JEFFREY BOWSER,Petitioner v. CRB-4-14 DISTRICT OF COLUMBIA DEPARTMENT OF EMPLOYMENT SERVICES, and CLARK CONSTRUCTION, LLC, Intervenors

129 A.3d 253, 2015 D.C. App. LEXIS 592, 2015 WL 9589891
CourtDistrict of Columbia Court of Appeals
DecidedDecember 31, 2015
Docket14-AA-935
StatusPublished
Cited by2 cases

This text of 129 A.3d 253 (JEFFREY BOWSER,Petitioner v. CRB-4-14 DISTRICT OF COLUMBIA DEPARTMENT OF EMPLOYMENT SERVICES, and CLARK CONSTRUCTION, LLC, Intervenors) is published on Counsel Stack Legal Research, covering District of Columbia Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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JEFFREY BOWSER,Petitioner v. CRB-4-14 DISTRICT OF COLUMBIA DEPARTMENT OF EMPLOYMENT SERVICES, and CLARK CONSTRUCTION, LLC, Intervenors, 129 A.3d 253, 2015 D.C. App. LEXIS 592, 2015 WL 9589891 (D.C. 2015).

Opinion

THOMPSON, Associate Judge:

In this matter, petitioner Jeffrey Bow-ser challenges a Decision and Order of the District of Columbia Department of Employment Services (“DOES”) Compensation Review Board (the “CRB”) that upheld. a Modification Order (the “MO”) terminating petitioner’s temporary total disability (“TTD”) benefits. Petitioner contends that the CRB’s Decision and Order must be reversed because (1) the in-tervenor/employer failed to make a threshold showing of a change in conditions and thus was not entitled to the hearing that led to • the MO; (2) the DOES administrative law judge (“ALJ”) improperly shifted to petitioner the burden of proving that he was entitled to a continuation of TTD benefits; (3) the in-tervenor/employer failed to prove that petitioner’s condition had changed, with the result that the MO is not supported by substantial evidence; and. (4) in any event, a remand is required for DOES to properly consider petitioner’s claims for medical benefits for carpal tunnel syndrome and psychological treatment. We remand for further consideration of petitioner’s claim for the foregoing medical benefits, but affirm the CRB’s ruling insofar as it upheld the termination of TTD benefits.

I.

On April 28, 2010, petitioner was working as a pile driver for intervenor Clark Construction Group (the “Employer”) when he was thrown backward in a boat, injuring his head, neck, and back. Petitioner sought medical treatment and thereafter filed a claim for workers’ compensation benefits. On May 26, 2011, a hearing was held on his claim. Petitioner’s evidence at the hearing included reports from his treating physicians. The Employer submitted reports by independent medical examiner (“IME”)' Dr. Louis London, a neurologist, and IME Dr. Gary Levitt, an orthopedist. Dr. London opined.that petitioner’s injuries had “resolved without residual,” that petitioner had “no continuing injury causally related to anything that occurred'on [April 28, 2010],” and that he “require[d] no further medical care” and could “return to his normal and usual employment as a [p]ile [d]river without restriction.” Similarly, Dr. Levitt opined that petitioner had “reached maximum medical improvement” and had “the ability to return to work immediately” without limitation or modification of his work activity.

*257 In a June 24, 2011, Compensation Order (the “Initial CO”), which was upheld on appeal to the CRB, DOES ALJ Heather Leslie awarded petitioner TTD benefits, finding that petitioner’s “back and lower extremity complaints [had] resolved” but that his “neck, left shoulder, left upper extremity and head condition [were] causally related to the injury of April 28, 2010” and continued to render him disabled. After the Initial CO was issued, the Employer caused additional - examinations to be performed by IMEs London and Levitt. After re-examining petitioner on December 5, 2011, and June 25, 2012, and reviewing new records from petitioner’s treating physicians, Dr. London again found that petitioner had “no condition related to anything that occurred on [April 28, 2010],” had “reached maximum medical improvement long ago,” and could return to his normal employment without restriction. Dr. Levitt examined petitioner again on November 1, 2011, and May 29, 2012. On the basis of those examinations, he stated that it - was “beyond [his] comprehension ... as to why [petitioner] still require[d] care,” that petitioner’s treatment- by his treating physicians had been “driven purely on the basis of subjective complaints by the [petitioner] and a willingness for his doctors to treat him without clear evidence of any objective measure of pathology” or “structural injury,” and that petitioner could return to work immediately without modification of work activity.'

After receiving the additional IME reports, the Employer filed an application for a hearing, seeking to modify the Initial CO. On January 18, 2013, DOES ALJ Karen Calmeise held an evidentiary hearing. On December 13, 2013, ALJ Cal-meise issued the MO, terminating petitioner’s TTD benefits and medical benefits upon finding .that petitioner had reached maximum medical improvement and that the injuries to his head, neck, and back had resolved. In an August 14, 2014, Decision and Order, the CRB upheld the' MO.

This petition for review followed. Petitioner argues that the Employer made no affirmative factual showing of a change in his condition and thus there was no basis for a modification hearing to be held. Petitioner also argues that the Employer failed to prove ■ that his condition had changed so as to warrant a modification of benefits, because the Employer’s medical evidence — new reports by IMEs Levitt and London — were “nearly identical” to their opinions that were rejected by ALJ Leslie in the Initial CO. Petitioner further contends -that ALJ Calmeise “improperly applied the burden of proof’ to him, by “effectively requiring him to prove that his condition had not changed.” Finally, petitioner argues that both the ALJ and the CRB failed to apply the presumption of compensability in addressing his claims for medical benefits.

II.

Under D.C.Code § 32-1524 (2012 Repl), a provision of the District of Columbia Worker’s Compensation Act (the “Act”), upon application by a party, DOES may “order a review of a compensation case ... where, there is reason to believe that a change of conditions has occurred which raises issues concerning: (1) [t]he fact or the degree of disability or the amount of compensation payable pursuant thereto[.]” D.C.Code § 32-1524(a). A party may apply for a § 32-1524 review “[a]t any time prior to 1 year after the date of the last payment of compensation or at any time prior to 1 year after the rejection of a claim[.]” Id. (emphasis added). 1 The re *258 view “shall be limited solely to new evidence which directly addresses the alleged change of conditions.” D.C.Code § 32-1524(b).

This court has approved .DOES’s interpretation that .when an applicant requests a § 32-1524 review, the agency must conduct a “preliminary examination of evidence intended to be submitted at an ev-identiary hearing” and then — rif that examination reveals “evidence which could establish, if credited, .changed conditions” (the. “threshold test”) — conduct an evidentiary hearing on the issue of whether there has been a change in conditions. Snipes v. District of Columbia Dep’t of Emp’t Servs., 542 A.2d 832, 834 n. 4, 835 (D.C.1988); see also Washington Metro. Area Transit Auth. v. District of Columbia Dep’t of Emp’t Servs. (“WMATA ”), 703 A.2d 1225

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129 A.3d 253, 2015 D.C. App. LEXIS 592, 2015 WL 9589891, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jeffrey-bowserpetitioner-v-crb-4-14-district-of-columbia-department-of-dc-2015.