Title: Houle v. Ethan Allen, Inc.

State: vermont

Issuer: Vermont Supreme Court

Document:

2011 VT 62













Houle v. Ethan Allen, Inc. (2010-129)
 
2011 VT 62
 
[Filed 14-Jun-2011]
 
ENTRY ORDER
 
2011 VT 62
 
SUPREME COURT
  DOCKET NO. 2010-129
 
FEBRUARY TERM, 2011
 
Robin Houle
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APPEALED FROM:
 
}
 
     v.
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Commissioner of Labor 
 
}
 
Ethan Allen, Inc.
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DOCKET NO. 09-10WC
 
 
 
 
 
 
 
In the above-entitled
cause, the Clerk will enter:
 
¶ 1.            
Employer appeals from the Commissioner of the Department of Labor's
decision that claimant Robin Houle's right shoulder condition was compensable
under the Workers' Compensation Act.  Employer raises numerous
arguments.  We affirm.
¶ 2.            
Following a hearing, the Commissioner found as follows.  Claimant
began working at employer's furniture manufacturing factory in 1997.  She
was initially assigned to the "trim and wax" process, which involved removing
drawers from a finished dresser, sanding and waxing them, installing hardware,
and then returning the drawers to the dresser.  In August 1999, claimant
injured her neck and left shoulder while pulling on a drawer to remove it from
its dresser.  The injury was diagnosed variably as a left elbow, wrist,
and/or shoulder strain; tendonitis; or cervical radiculopathy.  Claimant
reached a medical end result for this injury in December 2000 and received
permanent partial disability benefits in accordance with a 9.5% impairment
referable to her neck.
¶ 3.            
Claimant continued to experience pain and weakness in her left shoulder
and arm, and her job duties were modified to account for her medical
restrictions.  Claimant was assigned to an inventory control/stockroom
clerk position where she engaged in a variety of duties.  Interspersed among
these duties, claimant also wrapped finished shelves to prepare them for
shipping.  Depending on production needs, claimant might wrap as many as
200 to 250 shelves in a day.  Until 2007, claimant performed her duties in
an enclosed area that was well-suited to her needs and took into account her
left shoulder restrictions.  In October 2007, however, claimant was
reassigned to the "trim and wax" process for as long as two hours per
day.  Her work station was also changed, and claimant was moved out onto to
the production floor.  This workspace was more cramped and required
claimant to engage in more turning and reaching to complete tasks. 
Claimant testified that the combination of being reassigned to "trim and wax"
and moving to a new work station caused increased stress to her left shoulder
and required her to use her right arm more to compensate.  
¶ 4.            
In February 2008, claimant was assigned to work on the "sand and seal"
line, which involved repetitive motions with both arms and some overhead
reaching.  Claimant's supervisor assisted her, but even with this
assistance, claimant began to feel burning pain in her neck and shoulders after
thirty minutes.  Claimant remained at this task for approximately ninety
minutes and then returned to her other job duties.  The following day,
claimant reported to a nurse at work that she had significant pain in her neck
and left shoulder and that she needed to seek medical treatment.  Employer
determined that it could no longer accommodate claimant's modified work duty
restrictions and consequently, claimant did not return to work following this
incident.  
¶ 5.            
Claimant was initially treated for the increased symptoms in her
shoulder and neck by Dr. Latham, her primary care provider.  Dr. Latham
referred her to Dr. James, an orthopedist, for further evaluation.  Dr.
James evaluated claimant in May 2008, and he suspected that her left shoulder
complaints were most likely due to her repetitive work for employer.  He
attributed claimant's right shoulder pain to normal wear and tear to be
expected of someone claimant's age.  Claimant was dissatisfied with this
evaluation, and consequently, Dr. Latham referred her to Dr. Chen, an
orthopedic surgeon, for further evaluation and treatment.  
¶ 6.            
Dr. Chen evaluated claimant in July 2008.  The Commissioner found
it notable that, according to Dr. Chen's report, claimant stated that she
injured both of her shoulders in August 1999, not just her left shoulder. 
As to the right shoulder, an August 2008 MRI revealed findings indicative of
degenerative changes and also two rotator cuff tearsan inferior labral tear
and a "bucket handle" tear of the superior labrum from anterior to posterior
(referred to as a SLAP tear).  According to Dr. Chen, the combination of
claimant's repetitive work for employer and her need to compensate for the pain
and weakness in her left shoulder most likely resulted in a "cumulative dose
injury" to her right shoulder.  
¶ 7.            
In reaching his conclusion, Dr. Chen acknowledged that SLAP tears often
result from the natural wear and tear of the aging process.  In his
opinion, however, the tears that claimant appeared to have suffered most
commonly were associated with either trauma or repetitive motion, not simply
aging.  Dr. Chen admitted that he lacked detailed information about the
nature of claimant's job duties, particularly the type, extent, and duration of
any repetitive activities.  He noted, however, that it would be quite
common for a person with a long-standing history of symptoms in one shoulder to
overcompensate and thereby develop problems in the other shoulder as
well.  Dr. Latham concurred in Dr. Chen's analysis, but the Commissioner
discounted Dr. Latham's opinion, finding that he made erroneous assumptions
about the extent to which claimant must have engaged in repetitive heavy
lifting based solely on his own understanding of what goes on in a furniture
manufacturing plant.  
¶ 8.            
Dr. Wieneke, an orthopedic surgeon, and Dr. Johansson, an osteopath,
disagreed with Dr. Chen's analysis.  Dr. Wieneke performed a medical
records review in April 2009; he also reviewed claimant's deposition, from
which he gleaned claimant's specific job duties.  Dr. Johansson conducted
a similar review, and also performed an independent medical evaluation of
claimant in August 2009.  These doctors concluded that claimant's right
shoulder symptoms most likely were the result of degenerative changes in her
joint rather than any rotator cuff tear.  As to the latter, Dr. Wieneke
asserted that even if such tears existed (which in his opinion had not yet been
conclusively determined), the medical literature did not support any causal
association whatsoever between the injury and the light duty repetitive work
that claimant performed for employer.  Dr. Chen testified, in contrast,
that it was well-accepted that certain SLAP tears could be the result of the
aging process, but that more significant SLAP tears, such as that at issue
here, may not be.  
¶ 9.            
In view of the competing expert medical opinions, the Commission relied
on a traditional five-part test to evaluate their persuasiveness.  This
test considers: (1) the nature of treatment and the length of time there has
been a patient-provider relationship; (2) whether the expert examined all
pertinent records; (3) the clarity, thoroughness, and objective support
underlying the opinion; (4) the comprehensiveness of the evaluation; and (5)
the qualifications of the experts, including training and experience.  The
court found both parties' experts deficient in some respects.  Dr. Latham
and Dr. Chen did not attempt to understand the specifics of claimant's job
activities, and thus the Commissioner found their conclusions as to the
repetitive nature of claimant's work and its probable impact on her right
shoulder somewhat suspect.  Employer's experts focused on the light duty
nature of claimant's work, but failed to adequately address the extent to which
claimant still might have overused her right arm to compensate for the deficits
in her left shoulder.  The Commissioner found this to be a close case, but
she was ultimately persuaded by claimant's credible testimony and by Dr. Chen's
status as claimant's treating orthopedic surgeon.  The Commissioner
reasoned that whether the injury resulted directly from claimant's job
activities or from overcompensating for her work-related left shoulder injury,
both events were compensable.  The Commissioner therefore found in favor
of claimant and ordered employer to pay all workers' compensation benefits that
claimant proved were causally related to her compensable right shoulder
injury.  Employer appealed.
¶ 10.        
Because employer appealed directly to this Court, our jurisdiction is
limited to a review of questions of law certified to this Court by the
Commissioner.  21 V.S.A. § 672.  The question certified here was
"[d]id the Commissioner err in concluding that claimant's right shoulder
condition was compensable."  In other words, did the Commissioner
correctly conclude that claimant's injury was incurred "by accident arising out
of and in the course of employment"?  Id. § 618(a)(1) (compensable
injuries under Vermont's Workers' Compensation Act are those received "by
accident arising out of and in the course of employment").  We defer to
the Commissioner's conclusion, and will overrule her decision only if the
"findings have no evidentiary support in the record or where the decision is
based on evidence so slight as to be an irrational basis for the result reached." 
Cehic v. Mack Molding, Inc., 2006 VT 12, ¶ 6, 179 Vt. 602, 895 A.2d 167
(mem.) (quotation and citations omitted).  If "the Commissioner's
conclusions are rationally derived from the findings and based on a correct
interpretation of the law, we will affirm."  Id. (quotation and
citation omitted).* 

¶ 11.        
Employer first challenges the Commissioner's use of the five-part test
to evaluate competing medical opinions, both as applied in this case and in
general.  According to employer, the use of this test improperly shifts
the burden of proof from claimant to employer, unfairly places employers at a
disadvantage, and erroneously employs a "winner take all" approach to
evaluating a claimant's expert testimony.  Claimant did not raise any of
these arguments below, however, and thereby waived them.  See Cehic,
2006 VT 12, ¶ 14 (similarly refusing to consider issue not raised before
Commissioner).  We reject employer's unsupported assertion that it had no
obligation to challenge the use of the test below.  One primary purpose of
our rules on preservation is to give the factfinder "the opportunity to
consider the matter in the first instance."  Id.  No such
opportunity was provided to the Commissioner here.  To the contrary, employer
urged the Commissioner to conclude that its experts were more persuasive under
the five-part test.  Given this, we decline to address employer's
challenge to the test for the first time on appeal.  
¶ 12.        
Assuming the test applies, employer takes issue with the Commissioner's
evaluation of the evidence.  It maintains that claimant failed to prove
that her injury resulted from overuse.  Employer suggests that because the
Commissioner found deficiencies in the analysis of both parties' experts, the
Commissioner was obligated to find in its favor.  Employer also asserts
that the Commissioner erred in crediting Dr. Chen's testimony because he did
not know exactly what claimant's work entailed or what repetitive activities
she engaged in at work or at home.  Absent such knowledge, employer
argues, this claim and all overuse claims must fail.  Employer also faults
the Commissioner for failing to explicitly address several components of the
five-part test cited above, namely, whether claimant's experts had all
pertinent records and whether their evaluations were comprehensive. 
Employer states that there can be "no doubt" that its experts were more
knowledgeable about claimant's activities and medical history than claimant's
experts.  
¶ 13.        
Employer fails to show that the Commissioner's findings are clearly
erroneous or that her conclusions are unsupported by the findings.  As
claimant's treating orthopedic surgeon, Dr. Chen testified to his examination
of claimant.  He understood that claimant had injured her left shoulder in
1999, following which claimant was on limited duty until her workstation was
changed and her job duties were modified to include repetitive motions for up
to two hours per day.  He was aware that she experienced a recurrence of
pain as a result.  Claimant also testified to her job responsibilities and
modified workstation, and the effect that they had on her physical
condition.  As stated above, claimant's MRI indicated a bucket handle tear
in her right shoulder, which was a much more significant tear than typical SLAP
tears.  A bucket handle tear, Dr. Chen explained, was not something that
was simply age-related, but rather, was related to either trauma or repetitive
motion.  Dr. Chen opined that claimant's injury to her right shoulder was
due to over-compensating for the injury to her left shoulder.  He reasoned
that because claimant's left shoulder injury was work-related and her work
duties were subsequently limited due to that injury, and because claimant could
not use the left shoulder but had to rely on the right upper extremity instead,
it followed that claimant's overuse of her right shoulder was directly and
causally related to the prior injury.  
¶ 14.        
The Commissioner found Dr. Chen's opinion persuasive, and she did not
err in doing so.  Dr. Chen's opinion was based on facts, not speculation,
and he offered his opinion to a reasonable degree of medical certainty.  Jackson
v. True Temper Corp., 151 Vt. 592, 595-96, 563 A.2d 621, 622-23 (1989)
(explaining that "[o]pinions must be based on facts disclosed by the evidence
in the case and not in whole or in part upon speculation of the witness as to
what might have been such evidence," and "expert testimony must meet a standard
of reasonable probability or a reasonable degree of medical certainty"
(quotations and citations omitted)).  What employer identifies as
shortcomings in Dr. Chen's opinion go to the weight of the evidence, a matter
exclusively reserved for the factfinder.  See id. at 596, 563 A.2d 
at 623 ("Weaknesses in the basis for the opinion and the precision of the
opinion properly go to the weight to be accorded it by the trier of
facts.").  Dr. Chen did not suggest, moreover, nor did the Commissioner
find, that claimant's injury was the result of a progressive, underlying
degenerative condition, namely, the osteoarthritis in claimant's right
shoulder.  Employer's reliance on Stannard v. Stannard Co. is thus
misplaced.  2003 VT 52, ¶ 11, 175 Vt. 549, 830 A.2d 66 (stating causation
test for progressively degenerative disease such as osteoarthritis).  
¶ 15.        
In reaching her conclusion, the Commissioner reasonably considered
claimant's testimony in conjunction with that provided by Dr. Chennot as a
surrogate for medical evidence on causation, as employer assertsbut rather as
a factual predicate for Dr. Chen's expert medical opinion.  Claimant was
certainly in the best position to describe to the Commissioner her daily work
responsibilities, and the physical effects that she experienced following changes
to her duties and her workstation.  While employer believes its evidence
was more compelling than that presented by claimant, it fails to show that the
Commissioner's decision was based on evidence "so slight as to be an irrational
basis for the result reached."  Cehic, 2006 VT 12, ¶ 6 (quotations
and citation omitted).  We thus find no basis to disturb the
Commissioner's decision.  
¶ 16.        
None of employer's arguments persuade us otherwise.  The fact that
Dr. Chen was not intimately familiar with claimant's work schedule was not
fatal to claimant's case.  As stated above, Dr. Chen knew that claimant's
new job responsibilities at times included up to two hours of repetitive
motions in a given workday.  Additionally, he stated that even if claimant
had only engaged in wiping down furniture on one day for an hour and a half,
such activity could cause her injury.  Employer suggests that Dr. Chen's
opinion was unreliable because he, like Dr. Latham, relied on unfounded
assumptions.  The Commissioner found that Dr. Latham made erroneous
assumptions about the extent to which claimant must have engaged in repetitive
heavy lifting based on solely his own understanding of what goes on in a
furniture manufacturing plant.  This finding is supported by Dr. Latham's
testimony.  Dr. Chen did not base his opinion on any such assumptions, and
the Commissioner was well within her discretion in finding Dr. Chen's testimony
credible while discounting Dr. Latham's testimony.  
¶ 17.        
We similarly reject employer's assertion that simply because the
Commissioner found shortcomings in both parties' expert opinions that claimant
cannot prevail.  It is evident that, despite these shortcomings, the
Commissioner found that Dr. Chen offered a more persuasive opinion on causation
than employerone that was sufficient to establish that claimant's injury was
more probably than not incurred "by accident arising out of and in the course
of employment."  21 V.S.A. § 618(a)(1).  We note that claimant
provided the Commissioner with additional information about her job duties,
which was one of the shortcomings identified by the Commissioner in Dr. Chen's
testimony.  
¶ 18.        
Finally, we reject employer's assertion that the Commissioner erred by
not explicitly making findings on all of the factors in the five-part test
cited above.  There appears to be no legal requirement that the
Commissioner make findings on all five factors.  Nor is this case like McNally
v. Department of PATH, cited by employer, where the Commissioner "failed to
make any findings with regard to the evidence presented by the medical
experts."  2010 VT 99, ¶ 8, ___ Vt. ___, 13 A.3d 656.  In any
event, it is implicit in the Commissioner's decision that she found claimant's
expert had considered all pertinent records and that he had done a sufficiently
comprehensive evaluation to support a judgment in claimant's favor.  See Moody
v. Humphrey & Harding, Inc., 127 Vt. 52, 54, 238 A.2d 646, 647-48
(1968) (our review of the Commissioner's factual findings is limited to the
issue of law relating to the sufficiency of the evidence to support the
findings, and "we must test the sufficiency of the facts from a point of view
favorable to the award, if this can reasonably be done").  Essentially,
employer challenges the Commissioner's assessment of the weight of the
evidence.  As we stated in Cehic, "it is not our role to weigh the
evidence in the record."  2006 VT 12, ¶ 12; see also Coburn v. Frank
Dodge & Sons, 165 Vt. 529, 533, 687 A.2d 465, 468 (1996) ("[T]he weight
of the evidence is not reviewable by this Court on appeal.").  If employer
believed that the weight of the evidence preponderated in its favor, it could
have sought a new trial on the facts in the superior court.  It declined
to do so.  This Court is "bound by the Commissioner's findings so long as
they are supported by the evidence," Cehic, 2006 VT 12, ¶ 6, and
the findings are supported by the evidence here.  We have considered all
of employer's arguments, and we find no error.  
           
Affirmed.
 
BY THE COURT:
 
 
 
 
 
 
 
Paul L. Reiber, Chief
  Justice
 
 
  
 
 
John A. Dooley, Associate
  Justice
  
 
 
 
 
Denise R. Johnson,
  Associate Justice
 
 
 
 
 
Marilyn S. Skoglund, Associate
  Justice
 
 
 
 
 
Brian L. Burgess, Associate
  Justice
 
 
 

*  Claimant argues that we lack
jurisdiction to consider this appeal because it does not involve a question of
law as required by 21 V.S.A. § 672.  Certainly, the statutory provisions
governing appeals from the Commissioner's decision are not models of clarity,
and there is much room for confusion and seemingly overlapping jurisdiction between
this Court and the superior court.  See, e.g., Stoll v. Burlington
Elec. Dep't, 2009 VT 61, 186 Vt. 127, 977 A.2d 1282.  Nonetheless, we
conclude that jurisdiction is present here.  As set forth above, our
review of the facts is highly limited and "confined to the issue of law
relating to the sufficiency of the evidence to support the factual
findings."  Peabody v. Jones & Lamson Mach. Co., 122 Vt. 431,
433, 176 A.2d 759, 761 (1961).  We evaluate any "factual" challenges
advanced by employer under this deferential standard.