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 registered nurse employed by Lovelace Hospital suffered a work-related accident on April 17, 2015, when assisting a patient. The patient grabbed her arm and pulled her down, causing her to hit her right hip and lower back on a toilet, resulting in immediate pain. She received medical treatment from various providers, including being taken off work completely due to worsening pain. The employer filed a complaint with the Workers’ Compensation Administration seeking a determination of compensability and benefits, among other things (paras 2-3).

Procedural History

• Workers’ Compensation Administration, Terry S. Kramer, Workers’ Compensation Judge, September 1, 2016: Awarded the worker temporary total disability benefits from April 17, 2015, to January 29, 2016, but concluded the worker reached maximum medical improvement (MMI) with no permanent impairment for her right hip injury (para 1).

Parties' Submissions

• Worker-Appellant: Contended that the Workers’ Compensation Judge’s order, specifically its findings and conclusions regarding the date the worker reached MMI for her work-related right hip injury and the overall compensability of that injury, is not supported by substantial evidence (para 1).
• Employer/Insurer-Appellees: Filed a complaint with the Workers’ Compensation Administration seeking a determination of compensability and benefits, a suspension or reduction of benefits, and a credit for overpayment, indicating contemplation of reevaluation or an independent medical examination (IME) to assess MMI (para 3).

Legal Issues

• Whether the record supports the Workers’ Compensation Judge’s findings and conclusions regarding the compensability of the worker’s right hip injury (para 6).

Disposition

• The Court of Appeals reversed the Workers’ Compensation Judge’s compensation order and remanded for further proceedings to make a reasonable and supportable determination regarding the compensability of the worker’s right hip injury (para 21).

Reasons

• The Court of Appeals, per J. Miles Hanisee, with Julie J. Vargas and Briana H. Zamora concurring, found that the whole record does not support the Workers’ Compensation Judge’s ruling regarding the worker’s right hip injury. The court determined that substantial evidence does not support the findings that the worker had a preexisting right hip injury, that the only injury to the right hip was a temporary exacerbation of her preexisting injury, and that the worker had reached MMI for that injury. The court noted deficiencies in the Workers’ Compensation Judge’s order, particularly the lack of substantial evidence supporting the finding that the worker suffered only a "temporary exacerbation" of her right hip injury and the finding that the worker had reached MMI for her right hip injury. The court criticized the Workers’ Compensation Judge’s reliance solely on the opinion contained in Dr. Kiburz’s form letter without considering the testimony and opinions of Drs. Lyman and Knaus. The court concluded that the Workers’ Compensation Judge’s ruling was not supported by substantial evidence and required reversal and remand for a determination supported by substantial evidence, including express findings relating to the date of MMI of the worker’s right hip injury and the degree of disability caused by that injury (paras 7-20).