Montgomery Cnty. v. Jackson
| Decision Date | 04 September 2020 |
| Docket Number | No. 2405,2405 |
| Parties | MONTGOMERY COUNTY, MARYLAND v. TIMOTHY O. JACKSON |
| Court | Court of Special Appeals of Maryland |
Circuit Court for Montgomery County
Case No. 422752V
UNREPORTED
Graeff, Nazarian, Zarnoch, Robert A. (Senior Judge, Specially Assigned), JJ.
Opinion by Zarnoch, J.
*This is an unreported opinion and therefore may not be cited either as precedent or as persuasive authority in any paper, brief, motion, or other document filed in this Court or any other Maryland court. Md. Rule 1-104.
Montgomery County challenges a 2016 decision by the Workers' Compensation Commission to authorize medical treatment for Timothy O. Jackson, following a 2011 workplace injury for which Jackson was previously awarded permanent partial disability. The County contends that the Commission's decision to authorize the medical treatment was legally insufficient because Jackson failed to put forth any requisite expert opinion attesting to a causal relationship between the 2011 injury and his need for treatment in 2016. Like the Circuit Court for Montgomery County, we believe that the Commission could reasonably infer a cause-and-effect relationship that merited granting the follow-up treatment. Accordingly, we affirm.
Appellee Timothy O. Jackson is a bus operator for Montgomery County. On October 25, 2011, Jackson injured his left knee and ankle when he fell getting off a bus during the course of work ("the 2011 accident"). In April 2013, the Workers' Compensation Commission determined that Jackson suffered 15% permanent partial disability to his left leg—including the knee and ankle—on account of the accident.
Subsequently, in December 2015, Jackson filed Issues1 before the Commission seeking a follow-up visit with a physician. In February 2016, Jackson filed a Request forModification; the attached Issues form sought supplemental Issues for medical expenses. After holding a hearing on June 1, 2016, the Commission found that Jackson's need for treatment was causally related to the earlier injury from the 2011 accident. The Commission's order authorized a follow-up consultation and ordered that Montgomery County (a self-insurer) pay medical expenses in accord with the Commission's Medical Fee Guide.
The County appealed the Commission's award, on the record,2 to the Circuit Court for Montgomery County. The circuit court originally remanded the case so that the Commission could explain the basis for the finding that Jackson's requested medical treatment was causally related to the 2011 accident. In response, the Commission issued an order dated May 22, 2018; the order stated that it did not constitute "new" findings, but rather that it "explain[ed]" the previous order. In a brief explanation, the Commission found that the requested treatment was causally related to the 2011 accident because: 1)the Commission's original permanent partial disability award was not apportioned (i.e., the 15% permanent partial disability award was attributed solely to the 2011 accident, and not to any preexisting condition, such as arthritis)3; 2) Jackson testified that he had not had any new accidents; and 3) the Commission found Jackson's testimony about his ongoing pain in his left knee to be credible.
The County contends that this finding was legally insufficient because Jackson did not put forth expert medical evidence before the Commission attesting to the fact that his then-current need for treatment was causally related to the 2011 accident. The County adds that the Commission's finding is further undercut by the fact that the County submitted a medical evaluation at the hearing in which a physician concluded that Jackson's need for treatment was due to underlying arthritis, and not the 2011 accident.
The County appealed the Commission's order to the Circuit Court for Montgomery County. After holding a hearing in August 2018, the circuit court affirmed the Commission's decision.
This timely appeal followed.
Montgomery County maintains on appeal that the evidence undergirding the Commission's 2016 authorization of medical treatment was legally insufficient becausethe issue of whether Jackson's knee pain, in 2016, was causally related to the 2011 accident for which he was awarded disability was a complicated medical question that required expert medical opinion. Based on the particular circumstances on this individual case, we do not agree.
The Workers' Compensation Act4 establishes that an employer may remain liable for continued workers' compensation benefits, such as medical treatment, "where the employee demonstrates a worsening of his or her medical condition was caused by an accidental personal injury or occupational disease." Elec. Gen. Corp. v. Labonte, 454 Md. 113, 145-46 (2017). "For purposes of permanent partial disability benefits, [the question of whether] the worsening of the employee's medical condition was reasonably attributable solely to the accidental personal injury, [is a] factual matter[] for the Commission to determine in each individual case." Id. at 137. Though it is within the Commission's purview, as the finder of fact, to weigh competing evidence, "[t]he question of whether evidence before the Commission is legally sufficient to support its decision is a question of law." Calvo v. Montgomery County, 459 Md. 315, 326 (2018); see also Baltimore County v. Kelly, 391 Md. 64, 76 (2006) (quoting Moore v. Clarke, 171 Md. 39, 45 (1936)) ("The provision that the decision of the Commission shall be 'prima facie correct' and that the burden of proof is upon the party attacking the same does not mean, therefore, that if no facts are established before the Commission sufficient to support its decision, that there is any burden of factual proof on the person attacking it,for the decision of the Commission cannot itself be accepted as the equivalent of facts which do not exist...."); Dove v. Montgomery County Bd. of Educ., 178 Md. App. 702, 724-25 (2008) () (Citation and quotation marks omitted); Bridgett v. Montgomery County, 186 Md. App. 616, 625 (2009) () (Citations and quotation marks omitted).
Accordingly, Montgomery County's position on appeal is that the evidence Jackson put forth before the Commission was legally insufficient to support the Commission's ultimate finding because the issue at hand—whether Jackson's knee pain, circa 2016, was causally related to the 2011 accident for which the Commission had earlier found 15% permanent partial disability—was complex enough to be a "complicated medical question" that required expert medical opinion. Pointing to the factors described by this Court in S.B. Thomas, Inc. v. Thompson, 114 Md. App. 357 (1997), Montgomery County argues that the length of time between the accident (2011), the Commission's original disability award (2013), the latest treatment for which the County had agreed to (2015), and the Commission hearing that is now at issue on appeal (2016) constitutes a "significant passage of time between the initial injury and the onset of the trauma" that, according to S.B. Thomas, creates a circumstance that will "almost always" require expert testimony:
[T]he causal relationship will almost always be deemed a complicated medical question and expert medical testimony will almost always be required when one or more of the following circumstances is present: 1) some significant passage of time between the initial injury and the onset of the trauma; 2) the impact of the initial injury on one part of the body and the manifestation of the trauma in some remote part; 3) the absence of any medical testimony; and 4) a more arcane cause-and-effect relationship that is not part of common lay experience[.]
114 Md. App. at 382. Notwithstanding the County's invocation of S.B. Thomas, we believe that under the particular circumstances of the case before us, the Commission was able to reasonably infer that Jackson's knee pain was causally related to the 2011 accident, even without Jackson providing expert medical opinion to that effect at the 2016 hearing.5
To begin, we note that the Court of Appeals has reiterated that in workers' compensation cases it has "not establish[ed] a per se requirement for expert testimonywhen a medical question was involved." Maldonado v. Am. Airlines, 405 Md. 467, 479 (2008) (Emphasis in original); see also Jewel Tea Co. v. Blamble, 227 Md. 1, 7 (1961) (). Indeed, even the S.B. Thomas factors that the County relies upon do not unequivocally create an ironclad or bright-line "test"6: S.B. Thomas stated that "expert medical testimony will almost always be required when one or more of the following circumstances is present," and it did not define what constitutes a"significant passage of time." 114 Md. App. at 382 (Emphasis added). S.B. Thomas even went on to recognize that "[t]here can be no hard and fast rule controlling all cases."7 Id. at 382-83. As such, the question of whether expert medical opinion might be required in any particular workers' compensation claim remains a case-by-case determination. Kelly v. Baltimore County, 161 Md. App. 128, 146 (2005), aff'd, 391 Md. 64 (2006) (quoting Am. Airlines Corp. v. Stokes, 120 Md. App. 350, 382-83 (1998)) ("Whether the causation issue is deemed a 'complicated medical question' requiring expert medical testimony cannot be reduced to a 'hard and fast rule controlling all cases.'").
Here, we believe that the cause-and-effect relationship between falling off a bus...
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