Liberty Mutual v. Leon

CourtNevada Supreme Court
DecidedMay 16, 2013
Docket58322
StatusUnpublished

This text of Liberty Mutual v. Leon (Liberty Mutual v. Leon) is published on Counsel Stack Legal Research, covering Nevada Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Liberty Mutual v. Leon, (Neb. 2013).

Opinion

aggravated a preexisting back condition, but that the injury was not a substantial contributing cause of appellant's current condition. The appeals officer determined that Dr. Vater's report was credible and that respondent had met her burden under NRS 616C.150 to establish that her injury was industrial. The appeals officer then reversed the hearing officer's decision and ordered appellant to provide appropriate treatment for an accepted claim of lumbar sprain/strain, but noted that "[w]hether the diagnosed aggravation of the Claimant's pre-existing back condition is a temporary condition is something to be determined after conservative medical treatment/investigation proceeds under her claim for, an accepted lumbar sprain/strain." In making this determination, the appeals officer did not address Dr. Vater's conclusion that the injury was not a substantial contributing cause of appellant's current condition. Appellant subsequently filed a petition for judicial review in the district court." The district court granted the petition and remanded the matter to the appeals officer to make specific findings as to whether respondent's injury was a substantial contributing cause of her current condition and to address the implications of NRS 616C.175, which sets forth an exception to the insurer's liability in cases involving the aggravation of a preexisting nonindustrial condition, in precluding compensation. On remand, the appeals officer issued a supplemental decision and order, which clarified that he could not at that time determine whether respondent's industrial injury had "more than temporarily

'Appellant did not provide the briefing associated with either of its petitions for judicial review in its appendix on appeal.

2 aggravated her preexisting condition and whether it is a substantial contributing cause of the entirety of her resulting condition," and he ordered the claim accepted for a lumbar sprain/strain, but deferred a determination on the NRS 616C.175 issue until "further medical investigation and conservative care is provided. . . ." Appellant filed another petition for judicial review of the supplemental decision and order, asserting that the appeals officer's decision was an abuse of discretion. The district court denied the petition, concluding that, under NRS 616C.330, the appeals officer had the authority to require appellant to pay for continuing treatment of respondent's injury to resolve the question regarding her preexisting back condition. This appeal followed. On appeal, appellant argues, among other things, that the appeals officer erred by not addressing the NRS 616C.175 issue when he ordered the acceptance of respondent's claim for lumbar sprain/strain. We agree, and we therefore reverse the district court's decision. DISCUSSION This court reviews an appeals officer's decision in a workers' compensation matter for clear error or abuse of discretion. NRS 233B.135(3); Vredenburg v. Sedgwick CMS, 124 Nev. 553, 557, 188 P.3d 1084, 1087 (2008). Judicial review is confined to the record before the appeals officer, and on issues of fact and fact-based conclusions of law, the appeals officer's decision will not be disturbed if it is supported by substantial evidence. Vredenburg, 124 Nev. at 557, 188 P.3d at 1087-88; Grover C. Dils Med. Ctr. v. Menditto, 121 Nev. 278, 283, 112 P.3d 1093, 1097 (2005). An appeals officer's determinations on pure issues of law, however, are reviewed de novo. Roberts v. State Indus. Ins. Sys., 114 Nev. 364, 367, 956 P.2d 790, 792 (1998). SUPREME COURT OF NEVADA 3 (0) 1947A When an employee suffers an industrial injury that aggravates a preexisting nonindustrial condition, the compensability of that employee's workers' compensation claim requires a two-part evaluation. See NRS 616C.150(1) (setting forth the injured employee's initial burden to establish that workers' compensation benefits are warranted); NRS 616C.175(1) (explaining when a preexisting condition may preclude an injured employee from receiving workers' compensation benefits for his or her current injury). First, an injured employee is required to establish that his or her injury occurred within the course of employment in order to obtain workers' compensation benefits. NRS 616C.150(1). Second, if the injured employee meets his or her burden under NRS 616C.150, the burden shifts to the insurer to prove that the injury, which aggravated, precipitated, or accelerated a preexisting nonindustrial condition, is not a substantial contributing cause of the employee's current condition and that the insurer is therefore not liable for workers' compensation benefits. NRS 616C.175(1); see also Ross v. Reno Hilton, 113 Nev. 228, 229, 931 P.2d 1366, 1367 (1997). Here, the appeals officer determined that respondent had met her burden under NRS 616C.150 of showing that her injury was industrial and that the injury had aggravated a preexisting back condition. This determination is supported by substantial evidence in the record. See Vredenburg, 124 Nev. at 557 11.4, 188 P.3d at 1087 n.4 ("Substantial evidence is evidence that a reasonable person could accept as adequately supporting a conclusion."). The appeals officer erred, however, in ordering the acceptance of respondent's claim while deferring a determination regarding respondent's preexisting condition. If appellant can show that respondent's current lumbar sprain/strain injury is not a substantial

SUPREME COURT OF NEVADA 4 (0) 1947A contributing cause of her present back pain condition, then respondent's claim will not be accepted and no benefits for her injury will be paid. Thus, the appeals officer's order that appellant accept respondent's lumbar sprain/strain claim and provide conservative medical treatment before any determination regarding appellant's NRS 616C.175 argument was premature and is a legal error. See NRS 616C.175

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Related

Grover C. Dils Medical Center v. Menditto
112 P.3d 1093 (Nevada Supreme Court, 2005)
Vredenburg Ex Rel. Vredenburg v. Sedgwick CMS
188 P.3d 1084 (Nevada Supreme Court, 2008)
Ross v. Hilton
931 P.2d 1366 (Nevada Supreme Court, 1997)
Roberts v. State Industrial Insurance System
956 P.2d 790 (Nevada Supreme Court, 1998)

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Liberty Mutual v. Leon, Counsel Stack Legal Research, https://law.counselstack.com/opinion/liberty-mutual-v-leon-nev-2013.