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

The claimant, a heavy-equipment operator, was injured on February 22, 1989, when the front-end loader he was operating rolled over. He suffered cervical and thoracolumbar strain, later developing fibromyalgia syndrome and depression. Despite being prescribed physical therapy and other treatments, the claimant was noncompliant, citing incapacitating pain. His condition included chronic pain syndrome and somatization, which contributed to his ongoing disability (paras 3, 5-6).

Procedural History

• Workers' Compensation Administration, January 21, 1992: The judge found the claimant to be totally disabled and awarded compensation benefits, determining that after six months of therapy, the claimant would be 25% permanently disabled (para 4).

Parties' Submissions

• Appellants (Employer and Insurer): Argued that the claimant's refusal to comply with prescribed physical therapy constituted a refusal to submit to medical treatment under NMSA 1978, Section 52-1-51(C), warranting a reduction or suspension of benefits. They also contended that the claimant's disability was primarily a secondary mental impairment, limiting benefits to 100 weeks under NMSA 1978, Section 52-1-42 (paras 2, 7, 22-23).
• Appellee (Claimant): Asserted that his refusal to fully participate in physical therapy was reasonable due to incapacitating pain. He argued that his disability resulted from a combination of physical and mental impairments, making the 100-week cap inapplicable (paras 13, 22, 26).

Legal Issues

• Whether the claimant's refusal to comply with prescribed physical therapy justified a reduction or suspension of benefits under NMSA 1978, Section 52-1-51(C).
• Whether the claimant's benefits should be limited to 100 weeks under NMSA 1978, Section 52-1-42 due to his secondary mental impairment.

Disposition

• The court affirmed the decision of the Workers' Compensation Administration, rejecting the appellants' arguments (para 31).

Reasons

Majority Opinion (Flores J., Pickard J. concurring):

Refusal to Submit to Medical Treatment: The court held that the claimant's refusal to fully participate in physical therapy was reasonable due to incapacitating pain. Evidence from medical professionals supported the claimant's assertion that his pain prevented full compliance, and the judge was not required to reduce or suspend benefits under Section 52-1-51(C) (paras 9-21).

100-Week Cap on Benefits: The court found substantial evidence that the claimant's disability resulted from a combination of physical and mental impairments. The physical impairment, including cervical and thoracolumbar strain, persisted and contributed to the claimant's disability. Therefore, the 100-week cap under Section 52-1-42 did not apply (paras 22-30).

Dissenting Opinion (Bivins J.):

Bivins J. dissented on the second issue, arguing that the claimant's disability was solely attributable to his secondary mental impairment, as the physical impairment no longer caused a disability. Under Section 52-1-42, the claimant's benefits should have been limited to 100 weeks. The dissent emphasized that combining physical impairment with mental disability to extend benefits undermines the legislative intent to limit compensation for mental impairments (paras 33-48).