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 corrections officer by the City of Albuquerque sustained injuries to her right shoulder and upper extremity on June 3, 1996, and to her left shoulder and spine on August 15, 1996, during the course of her employment. The worker underwent multiple surgeries on her right shoulder between 1998 and 2004 and experienced ongoing physical and psychological issues, including depression and pain disorder, related to her injuries. The employer paid temporary total disability (TTD) and permanent partial disability (PPD) benefits at various times but disputed the worker's entitlement to further benefits.
Procedural History
- Workers’ Compensation Administration, June 3, 2008: The Workers’ Compensation Judge (WCJ) ruled that the worker had not reached maximum medical improvement (MMI) for her physical and psychological injuries and awarded TTD benefits retroactively from May 5, 1998, to the present, as well as temporary partial disability (TPD) benefits for periods when the worker returned to work but earned less than her pre-injury wage.
Parties' Submissions
- Appellant (City of Albuquerque): Argued that the WCJ erred in finding that the worker had not reached MMI, as several physicians had opined that she had reached MMI at various points. The employer also contended that the retroactive award of benefits was barred by the statute of limitations and that the worker’s failure to seek consistent psychological treatment delayed her MMI status artificially.
- Appellee (Worker): Asserted that she had not reached MMI due to ongoing physical and psychological issues requiring treatment. She argued that the employer failed to provide adequate psychological care and that her claims for benefits were not barred by the statute of limitations.
Legal Issues
- Was the worker’s claim for retroactive benefits barred by the statute of limitations?
- Did the worker reach maximum medical improvement (MMI) for her physical and psychological injuries?
- Did the employer’s actions or inactions contribute to the delay in the worker reaching MMI?
Disposition
- The court affirmed the WCJ’s finding that the worker had not reached MMI as of the date of trial, considering both her physical and psychological conditions.
- The court reversed the retroactive award of TTD benefits prior to August 10, 2002, as it was barred by the statute of limitations.
- The case was remanded for further proceedings consistent with the court’s opinion.
Reasons
Per Roderick T. Kennedy J. (Jonathan B. Sutin and Linda M. Vanzi JJ. concurring):
The court applied a whole record standard of review, considering all evidence in the light most favorable to the WCJ’s judgment. It found that the statute of limitations under Section 52-1-31(A) barred the worker’s claims for benefits prior to June 30, 2002, as the worker filed her complaint on June 30, 2003. However, claims for underpayment of benefits after that date were not barred.
The court upheld the WCJ’s conclusion that the worker had not reached MMI for her physical injuries until at least November 2, 2004, based on the need for repeated surgeries and ongoing treatment. It also agreed with the WCJ that the worker had not reached MMI for her psychological condition, as her depression and pain disorder required continuous treatment, and the employer failed to provide adequate psychological care.
The court rejected the employer’s argument that the worker’s failure to seek consistent treatment delayed her MMI status artificially, noting that much of the delay was attributable to the employer’s inaction in securing appropriate psychological care. Accordingly, the court affirmed the WCJ’s findings regarding MMI and entitlement to benefits after August 10, 2002, but reversed the retroactive award of benefits prior to that date.