Wash. Cnty. Sch. Dist. v. Labor Comm'n

• Decision Date: 25 August 2015
• Docket Number: No. 20130847.,20130847.
• Citation: 2015 UT 78,358 P.3d 1091
• Parties: WASHINGTON COUNTY SCHOOL DISTRICT and Utah School Boards Risk Management Association, Petitioners, Appellants, v. LABOR COMMISSION and Steven H. Brown, Respondents, Appellees.
• Court: Utah Supreme Court

358 P.3d 1091

2015 UT 78

WASHINGTON COUNTY SCHOOL DISTRICT and Utah School Boards Risk Management Association, Petitioners, Appellants

v.LABOR COMMISSION and Steven H. Brown, Respondents, Appellees.

No. 20130847.

Supreme Court of Utah.

Aug. 25, 2015.

Bret A. Gardner, Kristy L. Bertelsen, Salt Lake City, for petitioners.

Sherry Hayashi, Jaceson R. Maughan, Salt Lake City, for respondents Labor Commission.

Aaron J. Prisbrey, Trevor C. Sanders, St. George, for respondent Steven H. Brown.

Chief Justice DURRANT authored the opinion of the Court, in which Associate Chief Justice LEE, Justice DURHAM, Justice PARRISH,^* and Justice HIMONAS joined.

On Certiorari to the Utah Court of Appeals

Chief Justice DURRANT, opinion of the Court:

Introduction

¶ 1 This case concerns the scope of the Utah Workers' Compensation Act. Specifically, we are asked to address the causal connection that an employee must establish between an initial workplace injury and a subsequent non-workplace injury in order to recover workers' compensation for the subsequent injury. In January 2003, Steven Brown, suffered a back injury when he fell down the steps of his bus while at work as a school bus driver for the Washington County School District (School District). This injury required medical treatment and eventual spinal surgery. He received workers' compensation for this injury. Subsequently, in September 2007, Mr. Brown was reinjured when a child jumped on his back and knocked him to the ground at a local festival. He required additional spinal surgery for this second injury.

¶ 2 Mr. Brown requested and received workers' compensation for his second injury. The Administrative Law Judge (ALJ) with the Utah Labor Commission (Commission) determined that his second injury was causally linked to his workplace injury and awarded benefits. The School District appealed the ALJ's decision to the Commission, which affirmed. It then appealed to the court of appeals, which also affirmed. The School District presents two issues on appeal.

¶ 3 First, it claims the court of appeals erred in determining that the second injury was a natural result of the primary injury and thus compensable under the Utah Workers' Compensation Act. Mr. Brown disagrees. Specifically, the parties argue over what causal connection is required between the primary workplace injury and the subsequent non-workplace injury in order to allow workers' compensation benefits for the second injury. After reviewing the statute and our caselaw, we clarify that under the direct and natural results test we adopted when interpreting the Workers' Compensation Act in Mountain States Casing Services v. McKean,¹ the compensable workplace injury must be a significant contributing cause of the subsequent non-workplace injury. We remand to the Commission to decide whether Mr. Brown's injury meets this clarified standard.

¶ 4 Second, the School District challenges the court of appeals' decision affirming the Commission's finding that there were no conflicting medical reports that required submission of the issue of medical causation to a medical panel. Because we have clarified the applicable standard and remand the case to the Commission, we decline to address the School District's second issue. As additional hearings on medical causation will be required, the ALJ will have to decide anew if there are conflicting medical opinions and thus whether a medical panel is appropriate.

Background

¶ 5 This case concerns the causal relationship between injuries that resulted from two separate incidents involving Mr. Brown.² The first incident occurred on January 27, 2003, when Mr. Brown fell down the steps of a school bus and injured his lower back. At the time, he was employed as a school bus driver for the Washington County School District. As a result of the accident, Mr. Brown received pain management and eventually underwent surgery to address “a large extruded disc herniation” on the left side of his lumbar spine. He sought, and was awarded, workers' compensation benefits for this injury and in October 2004, he returned to work driving a school bus for the School District.

¶ 6 Subsequently, on September 1, 2007, Mr. Brown was attending the local “Peach Days” celebration when a child jumped on his back, knocking him to the ground. Following the incident, he experienced “constant stabbing, burning pain in his lumbar area that radiated from his back all the way down his legs.” His treating physicians identified an injury to the right side of his lower back, and he underwent corrective surgery. Mr. Brown filed for workers' compensation benefits, and the School District denied liability, “assert[ing] that Brown had sustained a subsequent non-industrial intervening accident ... over four years after the industrial accident, for which [it] did not have workers' compensation liability.” An ALJ with the Labor Commission held a hearing and concluded that “all medical evidence support[ed] a finding that the prior industrial disc injury was a contributing cause to the outcome and injury resulting from the festival incident.” The School District appealed this decision to the Commission, which affirmed the ALJ's decision. It then appealed to the court of appeals, which affirmed the Commission's decision.³ Below, we review the medical evidence and then discuss the parties' arguments on appeal.

¶ 7 Following Mr. Brown's fall from the bus in January 2003, he was treated for left-side lower-back pain by Dr. Dale Stott. Dr. Stott attempted to manage his pain with various procedures, including steroid injections and a nerve block. But Mr. Brown continued to experience back pain and was referred to a spinal surgeon, Dr. Mark Kabins. In August 2004, Mr. Brown was given an MRI and Dr. Kabins concluded based on the MRI that he was suffering from a large disk herniation and sequestration in his lower spine at L4/5—the fluid between these disks had ruptured, been squeezed out, and separated from the main part of the disk. In late August 2004, Dr. Kabins performed surgery on the left side of Mr. Brown's lower spine to repair this damage. In postoperative examinations, Dr. Kabins noted that Mr. Brown “does have intermittent back discomfort, but is clearly improved and stable.” Dr. Kabins prescribed pain medication and treated Mr. Brown again for a flare-up of back discomfort in mid-October 2004. But three weeks later, Dr. Kabins reported that Mr. Brown was “doing well with minimal discomfort.” Mr. Brown returned to work for the School District as a bus driver in October 2004.

¶ 8 Mr. Brown did not seek medical attention for his back for more than two years. But in March 2007, Mr. Brown visited Dr. Stott and reported low back pain and pain and numbness in his left leg. He indicated that this pain had existed during the prior two years and that he suffered daily. Dr. Stott diagnosed Mr. Brown with “Failed Back Surgery Syndrome ” and “[p]robable recurrent disc herniation,” and ordered an MRI. The March 2007 MRI revealed a reoccurrence of issues at the previous injury site. Specifically, it showed an L4/5 recurrent disc extrusion, meaning that the disk had ruptured and fluid had been excreted. The MRI indicated that this injury was also affecting the right side of Mr. Brown's spine. The radiology report found that the disc extrusion had mildly compromised both the lateral recesses, the area within the spinal canal on either side of the spine, and the right neuroforamen, the opening on the right side of the vertebra that allows nerves to pass from the spinal cord to other parts of the body. Dr. Stott tried to manage Mr. Brown's pain with steroid injections in April and May 2007.

¶ 9 In addition to the March 2007 flare-up, Mr. Brown “testified that he never recovered from the January 27, 2003 accident and was always stiff and sore and would have flair [sic] ups that required pain medication.” This pain medication was covered by workers' compensation.

¶ 10 Four months after receiving steroid injections for his back pain, Mr. Brown was injured while attending a local festival when a child jumped onto his back, knocking him to the ground. Mr. Brown did not see, and could not identify, the child who jumped on him. Following the incident, he suffered from “constant stabbing, burning pain in the lumbar area which radiated to the buttock bilaterally and down his legs.” Mr. Brown visited Dr. Stott on September 19 concerning his back pain. Dr. Stott again diagnosed him with “Failed Back Surgery Syndrome ” and “[l]umbar radiculopathy.” A subsequent MRI showed “a large extruded disc herniation at the L4–5 level, which is the same level of his previous work-related injury, but on the opposite side of the disc.”

¶ 11 In October 2007, Mr. Brown consulted with Dr. Kabins—the doctor who had performed his previous spinal surgery. Based on his examination of Mr. Brown, Dr. Kabins decided surgery was appropriate. Mr. Brown then consulted Dr. Gary Snook, who diagnosed him with “[i]ntervertebral disc disorder with myelopathy, lumbar region” and performed surgery in November 2007. A follow-up surgery was performed to remove some remaining disc fragments that were causing significant pain.

¶ 12 Three doctors expressed medical opinions regarding whether the January 2003 injury had contributed to the September 2007 injury. All expressed the opinion that there was some causal connection. Dr. Richard Knoebel examined Mr. Brown at the request of the School District in March 2008, after Mr. Brown had filed a claim for workers' compensation for the 2007 injury. In his report, Dr. Knoebel concluded that “it must be said with a reasonable degree of medical probability that ‘the initial work-related accident (is merely) a contributing cause of the subsequent injury.’ ” He also stated that, “[i]n summary, from a medical viewpoint, the significant incident requiring subsequent surgery by Dr. Snook was the non-industrial 9/1/07 aggravation of the patient's low back and L4/5 disc. There was a...