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, employed as a heavy equipment operator, suffered an accidental injury on March 19, 1989, during the course of his employment. The Employer provided medical care, rehabilitation services, and temporary total disability benefits until February 1, 1990. The Worker later filed claims for additional benefits, including temporary partial disability, reimbursement for medical costs, and a transfer of medical care to a provider of his choice (paras 2-3).
Procedural History
- Workers' Compensation Administration, Mediation Conference: The parties entered into a stipulation resolving certain claims, including a 10% partial disability settlement for a specific period and temporary total disability benefits until October 13, 1990 (para 2).
- Workers' Compensation Administration, Hearing: Following a second claim and mediation, the Workers' Compensation Judge (WCJ) awarded the Worker 22% temporary partial disability benefits and denied his claims for reimbursement of medical costs and transfer of medical care (paras 2-3).
Parties' Submissions
- Appellant (Worker): Argued that the WCJ erred in awarding only 22% temporary partial disability instead of 100%, denying reimbursement for an independent medical examination, refusing to transfer medical care to his chosen provider, and concluding that disputes over benefits prior to August 19, 1990, were resolved (paras 1, 4, 20, 24, 28).
- Respondents (Employer and Insurer): Contended that the WCJ's findings were supported by substantial evidence, the Worker failed to meet the statutory requirements for reimbursement of medical costs, the medical care provided was adequate, and the prior stipulation resolved earlier disputes (paras 6, 22, 26, 28).
Legal Issues
- Was the award of 22% temporary partial disability supported by substantial evidence?
- Did the WCJ err in denying reimbursement for the Worker’s independent medical examination?
- Did the WCJ err in refusing to transfer the Worker’s medical care to his chosen provider?
- Did the WCJ err in concluding that disputes over benefits prior to August 19, 1990, were resolved?
Disposition
- The Court affirmed the WCJ’s decision on all issues (para 30).
Reasons
Per Bivins J. (Donnelly and Pickard JJ. concurring):
Substantial Evidence for Disability Award: The Worker failed to comply with the appellate rule requiring a summary of all evidence bearing on the issue. The Court emphasized the importance of presenting all relevant evidence, including that which supports the WCJ’s findings, and declined to review the sufficiency of the evidence (paras 4-19).
Reimbursement for Medical Costs: The Worker did not meet the statutory requirement under Section 52-1-51(E), which mandates a difference of more than 20% between the Worker’s and Employer’s impairment ratings. The WCJ’s findings did not necessarily accept the Worker’s claimed 50% impairment, and the evidence did not support reimbursement (paras 20-23).
Transfer of Medical Care: The WCJ found that the Employer provided adequate and satisfactory medical care, and the Worker failed to meet the standard for transferring care under Bowles v. Los Lunas Schools. The Worker did not directly challenge these findings (paras 24-27).
Resolution of Prior Disputes: The Worker did not demonstrate harm from the WCJ’s conclusion that disputes over benefits prior to August 19, 1990, were resolved. The Worker successfully established causation, and the issue was not preserved for appeal (paras 28-29).