Medical Panel Not Following the ALJ's Instruction

Claimant argues Utah Labor Commission exceeded its discretion considering a medical panel's report which gave exposure to surveillance video descriptions.

In Horning, the claimant argued that the Utah Labor Commission (the Labor Commission) exceeded its discretion in considering a medical panel’s report, which he alleged was tainted by exposure to descriptions of surveillance video that had been excluded from evidence. The exclusion included a stipulation that two pages of medical records that contained a description of what was seen in the surveillance video would be stricken. Unfortunately, despite the stipulation, the medical panel received records that included the description of the surveillance footage. The medical panel was exposed to those records during their comprehensive review. This became clear once the report was released and references to the footage were present.

The ALJ later issued an order denying ongoing benefits. The claimant then filed a motion for review, which was also rejected. The claimant continued to file objections to the substance of the panel’s report, other issues, and filed a second motion for review. The Labor Commission then issued an order affirming the ALJ’s decision. As result, the claimant appealed to the Utah Court of Appeals (the Court).

Objection Under an Abuse of Discretion Standard

On appeal, the claimant sought judicial review on multiple issues, including whether the ALJ and the Labor Commission were within their discretion in considering the medical panel’s report. The Court reviewed the Labor Commission’s refusal to exclude the medical panel report on the basis of an objection under an abuse of discretion standard, where relief would only be provided if reasonable basis for that decision is not apparent from the record. Foye v. Labor Comm’n, 2018 UT App 124, 428 P.3d 26), abrogated on other grounds by Gamez v. Utah Labor Comm’n, 2022 UT 20.

With this standard of review in mind, the Court concluded that the claimant had not shown that it was an abuse of discretion for the Labor Commission to consider the medical panel’s report.  The Court pointed out that the ALJ had, in response to the claimant’s objection, instructed the medical panel to “exclude from . . . consideration” any assertions of what was seen on the surveillance video and rely instead on “the remaining medical exhibit [the ALJ’s] fact findings, and the results of [the medical panel’s] evaluation” of the claimant. The Court also found that just because the panel came to different conclusion about the claimant’s motives for asserting the severity and duration of his psychological disease, it did not illustrate that the panel relied on excluded evidence to reach those conclusions. In fact, the Court found that there was no reason to conclude that the medical panel ignored the ALJ’s instruction. Hence, the Court rejected the claimant’s claim that the ALJ and the Labor Commission abused their discretion in considering the medical panel’s report.

Horning v. Labor Comm’n., 529 P.3d 1260 (Utah Ct. App. 2023).

Want to know more? Contact Andrew Vogelgesang at avogelgesang@pollartmiller.com or 877-259-5693.

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