WHITNEY VALOSEK Applicant
SSM HEALTH CARE OF WISCONSIN INC Employer
SSM HEALTH CARE OF WISCONSIN INC Insurer
Wisconsin Workers Compensation
State of Wisconsin Labor and Industry Review Commission
April 5, 2019
Attorney James A. Meier
Attorney Paul R. Riegel
WORKER’S COMPENSATION DECISION
B. FALSTAD, CHAIRPERSON.
commission affirms the decision of the
administrative law judge. Accordingly, SSM Health Care of
Wisconsin, Inc. (employer) is prospectively ordered to pay
for the arthroscopic procedure proposed by Bradley M.
Fideler, M.D., in his clinic note dated June 13, 2017.
Jurisdiction is reserved for such further findings and orders
as may be necessary, consistent with this decision.
Michael H. Gillick, Commissioner
October 16, 2017, the applicant submitted a hearing
application claiming compensation, including prospective
surgery, for a right knee injury alleged to have arisen out
of and in the course of her employment with the employer. The
date of the claimed work injury is January 29, 2015. On April
10, 2018, an administrative law judge (ALJ) for the
Department of Administration, Division of Hearings and
Appeals, Office of Worker's Compensation Hearings held a
hearing in the matter. On May 17, 2018, the ALJ issued a
decision which found that the applicant sustained a
compensable right knee injury on January 29, 2015. The ALJ
awarded compensation that had been previously paid by the
employer, but which the employer subsequently contested as
paid under mistake of fact. The ALJ also found that the
employer was prospectively liable for proposed right knee
surgery. Respondent timely filed a petition for commission
review, alleging error in the ALJ's decision.
commission has considered the petition and the positions of
the parties, and has done so in conjunction with its review
of the evidence submitted at the hearing. Based on its
consideration and review, the commission agrees with the
decision of the ALJ. The commission adopts the findings and
conclusions in the ALJ's decision as its own.
answer to the applicant's October 2017 application for
hearing, the employer admitted that she had sustained a
compensable right knee injury on January 29, 2015. However,
it disputed the nature and extent of disability.
Subsequently, it made payments of temporary disability and
five percent permanent partial disability at the knee. In the
current proceeding it has asserted that these payments were
made under mistake of fact, but has offered no detailed
argument to support this contention, other than making
reference to the August 2017 and February 2018 medical
opinions of Steven Pals, M.D.
case, the employer has waived recovery of the compensation it
previously paid. The respondent's central argument before
the commission is that the ALJ erred in ordering liability
for the prospective right knee surgery currently proposed by
Dr. Fideler. The commission finds that the ALJ properly made
the employer liable for the prospective surgery, because it
is a compensable consequence of the work injury of January
29, 2015. To explain its finding, the commission must first
repeat many of the factual findings made by the ALJ.
applicant's birthdate is November 22, 1988. In June of
2001, she was a rear seat passenger in an automobile that was
struck from behind, causing her knees to impact against the
back of the front seat. As a result of this incident, she was
diagnosed with bilateral patellar tendinitis. On January 23,
2002, she received emergency room treatment for extreme right
knee pain after hearing a "pop" in the knee while
playing basketball. She was treated conservatively and...