Trujillo v. Los Alamos Nat'l Lab.
| Decision Date | 15 February 2016 |
| Docket Number | No. 34,185.,34,185. |
| Citation | 368 P.3d 1259 |
| Parties | Eric TRUJILLO, Worker–Appellant, v. LOS ALAMOS NATIONAL LABORATORY, Employer/Self–Insured–Appellee. |
| Court | Court of Appeals of New Mexico |
Annie–Laurie Coogan LLC, Annie–Laurie Coogan, Santa Fe, NM, for Appellant.
Camp Law, LLC, Minerva Camp, Albuquerque, NM, for Appellee.
WECHSLER
, Judge.
{1} Worker Eric Trujillo seeks review of a Workers' Compensation Administration ruling that denied reinstatement of temporary total disability (TTD) and medical benefits. The Workers' Compensation Judge (WCJ) dismissed Worker's claims after ruling that Worker failed to prove causation to a reasonable degree of medical probability. Because substantial evidence does not support the WCJ's ruling, we reverse.
{2} Worker was employed by Los Alamos National Laboratory (LANL) (Employer)1 as a laborer and labor foreman beginning in July 1994. Worker's duties included trenching, snow removal, tree cutting, moving furniture, construction, and demolition work. Over the years, Worker suffered various work and non-work related injuries. Several of these injuries affected Worker's back and neck. Worker did not miss significant time at work due to any of these injuries, although he did file a workers' compensation claim for an ergonomic injury in 2006 that was denied.
{3} On November 30, 2012, Worker was participating in the installation of electrical equipment when he fell approximately six feet to the ground from a scaffolding. Worker testified that he was carrying a chipping hammer down from the scaffolding platform, stepped on an oily or slick spot on the scaffolding, and landed flat on his back. Worker also testified that the chipping hammer weighed approximately twenty-five pounds and that his hard hat cracked when he hit the ground. Worker's testimony as to the circumstances of the accident are not in dispute.
{4} Several hours later, Worker arrived at Occupational Medicine (Occ Med), which is Employer's in-house medical facility. Occ Med is the initial medical provider for on-the-job injuries and also provides interim care for on-the-job injuries and clearance for employees to return to work from injuries or extended absences. Worker was diagnosed with (1) multiple contusions to the back
, neck, and upper-extremities; (2) tenderness in the mid-back and C-spine; and (3) tingling in both elbows. Worker's examination was described as "unremarkable," and he was given anti-inflammatory medication and allowed to return to work without restrictions.
{5} Worker finished his shift without further incident. After returning home, Worker became very stiff and was making nonsensical statements, at which point his wife drove him to Los Alamos Medical Center. Worker was diagnosed with similar conditions noted at Occ Med, as well as a head injury
.
{6} Worker returned to Occ Med for follow-up care on December 3, 2012, and he was seen by Dr. Sara Pasqualoni. Dr. Pasqualoni diagnosed Worker with (1) a concussion; (2) cervical, thoracic, and lumbar strains
; (3) chronic pain syndrome; and (4) elevated blood pressure. At the conclusion of the appointment, Worker stood to exit and fell directly onto his face. Worker was transported back to Los Alamos Medical Center and was re-admitted. During a follow-up to Worker's December 3, 2012 appointment, Dr. Pasqualoni also referred Worker to his primary care physician, Dr. Kidman, for continued management of Worker's chronic pain.
{7} Worker returned to Occ Med on December 10, 2012 for follow-up care. Worker was ordered to continue physical therapy and to return to Occ Med for additional evaluation.
{8} Worker again reported to Occ Med on December 20, 2012, and he was evaluated by Dr. Sandra Scher. During this visit, Dr. Scher conducted a physical evaluation and reviewed CT scans
of Worker's cervical spine, thoracic spine, and lumbar spine; a CT scan of Worker's head; an MRI of Worker's cervical spine; and X-rays of Worker's thoracic spine and lumbar spine. The resulting assessment was "chronic pain, unknown at this time whether it continues to be due to fall or underlying chronic pain syndrome."
{9} At this point, Worker was referred to Dr. Theresa Elliott for additional pain management. Dr. Elliott specializes in occupational medicine, chronic pain management, and interventional spine medicine. Occ Med periodically refers "complex pain patients [for whom] we can't find something identifiable" to Dr. Elliott.
{10} Dr. Elliott evaluated Worker on January 9, 2013. Following review of Worker's medical records and radiologic studies, Dr. Elliott took an oral history and conducted a physical examination. Dr. Elliott diagnosed Worker with injuries, including (1) cervical strain
, (2) thoracic strain, (3) lumbar strain, (4) bilateral elbow strains, and (5) preexisting cervical and lumbar pain that was "possibly aggravated" by the accident. Dr. Elliott also conducted a drug test that was positive for benzodiazepines, opioids, oxycodone, and THC. Dr. Elliott referred Worker for additional imaging studies and physical therapy.
{11} Worker returned to Occ Med on January 11, 2013, and he was evaluated by Dr. Pasqualoni. Dr. Pasqualoni reviewed Worker's radiologic imaging and conducted a physical exam but was unable to determine the cause of Worker's pain. Dr. Pasqualoni did not make any additional recommendations, electing to see if Dr. Elliott's examination resulted in objective findings directly associated with Worker's accident.
{12} Worker's final visit to Occ Med occurred on February 6, 2013. After a physical examination with Dr. Pasqualoni, Worker was ordered to continue physical therapy and continue pain management with Dr. Elliott. Worker was also cleared to return to work with restrictions, including no driving, climbing, or lifting items over ten pounds. Dr. Pasqualoni did not place Worker at maximum medical improvement (MMI) given her interest in the results of Worker's treatment with Dr. Elliott. Following his appointment at Occ Med, Worker was improperly ordered to undergo a drug test.2 Worker failed to complete the drug test and was subsequently terminated. Worker's TTD and medical benefits were also terminated at that time.
{13} Nearly one year later, on March 4, 2014, Dr. Belyn Schwartz evaluated Worker in connection with lingering injuries associated with Worker's November 30, 2012 accident. Following a physical examination, Dr. Schwartz made various conclusions as to the causal relationship between Worker's fall and his injuries. Dr. Schwartz prescribed a course of physical therapy and anti-inflammatory medication.
{14} After a series of hearings, the WCJ issued a compensation order denying Worker's claims based upon a finding that Worker failed to prove causation between the November 30, 2012 accident and injuries to a reasonable degree of medical probability.
{15} We apply whole record review to appeals of workers' compensation determinations in order to determine whether substantial evidence supports the WCJ's ruling. Henington v. Tech.-Vocational Inst., 2002–NMCA–025, ¶ 19, 131 N.M. 655, 41 P.3d 923
. In doing so, we "view[ ] the evidence in the light most favorable to the agency decision, but may not view favorable evidence with total disregard to contravening evidence." Grine v. Peabody Nat. Res., 2006–NMSC–031, ¶ 28, 140 N.M. 30, 139 P.3d 190 (internal quotation marks and citation omitted). After reviewing all the evidence, both favorable and unfavorable, we "disregard that which has little or no worth" and then "decide if there is substantial evidence in the whole record to support the agency's finding or decision." Tallman v. ABF (Arkansas Best Freight ), 1988–NMCA–091, ¶¶ 9–10, 108 N.M. 124, 767 P.2d 363.
to –70 (1929, as amended through 2015), provides that injuries caused by on-the-job accidents are compensable if the worker proves a disability that is a "natural and direct result of the accident." Section 52–1–28(A)(3). To prove causation, the worker must present expert medical testimony by a qualified health care provider. Section 52–1–28(B).
{17} 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. Archuleta v. Safeway Stores, Inc., 1986–NMCA–092, ¶ 6, 104 N.M. 769, 727 P.2d 77
. 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.
{18} Three health care providers offered opinion testimony: Dr. Sara Pasqualoni, Dr. Theresa Elliott, and Dr. Belyn Schwartz. Our administrative rules require that medical doctors testify by deposition during workers' compensation proceedings. 11.4.4.12(G)(4) NMAC
(12/31/12). Based upon these three depositions, the WCJ made the following findings related to causation.
{19} (1) Dr. Pasqualoni diagnosed Worker with cervical, thoracic, and lumbar strains
, and a concussion; (2) Dr. Pasqualoni deferred narcotic treatment of chronic pain in Worker's upper back, neck, and shoulders to Worker's primary care physician; and (3) Dr. Pasqualoni intended to release Worker to work on February 6, 2013.
{20} (1) Dr. Elliott completed a Form Letter to Health Care Provider on March 18, 2014, indicating that Worker's cervical, thoracic, and lumbar strains
are related to an on-the-job injury; (2) Dr. Elliott testified that Worker's pre-existing cervical and lumbar pain were "possibly aggravated" by the accident; (3) Dr. Elliott testified that Worker's...
To continue reading
Request your trial