Wright v. Labor Comm'n

• Decision Date: 15 April 2021
• Docket Number: No. 20200103-CA,20200103-CA
• Parties: Jerry B. WRIGHT, Petitioner, v. LABOR COMMISSION, Brent Brown Chevrolet & Buick, and WCF Mutual Insurance Company, Respondents.
• Court: Utah Court of Appeals

489 P.3d 211

Jerry B. WRIGHT, Petitioner,

v.LABOR COMMISSION, Brent Brown Chevrolet & Buick, and WCF Mutual Insurance Company, Respondents.

No. 20200103-CA

Court of Appeals of Utah.

Filed April 15, 2021

Michael Gary Belnap, Ogden, Virginius Dabney, St. George, and Stony V. Olsen, Attorneys for Petitioner

Matthew J. Black, Salt Lake City, Attorney for Respondents Brent Brown Chevrolet & Buick and WCF Mutual Insurance Company

Judge Jill M. Pohlman authored this Opinion, in which Judges Ryan M. Harris and Diana Hagen concurred.

Opinion

POHLMAN, Judge:

¶1 Jerry B. Wright asks us to review the Labor Commission's decision denying his claim for benefits under Utah's Workers’ Compensation Act (the Act). He contends that the Commission erred in relying on the medical panel's opinions because its members were both biased and unqualified to render medical opinions in his case. He also contends that the evidence does not support the Commission's determination that his work accident only temporarily aggravated his preexisting conditions. Because we conclude the Commission did not err in relying on the medical panelists’ opinions, and because its decision is supported by substantial evidence in the record, we decline to disturb the Commission's decision.

BACKGROUND¹

¶2 On August 20, 2007, Wright was injured while working for Brent Brown Chevrolet & Buick (Brown). He reported feeling "pain and a cold sensation in his spine" and "sharp pain in his mid and low back" while moving fixtures and other items as part of a remodeling project in Brown's body shop (the Accident). Wright took several days off work after the Accident and, on August 28, sought medical treatment for his back pain with Dr. Schumann, who prescribed physical therapy. One week later, on September 5, 2007, Dr. Schumann released Wright to work with no restrictions because Wright "was feeling much better."²

¶3 Nearly one year later, in July 2008, Wright noticed pain in his mid and low back. At the time, "there was no attribution of his back symptoms to his employment with Brown." Instead, his treating physician prescribed him medication for possible reflux disease.

¶4 Then, in September 2009, Wright again sought treatment for back pain, and he obtained x-rays, a bone scan

, and MRIs of his thoracic and lumbar spine. Ultimately, Dr. Reichman, one of Wright's treating physicians, recommended lumbar surgery and performed the procedure in March 2012. In his post-operative notes, Dr. Reichman observed that Wright's lumbar spine "showed end-stage disc disease and severe stenosis." Although Wright's lumbar symptoms improved after surgery, his mid-back pain increased. Dr. Reichman diagnosed Wright with "T11 disc disease causing chronic pain syndrome," and he performed a "T11-12 decompression and fusion" of Wright's thoracic spine in March 2013.

¶5 That same year, Wright applied for a hearing with the Commission, claiming entitlement to workers’ compensation benefits as a result of the Accident. Brown's medical consultant, Dr. Mattingly, evaluated Wright in March 2013 and opined that Wright's ongoing back issues were not related to the Accident. She concluded that the Accident "caused a minor temporary aggravation of the pre-existing thoracic degenerative condition" and that Wright "reached medical stability from his work injuries as of September 5, 2007." In contrast, Dr. Reichman opined that Wright had not reached medical stability from the Accident-related injuries as late as December 2012. Similarly, Dr. Leininger, a pain management specialist who treated Wright, opined in March 2013 that injuries Wright sustained in the Accident had not reached medical stability.

¶6 Because of the conflicting medical opinions, the administrative law judge (ALJ) appointed a medical panel to independently assess the medical aspects of Wright's claim. The ALJ appointed Dr. Jones, a general surgeon, as the medical panel chair and charged him with selecting at least one additional specialist to serve on the panel. Dr. Jones chose Dr. Biggs, a family practice and occupational physician, to be the second panel member. The ALJ asked the panel to, among other things, opine on what injury was caused or worsened by the Accident, what medical care was necessary to treat any such injuries, and whether those injuries had reached medical stability.

¶7 The panel reviewed Wright's extensive medical records and interviewed him about the Accident and his symptoms.³ Its report included what the ALJ described as "a thorough discussion of intervertebral disc degeneration

." Following that discussion, the panel applied its "understanding of degenerative changes" to Wright's condition and observed that his scans presented no evidence of acute injury but revealed "clear evidence of progressive degenerative disease ... in many areas of the spine." Based on those observations, the panel concluded that the Accident caused a "[s]prain/strain of [Wright's] back muscles" and only temporarily exacerbated the degenerative disease of his thoracic and lumbar spine. The panel explained that the pain Wright experienced "every few years" after the Accident was "expected and [is] considered to be a normal manifestation of the chronic disease process" but that Wright's Accident-related injuries "reached stability in September 2007." And when asked in a supplemental inquiry whether Wright's injuries "returned to baseline"—meaning "the thoracic spine's condition immediately before the industrial accident"—the panel responded that "it is more probable than not that [Wright] was returned to baseline" by September 5, 2007. Finally, the panel opined that the "physician visits and a diagnostic procedure to manage the low back sprain /strain and the thoracic mid-back symptoms" were the only necessary treatments stemming from the Accident. "The panel further clarified that neither the 2012 lumbar fusion nor the 2013 T11 fusion were necessary" to treat the injuries attributable to the Accident.

¶8 Relying on the medical panel's evaluation, the ALJ concluded that the Accident "caused a temporary exacerbation of [Wright's] pre-existing lumbar and thoracic spinal degeneration" and that he was entitled to recover medical expenses for the physician visits and a diagnostic procedure associated with the Accident. But the ALJ rejected Wright's claim for temporary total disability compensation for the period of March 13, 2013, to the date of medical stability, concluding that Wright's Accident-related injuries "reached medical stability on September 5, 2007."⁴ The ALJ also addressed Wright's objection to the medical panel's composition, as well as his contention that the panelists lacked the requisite expertise to evaluate his claims. The ALJ found that Dr. Jones has "extensive experience in causation analysis for work-related conditions" like the injuries alleged in Wright's claim and that "Dr. Biggs has extensive experience[ ] in diagnosing, treating and determining the medical cause of work related low back injuries and lumbar degenerative disc disease

."

¶9 Wright filed a motion for review with the Commission. Among other things, he argued that the panel lacked the knowledge and skill to opine on his back injuries. He also challenged the ALJ's dismissal of his claim for temporary total disability, arguing that the evidence does not support the conclusion that the Accident caused only temporary aggravation of his preexisting conditions, which reached medical stability by September 5, 2007.

¶10 The Commission affirmed the ALJ's decision and adopted the ALJ's findings of fact. Regarding Wright's argument that the panel was not qualified, the Commission shared the ALJ's view that the panelists "ha[d] the requisite experience in treating the specific condition at issue in this matter." The Commission also determined that the panel's evaluation was persuasive and that its "opinion that the [Accident] resulted in only a temporary back injury that returned to baseline and reached medical stability by September 5, 2007, is supported by the evidence in the record." Specifically, the Commission concluded that the panel's opinions were supported by the opinions of Dr. Schumann and Dr. Mattingly, as well as Wright's imaging studies, and were consistent with Dr. Reichman's diagnoses of lumbar and thoracic degeneration.

¶11 Wright filed a motion for reconsideration. He argued again that the medical panel was not qualified to opine in this case. He also argued that the panel failed to offer meaningful analysis in its report and that his treating physicians’ opinions should have been given more weight. The Commission denied Wright's motion, stating that Dr. Biggs and Dr. Jones were qualified to opine in this case because "they have extensive experience in treating back injuries." The Commission also rejected Wright's characterization of the medical panel's report, reaffirming that the panel had considered Wright's medical history, including the opinions of Dr. Reichman and Dr. Leininger, and had engaged in "a well-reasoned review and analysis" of Wright's back problems.

¶12 On the same day the Commission issued its order denying Wright's first motion for reconsideration, Wright filed a second motion for reconsideration. In his second attempt, Wright argued for the first time that the panel members were so "intimately intertwined" with WCF Mutual Insurance Company (WCF)—Brown's workers’ compensation carrier at the time of the Accident—that they could not be impartial. He asserted that Dr. Biggs's employment as an adjunct professor at the Rocky Mountain Center for Occupational and Environmental Health (Rocky Mountain), coupled with monetary donations WCF made to Rocky Mountain, created a financial conflict of interest requiring the appointment of a new, "unconflicted" panel. The Commission rejected Wright's argument on procedural grounds, finding his second motion was untimely and not "contemplated or permitted by the applicable statutes and rules governing ...