Padilla v. Coreslab Structures
| Decision Date | 21 January 2020 |
| Docket Number | No. A-1-CA-36776,A-1-CA-36776 |
| Parties | LEO L. PADILLA, Worker-Appellant, v. CORESLAB STRUCTURES and VALLEY FORGE INSURANCE COMPANY, Employer/Insurer-Appellees. |
| Court | Court of Appeals of New Mexico |
This decision of the New Mexico Court of Appeals was not selected for publication in the New Mexico Appellate Reports. Refer to Rule 12-405 NMRA for restrictions on the citation of unpublished decisions. Electronic decisions may contain computer-generated errors or other deviations from the official version filed by the Court of Appeals.
APPEAL FROM THE WORKERS' COMPENSATION ADMINISTRATION Reg C. Woodard, Workers' Compensation Judge
Albuquerque, NM
for Appellant
Elmore Law, LLC
Christopher T. Elmore
Albuquerque, NM
for Appellees
{1} Worker Leo L. Padilla filed for workers' compensation benefits following a work-related accident while employed with Coreslab Structures Inc. (Employer). The workers' compensation judge (WCJ) granted Worker temporary total disability (TTD) benefits from October 4, 2011 to February 2, 2012 for his right shoulder, but denied benefits for any other alleged injury. The WCJ also denied Worker any permanent partial disability (PPD) benefits. Worker appeals the WCJ's order, contending that it is not supported by substantial evidence and that the WCJ misapplied the law. We affirm.
{2} On October 4, 2011, Worker was injured when he fell off a scaffold while acting within the course and scope of his employment with Employer. Worker filed for workers' compensation benefits. The parties do not dispute the accident itself, but rather dispute the nature, extent, and causation of Worker's alleged injuries. The parties waived trial on the merits and agreed that the WCJ would adjudicate the case on the previously admitted evidence and evidence presented through the addendum to the pre-trial order.
{3} On appeal, Worker's arguments can be categorized into three points of error: (1) substantial evidence does not exist to support the WCJ's finding that the right shoulder was the sole compensable injury because there are other compensable injuries; (2) the WCJ failed to apply the correct legal standard in determining whether to award medical benefits; and (3) the WCJ failed to apply the correct legal standard in determining whether to award PPD benefits. We address each issue in turn.1
{4} We review workers' compensation claims under a whole record standard of review by determining whether substantial evidence in the record as a whole supports the WCJ's conclusion. See Dewitt v. Rent-A-Center, Inc., 2009-NMSC-032, ¶ 12, 146 N.M. 453, 212 P.3d 341. Substantial evidence is credible evidence in light of the whole record "that is sufficient for a reasonable mind to accept as adequate to support the conclusion[.]" Id. (internal quotation marks and citation omitted). We give deference to the WCJ as fact-finder and view the evidence in the light most favorable to the decision without disregarding contravening evidence. Id.
{5} "While we generally may not weigh the evidence, even under whole record review, such review allows the reviewing court greater latitude to determine whether a finding of fact was reasonable based on the evidence." Maez v. Riley Indus., 2015-NMCA-049, ¶ 10, 347 P.3d 732 (alteration, internal quotation marks, and citation omitted). Such review "has even greater latitude when reviewing an issue for which the evidence is documentary in nature." Id. As in this case, "when all or substantially all of the evidence on a material issue is documentary or by deposition, an appellate court may examine and weigh it." Id. (alteration, internal quotation marks, and citation omitted). That is because "[w]here the issue to be determined rests upon interpretation of documentary evidence, [appellate courts are] in as good a position as the trial court to determine the facts and draw [their] own conclusions." Flemma v. Halliburton Energy Servs., Inc., 2013-NMSC-022, ¶ 13, 303 P.3d 814 (); see Pena v. Westland Dev. Co., 1988-NMCA-052, ¶ 34, 107 N.M. 560, 761 P.2d 438 (). Still, we will not disturb the WCJ's findings unless they are "manifestly wrong or clearly opposed to the evidence." Maez, 2015-NMCA-049, ¶ 10 (internal quotation marks and citation omitted).
{6} Here, the WCJ found that Worker is entitled to TTD benefits for his right shoulder injury from October 4, 2011 until February 2, 2012, the date of Dr. Reeve's finding of Medical Maximum Improvement (MMI).2 The WCJ also found that Worker is not entitled to PPD benefits following February 2, 2012, seemingly also based at least in part on Dr. Reeve's assessment. Further, the WCJ concluded that "Worker's established lack of credibility irreversibly taints any medical testimony in support of medical benefits by health care providers following February 2, 2012." The WCJ determined that medical care Worker sought after February 2, 2012, was "based in large part [] upon false, inaccurate[,] and exaggerated medical claims." Ultimately, the WCJ determined that Worker failed to meet his burden of proof by credible medical testimony that he has a permanent impairment as a result of the October 4, 2011 accident, and as a consequence, Worker is not entitled to PPD benefits.
{7} We first address whether there was substantial evidence to support the WCJ's finding that the right shoulder was the sole compensable injury. Concluding that there is substantial evidence that the right shoulder is the only compensable injury, we review whether the WCJ misapplied the law when it did not grant Worker medical benefits after February 2, 2012, and PPD benefits for the right shoulder.
{8} In order to receive benefits under the Workers' Compensation Act (the Act), NMSA 1978, §§ 52-1-1 to -70 (1929, as amended through 2017), a worker must "sustain[ ] an accidental injury arising out of and in the course of his employment[.]" Section 52-1-28(A)(1). In cases where the employer disputes a causal connection between the accident and disability, Section 52-1-28(B) requires the worker to establish causation "as a probability by expert testimony of a health care provider." "The testimony of a qualified health care provider must establish, to a reasonable medical probability, that a causal relationship exists between the accident and disability." Trujillo v. Los Alamos Nat'l Lab., 2016-NMCA-041, ¶ 17, 368 P.3d 1259. The language required to convey a reasonable medical probability "need not [be offered] in positive,dogmatic language or in the exact language of the statute[,]" but it must permit "a reasonable inference that the disability is the natural and direct result, as a medical probability, of the accident." Gammon v. Ebasco Corp., 1965-NMSC-015, ¶¶ 22-23, 74 N.M. 789, 399 P.2d 279. "Causation exists within a reasonable medical probability when a qualified medical expert testifies as to his opinion concerning causation and, in the absence of other reasonable causal explanations, it becomes more likely than not that the injury was a result of its action." Sanchez v. Molycorp, Inc., 1985-NMCA-067, ¶ 16, 103 N.M. 148, 703 P.2d 925.
{9} "While Sections 52-1-28(A)(3) and (B) appear to require a single causation analysis (between the accident and the disability), embedded within that analysis is the requirement that there be an injury that is causally connected to both the accident and the disability." Molinar v. Larry Reetz Constr., Ltd., 2018-NMCA-011, ¶ 21, 409 P.3d 956, cert. denied, 2018-NMCERT-___ (No. S-1-SC-36739, Dec. 2017). "Thus, Section 52-1-28 must be understood as requiring the worker to establish that (1) a work-related accident caused an injury or injuries, and (2) the injury resulted in disability." Id. In this case, we are focused on the first requirement—whether the work-related accident caused each of Worker's claimed injuries.
{10} The WCJ found the right shoulder to be the only compensable injury. On appeal, Worker argues that substantial evidence does not exist to support this finding that the right shoulder was the sole compensable injury. We understand Worker's argument on appeal to be that there was substantial evidence that Worker sustained other compensable injuries to his "neck, both shoulders, low back, left wrist, left hip, brain, left eye, vestibular system[,] and both knees." Thus, we turn to whether Worker established a causal connection between the accident and his injuries. See Molinar, 2018-NMCA-011, ¶ 21 .
{11} Dr. Reeve, board certified in physical medicine and one of Worker's treating physicians, first saw Worker on October 17, 2011. Dr. Reeve examined Worker and concluded Worker suffered a closed-head trauma resulting in post-concussive syndrome. Based on this initial examination, Dr. Reeve ordered MRIs of Worker's hip, shoulder, head, cervical spine, and lumbar spine, and requested a neuropsychologic evaluation with Dr. Chiulli for cognitive deficits. Dr. Reeve testified to the results of the MRIs. The left shoulder MRI showed tendinitis with a full thickness tear in the supraspinatus, but no muscle atrophy. The right shoulder MRI showed "severe AC arthrosis with periarticular osteopenia, pericapsular edema, soft swelling, subscapularis tendinopathy, a longitudinal interstitial split tear, and medially perched, long head biceps tendon, and . . . a split tendon tear in the long head of the biceps." After reviewing...
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