In Beeler, the Industrial Claims Appeals Office (the Panel) affirmed the ALJ’s decision, finding that the situs of the claimant’s functional impairment extended beyond the arm at the shoulder, and therefore the permanent disability rating was properly calculated as a whole person impairment.
On August 4, 2022, the claimant was assaulted in a road rage incident while working as a utility meter reader. He sustained a traumatic, incomplete tear of the right rotator cuff, requiring shoulder replacement surgery and biceps tenodesis.
On April 17, 2024, the treating physician placed the claimant at maximum medical improvement (MMI) and assigned a 36% upper extremity impairment, convertible to a 22% whole person rating. A 5% mental impairment rating was also assigned for post-traumatic stress disorder.
On June 25, 2024, respondents filed a Final Admission of Liability (FAL), awarding permanent partial disability benefits based on a 36% scheduled loss of the arm at the shoulder along with the 5% mental impairment. The claimant contested the FAL, asserting the injury should be compensated as a whole person impairment.
At the hearing, the claimant testified to ongoing pain in his shoulder, neck, back, trapezius, solar plexus, and chest. The ALJ found the treating physician’s opinion persuasive that the functional impairment was located in the trapezius and neck. These areas are part of the torso, not the arm, and therefore justified a whole person rating.
Respondents appealed, arguing the ALJ misapplied the standard by focusing on physiological changes rather than functional impairment. They contended that pain alone was insufficient to establish the situs of impairment and that the ALJ erred by relying on the claimant’s physician over their own.
Respondents continued, albeit unsuccessfully, to assert the ALJ relied on changes in physiological structures rather than on functional impairment and upon the asserted presence of pain to demonstrate an impairment located beyond the arm at the shoulder. The ALJ noted “the pain and discomfort Claimant feels in his neck and trapezius limit his ability to use that portion of his body and Claimant’s situs of functional impairment is … in the area of his trapezius.” The ALJ did make findings related to function and its impairment as required. The ALJ also relied on the claimant’s testimony describing his pain and its effect on his functioning at work, as well as through activities of daily living.
Ultimately, the Panel found no error in the ALJ’s findings and affirmed the decision. In doing so, it agreed that the situs of the claimant’s functional impairment extended beyond the arm at the shoulder, warranting a whole person impairment rating.
Beeler v. Xcel Energy, W.C. No. 5-214-976-005, (I.C.A.O. May 19, 2025).
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