TODD v. WEST WIND VILL., No. WC22-6449 (WCCA June 27, 2022).
A compensation judge denied benefits to Employee. Employee appealed the compensation judge’s order under two legal theories. First, Employee argued that prior orders barred the compensation judge’s most recent findings under Res Judicata. Second, Employee argued that the decision was not supported by substantial evidence when considering the record as a whole. The WCCA affirmed the order denying benefits to Employee.
Employee’s initial injuries arose in 2008. Employee was found to have sustained a work injury to her low back injury on April 8, 2008 and a Gillette injury to her low back on September 25, 2008. Employee was granted compensation, including temporary total disability benefits from October 22, 2008 and continuing. Employee was in a motorcycle accident in 2011, which led to lower back surgery. However, the decision notes that “between 2011 and December of 2015, the employee had minimal treatment for her low back.” Employee requested workers compensation to cover treatment related to her lower back in 2017 onward, which the employer and insurer denied.
Concurrent to the issues involving the lower back injury, Employee pursued other workers compensation claims. In 2011 Employee raised a claim alleging depression arising from the 2008 injuries. Employee failed to prevail in her claims regarding depression. Employee further brought an action for underpayment of benefits in 2012, with the WCCA affirming an order denying underpayment but granting fees for late payments.
A hearing was held on September 14, 2021 to address Employee’s claims that she was entitled to permanent total disability benefits beginning in January of 2017 due to the 2008 injuries. The compensation judge found that Employee had failed to prove that the 2008 injuries substantially contributed to the employee’s most recent need for treatment. Employee appealed.
Res Judicata is a legal doctrine which prohibits litigating an issue that has already been determined in previous litigation. Employee’s argument was that because the compensation judge in 2009 found Employee to have temporary total disability substantially related to her 2008 injuries, the compensation judge in the present case was barred from finding Employee’s current disability to not be substantially related to the 2008 injuries. The WCCA did not find Employee’s argument persuasive. WCCA noted that there was no finding of permanent disability in the original order, nor any of the subsequent orders.
Employee also argued that the substantial evidence on the record contradicted the compensation judge’s order. The WCCA noted that the compensation judge relied on “voluminous” medical records and made a determination mainly by weighing the expert testimony of Employee and Employer’s medical witnesses. Due to the strong factual record and the discretion affording compensation judges when determining factual matters, the WCCA refused to reverse the order,
Takeaway: Employees cannot rely on prior temporary disability determinations to piggy back permanent disability determinations into future orders without meeting their evidentiary burdens.