Ernest Health, Inc. v. Labor Commission

2016 UT App 48, 369 P.3d 462, 808 Utah Adv. Rep. 4, 2016 Utah App. LEXIS 49, 2016 WL 932918
CourtCourt of Appeals of Utah
DecidedMarch 10, 2016
Docket20141138-CA
StatusPublished
Cited by3 cases

This text of 2016 UT App 48 (Ernest Health, Inc. v. Labor Commission) is published on Counsel Stack Legal Research, covering Court of Appeals of Utah primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ernest Health, Inc. v. Labor Commission, 2016 UT App 48, 369 P.3d 462, 808 Utah Adv. Rep. 4, 2016 Utah App. LEXIS 49, 2016 WL 932918 (Utah Ct. App. 2016).

Opinion

Memorandum Deéision

ROTH, Judge:

T1 On October 22, 2009 Martie Breivik, who was employed at the time as a medical secretary at Utah Valley Specialty Hospital, fell while walking in to work and hit her right hand on the cement ground, causing her to "hyper extend[ ] her right small finger [and] right ring finger," There is no dispute that her fall was an industrial accident covered by Utah's Workers' Compensation Act. The following month, an MRI revealed ligament damage to her hand but no fractures. In December 2009, Breivik was diagnosed with complex regional pain syndrome, anxiety, and depression, all of which originated from the fall, Breivik continued to work for Utah Valley Specialty Hospital in a light-duty capacity until October 31, 2011, when she was terminated "because she did not have a full work release." In August 2018, Breivik applied for permanent-total-disability compensation. Ree generally Utah Code Ann. § 34A-2-418 (LexisNexis Supp, 2015) 1 On *464 May 28, 2014, an administrative law judge (the ALJ) made a preliminary determination that Breivik was permanently and totally disabled as a result of her industrial accident. See Utah Admin. Code R612-200-5(C) (stating that permanent total disability claims arising under section 34A-2-418 of the Utah Code "require[ ] a two-step adjudicative process": first, a "preliminary determination whether the applicant is permanently and totally disabled" and, second, a determination "whether the applicant can be reemployed or rehabilitated"); see also Thomas v. Color Country Mgmt., 2004 UT 12, ¶ 21, 84 P.3d 1201 ("Section 84A-2-418(6) . requires that a finding be issued in two parts-an initial finding and a final finding, The initial finding of permanent total disability triggers a review period in which the employer or its insurance carrier may submit a reemployment plan.") 2 The Labor Commission (the Commission) upheld the ALJ's decision.

T2 Ernest Health, Inc. 3 and North River Insurance Company (collectively, Ernest Health) seek judicial review of the Commission's decision affirming the ALJ's order awarding permanent-total-disability-compensation benefits to Breivik. Ernest Health argues: first, that the Commission erred by not remanding the case and directing the ALJ to reopen the evidentiary record and consider newly obtained video surveillance and the supplemental medical report that accompanied it; second, that the Commission erred by not remanding the case and directing the ALJ to make a referral to a medical panel; and third, that the ALJ's order provides an insufficient basis for Ernest Health to develop a re-employment plan. We do not disturb the Commission's ruling.

I, Motion to Reopen the Evidentiary Record

13 Ernest Health asserts that "[slection 63-46b-8(1)(a) of the Utah Administrative Procedures Act requires that ALJs obtain full disclosure of relevant facts" and argues that the Commission should have granted its motion to reopen the evidentiary record and admit additional evidence. Specifically, Eir-nest Health argues that the Commission erred by not remanding the case to the ALJ to consider newly obtained video surveillance of Breivik in conjunction with the accompanying supplemental medical report from Ernest Health's independent medical examiner.

T4 Approximately four months after the evidentiary hearing on Breivik's permanent disability petition (and approximately three months after the ALJ's order), Ernest Health moved the Commission to reopen the evidentiary record, stating that "[in anticipation of the hearing on the reemployment plan" it had "conducted surveillance of [Breivik] on various dates [during July and August of 20141." 4 Ernest Health requested that the evidentiary record be reopened so it could "present evidence" of the video surveillance of Breivik, taken months after the conclusion of the hearing, along with the supplemental medical report, According to Ernest Health, because Breivik's testimony about her limitations "served as a substantial basis for the ALJ's order" and "[the video provides direct and concise evidence that [Breiv-ik] was not truthful in her testimony," the ALJ's order was based on "[al flawed foun *465 dation." Ernest Health now argues that "Iwlithout a review of the relevant and outcome determinative surveillance video, [it is] substantially prejudiced [because] the agency action is based -upon a determination of fact that is not supported by substantial evidence when viewed in light of the whole record[ ] before the court."

15 In its order affirming the ALJ's decision, the Commission stated, |

As a preliminary matter, the [Commission] rejects Ernest [Health's] attempt to submit additional evidence, including surveillance video of Ms. Breivik, which was not presented before [the ALJ]. The [Commigsion] does not agree with Ernest [Health] that the proffered new evidence warrants re-opening of the evidentiary record. Ernest [Health] has not provided sufficient explanation as to why it waited until after the close of the record to obtain the proffered evidence, The [Commission] therefore did not consider such evidence.

Ernest Health filed a Motion for Reconsideration, and the Commission again re-affirmed that "the late-submitted evidence was properly excluded [by the ALJ] ... and cannot be the basis for referral to an 1mpart1al medical panel."

16 Rule 6022-1 of the Utah Administrative Code sets forth the pleading and discovery procedures for an adjudication of workers' compensation benefits before the Commission. See Utah Admin,. Code R602-2-1, It provides that "the evidentiary record shall be deemed closed at the conclusion of the hearing and no additional evidence will be gecepted without leave of the [the ALJ hearing the case]." Id. R6022-1(D(8). We "will not disturb the agency's interpretation or application of one of the agency's rules unless its determination exceeds the bounds of reasonableness and rationality." Brown & Root Indus. Serv. v. Industrial Comm'n of Utah, 947 P.2d 671, 677 (Utah 1997) (citation omitted). In addition, the Commission is afforded broad discretion in determining how best to conduct its inquiry into each case: "The commission may make its investigation in such manner as in its judgment is best calculated to ascertain the substantial rights of the parties and to carry out justly the spirit of the chapter." Utah Code Ann. § 34A-2-802(1) (LexisNexis 2011). In particular, "whether further findings. are made is a matter of discretion with the Commission." Jones v. Ogden Auto Body, 646 P.2d 708, 705 (Utah 1982) (per curiam).

17 We are not persuaded that the Commission's decision to exclude Ernest Health's late-submitted evidence exceeded the bounds of the Commission's discretion.

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Bluebook (online)
2016 UT App 48, 369 P.3d 462, 808 Utah Adv. Rep. 4, 2016 Utah App. LEXIS 49, 2016 WL 932918, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ernest-health-inc-v-labor-commission-utahctapp-2016.