The petitioner was working as a respiratory therapist on August 19, 2017. The petitioner entered a patient’s room and found the patient standing over the bedside and swaying as if she was going to fall. The petitioner caught the patient and then immediately felt a sharp, pinching pain in her back. The petitioner was eventually diagnosed with a muscle and tendon sprain of the lower back. Over the next several months, the petitioner’s recovery fluctuated.
Later the petitioner had severe coughing episodes that caused flare-ups in the petitioner’s back. Following hearing, the ALJ referred the medical aspects of the case to a Medical Panel. The Panel determined that the petitioner had pre-existing degenerative disc disease and that her accident had caused an acute exacerbation of that condition, but that the injury had reached medical stability by September 21, 2017. In regard to the coughing incident, the Panel opined that the coughing episodes had caused the petitioner’s flare ups.
The Panel also opined that after November 19, 2017, the petitioner’s symptoms were no longer a clinically significant result of her lifting injury at work. The ALJ found that the work injury caused a temporary exacerbation of a pre-existing condition. Further, that the first coughing episode was an intervening injury that severed medical causation. The petitioner filed a motion for review, and then filed a petition with the Utah Court of Appeals (the Court).
Our office successfully argued that the Court should not disturb the ALJ’s determinations. The Court determined that in regard to aggravation of a pre-existing condition, entitlement to benefits ends when the aggravation stops being attributable to the industrial accident. In other words, a petition can only recover for the temporary aggravation, not for unrelated symptoms or complications she may experience down the road. The Court determined that in this instance the substantial evidence standard was satisfied, and that it was more likely than not that the petitioner’s back issues were aggravated by the subsequent coughing episodes. Supporting the ALJ’s conclusion that the industrial incident caused only a temporary aggravation of the petitioner’s pre-existing condition that resolved by November 19, 2017.
The Court then addressed the petitioner’s argument that the claim was compensable under Cox v. Labor Comm’n. The Court determined that the petitioner could not meet the second element of Cox, namely that the aggravation must be permanent. The petitioner argued that the second prong was satisfied because the petitioner was allegedly fully functional before the accident but since that point had chronic low back pain and therefore had not returned to “baseline.” The Court took the opportunity to explain the term “baseline.” It is inappropriate to require that the employer be responsible even though the employee has not returned to the condition they were in before the accident. Specifically, the Court stated, “[p]ut another way, an aggravation caused by a workplace accident is not permanent simply because the petitioner begins to experience new symptoms of the same preexisting condition – symptoms that were not caused by the accident – before the symptoms caused by the accident are fully resolved. Were the rule otherwise, employees could argue that they are entitled to permanent benefits simply because their general health has declined for reasons entirely unrelated to a workplace accident.” The Court declined to disturb the ALJ’s decision.
Morris v. Labor Comm’n, 2021 UT App 131, –P.3d–
Want to know more? Contact Jeff Callister at [email protected] or 877-259-5693 or Christin Bechmann at [email protected]
