One of the three employers involved in this case, Sioux Trails Mental Health Center, appealed the compensation judge’s prior apportionment of liability between Becklund Home Health and the State of Minnesota (MN Dept. Human Services). The standard on appeal was whether the prior apportionment was supported by substantial evidence.
This case involved three admitted work injuries: September 26, 1997 (Becklund and State of Minnesota), July 4, 2003 (State of Minnesota), and January 4, 2010 (Sioux Trails). The 1997 accident involved an auto accident resulting in neck and head trauma. She had a cervical fusion in 2002 and was unable to work. The 2003 accident resulted from the employee pulling her neck and left shoulder when lifting heavy cassettes. She had a cervical MRI showing a disc protrusion at C6-7 with bulging at C4-5. The employee underwent an independent medical examination (IME) in 2004 with Dr. Yellin who opined the 2003 incident aggravated her neck condition following the 1997 accident. She received disability benefits after the work accident in 2003, had an additional cervical surgery extending the fusion to C6-C7, and entered into a stipulation in 2007 to obtain retraining.
She also had a personal motor vehicle accident in 2007 and a subsequent IME obtained by the automobile insurer attributed her symptoms and need for care to her prior condition.
She obtained a bachelor’s degree in nursing and in 2009 began working for Sioux Trails as an RN and clinic coordinator. On January 4, 2010, she struck her head, left shoulder, left hip, and left knee. Thoracic injections were performed and imaging showed herniation and protrusions at T5-T8. She stated her neck was 60-70% worse after the fall and that her thoracic spine was contributing to over 50% of her back pain.
With regards to permanent total disability, Dr. Segal attributed 50% of her condition to non-work-related factors, 35% to the September 26, 1997 injury, and 15% to the July 4, 2003 injury. Liability for ongoing medical had the same breakdown. Dr. Engasser also performed an IME in 2014 and allocated responsibility for future medical treatment 60% to her personal condition, 30% to the July 4, 2003 injury, and 10% to the January 4, 2010 injury. In a subsequent IME report by Dr. Yellin, he apportioned medical treatment for the cervical spine condition 85% to the 1997 injury and 15% to the 2003 injury; he allotted all thoracic spine treatment to the 2010 opinion. In 2015, Dr. Hess at United Pain Clinic was deposed and attributed 100% the employee’s thoracic and lumbar pain, as well as her inability to work, to the 2010 injury.
Compensation Judge Dallner allocated 100% of liability for lumbar and thoracic treatment to the 2010 injury (Souix Trails) and further broke down liability for permanent partial disability and other medical treatment among the other employers. She found Sioux Trails was not entitled to contribution for permanent total disability benefits paid. Souix Trails appealed the denial of contribution for permanent total disability benefits, arguing that Judge Dallner’s Order was inconsistent insofar as it divided medical care costs between responsible insurers without doing the same for these indemnity benefits.
On appeal, the Workers’ Compensation Court of Appeals stated that responsibility for permanent total disability benefits lies with the injury that produces total and permanent incapacity from working. Judge Dallner’s decision not to order contribution was supported by the fact that the employee was able to work at a greater compensation rate after retraining and changing her vocational focus, despite the effects of the 1997 and 2003 injuries; this ability to work extended to the date of the January 4, 2010 injury. In affirming Judge Dallner’s decision, the Court of Appeals also noted that her reasoning was supported by Dr. Hess’ medical opinion and the employee’s testimony.