Morris v. Labor Comm'n

503 P.3d 519

Ilene MORRIS, Petitioner,

v.LABOR COMMISSION, HERITAGE PARK CARE CENTER, and Safety National Casualty Corp. Co., Respondents.

No. 20200440-CA

Court of Appeals of Utah.

Filed November 26, 2021

Rehearing Denied December 17, 2021

Jared L. Mortenson, Salt Lake City, Attorney for Petitioner

Christin Bechmann and Jeffrey A. Callister, Attorneys for Respondents Heritage Park Care Center and Safety National Casualty Corp. Co.

Judge Diana Hagen authored this Opinion, in which Judges Gregory K. Orme and Jill M. Pohlman concurred.

Opinion

HAGEN, Judge:

¶1 Ilene Morris applied for workers’ compensation benefits after injuring her back at work. The Utah Labor Commission found that Morris had a preexisting back condition and that her accident had temporarily aggravated her condition for a period of three months. Although Morris complained of health issues beyond that time, the Commission found that those issues were not medically caused by the accident. Accordingly, it awarded her three months’ worth of temporary benefits. Morris now seeks judicial review. We decline to disturb the Commission's decision.

BACKGROUND¹

¶2 At the time of her accident, Morris worked as a respiratory therapist for Heritage Park Care Center. On August 19, 2017, Morris entered a patient's room and found her standing over the bedside commode, swaying as if she were about to fall. Morris caught the patient and immediately felt a sharp, pinching pain in her back. Although the pain eventually dulled, it returned later that day after Morris tried to lift a different patient with the help of a coworker. Morris was ultimately referred to an occupational health services provider and diagnosed with a muscle and tendon sprain of the lower back.

¶3 Morris's recovery fluctuated over the next several months. On September 21, 2017, Morris told one of her treating physicians that she was "definitely doing better" and rated her pain as a one on a ten-point scale. By the following month, however, Morris began experiencing flare-ups of pain in her lower back, along with other health issues. Two of these flare-ups coincided with severe coughing episodes that Morris suffered on October 24 and November 1, 2017.

¶4 Morris requested workers’ compensation in the form of permanent partial disability benefits.² After Heritage opposed the request, the administrative law judge (ALJ) referred the medical aspects of Morris's claim to a panel of experts. The medical panel then reviewed 1,072 pages of Morris's medical records and physically examined Morris before submitting a written report to the ALJ. The panel concluded that Morris had preexisting degenerative disc disease and that her accident had caused "an acute exacerbation" of that condition. It opined that Morris's workplace injury had "most likely reached medical stability on September 21, 2017." Neither party objected to the panel's report, and the ALJ entered the report into evidence.

¶5 Based on the medical panel report, the ALJ awarded Morris temporary partial disability benefits from the date of the accident through September 21, 2017. Morris sought review from the Commission, arguing that the ALJ should not have adopted the medical panel's conclusions because the report failed to account for her ongoing health issues. The Commission found that the report was thorough, well-reasoned, and impartial, and that it supported the ALJ's determination that "Morris's work-related low-back injury was temporary in nature." But "in light of the evidence that [Morris's] symptoms appeared to continue beyond September 21, 2017," the Commission remanded for clarification from the medical panel as to the date Morris's workplace injury had resolved.

¶6 In a supplemental report, the panel expanded on several of its prior conclusions. Regarding Morris's preexisting condition, the panel explained that "[o]ften, ... degenerative disc disease is asymptomatic," but that when symptoms occur, they "can range from having no pain to having significant low back pain .... Pain often occurs without a known injury or change in daily activity." The panel added that "[a]cute episodes of back pain are expected and considered to be a normal manifestation of the chronic disease process" and that "[ninety percent] of people with an acute episode of low back pain will recover" within three months.

¶7 The panel next discussed the relationship between Morris's coughing episodes and her preexisting condition: "With degenerative disc disease, an increase in pressure near the disc can cause pain. An increase in pressure can occur with lifting or with coughing or sneezing." In the panel's view, it was "medically more likely than not" that this increase in pressure explained Morris's flare-ups following each of her coughing episodes.

¶8 Finally, the panel clarified its opinion regarding the date Morris's workplace injury had resolved. For the period before November 19, 2017 (three months after Morris's accident), the panel concluded that it was "medically more likely than not that" Morris's health issues "were a result of her industrial accident, her degenerative disc disease [,] and the reported coughing episode[s]." After November 19, 2017, however, the panel said Morris's symptoms were no longer "a clinically significant result of her lifting injury at work."

¶9 Over Morris's objection, the ALJ entered the supplemental report into evidence. And based on the panel's clarified opinions, the ALJ found that Morris's workplace "accident caused an acute lumbar strain, which would be considered a temporary exacerbation of her preexisting [condition]." The ALJ also found that Morris's workplace injury "would have been expected to reach medical stability within three months of the injury date," but that her first coughing episode was an intervening injury that "sever[ed] medical causation." The ALJ then awarded Morris benefits from the date of her accident up to October 23, 2017, the day before Morris's first coughing episode.

¶10 On review, the Commission adopted the ALJ's findings of fact but modified the temporary benefits award. The Commission reasoned that, according to the supplemental medical panel report, Morris's workplace accident affected her until November 19, 2017, after which the accident was no longer a clinically significant cause of her health issues. Therefore, Morris was entitled to benefits from the date of her accident until November 19, 2017. As the Commission explained, "Whether such problems after that date resulted from the coughing episodes or progression of [Morris's] underlying lumbar-spine degeneration, the medical causal connection between ... Morris's low-back condition and her work activities was severed."

¶11 Morris now seeks judicial review of the Commission's decision.

ISSUE AND STANDARD OF REVIEW

¶12 Morris challenges the Commission's determination of medical causation. "[W]hether the Commission properly found that medical causation exists is a question of fact we review for substantial evidence." YESCO v. Labor Comm'n , 2021 UT App 96, ¶ 13, 497 P.3d 839. "Substantial evidence is more than a mere scintilla of evidence though something less than the weight of the evidence, and the substantial evidence test is met when a reasonable mind might accept as adequate the evidence supporting the decision." Hutchings v. Labor Comm'n , 2016 UT App 160, ¶ 30, 378 P.3d 1273 (cleaned up).

ANALYSIS

¶13 Morris argues that the Commission erred in finding that her workplace accident was not the medical cause of her health issues after November 19, 2017. We conclude that there is substantial evidence supporting that determination and, therefore, decline to disturb the Commission's decision.

¶14 Under Utah's Workers’ Compensation Act (the Act), an employer must compensate an employee "who is injured ... by accident arising out of and in the course of [her] employment." Utah Code Ann. § 34A-2-401(1) (LexisNexis 2019). "Thus, in addition to proving that an injury was accidental, an employee must establish that there is a causal connection between the injury and the employment." Wright v. Labor Comm'n , 2021 UT App 43, ¶ 28, 489 P.3d 211 (cleaned up), cert. granted , 496 P.3d 711 (Utah 2021). To establish a causal connection, the employee must show that the "accident was both the legal cause and the medical cause of the injury." Cox v. Labor Comm'n , 2017 UT App 175, ¶ 14, 405 P.3d 863 (citing Allen v. Industrial Comm'n , 729 P.2d 15, 25 (Utah 1986) ). In this case, Morris challenges the Commission's finding only as to medical causation.

¶15 "To prove medical causation, an injured employee must establish by evidence, opinion, or otherwise that the stress, strain, or exertion required by his or her occupation led to the resulting injury or disability." Wright , 2021 UT App 43, ¶ 29, 489 P.3d 211 (cleaned up). A workplace accident leads to an injury even if it is merely "a cause—as opposed to the cause—of the condition requiring treatment." Cox , 2017 UT App 175, ¶ 18, 405 P.3d 863. For this reason, "the aggravation or lighting up of a pre-existing disease by an industrial accident is compensable" under the Act. Id. (cleaned up).

¶16 Like any workplace injury, the aggravation of a preexisting condition is compensable only to the extent there is "a nexus between the accident and the injury for which treatment is sought." See Petersen v. Labor Comm'n , 2016 UT App 222, ¶ 18, 385 P.3d 759. This means that even though

a claimant may be compensated for the aggravation of preexisting conditions caused by an industrial accident ..., that entitlement ends when the aggravation stops being attributable to the industrial accident. In other words, if a preexisting condition is only temporarily aggravated by an industrial accident, a claimant may only recover for the temporary aggravation, and not for unrelated symptoms or complications [s]he may experience down the road.

Valdez v. Labor Comm'n , 2017 UT App 64, ¶ 14, 397 P.3d 753 (cleaned up). This principle "prevents...