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

• The Worker-Appellant appealed from a compensation order related to an injury sustained during employment with Los Lunas Public Schools. The core of the dispute revolved around the assignment of an impairment rating and the admissibility and impact of an independent medical examination (IME) by Dr. Auerbach, alongside issues of causation and entitlement to permanent partial disability (PPD) benefits.

Procedural History

• Appeal from the Workers’ Compensation Administration, presided over by David L. Skinner, Workers’ Compensation Judge, with a decision date prior to May 4, 2016.

Parties' Submissions

• Worker-Appellant: Argued that the Workers’ Compensation Judge (WCJ) erred by not assigning an impairment rating in the absence of expert medical testimony and contended that the WCJ should have applied the AMA Guides directly. Additionally, the Worker-Appellant argued that Dr. Auerbach's testimony should have been excluded due to lack of mutual agreement for the IME and that, without Dr. Auerbach's records, the evidence on causation was insufficient.
• Employer/Insurer-Appellees: Supported the WCJ's decision, arguing that the absence of competent medical evidence from the Worker-Appellant justified the decision not to assign an impairment rating. They also contended that the IME by Dr. Auerbach was reasonable and that the Worker-Appellant's primary healthcare provider had agreed to the adjuster's request for an IME.

Legal Issues

• Whether the WCJ erred in declining to assign an impairment rating in the absence of competent medical evidence.
• Whether the testimony of Dr. Auerbach, who performed an IME, should have been excluded due to lack of mutual agreement.
• Whether the evidence was sufficient to support the WCJ’s decision on causation in the absence of Dr. Auerbach’s records.

Disposition

• The Court of Appeals affirmed the decision of the Workers’ Compensation Judge.

Reasons

• Per Jonathan B. Sutin, with concurrence from Roderick T. Kennedy and M. Monica Zamora, the Court reasoned as follows:
  On the assignment of an impairment rating: The Court found that the Worker-Appellant's argument contradicted controlling precedent, specifically citing Yeager v. St. Vincent Hospital, which held that a WCJ could not assign an impairment rating without medical testimony on the percentage of impairment (paras 3-5).
  On the admissibility of Dr. Auerbach's testimony: The Court acknowledged an evidentiary error in admitting Dr. Auerbach's testimony and records due to the lack of mutual agreement for the IME. However, this error was deemed harmless as the Worker-Appellant's failure to satisfy the burden of proof regarding impairment was fatal to the claim for PPD benefits, regardless of Dr. Auerbach's testimony (paras 6-7).
  On causation: The Court found no merit in the Worker-Appellant's argument regarding insufficiency of evidence on causation. It noted that the WCJ had found the Worker did suffer from non-specific low back pain as a direct result of the accident and was awarded temporary total disability (TTD) benefits accordingly. The Court deferred to the WCJ's findings on conflicting medical testimony concerning causation (paras 8-10).