Jafar Saiyed Applicant
Wheaton Franciscan Healthcare Employer
Wheaton Franciscan Healthcare, c/o Sedgwick Claims Management Insurer
No. 2016-006111
Wisconsin Workers Compensation
State Of Wisconsin Labor And Industry Review Commission
February 22, 2019
Atty.
Russell J. Fenton
Atty.
Scott W. French
WORKER’S COMPENSATION
DECISION
1
Georgia E. Maxwell, Chairperson
ORDER
The
commission modifies and affirms the decision of the
administrative law judge. Accordingly, the application for
benefits is dismissed.
By the
Commission:
David
B. Falstad, Commissioner
Procedural
Posture
This
case is before the commission to consider the
applicant’s entitlement to worker’s compensation
benefits. The applicant filed hearing applications in
February of 2016 and in September of 2017, alleging a left
shoulder injury from a fall at work on December 31, 2008, and
claiming 50% permanent partial disability to the left
shoulder. The employer and its insurer (collectively, the
respondent) conceded jurisdictional facts and an average
weekly wage of $843.20. An administrative law judge for the
Department of Administration, Division of Hearings and
Appeals, Office of Worker’s Compensation Hearings,
heard the matter on April 30, 2018, and issued a decision on
June 26, 2018, dismissing the application. The applicant
filed a timely petition for commission review.
The
commission has considered the petition and the positions of
the parties and has independently reviewed the evidence
submitted at the hearing. Based on its review, the commission
modifies and affirms the decision of the administrative law
judge.
Findings
of Fact and Conclusions of Law
The
commission makes the same findings of fact and conclusions of
law as stated in the decision of the administrative law judge
and incorporates them by reference into the
commission’s decision, subject to the following:
Modification
On page
4 of the decision, in the third full paragraph, replace the
fifth and sixth sentences with the following:
It is not until November of 2010 that the applicant’s
main complaint is his left shoulder. Thereafter, it is not
until September of 2011 that the applicant seeks robust
treatment for his left shoulder. Indeed, it was not until
December of 2011, or nearly three years after the workplace
fall, that the applicant had a left shoulder MRI that showed
evidence of a near complete tear of the long head of the
biceps tendon, along with impingement syndrome and a labral
tear.
Memorandum
Opinion
The
applicant, who was born in 1954, worked as a respiratory
therapist for the respondent. He was injured on December 31,
2008, when he fell down icy steps as he left
work.
[2] According to the applicant, he slipped
and fell backwards down the steps. The applicant asserts that
he injured his left shoulder in this fall which resulted in
the need for his 2015 total left shoulder replacement.
The
issues in this case are whether the applicant sustained a
left shoulder injury arising out of and incidental to his
employment on December 31, 2008, and the respondent’s
liability for medical expenses and indemnity. The applicant
has the burden of proving beyond a legitimate...
