COURT OF APPEALS DECISION DATED AND FILED October 14, 2009 David
R. Schanker Clerk of Court of Appeals |
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NOTICE |
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This opinion is subject to further editing. If published, the official version will appear in the bound volume of the Official Reports. A party may file with the Supreme Court a petition to review an adverse decision by the Court of Appeals. See Wis. Stat. § 808.10 and Rule 809.62. |
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APPEAL
from an order of the circuit court for
Before Curley, P.J., Kessler and Brennan, JJ.
¶1 KESSLER, J. Greenfield Pontiac-Buick,
Inc., and its insurer, Federated Mutual Insurance Company (collectively,
“Greenfield”), appeal from an order affirming a Labor and Industry Review
Commission (LIRC) decision requiring Greenfield to pay two-thirds of injured
employee Chris H. Werdin’s worker’s compensation benefits.
BACKGROUND
¶2 The facts are not at issue on appeal. Werdin sought worker’s compensation benefits
for back injuries he suffered on two occasions, occurring five years apart. An administrative law judge (ALJ) awarded him
benefits and
¶3 Werdin was first injured on July 27, 1998, while an employee at ABRA Auto Body and Glass. His supervisor told him to climb over an eight-foot wall and jump down into a room to unlock a door. The fall to the ground injured his back. To remedy his back pain, Werdin had fusion surgery. He continued to experience low back and leg pain. His doctor released him effective December 22, 2000, with a ten percent permanent partial disability rating. As of mid-April 2001, Werdin was released for medium duty for eight-hour days. In June 2001, Werdin worked for two weeks at an auto body business, but quit “because the work bothered his back too much.”
¶4 In August 2001, Werdin began working as an auto body
repairman for
A I was doing a lot of bending. I was spot riveting these steel nails onto the right quarter panel to make a repair….
Q And what did you feel when it tore loose?
A Like my tailbone was waging all of a sudden.
Q What do you mean it was wagging?
A It was loose.
Q You actually felt something moving?
A Something had tore loose back there.
Q Had anything been tearing loose like that before?
A No.
….
Q So did you ever tell your boss at
A It was the day before.
Q And why didn’t you tell him?
A Because I have had something moving and rocking and clicking in my back prior, ever since the first surgery.
Q Was there a difference between the
rocking and clicking that you had since the first surgery and the rocking and clicking
you had when this happened at
A Yes.
Q What’s the difference?
A This one was really moving and I was in a great deal of pain.
Q And that’s more pain than you had been in before?
A Oh, yes.
Q More rocking and clicking?
A Oh, yes.
(Spacing and quotation marks omitted; second set of ellipses added.)
¶5 LIRC found that Werdin did not immediately tell
The next day, January 23, 2003, [Werdin] was “in a great deal of pain” at work, and he was performing spot welding when he accidentally started a fire in a van. This resulted in the employer discharging him that same day. Within a couple of days, [Werdin] contacted [the insurer for his former employer, ABRA Auto Body and Glass] and began requesting renewed medical care for his back. He did not know what was causing his problem at that time, but he noted that “something wasn’t right all along” with the result of the April 2000 fusion surgery.
¶6 In June 2003, Werdin received medical care authorized by ABRA’s insurer. Over the next year, he worked a variety of jobs but was terminated from one job due to a slowdown in business and from another job because his back problems made it difficult for him to perform his job.
¶7 In 2004 and 2005, Werdin continued to seek medical care for his back pain. Werdin underwent a second surgery in November 2005. His doctor told Werdin’s attorney that the initial fusion had never healed and that Werdin’s current back problems were related to the original surgery. Werdin’s doctor also opined that Werdin’s “episodes” in 2003 may have aggravated the problem. Ultimately, the doctor concluded as follows, as quoted in LIRC’s decision: ‘“Both traumatic events [the injuries sustained on July 27, 1998, and January 22, 2003] contributed to [the] injury for which [Werdin] underwent surgery [in November 2005]. Suspect latter injury 2/3; former injury 1/3, in need for surgery.’”
¶8 A different doctor examined Werdin in July 2006 at ABRA’s request. That doctor opined:
I think the work [Werdin] did at … Greenfield Pontiac
was a material contributory causative factor in the progression of his back
condition, as he had healed from his previous fusion. I also want to point out that the heavy
lifting he did at [
¶9 According to LIRC’s findings, a third doctor opined “that
there was no causal connection to the January 2003 incident…. [W]ork exposure at
¶10 LIRC found, “[o]ut of this complicated and conflicting set of medical opinions,” that the “facts support the inference that at least a substantial portion of the low back problem the applicant continued to experience on January 22, 2003, was attributable to the July 1998 work injury and resulting failed fusion.” However, LIRC rejected the opinion of one of the doctors “that there was no work injury on January 22, 2003.” LIRC explained:
[Werdin] credibly testified that “something tore loose”
in his back while performing his work duties for
¶11 LIRC ultimately found that Werdin was “temporarily totally
disabled from May 7, 2004, through the date of the hearing on April 18,
2007.” LIRC found ABRA one-third
responsible and
¶12 LIRC also addressed
[Section] 102.12 requires notice to the employer within two years “from the date the employee … knew or ought to have known the nature of the disability and its relation to the employment.” [Werdin] was understandably confused as to the cause or causes of his low back/leg pain as of January 22, 2003. He is not a physician, and it was never his responsibility to fix medical causation for his condition. He initially guessed that his symptoms were attributable to a recurrence of problems stemming from the 1998 injury, as evidenced by his contact with [ABRA’s insurer] almost immediately subsequent to January 2[2], 2003. Since nobody at the hearing [before the ALJ] asked the applicant why he waited until June of 2005 to notify Greenfield that he believed he had sustained a work injury on January 2[2], 2003, the record does not reveal precisely what it was that prompted him to conclude at that time that the January 2003 incident had been causative. However, the reasonable inference is that after seeking medical care and considering the matter, in June of 2005 the applicant reached this conclusion. Given the complicated nature of the causation issue, as evidenced by the ongoing controversy before [LIRC], it is inferred that the applicant delayed so long in reporting a work injury to Greenfield because he was simply uncertain as to what had been and had not been causative. Accordingly, the commission finds that the applicant satisfied the notification requirement as set forth in [] § 102.12.
¶13
DISCUSSION
I. Application of Wis.
Stat. § 102.12 to injuries caused by accidents.
¶14
¶15 As a threshold matter, we must address the fact that
To start counting the two years for Applicant to provide notice, the statute only requires that he knew or ought to have known about the disability and its relation to his employment. There cannot be any question, if Applicant’s testimony is found to be credible, that he did not immediately know he had suffered disability…. [H]e felt immediate pain, a tearing, a loosening and a wagging.
(Emphasis added.) Greenfield did not argue before LIRC that under § 102.12, Werdin was absolutely required to file an application or notify his employer about his injury within two years of the date of injury, and it did not argue that the legislative history of § 102.12 and subsequent case law support a distinction between the notice requirements for accidental injury and occupational disease claims.
¶16 LIRC rejected
¶17 “It is settled law that to preserve an issue for judicial
review, a party must raise it before the administrative agency.” State v.
¶18 At oral argument,
¶19 For the foregoing reasons, we decline to address on the merits
Greenfield’s argument that Werdin was required to take action within two years
of the date his accidental injury occurred, regardless of when he “knew or
ought to have known the nature of the disability and its relation to the
employment.” See id.
II. Review of LIRC’s finding
that Werdin notified
¶20
When making factual
determinations LIRC at no point determined that Werdin was unaware that he
injured himself on January 22, 2003. In
its decision, LIRC indicated that “[Werdin] credibly testified that ‘something
tore loose’ in this back while performing his work duties for
Instead, LIRC found that Wis. Stat. § 102.12 did not bar Werdin’s claim because he did not know that the traumatic injury … when combined with the effects of [his 1998] injury, was a causative factor in his condition…. This is not the proper application of the “knew or ought to have known” standard for any type of injury, including occupational disease.
(Some bracketing in
original.) We begin our analysis of
A. Standards of review.
¶21
¶22 Here,
¶23 We are challenged to fully address
¶24 LIRC does not provide detailed argument on the deference issue, but notes that regardless of whether great weight or due weight deference is applied, the result is the same: LIRC’s decision should be affirmed.
¶25 We agree with LIRC.
Certainly LIRC has been interpreting Wis.
Stat. § 102.12 for a long time.
B.
Reasonableness of LIRC’s interpretation and application of Wis. Stat. § 102.12.
¶26 As noted,
In nearly every accident case this will immediately be apparent, and the provision was directed primarily to cases of industrial disease where it was factually possible for some time after the onset of the disease for the applicant to be in doubt or ignorant, (1) as to what the disease was, and (2), whether it had in fact any relation to his employment.
¶27 Although LIRC did not discuss Larson in its written
decision, we conclude that LIRC’s decision is consistent with Larson. Larson recognized that there are
certain accident cases where the employee will be in doubt of “the nature of
the disability and its relation to the employment.” See
id.;
see also Wis. Stat. § 102.12.
LIRC found such was the case here, noting that Werdin was “understandably
confused as to the cause or causes of his low back/leg pain as of January 22,
2003” due to the fact he had suffered an injury in 1998 and had continued to
suffer pain from that injury. LIRC
explained that Werdin “initially guessed that his symptoms were attributable to
a recurrence of problems stemming from the 1998 injury, as evidenced by his
contact with [ABRA’s insurer] almost immediately subsequent to January 2[2],
2003.” LIRC found that in light of the
“complicated nature of the causation issue, as evidenced by the ongoing
controversy before [LIRC],” it could be inferred that Werdin “delayed so long
in reporting a work injury to
¶28 LIRC’s application of Wis.
Stat. § 102.12 was reasonable.
Under the unique facts of this case, where Werdin had a previous injury
that had continued to bother him and doctors offered differing opinions as to
whether his continuing back problems were caused by the 1998 injury, the 2003
injury or both, it was reasonable to conclude that Werdin did not immediately
know, and need not have immediately known, “the nature of the disability and
its relation to the employment.” See id.
As our supreme court noted in Trustees v. Industrial Commission,
224
What an employee may think as to the nature of his disability and its relation to his employment is not alone sufficient to start the running of the two-year statute of limitations. To so hold would be to adopt an unthinkably harsh rule. What an employee thinks must be based on something more than suspicion and conjecture in order to start the running of the statute of limitations. Such thought must be based upon knowledge of, or upon reliable information regarding the nature of his disability and its relation to his employment….
….
In our opinion, the compensation law does not put upon an employee the duty of knowing the nature of his disability and its relation to his employment before those things are reasonably ascertainable by the medical profession.
¶29 For the foregoing reasons, we affirm the circuit court order affirming LIRC’s decision.
By the Court.—Order affirmed.
Not recommended for publication in the official reports.
[1] The 2007-08 version of Wis. Stat. § 102.12 is the same as the version in effect at the time Werdin was injured in 2003. For ease of reference, all references to the Wisconsin Statutes are to the 2007-08 version unless otherwise noted.
[2]
[3]
Notice of injury, exception, laches. No claim for compensation may be maintained unless, within 30 days after the occurrence of the injury or within 30 days after the employee knew or ought to have known the nature of his or her disability and its relation to the employment, actual notice was received by the employer…. Absence of notice does not bar recovery if it is found that the employer was not misled thereby. Regardless of whether notice was received, if no payment of compensation, other than medical treatment or burial expense, is made, and no application is filed with the department within 2 years from the date of the injury or death, or from the date the employee or his or her dependent knew or ought to have known the nature of the disability and its relation to the employment, the right to compensation therefor is barred, except that the right to compensation is not barred if the employer knew or should have known, within the 2-year period, that the employee had sustained the injury on which the claim is based….
[4] Throughout this case, both
In this case, the parties have not identified the date Werdin’s application was filed. It appears undisputed, however, that the application was not filed until after Werdin told his employer about his January 2003 injury in a telephone conversation and then sent a follow-up letter to his employer; both of those events occurred in June 2005. Thus, the issue in this case is whether Werdin’s communications with his employer occurred within two years of the date Werdin “knew or ought to have known the nature of the disability and its relation to the employment.” See id.
[5] Although ABRA and its insurer were found liable for one-third of the claim, they did not seek review of LIRC’s decision. Indeed, they urged the circuit court to affirm it in its entirety.
At the circuit court,
[6] Because we review LIRC’s decision and not that of the circuit court, we decline to summarize the circuit court’s reasoning. However, we appreciate the circuit court’s careful and detailed analysis of the issues presented.
[7] At
oral argument, LIRC acknowledged that
[8] The
legislative history and case law that
[9] At
oral argument, the parties could not provide this court with references to
cases where LIRC has addressed the issue