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 underwent a knee replacement and subsequently slipped and fell on an icy sidewalk, disrupting the knee replacement and causing further damage. This fall was recognized as arising out of and occurring in the course of employment. Following surgeries to address the knee injury, the Worker suffered a series of medical complications, including an infection treated with Daptomycin, which led to eosinophilic pneumonia and hypoxia, resulting in temporary blindness and later, a pulmonary embolism. These events led to memory loss, decreased organizational skills, vision problems, and accelerated macular degeneration. The Worker filed a complaint with the Workers’ Compensation Administration (WCA), leading to a trial and the award of permanent total disability (PTD) benefits, loss of use benefits, and attorney fees (paras 2-4).

Procedural History

• [Not applicable or not found]

Parties' Submissions

• Employer: Argued that the Worker sustained only one compensable accidental injury, thus entitling him to a single statutory cap of attorney fees; contended that the Worker is not entitled to PTD benefits as the impairment rating included impairments to other body parts and preexisting conditions; and argued that loss of use benefits should not have been awarded in addition to PTD (para 1).
• Worker: Argued that the Workers’ Compensation Judge (WCJ) erred in failing to find a third compensable accidental injury, which would entitle the Worker to an additional award of permanent partial disability (PPD) benefits and attorney fees (para 1).

Legal Issues

• Whether the WCJ correctly determined the number of compensable accidental injuries the Worker suffered, which in turn governs the WCJ’s ability to award multiple caps of attorney fees.
• Whether the WCJ erred by including the Worker’s visual field and visual acuity impairments when assessing his brain impairment.
• Whether the WCJ erroneously included preexisting impairments when assessing the Worker’s brain impairment.
• Whether the WCJ erred in the benefits awarded to the Worker, including the assertion that loss of use benefits cannot be awarded in addition to PTD benefits, and the Worker’s contention that the WCJ erred in failing to additionally award PPD benefits (paras 6-7).

Disposition

• The Court of Appeals reversed in part and affirmed in part the WCJ’s order. It reversed the finding that the Worker suffered two compensable accidental injuries and the corresponding additional award of attorney fees, remanding for the determination of appropriate attorney fees. The Court affirmed the WCJ’s award of PTD benefits and loss of use benefits (para 37).

Reasons

• The Court found that substantial evidence supported only one compensable accidental injury, the initial December 9, 2009, slip-and-fall, thus reversing the WCJ’s award of a second cap of attorney fees. It concluded that the Worker’s allergic reaction and subsequent hospitalization did not arise out of employment, and therefore, did not qualify as separate compensable accidental injuries. The Court also held that the WCJ did not err by including Worker’s visual system impairments when calculating impairment due to brain injury, as uncontradicted expert medical evidence established the retina as part of the brain. Furthermore, the Court determined that even with a revised assessment of Worker’s visual system impairment, the evidence established that Worker suffered a sufficient percentage of Whole Person Impairment (WPI) attributable to his traumatic brain injury to satisfy the requirements for the award of PTD benefits. Lastly, the Court did not address Worker’s contention for additional PPD benefits due to lack of preservation of the issue for appeal (paras 8-36).