AI Generated Opinion Summaries

This summary was computer-generated without any editorial revision. It is not official, has not been checked for accuracy, and is NOT citable.

Facts

• A worker employed as a housekeeper at St. Vincent Hospital was injured on May 11, 2006, when she slipped while mopping a wet floor, twisting her right foot and ankle. Over the following eleven years, the worker and the employer litigated various aspects of the workers' compensation benefits to which the worker was entitled.

Procedural History

• [Not applicable or not found]

Parties' Submissions

• Worker-Appellant: Argued that the Workers' Compensation Judge (WCJ) erred in several orders regarding compensation, the calculation of permanent partial disability (PPD) benefits, the sufficiency of evidence for the WCJ’s factual findings, and the handling of bad faith claims.
• Employer/Self-Insured-Appellee: Contended that the worker's appeal was untimely and defended the WCJ's decisions on the calculation of PPD benefits, the sufficiency of evidence, and the handling of bad faith claims.

Legal Issues

• Whether the worker's appeal was timely.
• Whether the WCJ improperly calculated the worker's PPD benefits by using the sixth edition of the AMA Guide.
• Whether there was sufficient evidence to support the WCJ’s findings on the worker's hip and lower back pain, psychological impairment, calculation of PPD benefits, and scheduled injury benefits.
• Whether the worker's bad faith claims were time-barred.

Disposition

• The court affirmed in part and reversed in part the WCJ's orders.

Reasons

• The Court of Appeals, with Judges Duffy, Hanisee, and Ives concurring, addressed several key points in their decision:
  Timeliness of Appeal: The court rejected the employer's argument that the worker's appeal was untimely, establishing jurisdiction to consider the appeal based on the timing of the worker's notice of appeal after the WCJ issued an order awarding attorney fees (paras 3).
  Calculation of PPD Benefits: The court found no error in the WCJ's reliance on the sixth edition of the AMA Guide for calculating PPD benefits, noting the worker had stipulated to its use (para 4).
  Sufficiency of Evidence: The court reviewed the sufficiency of evidence regarding the worker's hip and lower back pain, psychological impairment, and calculation of PPD benefits. It upheld the WCJ's findings that were supported by substantial evidence, including the opinions of independent medical examiners over the worker's treating physicians (paras 5-23).
  Scheduled Injury Benefits: The court affirmed the WCJ's award of scheduled injury benefits for the worker's right foot at the ankle, rejecting the worker's argument for additional benefits for an injury to her leg between the knee and ankle (paras 24-27).
  Bad Faith Claims: The court reversed the WCJ's denial of the worker's bad faith claims, finding that the WCJ erred in concluding some claims were time-barred. The court remanded for reconsideration of these claims with instructions to enter specific findings and conclusions (paras 28-30).
  Attorney Fees: The court did not address the worker's argument regarding the division of attorney fees due to insufficient briefing on whether the WCJ erred in declining to shift fees with respect to the second injury award (paras 31-35).
  The decision reflects a comprehensive review of the worker's claims, the evidence presented, and the legal standards applicable to workers' compensation disputes, leading to a partial affirmation and partial reversal of the WCJ's orders.