John R. Gerardy v. Anagram Int’l.

John R. Gerardy v. Anagram Int’l, No. WC16-6005 (W.C.C.A. Sept. 15, 2017).

The Workers’ Compensation Court of Appeals affirmed Compensation Judge Behounek’s denial of the employee’s and the intervenors’ claims.

The employee sustained an admitted low back injury on May 30, 2010. Both the treating doctor, and later the independent medical examination doctor opined that the employee’s low back injury completely resolved by July 13, 2010, having reached MMI without the need for work restrictions and without the need for further medical treatment or care. The employee had returned to work performing his date of injury job duties.

On January 7, 2011, the employee was laid off, along with 7 other employees, for economic reasons. The employer based its lay off decision on individual performance, and determined that the employee was having trouble keeping up with the expected pace of operating the machine at work. In late January, 2011, the employee sought medical treatment. In February 2011, the employee filed a claim petition alleging a back and neck injury on May 30, 2011. Chiropractor, Dr. Robert Martin, examined the employee on March 18, 2011, and noted that the employee had “initially developed severe neck, upper back, mid/low back pain, constant stiffness, and excruciating headaches.” At some point, the employee became eligible for SSDI benefits.

The Claim Petition was dismissed without prejudice in February 2015. The employee filed a new Claim Petition on November 5, 2015, This time, the employee alleged that the May 30, 2010 work injury resulted in injuries to his neck, back, and left SI joint, seeking entitlement to various benefits, including permanent total disability and approval of a fusion surgery. Judge Behounek denied the employee’s and intervenors’ claims.

On appeal, the W.C.C.A. ruled on three issues raised by the now-pro se employee.

Nature and Extent of Injuries – The W.C.C.A. affirmed by stating that the substantial evidence supported the lower court’s decision.

Negligence – (Jurisdiction) The employee argued that the work injury occurred because of employer negligence. The W.C.C.A. held that (a) this issue was not raised at hearing, and thus the issue could not be raised on appeal; and (b) liability for workers’ compensation benefits is determined without regard to negligence.

Wrongful Termination – The employee argued that the Compensation Judge mischaracterized the employee’s termination. The court held that the Compensation Judge’s findings regarding termination is not for resolving a wrongful termination grievance; rather, it was made for determining whether the employee is entitled to TTD or TPD benefits claimed.

Furthermore, the employee argued that the SSDI determination was further evidence that he could not work. But, the WCCA held that this does not alter the employee’s burden to demonstrate that the effects of the work injury resulted in that inability to work. SSDI determinations do not meet that burden.