AI Generated Opinion Summaries

This summary was computer-generated without any editorial revision. It is not official, has not been checked for accuracy, and is NOT citable.

Facts

• A worker injured his left knee in April 2010 while employed as a floor sander and refinisher. He sought benefits under the Workers’ Compensation Act, claiming temporary total disability (TTD) and scheduled injury benefits due to the injury's impact on his ability to work and perform daily activities.

Procedural History

• [Not applicable or not found]

Parties' Submissions

• Worker-Appellee: Argued for eligibility for scheduled injury benefits at seventy-five percent and resumption of full TTD benefits, asserting that he was no longer at maximum medical improvement (MMI) due to ongoing treatments.
• Employer/Insurer-Appellant: Contended that the worker voluntarily removed himself from the workforce for unrelated reasons, remained at MMI despite further treatments, and challenged the seventy-five percent partial loss-of-use benefits awarded for the knee injury.

Legal Issues

• Whether the worker voluntarily removed himself from the workforce for reasons unrelated to his knee injury.
• Whether the worker remained at MMI after returning to his regular physician for follow-up treatments.
• Whether the WCJ erred in awarding seventy-five percent partial loss-of-use benefits for the knee injury.

Disposition

• The court affirmed in part and reversed in part the WCJ's order, specifically reversing the decision that the worker was no longer at MMI and affirming the seventy-five percent partial loss-of-use determination, and remanded for proceedings consistent with the opinion.

Reasons

• Per M. Monica Zamora, with Jonathan B. Sutin and Michael E. Vigil concurring, the court found:
  The employer's argument that the worker voluntarily left the workforce was not preserved for appeal due to lack of evidence presented to the WCJ (paras 5-6).
  The worker was deemed to have remained at MMI despite further treatments, as the treatments were for pain management and did not indicate a reasonable probability of further recovery or lasting improvement. The only medical testimony supported that the worker's condition was stable and expected to remain so (paras 7-13).
  The seventy-five percent partial loss-of-use determination for the worker's knee injury was supported by substantial evidence, including medical testimony, physical restrictions, and the impact on the worker's daily life and ability to perform job functions. The court emphasized that loss of use encompasses more than just medical impairment as defined by the AMA guidelines, considering factors such as vocational limitations and pain level (paras 14-20).