Medina v. Berg Construction, Inc.

924 P.2d 1362, 122 N.M. 350
CourtNew Mexico Court of Appeals
DecidedAugust 7, 1996
DocketNo. 16456
StatusPublished
Cited by15 cases

This text of 924 P.2d 1362 (Medina v. Berg Construction, Inc.) 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
Medina v. Berg Construction, Inc., 924 P.2d 1362, 122 N.M. 350 (N.M. Ct. App. 1996).

Opinion

OPINION

BUSTAMANTE, Judge.

1. Worker, Eotavio Medina, Jr., appeals, and Employer-Insurer (Employer) cross-appeals from a compensation order amending the compensation order and the award of attorney fees and costs. Worker challenges (1) the decision of the Workers’ Compensation Judge (WCJ) holding that his previous work in the mines near Grants, New Mexico, was as a miner, as described in the DOT Job Code 850.381.010 in the Dictionary of Occupational Titles (Dictionary), published by the Department of Labor; and (2) the WCJ’s determination that he was entitled to zero points in calculating his residual physical capacity based on his ability to perform a specific vocational pursuit.

2. Employer raises four issues in its cross-appeal: (1) whether the WCJ erred as a matter of law in determining that Worker’s residual capacity was light; (2) whether the medical expenses awarded to Worker exceeded the amounts allowed by law; (3) whether the WCJ abused his discretion in awarding attorney fees; and (4) whether the WCJ erred in ordering Employer to pay all of the discovery costs incurred by Worker.

3. We hold that the WCJ erred in finding that Worker was not entitled to any points in determining his rate of permanent partial disability under NMSA1978, Section 52-1-26.3(D) (Repl.Pamp.1991) (effective Jan. 1, 1991). We affirm on all other issues raised in the appeal and cross-appeal.

FACTS

4. We confine our recitation of the facts and procedure below to those relevant to the issues raised on appeal. Worker was, at time of trial, forty-four years old. He has lived in Grants, New Mexico, for twenty-one years. Before he went to work for Berg Construction, he had worked for substantial periods of time in the mines near Grants and as a truck driver. His work for Berg Construction was as a construction laborer. Worker has an eighth grade education and, although he speaks English well, has difficulty reading and writing English. He was injured on August 11, 1993, while carrying rebar with some of his coworkers. His coworkers set down their end of the rebar without warning Worker, suddenly subjecting him to the full weight of the rebar. Worker immediately felt pain in his back. He left work later that day and, at the time of the formal hearing, had not returned to work.

5. Worker was treated for his back injury by Dr. Brian P. Delahoussaye and, at the direction of Dr. Delahoussaye, by physical therapist Gary Saunders. On November 11, 1993, Dr. Delahoussaye signed a medical work release. At that time, Dr. Delahoussaye restricted Worker’s lifting to up to fifty pounds occasionally and up to twenty pounds frequently. Employer then reduced Worker’s compensation benefits from temporary total disability to payments based on an 11% permanent partial disability.

6. Worker was still in pain when he was released by Dr. Delahoussaye, and, when the pain did not go away, consulted Dr. George R. Swajian. Dr. Swajian prescribed additional conservative treatment, and, because Worker lived in Grants, referred Worker to Dr. Louis T. Uttaro, a Grants chiropractor, so that Worker would not need to drive into Albuquerque every day for his treatment. As a result of a mediation conference held by the Workers’ Compensation Administration, Employer agreed to pay additional temporary total benefits while Worker received treatment from Doctors Swajian and Uttaro. However, the treatment by Dr. Uttaro did not result in any improvement. At the end of the treatment, Employer again terminated temporary total disability payments and reinstated permanent partial disability benefits at the rate of 11%. Later, for reasons discussed below, Employer refused to pay a portion of Dr. Uttaro’s fees for treatment of Worker.

7. Worker received an Independent Medical Examination (IME) by Dr. Robert W. Benson. Dr. Benson concurred in Dr. Delahoussaye’s diagnosis of a sprain or strain to the lower back.

8. At the formal hearing, Worker testified that he had lived in Grants for twenty-one years. For ten of those years he worked in underground mines. He described his work in the mines as follows: “I was a driller — blaster—handling the drill machines — dragging the drill machines — lot of heavy lifting — running an underground loader — different types of equipment for underground.” He alternately characterized his job as that of a mining laborer or a miner. On cross-examination, he agreed that he did all aspects of mining work, including running a drill and operating underground loaders, slushers, and mucking machines. He also agreed that his usual and customary work was as a miner, that was why he had moved to Grants, and that when there was no mining work available, he went to work as a truck driver. The only construction work he had done since moving to Grants was the four months that he worked for Berg Construction.

9. Employer presented the testimony of Yolanda Mascarenas, the claims adjuster assigned to Worker’s case. Mascarenas testified that New Mexico Mutual had refused to pay approximately $727.57 of Dr. Uttaro’s fees based on an internal audit performed by another New Mexico Mutual employee. Mascarenas did not prepare the notice to Dr. Uttaro’s office and could not explain why certain charges by Dr. Uttaro had not been paid.

10. During closing arguments, both parties presented their views concerning the application of the statutory disability formula. Both sides agreed that, with respect to the education modifier, Worker was entitled to zero points for age and one point for his eighth grade education. Again with respect to the education modifier, Worker’s attorney argued: (1) that Worker’s usual and customary employment was as an underground driller machine operator, DOT 930.382-010 (SVP 2); (2) that Worker was entitled to one additional point under Section 52-l-26.3(D) because he could no longer perform a specific vocational pursuit; and (3) that Worker’s residual physical capacity under Section 52-1-26.4 was light duty. Worker’s counsel also argued that Dr. Uttaro’s treatment was reasonable and necessary, and therefore Employer should pay the balance of Dr. Uttaro’s fees.

11. With respect to the issues on appeal, Employer contends: (1) that Worker’s usual and customary employment was as a miner, DOT 850.381-010 (SVP 7); (2) that Worker was not entitled to an additional point under Section 52-l-26.3(D); (3) that Worker’s residual physical capacity was medium rather than light duty; and (4) that Dr. Uttaro had been paid pursuant to the audit conducted by New Mexico Mutual, and if Dr. Uttaro wished to challenge the audit, Dr. Uttaro should take that up with the Director of the WCA under the applicable rules and regulations. Employer briefly indicated its belief that Dr. Uttaro’s charges exceeded the MAP schedule, and that ordering payment of the balance would be tantamount to ordering New Mexico Mutual to violate the law.

12. At some time after the hearing, the WCJ issued a letter decision which, unfortunately, is not part of the record on appeal. Both parties filed proposed findings and conclusions. We note in passing that in his proposed findings, Worker asked the WCJ to find that his work in the mines be classified as labor or construction work, DOT 869.687.026 (SVP 2), making his work as a truck driver, DOT 904.383.010 (SVP 4), the job with the highest SVP level in the last ten years.

13.

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Cite This Page — Counsel Stack

Bluebook (online)
924 P.2d 1362, 122 N.M. 350, Counsel Stack Legal Research, https://law.counselstack.com/opinion/medina-v-berg-construction-inc-nmctapp-1996.