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 worker suffered a severe work-related injury in 1993 when his right ankle and foot were caught under a heavy asphalt roller machine, leading to multiple amputations and the use of a prosthetic limb. The worker experienced ongoing physical and psychological challenges, including phantom pain, difficulty adjusting to the prosthetic, and significant emotional distress. Despite extensive medical treatment and counseling, the worker's condition remained unstable (paras 2-7).
Procedural History
- Workers' Compensation Administration: Found that the worker had reached maximum medical improvement (MMI) for both his physical and psychological injuries.
Parties' Submissions
- Appellant (Worker): Argued that the findings of MMI for both physical and psychological injuries were not supported by sufficient evidence and that the admission of certain deposition testimony was erroneous (para 1).
- Appellees (Employer and Insurer): Supported the Workers' Compensation Judge's (WCJ) findings, asserting that the evidence demonstrated the worker had reached MMI for both physical and psychological injuries.
Legal Issues
- Was there sufficient evidence to support the finding that the worker had reached MMI for his physical injuries?
- Was there sufficient evidence to support the finding that the worker had reached MMI for his psychological injuries?
- Did the WCJ err in admitting the deposition testimony of Dr. Delahoussaye?
Disposition
- The finding that the worker reached MMI for his physical injuries was affirmed.
- The finding that the worker reached MMI for his psychological injuries was reversed.
- The case was remanded for further proceedings consistent with the opinion (para 20).
Reasons
Per M. Christina Armijo J. (Bosson and Bustamante JJ. concurring):
Physical MMI: The WCJ's finding that the worker reached MMI for his physical injuries was supported by substantial evidence. Dr. Atler's guarded estimate of a 20% chance of future improvement was insufficient to establish a reasonable medical probability of further recovery. Dr. Delahoussaye's testimony, which indicated the worker had reached MMI as of 1995, was consistent with the worker's stable physical condition over time. The need for ongoing medical care does not preclude a finding of MMI (paras 11-12).
Psychological MMI: The WCJ's finding that the worker reached MMI for his psychological injuries was not supported by substantial evidence. Dr. Strongin's report and testimony were internally inconsistent, as he indicated both that the worker had reached MMI and that significant improvement was likely after litigation concluded. Other medical evidence, including statements from Drs. Waybright, Muldawer, Irons, and Thompson, consistently indicated that the worker's psychological condition was not static or stabilized. The WCJ also erred in concluding that the worker's psychological issues were unrelated to his physical injury, as this finding was contrary to uncontroverted expert testimony (paras 13-18).
Admission of Testimony: The WCJ did not err in admitting Dr. Delahoussaye's testimony. Although the worker argued that Dr. Delahoussaye was not a "treating physician" under the Workers' Compensation Act, the court found that his examination at the request of Dr. Atler qualified him as a treating physician for the purposes of providing expert testimony (para 19).