Hall v. Carlsbad Supermarket/IGA

2008 NMCA 026, 177 P.3d 530, 143 N.M. 479
CourtNew Mexico Court of Appeals
DecidedDecember 6, 2007
Docket26,538
StatusPublished
Cited by8 cases

This text of 2008 NMCA 026 (Hall v. Carlsbad Supermarket/IGA) is published on Counsel Stack Legal Research, covering New Mexico Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hall v. Carlsbad Supermarket/IGA, 2008 NMCA 026, 177 P.3d 530, 143 N.M. 479 (N.M. Ct. App. 2007).

Opinion

OPINION

VIGIL, Judge.

{1} This case presents an issue of first impression under the Workers’ Compensation Act (the Act), NMSA 1978, §§ 52-1-1 to -70 (1929, as amended through 2007): Does a doctor who performs an independent medical examination (IME) under Section 52-1-51, pursuant to the parties’ agreement, exceed the scope of his authority when he diagnoses injuries not specifically identified in the agreement and concludes they were caused by the on-the-job accident? We hold that the doctor did not exceed the scope of the IME and that the worker’s compensation judge (WCJ) did not err by considering the information in awarding benefits. We also consider whether the parties’ agreement precluded Worker from raising the newly diagnosed injuries in an amended workers’ compensation claim, and hold that Worker was not precluded from seeking compensation for her newly diagnosed work injuries. We therefore affirm the WCJ’s compensation order.

I. BACKGROUND

{2} Worker is an elderly woman who worked at Carlsbad Supermarket (Employer) in the deli section of the store. She injured her knee and back when she fell while carrying supplies to the deli. Worker was diagnosed with a fracture to her patella and lower back lumbar strain, and Employer paid the costs of her medical care and provided disability benefits with respect to these injuries. Worker also complained of middle back thoracic back pain to Dr. Baca, her authorized healthcare provider. Dr. Baca diagnosed Worker’s back pain as resulting from a compression fracture of Worker’s T12 vertebra, and attributed the subtle wedging of Worker’s T12 vertebra to Worker’s on-the-job accident. Dr. Baca also determined that, as of February 4, 2004, Worker had reached maximum medical improvement.

{3} Employer denied Worker’s request for benefits for the T12 compression fracture, disputing that the injury was causally related to the workplace accident. Worker filed a workers’ compensation complaint and then a first amended complaint. After the first amended complaint was filed, the parties attended mediation and a recommended resolution was issued by the mediator and agreed to by the parties. In pertinent part the recommended resolution states, “[t]he primary issue in this case is whether Worker’s T12 compression fracture is related to the on-the-job accidental injury[,]” and “as a compromise, interim resolution” provides (1) that the parties agreed that Worker had reached maximum medical improvement as of February 4, 2004, and (2) that Worker will receive an IME to be performed by Dr. Nieves “to obtain an independent opinion of whether the T12 compression fracture is related to the on-the-job accidental injury.” The recommended resolution also contains a provision providing that “[bjoth parties reserve and retain all rights and defenses regarding the claim for additional permanent partial disability benefits.”

{4} On February 7, 2005, Dr. Nieves performed the IME of Worker and concluded that, while Worker had a T12 compression fracture, it was not causally related to her workplace accident because it predated the accident. However, in the course of his examination, Dr. Nieves identified injuries to Worker’s sacrum, and diagnosed Worker with sacroiliac joint dysfunction and radiculitis as a result of her on-the-job injury. Dr. Nieves further concluded that Worker had not reached maximum medical improvement from her injuries.

{5} Worker then filed a second amended complaint based on the IME, seeking temporary total disability and permanent partial disability benefits, in addition to medical benefits and attorney fees. Another recommended resolution was proposed, which Worker rejected, and the case proceeded to a compensation hearing before the WCJ.

{6} At the compensation hearing, Employer objected to Dr. Nieves’s opinions as exceeding the scope of the IME agreed to in the recommended resolution. Employer also contended that Worker was precluded from raising new injuries by the recommended resolution which, according to Employer, limited the issues in dispute to the causal relation of the T12 compression fracture to Worker’s workplace accident. The WCJ determined that, based on the language contained in the recommended resolution, Worker was not limited to the issue of the T12 fracture. Accordingly, the WCJ considered Dr. Nieves’s opinions about the newly diagnosed injuries in determining his compensation award to Worker. This appeal followed.

II. DISCUSSION

{7} The issues Employer raises on appeal require us to interpret several provisions of the Act. In interpreting a statute, our review is de novo. Smith v. Ariz. Pub. Serv. Co., 2003-NMCA-097, ¶ 5, 134 N.M. 202, 75 P.3d 418. “Our main goal in statutory construction is to give effect to the intent of the legislature.” Archer v. Roadrunner Trucking, Inc., 1997-NMSC-003, ¶ 7, 122 N.M. 703, 930 P.2d 1155. “We look first to the plain meaning of the statute’s words, and we construe the provisions of the Act together to produce a harmonious whole.” Smith, 2003-NMCA-097, ¶ 5, 134 N.M. 202, 75 P.3d 418. After we determine the meaning of the statutes, “we review the whole record to determine whether the WCJ’s findings and award are supported by substantial evidence.” Id.

A. Testimony of Independent Medical Examiner

{8} Employer argues on appeal that the WCJ erred by considering Dr. Nieves’s testimony to the extent it went beyond the causal relationship between Worker’s T12 compression fracture and the on-the-job accident. Employer also challenges the WCJ’s determination, based on Dr. Nieves’s testimony, that Worker was suffering from a sacral fracture, aggravation of bulging discs, and sacroiliac joint dysfunction, as a result of her on-the-job injury.

{9} To determine whether or not the WCJ erred by considering Dr. Nieves’s testimony regarding injuries other than the T12 compression fracture, we must determine if Dr. Nieves was authorized to provide the testimony pursuant to the Act. We conclude that Dr. Nieves was authorized to provide the challenged testimony and therefore hold that the WCJ did not err by considering Dr. Nieves’s opinions on issues other than Worker’s T12 compression fracture.

{10} The Act limits the testimony that can be provided by medical experts at a workers’ compensation hearing to testimony by “a treating physician or a health care provider who has provided an independent medical examination pursuant to the Act.” Banks v. IMC Kalium Carlsbad Potash Co., 2003-NMSC-026, ¶ 28, 134 N.M. 421, 77 P.3d 1014; see also § 52-l-51(C). The provision of the Act dealing with IMEs provides that, “[i]n the event of a dispute between the parties concerning any medical issue, if the parties cannot agree upon the use of a specific independent medical examiner, either party may petition a workers’ compensation judge for permission to have the worker undergo an independent medical examination.” § 52-l-51(A). 1 This provision provides two means by which an IME may be obtained: (1) by the agreement of the parties or (2) by order of the WCJ. Id.

{11} In this case, the parties agreed as part of the recommended resolution for an IME to be performed by Dr.

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Cite This Page — Counsel Stack

Bluebook (online)
2008 NMCA 026, 177 P.3d 530, 143 N.M. 479, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hall-v-carlsbad-supermarketiga-nmctapp-2007.