Continental Casualty Co. v. Baker

355 S.W.3d 375, 2011 Tex. App. LEXIS 6893, 2011 WL 3918155
CourtCourt of Appeals of Texas
DecidedAugust 25, 2011
Docket01-09-00881-CV
StatusPublished
Cited by27 cases

This text of 355 S.W.3d 375 (Continental Casualty Co. v. Baker) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Continental Casualty Co. v. Baker, 355 S.W.3d 375, 2011 Tex. App. LEXIS 6893, 2011 WL 3918155 (Tex. Ct. App. 2011).

Opinion

OPINION ON REHEARING

EVELYN V. KEYES, Justice.

Appellee James E. Baker filed a motion for en banc reconsideration of our May 5, 2011 opinion. We treat the motion for en banc reconsideration as a motion for rehearing, grant rehearing, withdraw our May 5, 2011 opinion and judgment, and issue this opinion and judgment in their place. The disposition of the case remains unchanged.

In this workers’ compensation case, appellant, Continental Casualty Company (“Continental”), brought suit for judicial review of the decision of the Texas Department of Insurance, Division of Workers’ Compensation (“Division”) in favor of Baker. The jury found that Baker’s com-pensable injury extended to a left knee meniscus tear identified on an MRI over five years after his work-related accident. The trial court entered judgment in favor of Baker and awarded $134,694.80 in trial-level attorney’s fees and expenses and $33,500 in conditional appellate attorney’s fees. In six issues, Continental contends that (1) the trial court erred in giving a charge that included an instruction on additional injuries, an instruction on aggravation injuries, and an incorrect instruction on producing cause; (2) the trial court erroneously allowed Baker to present a PowerPoint presentation displaying excerpts of evidence during opening statements; (3) the trial court improperly excluded a medical report made to the Division as hearsay; (4) the trial court improperly allowed Baker’s treating doctor to testify as an expert regarding causation of the 2005 meniscus tear because he was not qualified to render such an opinion and his opinions were not scientifically reliable; (5) factually insufficient evidence supported the jury’s verdict; and (6) the trial court erroneously determined the amount of Baker’s reasonable and necessary attorney’s fees, denying Continental its right to have a jury determine this issue.

We reverse the judgment and remand the case for further proceedings.

Background

On July 12, 2000, James Baker was injured during the course of his employment when he stepped off a ladder, lost his balance, and twisted his left knee. Baker sought workers’ compensation benefits from Continental, his employer’s insurance carrier. Continental initially agreed that Baker’s injury was compensable and accepted the claim; however, it now disputes the extent of Baker’s injury. Specifically, Continental disputes whether the compen-sable injury includes a tear of the medial meniscus in Baker’s left knee that was identified in 2005.

On July 26, 2000, Baker underwent a magnetic resonance imaging scan (“MRI”) on his left knee. The radiologist interpreting the MRI results preliminarily diagnosed Baker with a “degenerative tear of the posterior horn of the medial meniscus which reaches both the inferior and superi- or articular surfaces.” Shortly after this MRI, Baker was examined by Dr. William *378 Woods, an orthopedic surgeon who specializes in knee surgery. Dr. Woods noted that Baker had pre-existing arthritis, a positive McMurray’s test, which indicated an injury to the inside part of his knee, swelling, and “numerous loose bodies” of cartilage in the knee. Before performing arthroscopic surgery on Baker’s left knee, Dr. Woods tentatively diagnosed Baker with a medial meniscus tear and articular injury. He had observed a “large amount of degenerative change in the meniscus,” which he stated is sometimes interpreted by radiologists as a tear in the meniscus. Dr. Woods opined that the only way to confirm a meniscus tear, as opposed to a degenerative change in the meniscus, is to examine and probe the meniscus during arthroscopic surgery.

Dr. Woods performed arthroscopic surgery on Baker in August 2000, but found no visible tear in the meniscus. Therefore, he did not operate on a meniscus tear or perform a partial menisectomy. Instead, he performed arthroscopic debridement of the patella, arthroscopic removal of loose bodies, and extensive arthroscopic partial synovectomy, or surgical removal of a sy-novial membrane.

Baker returned to work in October 2000, and, in November 2000, Dr. Woods believed that Baker had reached maximum medical improvement. Specifically, Dr. Woods believed that Baker would never have a normally functioning knee and that he would continue to have knee problems due to his pre-existing arthritis.

In March 2001, Baker, who was experiencing continued pain in his left knee, visited a chiropractor, Dr. David Durkop, for further treatment and physical therapy. When the pain persisted despite rehabilitation exercises, Dr. Durkop referred Baker to Dr. Lubor Jarolimek, an orthopedic surgeon. In light of Baker’s continued pain, Dr. Jarolimek ordered a second MRI on Baker’s left knee in May 2001. This MRI reflected that: “The anterior horn of the lateral meniscus has grade II degenerative changes. There are also prominent grade II degenerative changes in the posterior horn of the lateral meniscus. The anterior horn of the medial meniscus shows Grade II degenerative changes. Prominent Grade II changes in the posterior horn of the medial meniscus.” The radiologist interpreting this MRI noted degenerative changes and thinning in both the anterior and posterior horns of the lateral meniscus, but stated that “[n]o grade III or IV tears [are] demonstrated.”

Dr. Jarolimek continued to treat Baker over the next five years. Throughout this time period, Baker continuously displayed pain and tenderness in his left knee. Dr. Jarolimek ordered a third MRI for Baker in December 2005, five years after Baker’s injury, first MRI, and surgery, and four and one-half years after Baker’s second MRI. This MRI demonstrated a “complex tear of the body and posterior horn of the medial meniscus. No definite lateral men-iscal tear is appreciated.”

Continental disputed Baker’s assertion that his July 2000 workplace accident caused the meniscus tear seen on the December 2005 MRI, and it denied further workers’ compensation benefits. After Continental and Baker were unable to resolve the dispute at a Benefits Review Conference, a contested case hearing was held before the Division on October 10, 2006. The sole issue at the hearing was whether “the compensable injury extended] to include the left knee meniscus tear identified on the MRI of December 5, 2005.” The hearing officer concluded that the compensable injury extended to include the meniscus tear identified on the December 2005 MRI.

After the Appeals Panel declined to reverse the decision, Continental brought *379 this suit for judicial review of the hearing officer’s decision. Baker filed a general denial and asserted a counterclaim to recover statutory attorney’s fees pursuant to Texas Labor Code section 408.221(c).

Before trial, Continental sought to exclude the expert medical testimony of Dr. Jarolimek on the grounds that (1) he lacked the necessary qualifications to render an expert opinion on the cause of the 2005 meniscus tear, (2) his opinion that Baker had had a meniscus tear since July 2000 that developed into the tear shown on the December 2005 MRI was not based on an accurate and reliable foundation, and (3) his alternate opinion, that Baker had an “intrasubstance tear” in the left knee meniscus that developed into a full-thickness tear, was based purely on speculation and thus was not reliable. The trial court denied this motion and allowed Dr. Jaroli-mek’s testimony.

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Cite This Page — Counsel Stack

Bluebook (online)
355 S.W.3d 375, 2011 Tex. App. LEXIS 6893, 2011 WL 3918155, Counsel Stack Legal Research, https://law.counselstack.com/opinion/continental-casualty-co-v-baker-texapp-2011.