Aurora Consolidated Health Care & Sentry Insurance v. Labor & Industry Review Commission

2012 WI 49, 814 N.W.2d 824, 340 Wis. 2d 367, 2012 WL 1649736, 2012 Wisc. LEXIS 344
CourtWisconsin Supreme Court
DecidedMay 11, 2012
DocketNo. 2010AP208
StatusPublished
Cited by5 cases

This text of 2012 WI 49 (Aurora Consolidated Health Care & Sentry Insurance v. Labor & Industry Review Commission) is published on Counsel Stack Legal Research, covering Wisconsin Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Aurora Consolidated Health Care & Sentry Insurance v. Labor & Industry Review Commission, 2012 WI 49, 814 N.W.2d 824, 340 Wis. 2d 367, 2012 WL 1649736, 2012 Wisc. LEXIS 344 (Wis. 2012).

Opinions

ANN WALSH BRADLEY, J.

¶ 1. The petitioners, Aurora Consolidated Health Care and Sentry Insurance, A Mutual Company (collectively, "Aurora") seek review of a decision of the court of appeals, which upheld a decision of the Labor and Industry Review Commission (LIRC) determining that Jeffrey Schaefer was permanently and totally disabled as a result of a work injury.1 LIRC made this determination after denying Aurora's last-minute request to cross-examine or make further inquires of Dr. Jerome Ebert, an independent physician appointed by the Department of Workforce Development (the Department) to examine Schaefer and report on the cause of his disability.

¶ 2. Aurora asserts that it has both a statutory and a constitutional due process right to cross-examine Dr. Ebert. It contends that LIRC erroneously exercised [371]*371its discretion by denying its requests to cross-examine or make further inquiries of Dr. Ebert.

¶ 3. We determine that neither Wis. Stat. § 102.17(l)(g) nor Wis. Stat. § 102.17(l)(d)2 provides Aurora a statutory right to cross-examine Dr. Ebert, an independent physician appointed by the Department. We further determine that LIRC did not violate Aurora's due process rights when it declined to remand for cross-examination.

¶ 4. Finally, we conclude that LIRC did not erroneously exercise its discretion. When it declined to remand for a third time to allow Dr. Ebert to be questioned further, LIRC considered the relevant facts, applied the proper standard of law, and reached a determination that a reasonable person could reach. Accordingly, we affirm the court of appeals.

I

¶ 5. Schaefer was hired by Aurora Consolidated Health Care in 1981. In 2001, he suffered a work-related injury. After his injury, Schaefer continued to perform various unskilled tasks for Aurora until he was terminated in 2006 due to Aurora's inability to accommodate his physical restrictions.3 Schaefer filed a worker's compensation claim for permanent and total disability.

[372]*372¶ 6. The medical and procedural facts in this case are complex. We begin by setting forth facts related to Schaefer's medical history and then we turn to the procedural facts related to his worker's compensation claim. In setting forth these facts, we rely on the factual findings made by LIRC.

¶ 7. Schaefer has an extensive medical history, including at least two work-related injuries, several injuries that are not work-related, and other medical conditions. Although much of Schaefer's medical history was at issue during the proceedings before the Department, only two of Schaefer's conditions remain at issue in this appeal: (1) a back condition that was caused, Schaefer asserts, by a 2001 work-related injury; and (2) non-work-related avascular necrosis of the hips that developed in 2005 and resulted in a 2006 hip replacement. In setting forth Schaefer's medical history, we focus on these two conditions.

¶ 8. The work-related injury at issue in this case occurred on February 27, 2001, when Schaefer slipped and fell on a patch of ice while making a delivery for his employer. Six days after the February 27, 2001 incident, Schaefer sought treatment from Dr. James Cain and was diagnosed with a L5-S1 recurrent disc herniation. Dr. Cain performed a lumbar fusion in June of 2001. Schaefer temporarily returned to work, but the fusion did not heal properly, and Dr. Cain performed a second lumbar fusion in February of 2002.

¶ 9. At the time, Aurora conceded worker's compensation liability for Schaefer's injury and surgeries, and it paid temporary total disability benefits, temporary partial disability benefits, and some medical expenses. Following the 2002 surgery, Schaefer temporarily returned to work on a full-time basis.

[373]*373¶ 10. In the fall of 2004, however, Schaefer began to experience recurrent low back and bilateral leg symptoms and pain, and Dr. Cain referred Schaefer to Dr. Ali Sadeghi for pain management. According to the medical records, Schaefer saw Dr. Sadeghi on a regular basis over a period of years, and they experimented with a variety of strategies to control the pain such as trigger point injections, Botox injections, and narcotic-based pain medication.

¶ 11. In 2005, Schaefer also developed pain in his right hip, and he underwent a total hip replacement on August 15, 2006 with a positive result. Schaefer has not claimed that the right hip pain and the hip replacement surgery resulted from any work-related injury.

¶ 12. Even after the hip replacement surgery, Schaefer continued to experience pain. In 2007, Schaefer underwent a third back surgery with a new doctor, who removed the fusion hardware and determined that the fusion was solid.

¶ 13. With the above as background, we turn to the facts related to Schaefer's present worker's compensation claim. Schaefer filed a claim with the Department, asserting that as a consequence of his work-related injury, he was permanently and totally disabled.

¶ 14. To support his claim of permanent total disability, Schaefer relied in part on a Lumbosacral Spine Impairment Medical Assessment Form completed by Dr. Sadeghi on July 10, 2006, just prior to his hip replacement surgery. In that form, Dr. Sadeghi noted that Schaefer had been diagnosed with postlaminectomy pain syndrome and bilateral avascular necrosis of the hips, and he imposed extreme physical restrictions that severely limited Schaefer's ability to work.

[374]*374¶ 15. According to Dr. Sadeghi, Schaefer could not continuously sit for more than 15 minutes. He could not continuously stand for more than 30 minutes, and after standing for that duration, he would need to lie down. Dr. Sadeghi reported that during an eight-hour workday, Schaefer could sit less than two hours and stand or walk less than two hours, and he would require more than ten unscheduled breaks. Further, Schaefer could lift less than 10 pounds only rarely, and could never twist, stoop, or bend. Dr. Sadeghi concluded that Schaefer would frequently experience symptoms which interfere with attention and concentration needed to perform even simple tasks, that he would be unable to perform routine, repetitive tasks at a consistent pace, and that he would likely be absent from work "more than four days per month" due to impairments or treatment. He concluded that the above restrictions are "likely to be permanent."

¶ 16. Both parties agreed that the restrictions imposed by Dr. Sadeghi were severe, and if adopted, the restrictions would mean that Schaefer was permanently and totally disabled. Additionally, both parties agreed that because Schaefer did not claim that his hip problem was work-related, any residual effects of the hip problem should not be taken into account when assessing Schaefer's disability for worker's compensation purposes.

¶ 17. The parties' disagreement revolved around the extent to which Schaefer's pain and the resulting restrictions were caused by the February 27, 2001 work-related injury. Aurora contended that Schaefer's pain and physical restrictions were not caused by the February 27 injury, and were instead caused by other injuries and medical conditions, including Schaefer's non-work-related hip problem.

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Bluebook (online)
2012 WI 49, 814 N.W.2d 824, 340 Wis. 2d 367, 2012 WL 1649736, 2012 Wisc. LEXIS 344, Counsel Stack Legal Research, https://law.counselstack.com/opinion/aurora-consolidated-health-care-sentry-insurance-v-labor-industry-wis-2012.