Howard University Hospital v. DC DOES and James M. Lyles

CourtDistrict of Columbia Court of Appeals
DecidedJanuary 31, 2019
Docket17-AA-832
StatusPublished

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Howard University Hospital v. DC DOES and James M. Lyles, (D.C. 2019).

Opinion

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DISTRICT OF COLUMBIA COURT OF APPEALS

No. 17-AA-832

HOWARD UNIVERSITY HOSPITAL, PETITIONER,

v.

DISTRICT OF COLUMBIA DEPARTMENT OF EMPLOYMENT SERVICES, RESPONDENT,

and

JAMES M. LYLES, JR., INTERVENOR.

On Petition for Review of an Order of the District of Columbia Department of Employment Services Compensation Review Board (CRB-36-17)

(Argued September 25, 2018 Decided January 31, 2019)

William H. Schladt for petitioner.

Karl A. Racine, Attorney General for the District of Columbia, Todd S. Kim, Solicitor General at the time the statement was filed, and Loren L. AliKhan, Deputy Solicitor General at the time the statement was filed, filed a statement in lieu of brief.

David J. Kapson, with whom Kevin H. Stillman was on the brief, for intervenor.

Before THOMPSON and MCLEESE, Associate Judges, and PRYOR, Senior Judge. 2

MCLEESE, Associate Judge: Petitioner Howard University Hospital (HUH)

challenges an award of workers’ compensation to intervenor James M. Lyles, Jr. We

vacate and remand for further proceedings.

I.

Mr. Lyles worked for HUH as a radiological technician. In 2013, he felt pain

in his right shoulder while lifting a patient to prepare for an x-ray. Mr. Lyles

received medical treatment and eventually filed a workers’ compensation claim

seeking disability benefits pursuant to D.C. Code § 32-1508 (3)(A) and (S) (2012

Repl.), which provide for compensation for permanent partial loss of the use of an

arm. HUH did not dispute that Mr. Lyles had suffered a work-related injury and was

entitled to some compensation. HUH and Mr. Lyles presented conflicting evidence

about the extent of Mr. Lyles’s disability.

At a February 2017 hearing before an administrative law judge (ALJ), Mr.

Lyles testified that he still felt a burning and tearing sensation from his neck down

into his arm, which was aggravated by motions such as lifting, pulling, and pushing.

He further testified that his right arm was very weak and that he therefore did not

use his right arm as much as he used to. At the time of the hearing, Mr. Lyles was 3

working for a new employer as a radiological technician/medical assistant. His

duties for his new employer did not include pulling or lifting of patients or

machinery. Mr. Lyles also testified that he was no longer able to bowl or lift heavy

weights at the gym. Mr. Lyles acknowledged that he had suffered a previous injury

to his right shoulder in 2011, while working for a different employer, and had

claimed disability benefits from his employer in connection with that injury. That

disability claim was settled.

Mr. Lyles introduced the results of an independent medical examination

conducted in 2016 by Dr. Matthew Menet. Dr. Menet concluded that Mr. Lyles still

had difficulty lifting, reaching, and pulling. In opining about the extent of Mr.

Lyles’s disability, Dr. Menet relied upon the Fourth Edition of the American Medical

Association Guides to the Evaluation of Permanent Impairment (AMA Guides). Dr.

Menet also considered pain, loss of function, weakness, and loss of endurance. Dr.

Menet concluded that Mr. Lyles had a 47% permanent impairment to his right upper

extremity. That figure rested on adding the following specific impairments: 3%

based on lack of full range of motion, 12% for pain, 10% for weakness, 12% for loss

of function, and 10% for loss of endurance. According to Dr. Menet, 20% of the

47% impairment was related to Mr. Lyles’s 2011 injury and 27% was related to Mr.

Lyles’s 2013 injury. 4

HUH introduced the results of an independent medical examination conducted

in 2016 by Dr. Mark Scheer. Dr. Scheer relied on the Sixth Edition of the AMA

Guides, as well as his assessment of Mr. Lyles’s pain, weakness, atrophy, loss of

function, and loss of endurance. Dr. Scheer concluded that Mr. Lyles had a 4%

permanent impairment to his right upper extremity. According to Dr. Scheer, 2% of

the 4% impairment was preexisting and 2% was related to Mr. Lyles’s 2013 injury.

The ALJ credited Mr. Lyles’s testimony and gave greater weight to Dr.

Menet’s opinion than to Dr. Scheer’s opinion. With one exception, the ALJ adopted

Dr. Menet’s calculations in determining the extent of Mr. Lyles’s disability. The

exception was that the ALJ did not accept the 10% impairment based on loss of

endurance, because Mr. Lyles had returned to full-time work as a radiological

technician/medical assistant. The ALJ therefore concluded that Mr. Lyles had

suffered a 37% permanent disability to his right upper extremity.

The ALJ further concluded that HUH should be held responsible for all of the

impairment at issue, not solely the portion of the impairment that was caused by Mr.

Lyles’s most recent injury. The ALJ explained that apportionment of disability was

precluded by D.C. Code § 32-1508 (6)(A) (“If an employee receives an injury, 5

which combined with a previous occupational or nonoccupational disability or

physical impairment causes substantially greater disability or death, the liability of

the employer shall be as if the subsequent injury alone caused the subsequent amount

of disability . . . .”).

HUH argued to the ALJ that, in determining the amount of Mr. Lyles’s award

under § 32-1508 (3)(A) and (S), the ALJ should not consider the impairment to Mr.

Lyles’s shoulder, because the shoulder is not part of the arm. Relying on the decision

of the Compensation Review Board (CRB) in Lawson, CRB No. 14-056(R), 2017

WL 576074 (Jan 11, 2017), the ALJ concluded that the shoulder is part of the arm

for purposes of § 32-1508.

HUH sought review before the CRB, which affirmed the ALJ’s compensation

order. Among other things, HUH argued that, in calculating the amount of Mr.

Lyles’s disability, the ALJ had not explained the connection between Mr. Lyles’s

physical impairments and the extent of Mr. Lyles’s disability. The CRB

acknowledged that ALJs must specifically explain the nexus between physical-

impairment factors -- including pain, weakness, atrophy, loss of endurance, and loss

of function -- and a claimant’s “industrial capacity.” The CRB concluded, however,

that the ALJ had adequately explained his conclusions. 6

Finally, the CRB concluded that § 32-1508 (6)(A), the provision the ALJ

relied upon as precluding apportionment, had not been repealed by § 2 (e)(2) of the

Workers’ Compensation Amendment Act (WCAA). D.C. Act 12-571, 46 D.C. Reg.

891, 893-94 (1999). We discuss the CRB’s reasoning on that point more fully later

in this opinion.

II.

We review a decision of the CRB to determine whether the decision was

“arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with

law.” Reyes v. District of Columbia Dep’t of Emp’t Servs., 48 A.3d 159, 164 (D.C.

2012) (internal quotation marks omitted). “Our principal function in reviewing

administrative action is to assure that the agency has given full and reasoned

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