This case arises out of an appeal by the employer regarding the interpretation the effect of a stipulation for settlement on conditions not contemplated by the parties at the time of the stipulation. The compensation judge determined the previous stipulation need not be vacated for the employee to bring a claim for benefits for such a condition, which arose as a consequence of the previous injury. The W.C.C.A. agreed with the judge’s determination.
The employee sustained a back injury in May of 2002 while working for Potlatch in a job moving heavy paper products. She was treated surgically for this injury. In 2003, the employee entered into a full, final, and complete settlement of the employee’s claims with the exception of future reasonable and necessary medical treatment. The stipulation did not mention anything regarding claims for psychiatric or emotional treatment. The employee obtained retraining and took a job as a medical secretary.
The employee’s back problems persisted, and in 2009 she underwent a fusion from which she didn’t return to work. The employee underwent another back surgery six months later. While in the hospital for the last surgery, the employee underwent a psychiatric consult which indicated the employee had become more depressed since her initial surgery, and was diagnosed with a major depressive disorder. The employee continued to treat for depression and chronic pain from 2009 to 2013.
The employee filed a claim petition in January 2013 for consequential depression/anxiety and bariatric surgery associated with her May 2002 injury.
The employer maintained they had previously paid benefits for pain clinic programs and psychological treatment as a result of the 2002 work injury and that the benefits were closed out with the prior stipulation.
The employer claimed that Sweep – which held that a stipulation for settlement couldn’t close out injuries not contemplated at the time of the stipulation – should not apply in cases, such as this, where the newly claimed condition is a “consequential injury” of the condition foreclosed in the stipulation, versus a wholly new and distinct condition, because it wasn’t a new and distinct condition.
The W.C.C.A. disagreed, finding that the correct test is whether a condition was reasonably within the contemplation of the parties at the time of the stipulation, not whether that condition is consequential or distinct from the settled condition.