Aplin & Ringsmuth

Legal Results with Lasting Impact

Madison 608-819-8408 • Waukesha 262-522-0660
Wausau 715-359-5034

May 2018 Worker’s Compensation Case Law Update

By Attorney Hayley Clark

Labor and Industry Review Commission

I. Felber v. GKN Sinter Metals, Inc., WC Claim No. 2013-015981 (LIRC May 2, 2018)

Rule: Compromise agreements are extremely difficult to re-open. Fearing having a claim barred due to an attorney’s (potential) failure to file a timely hearing application does not rise to the level of duress, and mutual mistake only occurs when all parties made the same mistake.

Facts: Todd Felber allegedly sustained a work-related injury on November 27, 2000. His attorney claims to have filed an Application for Hearing in September of 2012, but the Department had no such record of the same. Fearing his claim would be barred via the statute of limitations, Felber entered into a full and final compromise agreement during a November 27, 2013 hearing. The ALJ hand wrote, and both parties signed, the compromise, which addressed Felber’s alleged back and neck injuries and included a stamped notion allowing attorneys costs. The compromise was never submitted to the Department for approval or an order, but the respondents paid the agreed upon settlement amount.

At an unknown time, Felber filed an application to re-open his full and final compromise agreement, and a hearing was held on November 2, 2017. He claimed that his compromise agreement should be reopened for the following reasons: (1) duress and unusual stress due to his attorney potentially missing the filing deadline for his application; (2) mutual mistake due to a lack of discussing his apparent traumatic brain injury (TBI); and (3) a grossly inequitable result by the original ALJ. Following the November 2, 2017 hearing, the ALJ declined to re-open the compromise.

Decision: The Commission did not barr the claim because there was no proof of when Felber filed his application to re-open his compromise and neither party raised this issue, but the Commission did, ultimately, agree with the ALJ and decline to re-open the compromise agreement. Felber’s attorney may or may not have been guilty of failing to file a timely application (which the record cannot confirm or refute), but the Commission held that this does not equate to duress or unusual stress. Jurisdictional disputes are not uncommon in worker’s compensation claims, and Felber chose his attorney and chose to enter into the compromise agreement without determining whether his application was actually filed in a timely manner.

Second, there was no mutual mistake in the claim, because, prior to the 2013 hearing, the respondents filed a medical record opining that Felber did not sustain a TBI on the alleged date of injury. The Commission held that, because the respondents and the ALJ were aware of the potential claim for a TBI, Felber could not prove mutual mistake—only his own. Finally, the original ALJ did not allow a grossly inequitable result because (1) it was Felber’s burden to raise his potential TBI issue, and (2) Felber and his attorney knew the risks of entering into a compromise agreement without determining whether the application was actually late.

II. Maass v. J & L Targets, Inc., WC Claim No. 2016-008565 (LIRC May 8, 2018)

An Aplin & Ringsmuth claim

Rule: When comparing credibility of medical experts, the Commission will look at the history and facts upon which that physician’s opinion rests.

Facts: Daniel Maass was employed at J & L Targets, Inc., for four days in March of 2016 before complaining of pain and tingling in his bilateral hands. His symptoms allegedly began in the right hand and moved to the left approximately one week later. He informed his physicians that he used his hands and wrists extensively at work, which required him to not only bend them, but to also use extreme strength and tools. He also indicated that, on occasion, he would have to “slam” his hands onto the mold with which he was working.

Maass was ultimately diagnosed with carpal tunnel syndrome, and both of his physicians opined that the four-day work exposure was a material contributory causative factor in the onset or progression of his condition. The respondents obtained an independent review by Dr. Crimmins, who opined that Maass’ condition was too severe to have only manifested within the prior few weeks. Following a November 29, 2016 hearing, the ALJ found the claim compensable.

Decision: The Commission reversed the ALJ’s opinions. The Commission held that the treating physicians were not credible, as the medical records contained discrepancies as to Maass’ duration of work exposure and his onset of symptoms compared to when he began working. The Commission took issue with the fact that the records were inconsistent with a duration period, as they sometimes referenced four days versus four weeks of exposure, and how those exposure periods did not necessarily align with Maass’ complaint of an onset of pain.

III. Pruszka v. County of Milwaukee Risk Management, WC Claim No. 2014-026274 (LIRC May 3, 2018)

Rule: A physician’s opinion must contain detailed analysis and explanation of how an applicant’s work incident could (or could not) have caused the alleged injury. Simply stating an opinion on causation without further analysis is not credible.

Facts: Dennis Pruszka sustained a traumatic injury to his left knee on October 8, 2014 after he fell and his knee hit the pavement. An MRI on November 3, 2014 showed advanced degenerative changes and complex tearing of the medial meniscus. Pruszka underwent two arthroscopic surgeries in his left knee prior to the work incident, and he underwent another arthroscopic surgery in 2015. Pruszka’s surgeon offered two WKC-16B forms opining that Pruszka’s work injury precipitated, aggravated, or accelerated his pre-existing condition (arthritis) beyond its normal progression necessitating the arthroscopic surgery, but she did not provide any analysis as to why or how.

The respondents obtained an independent medical record review, and their physician opined that Pruszka’s pre-existing osteoarthritis necessitated the arthroscopic surgery, not the work incident. This physician provided a detailed, in depth explanation for how the work incident did not precipitate, aggravate, or accelerate the osteoarthritis beyond its normal progression, and he also explained why the work incident could not have caused the meniscus tears. Following a hearing on June 29, 2017, the ALJ found the claim compensable.

Decision: The Commission disagreed with the ALJ below, finding the respondents’ expert to be more credible. The Commission found Pruszka’s physician to be less credible because she provided no analysis or explanation of how the injury could have caused the meniscus tears, did not explain how the osteoarthritis was accelerated beyond normal progression, and did not appear to take into account Pruszka’s prior knee surgeries. On the other hand, the respondents’ physicians did address all of those issues and further explained how the direct trauma to the knee could not have caused Pruszka’s meniscus tears.