Jones v. Brasch-Barry General Contractors

189 S.W.3d 149, 2006 Ky. App. LEXIS 77, 2006 WL 572815
CourtCourt of Appeals of Kentucky
DecidedMarch 10, 2006
Docket2004-CA-000730-WC
StatusPublished
Cited by30 cases

This text of 189 S.W.3d 149 (Jones v. Brasch-Barry General Contractors) is published on Counsel Stack Legal Research, covering Court of Appeals of Kentucky primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Jones v. Brasch-Barry General Contractors, 189 S.W.3d 149, 2006 Ky. App. LEXIS 77, 2006 WL 572815 (Ky. Ct. App. 2006).

Opinion

OPINION

MINTON, Judge.

This case comes to us on remand from the Kentucky Supreme Court. 1 In fight of the Supreme Court’s opinion and upon review of the record, we conclude that the Workers’ Compensation Board correctly found that the decision of an Administrative Law Judge finding Jeff Jones to be twenty-six percent disabled was not supported by substantial evidence. Thus, we affirm.

As related by the Kentucky Supreme Court, the pertinent facts are as follows:

On April 14, 2000, Jeff Jones suffered a back injury in the course of his employment with Appellant. Soon thereafter, Jones sought medical attention and filed for workers’ compensation benefits. During a hearing to determine the extent of these benefits, medical evidence was introduced before Bonnie Kittinger, an administrative law judge (“ALJ”). The medical evidence consisted of testimony and/or reports from three doctors regarding the extent of Jones’ workplace injury. Two of the doctors determined that Jones’ condition qualified as a “DRE lumbar Category III” disability under the American Medical Association’s Guides to the Evaluation of Permanent Impairment, Fifth Edition (“AMA Guides”). As a “Category III” disability, Jones’ impairment rating could range between ten and sixteen percent (10-16%). These doctors assessed Jones at ten percent (10%) permanent impairment. One of the doctors, Dr. Gary Reasor, determined that Jones’ condition qualified as a “DRE lumbar Category IV” disability under the AMA Guides. A “Category IV” disability would allow an impairment rating for Jones between twenty and twenty-six percent (20-26%). Dr. Reasor assessed Jones at twenty-six percent (26%) permanent impairment.
During cross-examination, Dr. Reasor conceded that Jones did not meet the textbook definition for a “Category IV” disability under the AMA Guides, but rather, his condition fell within the parameters of a “Category III” disability. *152 However, Dr. Reasor maintained his conclusion of twenty-six percent (26%) total impairment for Jones, explaining that the category definitions in the AMA Guides are meant to be used solely as the name of the text implies, as a guide. He further surmised that the category definitions were perhaps flawed or incomplete in this instance. From this testimony, the ALJ made the following finding:
Despite persistent and skillful cross-examination by the Defendant, Dr. Rea-sor steadfastly maintained that Plaintiffs permanent impairment was 26%. He insisted that the AMA Guides are only that, guidelines, not final authority. The ALJ, as a finder of facts, must depend on interpretation of the Guides by a medical professional. Based on Dr. Reasor’s medical reports and deposition testimony, Plaintiff is found to have a 26% permanent impairment as the result of his work injury on April 14, 2000.
Without filing a petition for rehearing, Appellant appealed directly to the Board pursuant to KRS [Kentucky Revised Statutes] 342.285. The Board ruled that in order to comply with KRS 342.730(l)(b), impairment ratings must be determined in accordance with the category definitions contained in the AMA Guides. Since Dr. Reasor failed to base his impairment rating on the category definitions contained in the AMA Guides, the Board held that his finding of twenty-six percent (26%) permanent impairment was not, as a matter of statutory law, supported by substantial evidence. Based on this analysis, the ALJ’s finding of twenty-six percent (26%) impairment was reversed and the case was remanded back to the ALJ for a determination which was consistent with the Board’s opinion.
Pursuant to KRS 342.290, Jones appealed the Board’s decision to the Court of Appeals. Finding “the issue on appeal in this case [to be] of a completely factual nature,” the Court of Appeals reversed the Board’s decision because it determined that the issue was "ultimately unpreserved for review.... Because we find the Board’s ruling to pertain to a question of law and not fact, we reverse the Court of Appeals’ decision and remand for further proceedings. 2

The question before us on remand is whether the Board’s decision to reverse the ALJ’s impairment determination was correct. It is well-established that our function in workers’ compensation cases “is to correct the Board only where the ... Court perceives the Board has overlooked or misconstrued controlling statutes or precedent, or committed an error in assessing the evidence so flagrant as to cause gross injustice.” 3

Clearly, the ALJ is the sole, undisputed finder of fact in workers’ compensation cases, meaning that the ALJ alone “has the authority to determine the quality, character[,] ... substance[,]” 4 and weight of the evidence presented, as well as the inferences to be drawn from the evidence. 5 Thus, the ALJ “may reject any testimony and believe or disbelieve various parts of the evidence, regardless of whether it comes from the same witness or the same adversary party’s total proof.” 6 Ac *153 cordingly, given our limited scope of review, this Court may not “substitute its judgment” for that of the ALJ, nor may we render our own findings or direct the findings or conclusions the ALJ shall make. 7 As Jones was successful before the ALJ, the ultimate question before us is whether the ALJ’s decision is supported by substantial evidence. 8

The crux of Jones’s argument is that the Board erred in reversing the ALJ because the ALJ’s decision that he is twenty-six percent occupationally disabled is supported by substantial evidence in the form of Dr. Reasor’s findings. But since Dr. Reasor’s findings are not in accordance with the AMA Guides, we.disagree with Jones’s contention that those findings constitute substantial evidence.

A claimant found to have a compen-sable, permanent partial disability receives workers’ compensation benefits based on the percentage of the employee’s disability assessed by the ALJ in accordance with the AMA Guides. 9 Thus, the AMA Guides are an indispensable tool utilized by an ALJ to determine the nature and severity of any claimant’s injuries. In the case at hand, two physicians found that Jones suffers from a “Category III” impairment under the AMA Guides; and only Dr. Rea-sor found that Jones suffered from a “Category IV” impairment. Thus, the ALJ’s decision to find Jones twenty-six percent disabled rests solely upon Dr. Reasor’s opinion.

As noted by the Board, Dr.

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Bluebook (online)
189 S.W.3d 149, 2006 Ky. App. LEXIS 77, 2006 WL 572815, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jones-v-brasch-barry-general-contractors-kyctapp-2006.