Escolar Documentos
Profissional Documentos
Cultura Documentos
Workers’ Compensation
Court of Appeals
January through March 2004
Case summaries published are
those prepared by the WCCA
Substantial evidence, including expert opinion, supported the compensation judge’s decision as to the
nature of the employee’s work injury and as to the causal relationship of claimed medical expenses to
that injury.
Affirmed.
Rehabilitation – Retraining
Substantial evidence supports the determination of the compensation judge that the employee sustained
an impairment of earning capacity by reason of his work injury and was entitled to have his rehabilitation
plan amended to allow exploration of retraining.
Affirmed.
Where the parties disputed whether the compensation judge had subject matter jurisdiction to issue
a previous Decision and Order pursuant to Minnesota Statutes §176.106, the validity of the decision
was properly the subject of a settlement agreement. As the agreement is not a full, final and complete
Summaries of Decisions
settlement of the employee’s medical and rehabilitation benefits, it is conclusively presumed reasonable,
fair and in conformity with Chapter 176, and the compensation judge erred in disapproving the parties’
settlement.
Remanded.
Causation
Substantial evidence, including expert medical testimony, supports the compensation judge’s finding
that the employee’s Oct. 23, 2000, work injury was not a substantial contributing factor to his ongoing
disability and need for treatment after a non-work-related incident March 27, 2001.
Where the employer and insurer did not reimburse the employee for his expenses incurred when attending
the IME, and where that claim was before the compensation judge at the hearing, the compensation
judge’s denial of reimbursement of out-of-pocket expenses is reversed as it was clearly erroneous.
Where an employer and insurer originally admitted liability for the employee’s claimed injury and later
denied primary liability for the employee’s entire claim, and where the employer and insurer filed a notice
of intention to discontinue benefits and discontinued payment of temporary total disability benefits,
and where in an unappealed finding the compensation judge found that the employee sustained no
work-related injury, in view of the unusual circumstances of this case, no additional benefits are due.
Affirmed.
The compensation judge did not abuse his discretion in denying the employee’s request to depose one
of his treating physicians.
Substantial evidence, including expert opinion, supported the compensation judge’s decision that the
employee’s work injury was merely temporary and did not contribute to the employee’s disability
during the period in question.
Affirmed.
Causation
Where the opinion of the employee’s treating doctor was that the work injury continues to be a substantial
contributing factor in the employee’s need for restrictions, substantial evidence supports the decision
of the compensation judge.
Substantial evidence supports the decision of the compensation judge in awarding temporary partial
disability compensation where post-injury work with the employer was not available and the employee
found other employment within her restrictions.
Intervenors
Minnesota Statutes §176.361, subd. 4
Where the motion to intervene was served and filed before the effective date of the amendment to
Minnesota Statutes §176.361, subd. 4, the claim of the intervenors was properly granted despite its
failure to attend the hearing.
Affirmed.
Substantial evidence exists to support the decision of the compensation judge that the employee had
reached maximum medical improvement.
Affirmed.
D-3 • COMPACT • May 2004 * This case is on appeal to the Minnesota Supreme Court.
Summaries of Decisions
Where wage-loss benefits are being paid which are producing contingency fees, the determination of
whether contingency fees are adequate to compensate the employee’s attorney is premature.
Affirmed.
Where the employer and insurer’s notice to the employee’s physical therapist cited specific treatment
parameters and suggested that the provider’s treatments were excessive, the compensation judge’s
conclusion that the employer and insurer’s compliance with the notice provisions of Minnesota Rules
Part 5221.6050 was sufficient was neither legally erroneous nor unsupported by substantial evidence.
Where there was no clear evidence in the medical or physical therapy records that the therapy was
effective, and where the employee himself testified that his relief by the therapy was very minimal and
of only very brief duration, the compensation judge’s conclusion that the employee’s physical therapy
was not sufficiently effective in “maintaining functional status” to entitle the employee to treatment
beyond an additional twelve visits under Minnesota Rules Part 5221.6200, subp. 3.B.(2), was not clearly
erroneous and unsupported by substantial evidence.
Where it was not unreasonable in light of all of the evidence of record, the compensation judge’s
conclusion that the employee was not subject to “a documented medical complication” for purposes
of satisfying the departure provision of Minnesota Rules Part 5221.6050, subp. 8.A., was not clearly
erroneous and unsupported by substantial evidence.
Where there was little medical support for the position that the physical therapy at issue was materially
effective in improving or maintaining the employee’s functional status, and where that therapy was not
effective in keeping the employee at work, the compensation judge’s conclusion that the employee’s
circumstances did not qualify as a “rare case exception” to the treatment parameters under the Jacka
and Asti cases was not clearly erroneous and unsupported by substantial evidence.
Affirmed.
D-4 • COMPACT • May 2004 * This case is on appeal to the Minnesota Supreme Court.
Summaries of Decisions
Causation
Substantial evidence, including the employee’s testimony and his medical records, supported the
conclusion that the employee’s claustrophobia and post traumatic stress disorder are causally related
to the employee’s work injury.
Where the record would not support the conclusion that the employee was totally unable to work at all
due to his psychological condition, and where there was no evidence establishing a reasonably diligent
search for work, substantial evidence did not support the judge’s award of temporary total disability
benefits.
Where the employee accepted a special incentive retirement arrangement from the employer prior to a
workforce reduction, where the employee sought rehabilitation assistance and searched for work after
leaving his employment with the employer in order to supplement his income, and where the employee
testified that he doubted whether he could physically perform a position that the employer later contended
the employee would have been able to perform within his restrictions, substantial evidence supports the
compensation judge’s finding that the employee did not voluntarily retire from the entire job market
and that he was not precluded from claiming disability benefits.
Where the employee accepted a special incentive retirement arrangement from the employer prior to a
workforce reduction, and where the employee sought rehabilitation assistance and searched for work after
leaving his employment with the employer, substantial evidence of record supports the compensation
judge’s conclusion that the employee remained temporarily totally disabled for approximately 15 months
after his employment ended, and became permanently totally disabled thereafter.
Affirmed.
D-5 • COMPACT • May 2004 * This case is on appeal to the Minnesota Supreme Court.
Summaries of Decisions
Substantial evidence supported the compensation judge’s decision as to the date of the employee’s
Gillette injury, and, while the record might also have supported the choice of some other date, no other
injury date was so obviously correct as to justify reversing the judge’s decision.
Affirmed.
Where the findings and order do not contain findings on an issue that was specifically listed at hearing,
the matter is remanded to the compensation judge for reconsideration of that issue.
Causation
Substantial evidence, including expert medical opinion, supports the compensation judge’s finding that
the employee’s work injury of Aug. 21, 2000, was temporary, and the judge’s denial of the employee’s
claims for wage-loss benefits and medical expenses.
Affirmed.
Causation
Substantial evidence, including expert medical opinion, supports the compensation judge’s finding that
the employee sustained a diminution in earning capacity as a result of his work-related injury and was
entitled to payment of temporary partial disability benefits.
Affirmed.
The findings by the compensation judge support a conclusion that good cause exists to vacate the
compensation judge’s Findings and Order under Minnesota Statutes §176.461.
Where, since the time of the award, the employee’s ability to work had not changed at all, where her
diagnosis had changed very little, where any increase in her permanency rating was minimal and without
clear documentation or other support, and where any more costly and extensive medical care than may
have been anticipated had not been proved causally related to the alleged work injury and had been at
any rate left open for payment under a medical request pursuant to the stipulation, the employee did
not show good cause for vacating her 1989 award on stipulation on grounds that she had experienced
a substantial change in her condition.
Where it was clear that supplementary benefits were expressly at issue at the time of settlement, where a
portion of the employee’s settlement proceeds was expressly designated as representing supplementary
benefits and there was no evidence that this amount was ever intended to represent specific weekly
compensation or anything other than a compromised amount, and where all parties were represented
by counsel and the employee offered no evidence that any were actually “mistaken” as to what was at
stake, the employee did not show good cause to vacate her 1989 award on stipulation on grounds of
mistake because the parties may not have detailed in their stipulated agreement every element of the
employee’s potential entitlement to supplementary benefits.
Substantial evidence, including expert opinion, supported the compensation judge’s decision that the
employee’s Oct. 3, 1988, work injury was merely temporary and did not substantially contribute to the
employee’s subsequent disability and need for treatment for the period at issue.
Affirmed.
D-7 • COMPACT • May 2004 * This case is on appeal to the Minnesota Supreme Court.
Summaries of Decisions
Causation
Substantial evidence supports the decision of the compensation judge that the employee’s need for
surgery and result in disability was not the result of his work injury.
Affirmed.
Where the employee submitted evidence of a subsequent psychological condition, previously determined
by a compensation judge to be causally related to the employee’s November 1992 low back injury,
along with evidence of a substantial change in his ability to work, the employee’s petition to vacate the
1995 Award on Stipulation is granted.
Dependency Benefits
Minnesota Statutes §176.111, subd. 1
Minnesota Statutes §176.111, subd. 2
Minnesota Statutes §176.111, subd. 4
Substantial evidence supports the compensation judge’s determination that three of the employee’s
stepchildren were wholly dependent within the meaning of Minnesota Statutes §176.111, subd. 1, and
another stepchild was a partial dependent within the meaning of Minnesota Statutes §176.111, subds.
2 and 4, and that all were entitled to dependency benefits.
Affirmed.
Where the employee recovered payment from a third-party action, in which the self-insured employer
has a subrogation interest, and where the employer is due reimbursement of benefits already paid to
the employee, the compensation judge did not err in concluding that, once the employer’s credit has
been calculated pursuant to Minnesota Statutes §176.061, including a reduction of the credit to account
D-8 • COMPACT • May 2004 * This case is on appeal to the Minnesota Supreme Court.
Summaries of Decisions
for the employer’s share of the cost of collection, the employer may take a dollar-for-dollar offset of
benefits until it has recovered its full credit for past payments under Minnesota Statutes §176.061.
Where the employee recovered payment from a third-party action, in which the self-insured employer has
a subrogation interest, and where the employer is due a future credit for benefits payable in the future,
once the employer’s credit has been calculated pursuant to Minnesota Statutes §176.061, the employer
shall continue to make payments to the employee, for any benefits that the employer is obligated to
make in the future, at the rate of $.335 for each dollar owed, to cover the cost of collection, and then
shall reduce its credit by $1, until it has recovered its full future credit.
Given the record before him, the compensation judge did not err in awarding Roraff fees of $7,000,
rather than the more than $15,000 claimed.
Affirmed.
A party objecting to a penalty assessment is entitled to a formal hearing pursuant to Minnesota Statutes
§176.85, subd. 1. A compensation judge conducting a settlement conference pursuant to Minnesota
Statutes §176.306, subd. 3, has no authority to summarily decide disputed issues without affording the
parties a full evidentiary hearing. Further, this court is unable to review decisions issued following a
settlement conference because there is no evidentiary record of the proceedings.
Substantial evidence supports the finding that the employee failed to establish a Gillette injury to his
wrist which resulted in surgery.
Affirmed.
Where the independent contractors at issue were not ultimately “liable for a failure to complete the work
or service” as specified under subdivision 2(5) of the statute, where they did not “receive[] compensation
for work or service performed under a contract on a commission or per-job or competitive bid basis
and not on any other basis” as specified in subdivision 2(6) of the statute (emphasis added), and where
it was difficult to envision any likely circumstances under which they could suffer a loss under their
contracts as specified in subdivision 2(7) of the statute, the compensation judge’s conclusion that the
independent contractors at issue satisfied all nine provisions of Minnesota Statutes §176.042, subd.
2, so as to be excluded from coverage as employee’s under subdivision 1 of that section was clearly
erroneous and unsupported by substantial evidence.
Reversed.
Where the employee had filed an objection to her attorney’s statement of attorney fees, pursuant to
provisions of Minnesota Statutes §176.081, subd. 1(d), the compensation judge did not err as a matter
of law by considering the attorney’s claim for fees under the “reasonable fee” provisions of Minnesota
Statutes §176.081, subd. 5, rather than under the straight contingent fee provisions of Minnesota Statutes
§176.081, subd. 1(a).
Attorney Fees
Minnesota Statutes §subd. 7
Where the judge’s conclusion that the employee’s attorney had been successful in obtaining permanent
partial disability benefits for the employee had implied a conclusion that payment of those benefits had
D-10 • COMPACT • May 2004 * This case is on appeal to the Minnesota Supreme Court.
Summaries of Decisions
been resisted, the compensation judge’s denial of an additional award to the employee under Minnesota
Statutes §176.081, subd. 7, was reversed.
Under the circumstances of this case, including the fact that the job offer was within the restrictions
recommended by a treating physician, the compensation judge did not err in concluding that it was
unreasonable for the employee to refuse the offer.
Earning Capacity
Substantial evidence, including vocational opinion, supported the compensation judge’s decision that
the employee had a loss of earning capacity causally related to her work injury and that she was entitled
to temporary partial disability benefits based on actual earnings. The Workers’ Compensation Court of
Appeals rejects the employer’s request for a ruling that refusal of suitable employment bars subsequent
temporary partial disability benefits as a matter of law.
Rehabilitation – Eligibility
Minnesota Rules Part 5220.0100, subp. 22B
Under the current statute, an employee’s refusal of suitable employment does not preclude eligibility
for rehabilitation assistance. Where the job the employee refused was no longer available to her, the
compensation judge erred in denying the claim for rehabilitation expenses based on his conclusion
that, once the job offer was made, the employee was no longer a qualified employee under Minnesota
Rules Part 5220.0100, subp. 22B.
Substantial evidence, including expert opinion, supported the judge’s denial of the employee’s request
for approval of Botox injections.
D-11 • COMPACT • May 2004 * This case is on appeal to the Minnesota Supreme Court.
Summaries of Decisions
Where the employee had filed a claim for medical expenses and where there was no showing of material
prejudice to the parties, the compensation judge did not err in awarding payment to non-intervening
healthcare providers.
Affirmed.
Where the judge had denied the employee’s rehabilitation request on grounds that the employee’s injury
had been temporary and had not disabled the employee from work, the compensation judge did not err
as a matter of law in dismissing the employee’s claim petition for ongoing temporary benefits based
on the doctrine of collateral estoppel.
Where none of the items offered by the employee as newly discovered evidence had any bearing on either
of the orders at issue, the employee did not show good cause to vacate two orders of a compensation
judge dismissing the employee’s claim petition on grounds of collateral estoppel in light of a ruling on
a rehabilitation request filed shortly after the employee’s claim petition.
Where the findings and order are supported by the record, the compensation judge’s adoption of a
party’s proposed findings and order is not reversible error per se.
Where the employee had been terminated from his employment, his right to temporary benefits are
suspended until he demonstrates that his work-related disability is the cause of his wage loss through a
diligent job search. Substantial evidence supports a finding of a diligent job search from May 6, 2002,
D-12 • COMPACT • May 2004 * This case is on appeal to the Minnesota Supreme Court.
Summaries of Decisions
through the date of the hearing. Therefore, the compensation judge’s award of temporary total disability
benefits is modified to exclude the period of April 23, 2002, through May 5, 2002.
Affirmed as modified.
Rehabilitation – Retraining
An employee is not required to conduct a job search outside his or her community as a prerequisite
for retraining.
Reversed.
Causation – Gillette
Where the finding that the employee sustained a Gillette injury was based on the opinion of the
employee’s treating doctor which had adequate foundation, substantial evidence supports the decision
of the compensation judge.
Where the employee was receiving medical treatment through the claimed period of temporary total
disability and where the QRC concluded that the employee was unemployable, substantial evidence
supports the compensation judge’s award of temporary total disability compensation.
Affirmed.
Where the employee was subject to an extreme multitude of non-work-related diagnosed maladies
in addition to her work-related injuries, where the judge’s decision was supported by expert medical
opinion, and where the judge’s decision was not unreasonable in light of the employee’s age, training
and experience, the compensation judge’s conclusion that the employee remained permanently and
totally disabled and had not received benefits fraudulently or in bad faith was not clearly erroneous
and unsupported by substantial evidence.
D-13 • COMPACT • May 2004 * This case is on appeal to the Minnesota Supreme Court.
Summaries of Decisions
Where it was supported by expert medical opinion, the compensation judge’s conclusion that the
employee’s work injury was limited to her right and left shoulders was not clearly erroneous and
unsupported by substantial evidence.
Affirmed.
Under the circumstances of this case, the compensation judge committed reversible error by adopting
the employer and insurer’s proposed findings, order and memorandum verbatim.
Where the QRC testified that the job market in the employee’s area had worsened and where the QRC
no longer recommended job placement services, substantial evidence supported the compensation
judge’s determination of the effective date of permanent total disability.
Where the work injury was a substantial contributing factor in the employee’s receipt of Social Security
and PERA disability benefits, the employer was entitled to an offset.
Affirmed.
Causation
In this particular case, given the absence of supporting medical opinion, substantial evidence did not
support the judge’s decision that the employee sustained a right foot and ankle injury as a consequence
of his work-related left foot and ankle injury.
D-14 • COMPACT • May 2004 * This case is on appeal to the Minnesota Supreme Court.
Summaries of Decisions
Gillette Injury
Substantial evidence, including the employee’s testimony and expert opinion, supported the judge’s
conclusion that the employee sustained Gillette injuries to both feet and ankles as a result of his work
activities.
The compensation judge did not err in admitting into evidence a report of a treating physician obtained
the day before hearing, where the opposing parties did not ask to depose the doctor and were given the
opportunity to have their experts comment on the report.
Attorney Fees
Minnesota Statutes §176.191
Given the position of the parties, the judge did not err in concluding that the dispute was primarily between
the insurers for purposes of awarding attorney fees pursuant to Minnesota Statutes §176.191.
Causation
The compensation judge could rely upon the employee’s testimony to support a finding that the employee
sustained a temporary work-related injury.
Where the employee’s employment was terminated for reasons unrelated to her work injury, where
the employee had no work restrictions, and where the employee did not perform a diligent job search,
substantial evidence supports the compensation judge’s finding that the employee’s work injury did
not substantially contribute to her loss of earnings.
Where the compensation judge considered medical opinions finding that chiropractic treatment for three
months was reasonable, necessary, and causally related to the employee’s work injury, but specifically
rejected those opinions based upon other evidence, the compensation judge did not err by finding that
the employee’s chiropractic treatment was not reasonable and necessary medical treatment.
Affirmed.
Substantial evidence, including expert opinion, supported the compensation judge’s decision that certain
outstanding treatment charges and proposed treatment were not reasonable and necessary to treat the
employee’s work injury.
Parties relying on the medical treatment parameters to support their position as to the compensability
of medical treatment must raise the specific parameters at the hearing level. Where the parameters are
not raised or applied at the hearing level, this court will not consider them on appeal.
Substantial evidence, including expert opinion, supported the compensation judge’s decision that the
employee had reached MMI from the effects of her work injury and that the employee’s temporary
total disability claim should be denied on that basis.
Affirmed.
The purpose of Minnesota Statutes §176.111 is to provide wage replacement benefits to a surviving
spouse and dependent children. We cannot conclude the phrase “continue to be eligible to receive”
requires that benefits to the surviving spouse be suspended upon remarriage. Rather, the dependency
statute, as amended effective Jan. 1, 1984, continues to provide for the continuation of benefits to a
surviving spouse upon remarriage.
Affirmed.
D-16 • COMPACT • May 2004 * This case is on appeal to the Minnesota Supreme Court.
Summaries of Decisions
• Judicial •
Minnesota
Supreme Court
January through March 2004
Case summaries published are
those prepared by the WCCA
• Jean O. Kuisle v. Sunrise Assisted Living, a/k/a Karrington Assisted Living and Royal
& Sun Alliance Insurance Company, and Minnesota Department of Human Services,
Intervenor, A03-1178, Jan. 28, 2004
Decision of the Workers’ Compensation Court of Appeals filed July 23, 2003, affirmed without
opinion.
Decision of the Workers’ Compensation Court of Appeals filed Sept. 16, 2003, affirmed without
opinion.
• Mark Dimon v. Metz Baking and Sentry Claims Services, and Twin Cities Bakery Drivers
Health & Welfare Fund and Team Care of Minnesota, P.C., Intervenors, A03-1694,
Jan. 29, 2004
Decision of the Workers’ Compensation Court of Appeals filed Oct. 7, 2003, affirmed without
opinion.
Decision of the Workers’ Compensation Court of Appeals filed Nov. 10, 2003, affirmed without
opinion.
Decision of the Workers’ Compensation Court of Appeals filed Nov. 18, 2003, affirmed without
opinion.
Raymond H. Wagner v. City of Saint Paul, Self-Insured, A03-1975, March 18, 2004
Decision of the Workers’ Compensation Court of Appeals filed Nov. 21, 2003, affirmed without
opinion.