Appeal of Lalime

687 A.2d 994, 141 N.H. 534, 1996 N.H. LEXIS 140
CourtSupreme Court of New Hampshire
DecidedDecember 31, 1996
DocketNo. 95-544
StatusPublished
Cited by26 cases

This text of 687 A.2d 994 (Appeal of Lalime) is published on Counsel Stack Legal Research, covering Supreme Court of New Hampshire primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Appeal of Lalime, 687 A.2d 994, 141 N.H. 534, 1996 N.H. LEXIS 140 (N.H. 1996).

Opinion

Johnson, J.

The petitioner, Judy Lalime, appeals the decision of the New Hampshire Compensation Appeals Board (board) that her medical treatments subsequent to April 28, 1992, were not the responsibility of her former employer, K-Mart Enterprises of New [536]*536Hampshire (respondent), and that she was not entitled to temporary partial disability payments. We affirm in part, vacate in part, and remand.

The petitioner was employed, in various capacities, by the respondent at its Rochester store from August 1989 through September 1992. In August 1991, while working as a sales associate in the appliance department, the petitioner injured her right elbow and wrist by moving several television sets from a storeroom to the showroom floor. She returned to work in the appliance department that fall but reinjured her elbow, and again left work, in December 1991. The petitioner returned to K-Mart in March 1992 in a light duty capacity, initially as a cashier and later as a “door greeter.” In April 1992, her hours as a door greeter were reduced from forty hours per week to thirty-two. The petitioner left K-Mart in September 1992 and began working at Easy Street Shoe Company (Easy Street). She then sought temporary partial disability benefits for reductions in pay resulting from her position as door greeter, her decreased hours, and her lower earnings at Easy Street. The respondent denied her request.

Following her injury in August 1991, the petitioner sought treatment from a number of doctors to determine the nature and extent of her injuries, and for pain management therapy. Notably, the petitioner’s last appointment with her initial treating physician, Dr. Robert H. Harrington, was on April 28, 1992, at which time Dr. Harrington believed that she had reached “a point of maximum medical improvement.” While the petitioner continued to seek diagnostic and rehabilitative treatment for continued pain in her elbow through December 1992, the respondent refused to reimburse the petitioner for medical expenses incurred after April 28, 1992.

The petitioner sought compensation for medical expenses related to her arm injury pursuant to RSA 281-A:23 (Supp. 1992) (amended 1994, 1995, and 1996), and temporary partial disability payments under RSA 281-A:31 (Supp. 1992) (amended 1994). The hearing officer denied both claims, and the petitioner appealed this decision to the board. See RSA 281-A:43, I(b) (Supp. 1996). The board ruled that the respondent was not responsible for any medical costs incurred after April 28, 1992 - the date that Dr. Harrington determined that the petitioner had reached a point of maximum medical improvement. The board also denied the petitioner’s request for temporary partial disability payments. The petitioner’s motion for rehearing was denied, and this appeal followed.

[537]*537 I. Medical Reimbursement

The petitioner first argues that the board erred in finding that the respondent was not responsible for medical costs incurred after April 28, 1992. In so ruling, the board held that

the claimant has not met her burden of proof. From the medical records, all objective tests yielded negative results. The medical evidence distinctly shows that on April 28,1992 Dr. Harrington, her own treating physician states that “he feels that she has reached a point of maximum medical improvement.”

We will not overturn the board’s decision, except for errors of law, unless the petitioner has shown it to be clearly unreasonable or unjust. Appeal of Cote, 139 N.H. 575, 578, 660 A.2d 1090, 1093 (1995); see RSA 541:13 (1974). The petitioner argues that the board erred as a matter of law in finding that she had not carried her burden of proof with respect to the requirements of RSA 281-A:23, I (Supp. 1996). We agree.

“To obtain workers’ compensation benefits, a claimant has the initial burden to establish a prima facie case. Once the claimant has met this burden, the burden of production shifts to the respondent to rebut the claims made.” Cote, 139 N.H. at 578, 660 A.2d at 1093 (citation omitted). The burden of persuasion remains with the claimant, however. See Appeal of Stetson, 138 N.H. 293, 297, 639 A.2d 245, 248 (1994). RSA 281-A:23, I, provides that “[a]n employer subject to this chapter . . . shall furnish or cause to be furnished to an injured employee reasonable medical, surgical, and hospital services, [and] remedial care . . . for such period as the nature of the injury may require.” We have interpreted this statute to require that: “(1) the treatment must be reasonable; and (2) the treatment may continue only so long as required by the nature of the injury.” Appeal of Levesque, 136 N.H. 211, 214, 612 A.2d 1333, 1334 (1992).

Thus, in order for a claimant to receive reimbursement, the treatment in question must be “reasonable.” The board found that the petitioner failed to carry her burden of proof because all the objective tests revealed no further injury. We must determine, therefore, whether the fact that the petitioner’s test results were negative renders the cost of testing and treatment unreasonable. “We construe the [workers’ compensation] statute liberally, resolving all reasonable doubts in statutory construction in favor of the injured employee in order to give the broadest reasonable effect to [538]*538[its] remedial purpose . . . .” Appeal of Griffin, 140 N.H. 650, 654, 671 A.2d 541, 543 (1996). A determination of the “reasonableness” of the treatment should not be outcome dependent. Rather, the proper analysis is whether the petitioner presented objective evidence showing, that at the time the tests were ordered, it was reasonable for her to seek further treatment, be it diagnostic or palliative. Therefore, the board’s finding that reimbursement was not warranted because the tests yielded negative results is not sufficient to support their conclusion that the petitioner has failed to meet her burden of proof.

We also find that the board improperly relied on a finding of “medical endpoint” to deny the petitioner’s request for reimbursement. It is well settled that the fact that a patient has reached a “medical endpoint” is not conclusive as to whether the treatments have extended beyond the period required by the nature of the injury. See Levesque, 136 N.H. at 214, 612 A.2d at 1334-35. Reimbursable medical care may include treatments that are both curative and palliative in nature. Id. While determination of a “medical endpoint” may indicate that the curative value of further treatments is nil, it does not establish that there would be no palliative benefits to be reaped from further medical care.

Therefore, we vacate the ruling of the board with respect to reimbursement of the petitioner’s medical costs. Because “it is the board’s role, and not ours, to weigh all relevant factors in the first instance,” Appeal of Normand, 137 N.H. 617, 621, 631 A.2d 535, 537 (1993) (citations omitted), we remand for a determination of reimbursable medical costs consistent with the standards set forth in this opinion.

II. Temporary Partial Disability Payments

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Bluebook (online)
687 A.2d 994, 141 N.H. 534, 1996 N.H. LEXIS 140, Counsel Stack Legal Research, https://law.counselstack.com/opinion/appeal-of-lalime-nh-1996.