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 employed as a laborer for the City of Albuquerque injured his left knee while shoveling dirt on the job. Initially treated by the City's authorized health care provider, the worker later sought treatment from an unauthorized provider without notifying the City. The unauthorized provider diagnosed a preexisting condition, osteochondritis dissecans, aggravated by the workplace injury, and recommended surgery. The worker eventually underwent surgery at another unauthorized facility. The City contested the worker's claim for workers' compensation benefits, disputing the admissibility of medical records and testimony from unauthorized providers (paras 2-6).
Procedural History
- Workers' Compensation Administration, Change of Health Care Provider Proceeding: The judge sustained the City's objection to the worker's attempt to change his authorized health care provider to the unauthorized provider, finding the latter was not authorized under the Workers' Compensation Act (para 3). n[Not applicable or not found] for any other prior decisions.
Parties' Submissions
- Appellant (City of Albuquerque): Argued that the formal hearing judge erred by admitting medical records from the unauthorized provider and allowing testimony based on those records. Additionally, the City contended that the judge erred in excluding records from another unauthorized provider (the VA Center) that could have rebutted the testimony (paras 7, 13-14).
- Appellee (Worker): Requested attorney fees for the appeal and defended the admissibility of the unauthorized provider's records and testimony, arguing they were properly admitted under evidentiary rules (paras 7, 15).
Legal Issues
- Whether the formal hearing judge erred in admitting medical records from an unauthorized health care provider and allowing testimony based on those records.
- Whether the formal hearing judge erred in excluding medical records from another unauthorized provider that could have rebutted the testimony.
- Whether the worker is entitled to attorney fees for the appeal.
Disposition
- The Court of Appeals affirmed the decision of the workers' compensation judge (para 16).
Reasons
Per Pickard J. (Apodaca and Bosson JJ. concurring):
Admissibility of Unauthorized Provider's Records: The judge ruled that the records from the unauthorized provider were admissible under Rule 11-703 of the New Mexico Rules of Evidence, which allows experts to base their testimony on otherwise inadmissible evidence. The Court found this application appropriate, as the records were used to support the testimony of an authorized health care provider, not as substantive evidence themselves. The City's arguments that this contravened the Workers' Compensation Act were rejected (paras 8-12).
Exclusion of VA Center Records: The Court upheld the exclusion of the VA Center's records, as the VA Center was not an authorized provider under the Act. The City's last-minute request to provide these records to the authorized provider for a supplemental deposition was denied, as the City had ample opportunity to address this issue earlier in the discovery process (paras 13-14).
Attorney Fees: The Court deferred ruling on the worker's request for $3,000 in attorney fees pending clarification on whether fees had already been awarded by the workers' compensation judge and whether the statutory cap of $12,500 would be exceeded (para 15).