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Ramos v. Cobblestone Centre

Ramos v. Cobblestone Centre, 2020 UT 55 (Durrant, C.J.)

Workers’ Compensation

Employee was injured at work when a 300-pound metal trestle fell on him and pinned him. He was awarded permanent partial disability after he developed a consistent limp and had limited ability to participate in physical activities. In support of his award, a medical panel reported to the Administrative Law Judge (ALJ) that his injuries constituted a 1-percent-whole-person impairment rating. The ALJ agreed, over Employee’s objection, and awarded him $1,045.20. The ALJ refused to give Employee’s subjective claim that he was in continued pain more weight than the medical panel report. The Utah Supreme Court affirmed, holding:

  • The Labor Commission’s process for determining permanent partial disability benefits does not violate article VIII of the Utah Constitution. First, medical panels merely assist an ALJ in exercising its adjudicative authority; ALJs retain the power to determine permanent partial disability benefits under the Workers’ Compensation Act, even if they rarely, if ever, choose to reject a medical panel’s report. Second, medical panel recommendations are only one part of the overall process of adjudication of benefits. Third, parties may challenge a medical panel’s report. Using medical panels is not, therefore, an unconstitutional delegation of an ALJ’s authority.
  • The ALJ did not err in failing to consider Employee’s subjective pain and augment the medical panel’s impairment rating by 3 percent. The Utah Guidelines do not allow for consideration of a claimant’s subjective pain under AMA Guidelines. Employee is not entitled to an augmented impairment rating based on his subjective pain.
  • Employee’s claims are not moot merely because he failed to challenge the medical panel’s assigned impairment rating. If Employee’s constitutional argument were meritorious, he would have been entitled to a new hearing. And if the ALJ had erred in failing to consider his claims of subjective pain, he would have merited remand for a new hearing and a new determination.

Read the full court opinion

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