Professional Documents
Culture Documents
Workers’ Compensation
Court of Appeals
April through June 2003
Case summaries published are
those prepared by the WCCA
Attorney Fees
Where the employee was receiving wage loss benefits and the employee’s attorney was entitled to contingent
fees based on those benefits, the compensation judge did not err by dismissing the employee’s petition for
Roraff fees as premature.
Affirmed.
Where the employee conceded the requested MRI scan was not consistent with the treatment parameters and
did not qualify for a departure under the treatment parameter rules, the compensation judge was not required
to make findings applying the treatment parameters. Compare Martin v. Xerox Corp., 59 W.C.D. 509
(W.C.C.A. 1999).
Where without an MRI scan, the employee would be unable to obtain a neurosurgical consultation previously
ordered by a compensation judge, and where other evidence, including the employee’s testimony and the
employee’s physicians’ treatment records supports the reasonableness and necessity of an MRI scan, the
compensation judge’s determination that the employee’s request for an MRI scan was a rare case in which a
departure from the treatment parameters was necessary to obtain proper treatment is not clearly erroneous or
unsupported by substantial evidence.
Affirmed.
Summaries of Decisions
Causation
Substantial evidence supports the findings of the compensation judge that the employee sustained a work-
related injury to her left shoulder but did not have a work-related injury to the left elbow.
Affirmed.
Substantial evidence, including expert opinion, supported the compensation judge’s decision that the employee’s
Dec. 30, 2001, work injury was merely a temporary aggravation of the employee’s pre-existing condition.
Affirmed.
Substantial evidence supports the compensation judge’s credibility determination and conclusion that the employee
had failed to meet her burden of proof and establishing that she sustained a work injury.
Affirmed.
Where the employee continues to receive wage loss benefits, and there is a stream of benefits from which the
employee’s attorney may be paid a fee, the compensation judge properly denied the employee’s attorney’s
petition for fees pursuant to Gruber v. Independent Sch. Dist. #625, 57 W.C.D. 284 (W.C.C.A. 1997), for his
representation of the employee in an action brought by the employer and insurer to discontinue permanent total
disability benefits.
Penalties
Minnesota Statutes §176.225, subd. 1(a)
The court declines to impose a penalty under Minnesota Statutes §176.225, subd. 1(a), sought initially by the
employee on appeal, where the case involved an appeal from a decision of the Office of Administrative Hearing
rather than an original petition to discontinue to this court. Whether a penalty is appropriate, in this case, is a
factual determination best left to a compensation judge.
Affirmed as modified.
Substantial evidence, including expert opinion, supported the compensation judge’s decision that the employee’s
cervical injury was merely temporary and did not cause, aggravate or accelerate the employee’s current cervical
condition.
Affirmed.
Substantial evidence, including expert opinion, support the compensation judge’s denial of benefits related to
the employee’s cervical and thoracic conditions.
Substantial evidence, including expert opinion, supported the compensation judge’s decision that certain
treatment, including narcotic medication, was not reasonably required to treat the employee’s admitted low
back condition.
Affirmed as modified.
Where it was clear from his memorandum that the compensation judge did not reject the treating physician’s
opinion without weighing it against contrary medical evidence of record, and where that contrary medical
evidence of record was substantial notwithstanding arguable foundational weaknesses in the only formal adverse
expert opinion, the compensation judge’s conclusion that the employee did not prove by a preponderance of
the evidence that her work activities were a substantial contributing factor in the development of her bilateral
arthritic thumb condition did not constitute an improper dismissal of prima facie evidence.
Affirmed.
August 2003 • COMPACT • D-3
Summaries of Decisions
Where the employee sought workers’ compensation benefits claiming, at least in part, that the medical condition
in dispute was caused or substantially contributed to by the employee’s work activities, the compensation
judge erred in applying the direct and natural consequences rule to find a consequential injury.
Where all of the evidence supports the conclusion that the employee sustained a Gillette injury to her right and
left shoulders, the compensation judge’s finding of a consequential injury is vacated and the case remanded for
findings regarding the date or dates of the Gillette injury or injuries.
Substantial evidence, including records of the employee’s treating physicians and the employee’s testimony,
supports the compensation judge’s finding that the employee sustained a cervical spine injury on Jan. 4, 1979,
and that the treatment received to the cervical area at Medical Advanced Pain Specialists and the Minneapolis
Clinic of Neurology was causally related to her 1979 work injury.
The treatment parameters may not be applied to deny payment for treatment rendered after the employer
denied liability asserting the injury had resolved.
Substantial evidence, including the adequately founded opinion of Dr. Dowdle, supports the compensation
judge’s determination that treatment for the low back on Jan. 17 and 30, 2002, was reasonable and necessary
to cure and relieve from the effects of the employee’s 1995 personal injury to the low back.
Affirmed.
Substantial evidence supports the determination of the compensation judge that the employee did not sustain a
Gillette injury to her cervical spine.
Affirmed.
Where the employee’s post-injury drug screening, required by the employer’s drug and alcohol screening
policy, tested positive, and where the employee was discharged from employment due to his failure to attend
recommended chemical dependency treatment, also required by the employer’s policy, and where the employer
and insurer discontinued the employee’s ongoing temporary total disability benefits on the basis that the employee’s
conduct constituted misconduct that terminated his entitlement to temporary total disability benefits, and also
constituted a refusal of a job offer, the matter is remanded to the compensation judge for determination of
whether the employee demonstrated that his work-related disability is the cause of his inability to find or hold
new employment.
Where the employee objected to a discontinuance of temporary total disability benefits, where the issue to be
addressed at hearing was whether the employer and insurer could discontinue temporary total disability benefits,
and where the employee did not claim temporary partial disability benefits at this hearing, the compensation
judge erred by addressing an issue not presented to him and the court vacates the denial of temporary partial
disability benefits.
Where the employee had been paid benefits based upon 104 weeks of a combination of temporary total or
temporary partial compensation, and where the employee filed a request for retraining beyond the date when
he had been paid such benefits, the employee’s request for retraining is barred by an untimely filing of a request
for retraining.
Reversed.
Substantial evidence, including records of the employee’s treating physician and the employee’s testimony,
supports the compensation judge’s findings that the employee sustained a Gillette injury to her left and right
shoulders as a result of her work activities.
Affirmed.
Causation
Substantial evidence, including expert medical testimony, supports the compensation judge’s finding that the
employee sustained a work-related injury to his left knee when he slipped and fell at work.
Where the employee had withdrawn his claim for medical expenses relating to any of the potential intervenors
and only requested reimbursement for expenses related to parties who had intervened, the compensation
judge erred by extinguishing the rights of potential intervenors who had not filed motions to intervene.
Where a statement of the treating physician was minimal but sufficient evidence that fusion surgery was being
considered at the time that the discography was ordered, and where there was substantial evidence that the
other three criteria of the rule were also satisfied, the compensation judge’s conclusion that all four of the
criteria in Minnesota Rules Part 5221.6100, subp. 2G, for authorizing discography were satisfied was not
clearly erroneous and unsupported by substantial evidence.
Where there were abnormal findings on a discogram, and where there was expert medical opinion that the
employee was not a candidate for surgical intervention but had a 60 to 70 percent chance of some improvement
with IDET treatment, the compensation judge’s conclusion that the recommended IDET treatment was
reasonable and necessary in treatment of the employee’s work injury was not clearly erroneous and unsupported
by substantial evidence.
D-6 • COMPACT • August 2003
Summaries of Decisions
Where the compensation judge listened to the employer and insurer’s arguments as to the relevance of testimony
regarding the employee’s conduct during a previous neck injury for purposes of gauging the employee’s credibility,
and where the judge concluded that that conduct and injury were too remote to be relevant to the low back
injury at issue, the compensation judge’s exclusion of cross-examination regarding the neck injury was not an
abuse of discretion, such as would require reversal of the judge’s ruling.
Although the court continued to discourage the practice, there was no legal error in the judge’s nearly verbatim
adoption of proposed Findings and Order.
Affirmed.
Causation – Aggravation
Substantial evidence, including expert opinion, adequately supported the judge’s decision that the employee’s
need for total hip replacement surgery was not causally related to his alleged work injury.
Affirmed.
Substantial evidence, including expert opinion, supported the compensation judge’s finding that the employee’s
disability and need for treatment were not causally related to her work injury.
Affirmed.
Under the particular circumstances of this case, where no award on stipulation had been issued by the time the
compensation judge issued his decision, the judge had jurisdiction to decide the allegedly settled claim for
outstanding medical expenses.
Affirmed.
What is important in determining the compensability of medical treatment is not the diagnosis of potential
consequences of the injury but the fact that treatment against such consequences is incidental to, necessary as
a result of, and within the standard medical protocol for treatment of the work injury. Where the insurer did not
dispute the reasonableness and necessity of the treatment at issue, and where the judge reasonably concluded
that that treatment was causally related to the employee’s work injury, and where the treatment at issue was
within standard medical protocol in treatment of the employee’s injury, the compensation judge’s award of
payment for recommended testing for and protection against hepatitis B or HIV as a potential consequence of
the employee’s human bite injury was not clearly erroneous and unsupported by substantial evidence, regardless
of whether or not there might be coverage for such treatment under OSHA regulations, concerning which the
WCCA has no subject matter jurisdiction.
Affirmed.
Substantial evidence, including the employee’s testimony, medical records and expert medical opinion, supported
the finding that the employee’s cervical condition was causally related to a pre-existing condition and not the
result of her work activities.
Affirmed.
The employee failed to establish cause based on a mutual mistake of fact regarding the nature and extent of the
employee’s injury, where the reports of all of the employee’s treating physicians were available and known to
both parties at the time of the mediated settlement, and there was no significant change in the employee’s
diagnosis or treatment following issuance of the mediation award.
The employee failed to show evidence of an intentionally false representation of fact by the employer or insurer,
or evidence that the mediator was induced to act in reliance of a false representation of material fact. Nor does
the fact that the employee may have been motivated by financial hardship to enter into the mediation agreement
render the employee’s consent to the agreement ineffective on the facts of this case.
Substantial evidence, including treatment records and the opinion of the employee’s treating doctor, supported
the compensation judge’s decision that the employee had not reached maximum medical improvement as of
the date of an independent medical examination.
Substantial evidence supported the compensation judge’s decision that the employee was entitled to a 9
percent rating for her herniated cervical disc pursuant to Minnesota Rules Part 5223.0370, subp. 4D.
Given the employee’s date of injury, the compensation judge applied the wrong table in calculating the benefits
payable for the employee’s permanent partial disability.
Given her award of temporary total disability benefits, the compensation judge erred in awarding the employee
payment of a lump sum for permanent partial disability. See Minnesota Statutes §176.021, subd. 3; Minnesota
Statutes §176.101, subd. 2a(b).
Where the employee had a pre-existing low back condition at the time of his work injury in 1999, but was able
to return to work as a roofer, and later sustained another injury to his low back while not at work in 2001,
substantial evidence, including expert medical opinion, supports the compensation judge’s finding that the
employee did not establish medical causation between his 1999 work injury and his disability in 2001, or his
need for three-level fusion surgery in 2002.
Affirmed.
The compensation judge did not err in making a finding as to maximum medical improvement (MMI) where
one of three NOIDs sought discontinuance based on MMI, an administrative decision referred to that NOID,
and the employee filed an objection to that decision.
The compensation judge erred in awarding temporary partial disability benefits where there was no clear claim
for temporary partial disability benefits at the hearing and where no evidence whatsoever was submitted
concerning the employee’s alleged employment.
Where the decision of the judge was reasonably supported by expert medical opinion and was also not
otherwise unreasonable in light of the medical record as a whole, there being substantial evidence to support a
finding of all three elements required under the rule, the compensation judge’s award of permanent partial
disability compensation for a single-level lumbar pain syndrome pursuant to Minnesota Rules Part 5223.0390,
subp. 3.C.(1), was not clearly erroneous and unsupported by substantial evidence.
Penalties
Minnesota Statutes §176.225, subd. 1
Minnesota Statutes §176.225, subd. 5
Where any accounting sloppiness on the part of the employer and insurer had ultimately resulted in an overpayment
of benefits to the employee that was greater than the $45.99 in overwithheld attorney fees allegedly due to be
released to the employee and claimed for over two years, where accounting for the overwithholding was
relatively difficult, any delay by the employer and insurer in releasing the sum claimed did not warrant a penalty
under Minnesota Statutes §176.225, subd. 1 or subd. 5.
Affirmed.
Substantial evidence supports the determination of the compensation judge that the employee sustained a
Gillette injury in the nature of carpal tunnel syndrome.
Affirmed.
Where the compensation judge issued an order determining attorney fees without a hearing even though the
employer had requested a hearing, remand is required.
Where the employer’s query “Can you do the job?” reasonably did not constitute a clear inquiry specifically
into the diabetic employee’s physical condition or restrictions, and where the employee did, in fact, perform the
jobs in question for almost three years before being treated for an ulcer on the plantar aspect of his foot,
substantial evidence supported the compensation judge’s conclusion that the employer and insurer did not
prove that the diabetic employee’s representation that he could do to the job constituted a knowing and willful
false representation as to his physical condition, such as would bar his claim for benefits pursuant to the rule in
Jewison v. Frerichs Constr., 434 N.W.2d 259, 41 W.C.D. 541 (Minn. 1989).
Affirmed.
Causation – Aggravation
Substantial evidence, including expert opinion, supports the compensation judge’s decision that the employee’s
work-related motor vehicle accident aggravated the employee’s neck, back and bilateral hand/wrist conditions.
The compensation judge erred in making a finding as to causation of the employee’s psychological condition
where there was no claim of psychological injury properly before him.
* This case is on appeal to the Minnesota Supreme Court. August 2003 • COMPACT • D-11
Summaries of Decisions
Wages
Remand for reconsideration was required where the basis for the judge’s wage determination was not clear,
the judge did not explain why he had declined to deduct expenses from the employee’s earnings, and the judge
did not discuss the employer and insurer’s theory that the employee’s wage should be imputed from similar
employee’s wages given the employee’s brief work history.
Substantial evidence, including medical and vocational opinion, supported the judge’s decision that the employee
had been totally disabled from work during the period claimed.
Penalties
Practice and Procedure
The compensation judge did not err in failing to award penalties where no penalty claim had been asserted
prior to hearing.
Where the employee and QRC have managed to work together regarding the employee’s return to work, the
employer has accommodated the employee’s return to work, and extensive rehabilitation and job search
efforts are not currently needed, the compensation judge’s denial of the employee’s request to change QRCs
was not clearly erroneous and was supported by substantial evidence.
Affirmed.
Where there is no record of the proceeding on the employee’s claim for Roraff attorney fees, the compensation
judge’s Findings and Order must be vacated, and the case remanded to the judge for a hearing on the record.
Where it was conceded that the employee had continued to perform work that was outside her restrictions
through the April 28, 1999, date of her Gillette injury, where neither insurer ultimately contested the occurrence
of that injury, and where the judge essentially concluded, reasonably, that each day that the employee worked
between late 1998 and April 28, 1999, contributed to her disability, the compensation judge’s finding on
remand that the employee’s work activities during final insurer’s two-week period of coverage immediately
prior to the date of the Gillette injury were a substantial contributing cause of that injury was not clearly
erroneous and unsupported by substantial evidence, notwithstanding the brevity of the final period of coverage.
Where it was apparent from a preceding Findings and Order that the judge had thoroughly reviewed evidence
submitted by the parties with regard to the occurrence of and date of a Gillette injury, where neither of the two
insurers had sought in that proceeding to take the deposition of the employee’s treating physiatrist, and where
the WCCA had affirmed the judge’s finding of a Gillette injury and remanded only for findings as to the
substantial contribution to that injury of work activities during a certain period of time, the compensation judge
did not err in refusing to allow the deposition of the physiatrist on remand.
Affirmed.
Under the circumstances of this case, especially given the unappealed finding that the contingent fee was not
adequate to compensate the attorney’s attorney for his work on the employee’s behalf, the employee’s attorney
was entitled to $2,000 in Roraff fees, and the judge’s denial of the Roraff fee claim was reversed.
Reversed.
Substantial evidence, including the employee’s testimony, medical records and expert medical opinion, supported
the finding that the employee’s right wrist condition was causally related to a pre-existing condition and not the
result of his work activities during the summer of 1997.
Affirmed.
Appeals – Record
Where the compensation judge made only one finding on the ultimate issue and failed to make findings regarding
essential elements of either the employee’s claims or the employer and insurer’s defenses, precluding meaningful
appellate review, the Findings and Order is vacated and remanded for further findings on the record.
Where there was no contention an improvident or incautious act by the employee created a hazard while
leaving work, the test for compensability set forth in Qualy v. Metropolitan Transit Comm’n, 42 W.C.D. 1040
(W.C.C.A. 1990) (relying on Elfelt v. Red Owl Stores, 296 Minn. 41, 206 N.W.2d 370, 26 W.C.D. 660
(1973)), is not applicable. Rather, the employer and insurer allege the employee was engaged in a prohibited
act. The matter must, therefore, be remanded for consideration applying the factors appropriate to such cases.
Although the compensation judge failed to address the issue remanded to the court and argued by the parties,
that is, the employee’s permanent partial disability benefits for the cervical spine as a whole, the employee
conceded or stipulated that he was entitled to either 14 percent for his cervical stenosis or 19 percent for
compression fractures at two levels, but not both, and the judge’s award of 19 percent permanent partial
disability to the body as a whole is affirmed, as modified, based on the facts peculiar to this case.
Affirmed as modified.
Where the employee had offered no expert medical opinion that she had, since the date of the award, sustained
a rateable increase in permanent partial disability or experienced any substantial reduction in her ability to work
that was consequent to either of the work injuries at issue in her stipulation for settlement, the employee did not
show good cause to vacate her award on stipulation on grounds that she had sustained a substantial change in
condition since the date of the award.
The employee provided evidence of a significant change in diagnosis, in her ability to work, of additional
permanency, of more costly and extensive medical care than anticipated, and a causal connection between her
current disability and the work injury, sufficient to establish cause to vacate the Feb. 26, 1988 Award on
Stipulation.
Substantial evidence, including expert opinion, minimally but adequately supported the judge’s decision that
the employee’s November 1994 work injury substantially contributed to his need for total hip replacement
surgery.
Affirmed.
Substantial evidence supports the determination of the compensation judge that the employee failed to establish
the necessary elements of the permanent partial disability schedule which would allow the permanent partial
disability claimed.
Affirmed.
Where the self-insured employer failed to file a notice of intention to discontinue benefits and did not comply
with a compensation judge’s earlier Order on Discontinuance, the compensation judge did not err by concluding
that the employer improperly discontinued benefits and by awarding reinstatement of temporary total disability
benefits.
Causation
Substantial evidence supports the compensation judge’s denial of the self-insured employer’s petition to
discontinue benefits based on the judge’s findings that the employee had not yet fully recovered from his work
injuries, had continuing restrictions secondary to his personal injuries and the job offered by the employer to
the employee exceeded those restrictions.
Affirmed.
Causation – Aggravation
Substantial evidence, including expert opinion, minimally supported the judge’s decision that the employee’s
work injury was merely a temporary aggravation of the employee’s pre-existing condition.
Wages
Substantial evidence, including the employee’s testimony as to the terms of his hire, supports the compensation
judge’s decision that the employee’s wage was not irregular.
Affirmed as modified.
Where evidence as to the causal connection between the employee’s work injury and his current worsened
condition was equivocal, and where the causation issue was critical to this court’s resolution of the petition to
vacate, the matter was referred to the Office of Administrative Hearings for an evidentiary hearing and findings,
after which this court will make a final determination on the petition.
Substantial evidence, including expert medical opinion and the employee’s testimony, supports the compensation
judge’s finding that the employee’s permanent partial disability of the right knee and low back were causally
related to the employee’s work injury.
D-16 • COMPACT • August 2003
Summaries of Decisions
Where the employee’s permanent partial disability is casually related to the employee’s work injury, the
compensation judge did not err by finding that the employee’s permanent total disability was causally related to
the employee’s work injury.
Where the findings and order are supported by the record, the compensation judge’s adoption of a party’s
proposed findings and order almost verbatim is not reversible error per se.
Affirmed, as modified.
Minnesota
Supreme Court
April through June 2003
Case summaries published are
those prepared by the WCCA
• Lance Cloud v. Leech Lake Housing Authority, and Commerce and Industry with claims
administered by AIG Claim Services, Inc., and Minnesota Department of Labor and
Industry/Vocational Rehabilitation Unit, and Institute for Low Back and Neck Care,
Intervenors, C6-03-37, March 26, 2003
Decision of the Workers’ Compensation Court of Appeals filed Dec. 11, 2002, affirmed without opinion.
• Alta Kingbird v. Anderson Fabrics, Inc. and Royal and Sun Alliance Insurance, CX-03-
39, March 27, 2003
Decision of the Workers’ Compensation Court of Appeals filed Dec. 13, 2002, affirmed without opinion.
• Jacqueline S. Busch v. Advanced Maintenance and State Farm Fire & Casualty
Company, Viking Foods and State Fund Mutual Insurance Company, and Center for
Diagnostic Imaging, Institute for Low Back and Neck Care, Corestar Health Plan,
Intervenors, and Special Compensation Fund, C9-02-1480, April 24, 2003
1. The determination of controlling event is a legal conclusion which follows from factual findings that an
injury is either a new, separate injury or a consequential injury, a recurrence, or a mere temporary
aggravation.
2. The law in effect on the date of the new, separate injury determines the amount and period of an
injured employee’s compensation.
• Edwin a Lowell v. Lee Stamping and Chubb & Son, and Lee Stamping and Federated
Mutual Insurance Company, and Special Compensation Fund, C9-03-212, April 29, 2003
Decision of the Workers’ Compensation Court of Appeals filed Jan. 6, 2003, affirmed without opinion.
Summaries of Decisions
Decision of the Workers’ Compensation Court of Appeals filed Jan. 17, 2003, affirmed without opinion.
Decision of the Workers’ Compensation Court of Appeals filed Feb. 10, 2003, affirmed without opinion.
• William Monson v. White Bear Mitsubishi and Western National Insurance Company,
CX-03-235, June 12, 2003
Newly discovered evidence and mutual mistake of fact warrant reopening a stipulated settlement.