WALTER F. COX, Petitioner,
v.
INNOPHOS NUTRITION, CRUM & FORSTER INDEMNITY CO., and NORTH RIVER INS. CO., Respondents.
No. 16-0225
Utah Workers Compensation Decisions
Appeals Board Utah Labor Commission
March 13, 2018
ORDER ON MOTION FOR REVIEW
PATRICIA ABBOTT LAMMI, CHAIR.
ORDER
OF REMAND
Walter
F. Cox asks the Appeals Board of the Utah Labor
Commission[1] to review Administrative Law Judge
Newman’s denial of Mr. Cox’s claim for benefits
under the Utah Workers’ Compensation Act, Title 34A,
Chapter 2, Utah Code Annotated.
The
Appeals Board exercises jurisdiction over this motion for
review pursuant to §63G-4-301 of the Utah Administrative
Procedures Act and §34A-2-801(4) of the Utah
Workers’ Compensation Act.
BACKGROUND
AND ISSUES PRESENTED
Mr. Cox
claims workers’ compensation benefits for a low-back
injury he sustained while working for Innophos Nutrition
(“Innophos”) on February 29, 2016. Mr. Cox
underwent surgery on his lumbar spine following the accident
and then underwent another surgery after he fell at home. Mr.
Cox’s claim alleged entitlement to the cost of both
surgeries, along with other benefits. Judge Newman held an
evidentiary hearing and referred the medical aspects of the
claim to an impartial medical panel. The panel determined,
among other things, the date Mr. Cox reached medical
stability and that his second surgery after the fall at home
was not medically causally connected to the work accident.
Mr. Cox
objected to the medical panel’s report and Judge Newman
asked the medical panel to outline the specific evidentiary
basis for its opinion on the second surgery. The panel
responded by noting the evidence in the medical record on
which it based its opinion. Mr. Cox objected to the
panel’s supplemental report by arguing that the panel
improperly relied on evidence outside of the record in
determining that the second surgery was not causally
connected to the work accident. Judge Newman relied on the
panel’s conclusions over Mr. Cox’s objection and
awarded benefits to him, but denied his claim for the cost of
the second surgery.
Mr. Cox
now seeks review of Judge Newman’s decision by arguing
that the second low-back surgery should have been found to be
compensable as a natural result of the 2016 work accident and
injury. Mr. Cox reiterates that it was error to rely on the
medical panel’s conclusion regarding the medical cause
of the second low-back surgery because the panel improperly
relied on evidence outside Judge Newman’s findings of
fact to reach such conclusion. Mr. Cox also submits that
referral to a medical panel was not appropriate in the first
place.
FINDINGS
OF FACT
The
Appeals Board finds the following facts to be material to Mr.
Cox’s motion for review. Mr. Cox has a history of
low-back problems. He underwent surgery on his lumbar spine
in 2009 after being assessed with a right-sided disc
herniation at the L4-5 level and with radiculopathy on the
left side at the L5-S1 level. Mr. Cox was also
post-operatively diagnosed with degenerative disc disease in...
