, he retained net proceeds of $41,533.40, and employer/carrier filed an addendum to his case, stating that claimant did not reimburse employer/carrier from the settlement proceeds for any of the workers' compensation benefits claimant received from employer/carrier, as Utah law requires.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Brian Jorgensen vs. General Distributing Company and/or Ohio Casualty Insurance
Case Number --20011000
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 11/02
Amount --The ALJ noted that under Utah law, medical benefits cease if an injured worker fails to submit any medical expenses to the responsible workers' compensation carrier for a period of more than three years. Since that was the case in this claim, the ALJ therefore dismissed it with prejudice.
Injuries --Claimant suffered a lower back injury. In 2000 he underwent a lumbar laminectomy and discectomy at L4/5 left.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Thomas C. Sturdy of Blackburn & Stoll
Facts/Contentions --Claimant injured his low back in July of 1994 while lifting empty beer kegs, and employer/carrier accepted liability and paid benefits. Claimant sought benefits to pay for his related surgery, which was performed in 2000, and employer/carrier denied benefits on grounds that more than three years had elapsed without claimant submitting any medical expenses for reimbursement.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --(Name of case withheld)
Case Number --2000953
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 11/02
Amount --The ALJ found employer/carrier owes claimant additional temporary total disability benefits, since she has not yet attained medical stability with respect to her industrially-caused situational depression. The ALJ therefore ordered employer/carrier to pay claimant additional accrued temporary total disability benefits of $45,874.29 plus interest and less attorney's fees, which are to be deducted from this award and paid directly to claimant's attorney. Employer/carrier must then continue to pay claimant $321 per week in temporary total disability benefits from the date of this order until she attains medical stability or until employer/carrier has paid 312 weeks of compensation, whichever occurs first. Employer/carrier must also pay all of claimant's related medical expenses with the exception of the expenses for her cervical spinal surgery.
Injuries --Claimant suffered back injuries, the nature of which was disputed, and situational depression caused by her injuries and pain. Claimant underwent cervical spinal surgery in June of 2001.
Attorney(s) - Plaintiff --Bruce J. Wilson
Attorney(s) - Defense --Dori K. Petersen of Blackburn & Stoll
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel.
Damages --Employer/carrier paid claimant $3,331.80 in temporary total disability benefits and $3,713 in permanent partial disability benefits for a 5% related whole person permanent partial impairment.
Facts/Contentions --Claimant worked on a display crew at employer's furniture showroom. She and another worker attempted to move a large banquet table filled with heavy ceramic figurines. Claimant immediately dropped the table after grabbing hold of one end of it to lift it. She said she experienced pain and numbness in her right arm. After she was released to light duty work, employer offered her a PBX job, but it aggravated her arm pain, and she had to give it up. Her employer told her that job was the only light duty work available and claimant's only other option was to take a 90-day leave, which claimant did. When she returned, employer had no job available for her, so claimant went on long-term disability under a policy with a third-party insurer.
Employer/carrier accepted liability and paid benefits, but the parties disagreed on when and whether claimant reached medical stability, as well as on her compensation rate and the necessity of surgery for her back problems. Claimant worked a second job which earned her a small additional amount of money each week. Employer/carrier contended that claimant had already received all the disability benefits due her.
Medical care providers disagreed on the type and amount of degenerative disease and industrial injury present. All the medical providers agreed that the injuries from the industrial accident caused claimant's situational depression. Employer/carrier stipulated to the provision of psychological care for claimant with providers from employer/carrier's approved list.
The medical panel agreed that claimant suffered from a "poorly understood condition," but also found that claimant's industrial injury caused chronic pain syndrome involving the cervical region, scapular region, and upper right extremity, with no suggestion of neural compromise. The panel found that claimant attained medical stability regarding her back injuries on 2/1/2000, and the surgery she underwent was not medically necessary to treat her back condition; however, the panel found claimant will not attain medical stability with regard to her depression until after she has received a recommended psychological intervention. The panel noted that claimant's date of medical stability regarding the depression would be the date on which this intervention ended.
SLIP/FALL
Case Type --WA, SF; Work-related slip/fall
Case Name --Georgia Maloney vs. Highland Care Center and/or Workers' Compensation Fund
Case Number --20001084
Court/Judge --Hann
Verdict/Settlement --Order, 11/02
Amount --The ALJ accepted the medical panel's report and ordered employer/carrier to pay claimant accrued temporary total disability benefits of $5,648.76 plus interest. Employer/carrier must also pay all claimant's related medical expenses.
Injuries --Claimant suffered low back pain; employer/carrier contended that it was a re-aggravation of her previous back injury. The medical panel found that in this incident claimant suffered either a severe lumbar strain or a tear of the annulus fibrosis.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Eugene C. Miller Jr.
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Alvin Wirthlin--neurologist; and Dr. Glenn L. Momberger--orthopedic surgeon.
Facts/Contentions --Claimant was injured in 1994 when she slipped and fell on a wet floor while working as a certified nurse assistant at employer's residential care facility in California. She stabilized from that injury in 1995, but was reluctant to give patients showers after the incident because she was afraid of slipping and falling again. On May 6, 2000, she was working at Highland Care and had just completed her 13th patient shower. She said she was squatting in front of the patient to wash the patient's feet when she twisted slightly to her left to throw the washcloth aside and felt a pain in her back. She said she was unable to turn and face forward again for a couple of seconds until the pain subsided. She completed the shower, went home an hour later, took some Tylenol and went to bed early because of stiffness in her low back and a headache. She sought medical care four days after being injured. No light duty work was available, and employer told claimant not to come back until she was released with no restrictions. She began working at another care facility in December of 2000 after she was released to return to full duty, but by February of 2001 her headaches had returned and she began having pain in her left leg to the point that she was unable to continue working.
Employer/carrier contended that claimant's pain was caused by a re-aggravation of the previous injury from the 1994 fall. Employer/carrier also disputed the medical necessity for the ongoing care claimant was receiving.
The medical panel found claimant did not suffer any lasting impairment from the 1994 fall, and claimant therefore does not suffer from a pre-existing condition. The panel felt the medical care claimant has received to date was reasonable and necessary to treat her industrial injury.
WORK INJURY
Case Type --WA; Work-related injury
Case Name --Tony Romero vs. Nordstrom (self-insured)
Case Number --2002574
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 11/02
Amount --The ALJ found no persuasive evidence was presented to support claimant's story of how he was injured; the ALJ therefore dismissed this claim with prejudice.
Injuries --Claimant suffered an ankle injury.
Attorney(s) - Plaintiff --Claimant submitted a few documents but failed to appear at the hearing.
Attorney(s) - Defense --Mark D. Dean
Facts/Contentions --Claimant contended that he was injured on May 15, 2001. However, the ALJ noted that the summary of medical record submitted by claimant listed the date of the supposed injury as May 15, 2002, and the same document released claimant to return to work full-time with no restrictions on April 14, 2002 (before the ostensible date of injury). The work status statement claimant submitted provided yet a third date for the purported injury: March 21, 2002. These facts, plus the fact that claimant failed to appear at his scheduled hearing, led the ALJ to conclude that claimant's account of how he was injured was not credible.
SLIP/FALL
Case Type --WA, SF; Work-related slip/fall
Case Name --Georgia Maloney vs. Highland Care Center and/or Workers' Compensation Fund
Case Number --20001084
Court/Judge --Hann
Verdict/Settlement --Order, 11/02
Amount --The ALJ accepted the medical panel's report and ordered employer/carrier to pay claimant accrued temporary total disability benefits of $5,648.76 plus interest. Employer/carrier must also pay all claimant's related medical expenses.
Injuries --Claimant suffered low back pain; employer/carrier contended that it was a re-aggravation of her previous back injury. The medical panel found that in this incident claimant suffered either a new severe lumbar strain or a new tear of the annulus fibrosis.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Eugene C. Miller Jr.
Expert Witness(es) --Because of conflicting medical testimony, this case was referred to a medical panel consisting of Dr. Alvin Wirthlin--neurologist; and Dr. Glenn L. Momberger--orthopedic surgeon.
Facts/Contentions --Prior to this injury, claimant was injured in 1994 when she slipped and fell on a wet floor while working as a certified nurse assistant at employer's residential care facility in California. She stabilized from that injury in 1995, but was reluctant to give patients showers after that because she was afraid of slipping and falling again. On May 6, 2000, she was working at Highland Care and had just completed her 13th patient shower. She said she was squatting in front of the patient to wash the patient's feet when she twisted slightly to her left to throw the washcloth aside and felt a pain in her back. She said she was unable to turn and face forward again for a couple of seconds until the pain subsided. She completed the shower, went home an hour later, took some Tylenol and went to bed early because of stiffness in her low back and a headache. She sought medical care four days after being injured. No light duty work was available, and employer told claimant not to come back until she was released with no work restrictions. She began working at another care facility in December of 2000 after she was released to return to full duty, but by February of 2001 her headaches had returned and she began having pain in her left leg to the point that she was unable to continue working.
Employer/carrier contended that claimant's pain was caused by a re-aggravation of the previous injury from the 1994 fall. Employer/carrier also disputed the medical necessity for the ongoing care claimant was receiving.
The medical panel found claimant did not suffer any lasting impairment from the 1994 fall, and claimant therefore does not suffer from a pre-existing condition. The panel felt the medical care claimant received to date was reasonable and necessary to treat her industrial injury.
ORDER ON REMAND
Case Type --OD; Occupational disease claim
Case Name --Walter Roth vs. L. W. Miller and Workers' Compensation Fund
Case Number --00-0919
Court/Judge --This order was issued by the Labor Commission Appeals Board.
Verdict/Settlement --Order, 11/02
Amount --The Appeals Board noted that resolution of this matter was somewhat complicated by the fact that the Utah State Legislature recently amended the provisions of the law that apply to this case. However, the Appeals Board determined that employer/carrier was entitled to rely upon the law which was in effect at the time this occupational disease claim was initially adjudicated, which mandated medical panel referral for all occupational disease claims. The Appeals Board therefore reversed the ALJ's finding and remanded the case to the ALJ for additional evidentiary proceedings.
Injuries --Claimant developed epicondylitis.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Eugene C. Miller Jr. and Michael E. Dyer of Blackburn & Stoll
Facts/Contentions --After the ALJ in this case issued an order awarding benefits to claimant, employer/carrier appealed, contending that Utah law in effect at the time the ALJ conducted the hearing on the case required ALJs to refer all occupational disease claims to a medical panel.
FALL
Case Type --WA, SF; Work-related fall
Case Name --Kirk S. DeMille vs. Thurston Cable Construction and/or Fremont Comp
Case Number --2001059
Court/Judge --La Jeunesse
Verdict/Settlement --Order, 11/02
Amount --The ALJ adopted ALJ Sims' findings in his order on claimant's application for additional temporary total disability benefits, and incorporated those findings into this order. The ALJ found that claimant's fall from the front-end loader constituted a significant industrial injury in itself and also substantially aggravated claimant's pre-existing low back problems, causing significant additional impairment, although that impairment has not been rated. Furthermore, the ALJ concluded, the conclusive evidence in this case indicated that "the [insurance carrier's] interference in Mr. DeMille's medical care resulted in serious, permanent exacerbations to Mr. DeMille's back problems," removing him from the ranks of employable workers. The ALJ therefore found that claimant was rendered permanently and totally disabled by the carrier's intervention in his medical treatment; the ALJ ordered employer/carrier to pay claimant's related medical expenses and also to pay him subsistence benefits of $335 per week, starting on the date of this order and continuing until a finding of permanent and total disability is entered after compliance with the procedures required by Utah law in permanent total disability cases. If employer or carrier intends to submit a re-employment plan, they must do so within thirty days of the date of this order; a separate hearing will be scheduled to consider any such re-employment plan submitted.
Injuries --Claimant suffered injuries to his low back and left leg. He had a pre-existing 17% whole person permanent partial impairment rating from an earlier injury, for which he underwent fusion surgery. Scans taken after the incident that led to this claim revealed a small disc herniation at L5/S1. Claimant underwent surgery to remove the hardware and explore the pre-existing fusion a month after his most-recent injury. He underwent six surgeries and was hospitalized for ten months in connection with the implantation and finally the removal of a dorsal column stimulator intended to help him control his pain. Eventually he developed cellulitis, and his treating physician swore the infection was caused by the workers' compensation carrier's original insistence on a two-stage procedure, which allowed the infection to be introduced into the left flank. Claimant's treating physicians agree that he is totally disabled since his fall from the front-end loader and his infection, and his condition will probably get worse over time. He is unable to walk or sit for any length of time and cannot engage in any work-related activities because of his incessant pain.
Attorney(s) - Plaintiff --Virginius C. Dabney of Dabney & Dabney, St. George
Attorney(s) - Defense --Henry K. Chai II of Blackburn & Stoll
Expert Witness(es) --This case was referred to a medical panel appointed by ALJ Sims (see below).
Facts/Contentions --Claimant was injured when he fell off a front-end loader, and at an earlier hearing before the Labor Commission, ALJ Ben Sims awarded him benefits and determined that claimant was working for Thurston Cable Construction at the time of the accident. Claimant later filed a request for additional temporary total disability benefits, which were awarded to him by ALJ La Jeunesse in January of 2002; claimant subsequently filed this application for permanent total disability benefits. He said he tried to work at two other jobs for several months each after his fall, but had to quit because of severe pain.
This case was reviewed by two medical panels assembled by employer/carrier and also by a third medical panel appointed by ALJ Sims. The employer's two panels were of the opinion that the second industrial accident did not cause any further injury, but the Labor Commission medical panel found that claimant did indeed suffer a new back injury when he fell off the front-end loader. ALJ Sims accepted the Labor Commission medical panel's report and incorporated it into his findings after the first hearing.
Employer/carrier adamantly maintained that claimant suffered no additional injuries in the fall from the front-end loader; they maintained that because claimant did not receive an impairment rating after he fell, he suffered no additional impairment in the fall.
Legal Issues --The ALJ noted that it is now uniformly accepted that aggravation of primary injuries caused by medical or surgical treatment is compensable.
DISCRIMINATION
Case Type --SD; Discrimination Claim
Case Name --Barbara Fern Galindo vs. Foster Grandparent Program
Case Number --8020261
Court/Judge --Eblen
Verdict/Settlement --Order, 11/02
Amount --The ALJ dismissed this case with prejudice on grounds that volunteers are not covered by the Utah Anti-Discrimination Act unless they are volunteering with a reasonable expectation that the volunteer work will lead to regular employment.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Facts/Contentions --Claimant said she signed a contract to volunteer with respondent as a foster grandparent. She said respondents "fired her the wrong way" and sought damages for discrimination under the Anti-Discrimination Act. The ALJ noted that the contract which claimant signed did not in any way give an indication that the volunteer work might lead to gainful employment for claimant.
Claimant failed to show up at her scheduled hearing, and the ALJ dismissed the case; however, claimant moved to set aside the dismissal on grounds that she did not receive notice of the hearing. The ALJ eventually set aside the dismissal and ordered claimant and respondent to provide jurisdictional information, which formed the basis for this order.
DISCRIMINATION
Case Type --SD; Discrimination claim
Case Name --(Name of case withheld)
Case Number --8970462
Court/Judge --Hann
Verdict/Settlement --Order, 11/02
Amount --The ALJ granted employer's third motion to dismiss this claim with prejudice and ordered claimant to pay employer $848.50 in attorney's fees.
Attorney(s) - Plaintiff --Claimant was represented pro se.
Attorney(s) - Defense --Carolyn Cox of Ho,me, Roberts & Owen
Facts/Contentions --Claimant alleged discrimination and retaliatory action against her employer. A pre-hearing conference was continued at both parties' request, and was re-scheduled twice at claimant's request because of claimant's medical problems. The ALJ advised claimant after the second medical re-scheduling that the conference would not be re-scheduled again, and claimant should consider hiring legal representation if she was unable to attend the conference due to medical reasons. Claimant responded that because of her medical problems, she was dependent on others for transportation. Claimant failed to attend the conference, but phoned later in the day, at which time the conference was held and litigation was scheduled.
Employer moved to dismiss on grounds that claimant failed to comply with discovery, and the ALJ denied the motion but ordered claimant to comply with employer's discovery demands. Employer moved to dismiss a second time after claimant failed to appear at a scheduled deposition and still had not complied with written discovery requests. The ALJ again denied the motion, but ordered claimant to pay costs and fees to employer in an attempt to impress upon claimant the importance of compliance with litigation procedures. The deposition was re-scheduled, and claimant twice contacted the employer to request that it be re-scheduled again; the employer complied. The ALJ ordered claimant to appear at the deposition with exception allowed only for a medical emergency. Claimant failed to appear at the deposition, but showed up the next day and said she was confused about the date. Employer and ALJ still had not obtained any information from claimant after over three years, and ALJ granted the motion when employer moved to dismiss this case a third time. The ALJ noted that the Utah Rules of Civil Procedure, which govern adjudication procedures under Utah law, allow attorney's fees and costs to be awarded to be awarded for failure of a party to attend their own deposition or respond to written discovery requests.
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