Title: Flug v. Labor & Industry Review Commission

State: wisconsin

Issuer: Wisconsin Supreme Court

Document:

2017 WI 72 
 
SUPREME COURT OF WISCONSIN 
 
 
 
 
 
CASE NO.: 
2015AP1989 
COMPLETE TITLE: 
Tracie L. Flug, 
          Plaintiff-Appellant, 
     v. 
Labor and Industry Review Commission, Wal-Mart 
Associates, Inc. and New Hampshire Insurance 
Company c/o Claims Management, Inc., 
          Defendants-Respondents-Petitioners. 
 
 
 
REVIEW OF A DECISION OF THE COURT OF APPEALS 
Reported at 370 Wis. 2d 789, 882 N.W.2d 872 
(2016 – Unpublished) 
 
 
OPINION FILED: 
June 30, 2017 
SUBMITTED ON BRIEFS: 
        
ORAL ARGUMENT: 
March 15, 2017 
 
 
SOURCE OF APPEAL: 
 
 
COURT: 
Circuit 
 
COUNTY: 
Chippewa 
 
JUDGE: 
James M. Isaacson 
 
 
 
JUSTICES: 
 
 
CONCURRED: 
      
 
DISSENTED: 
ROGGENSACK, C.J. dissents (opinion filed).   
A.W. BRADLEY, J. dissents, joined by ABRAHAMSON, 
J. (opinion filed). 
 
NOT PARTICIPATING:          
 
 
 
ATTORNEYS: 
 
For the defendants-respondents-petitioners   Labor and 
Industry Review Commission, there were briefs filed by Jennifer 
L. Vandermeuse, assistant attorney general, and Brad D. Schimel, 
attorney general.  Oral argument by Jennifer l. Vandermeuse. 
 
For 
the 
defendants-respondents-petitioners 
Wal-Mart 
Associates, Inc. and New Hampshire Insurance Company c/o Claims 
Management, Inc., there were briefs filed by Ryan J. Steffes and 
Weld Riley, S.C., Eau Claire.  Oral argument by Ryan J. Steffes. 
 
 
 
2 
For the plaintiff-appellant, there was a brief and oral 
argument by Jeffrey J. Klemp and Law Offices of Jeffrey Klemp, 
Eau Claire. 
 
 
 
 
 
 
2017 WI 72
NOTICE 
This opinion is subject to further 
editing and modification.  The final 
version will appear in the bound 
volume of the official reports.   
No.  2015AP1989 
(L.C. No. 
2015CV98) 
STATE OF WISCONSIN  
 
 
   : 
IN SUPREME COURT 
 
 
Tracie L. Flug, 
 
          Plaintiff-Appellant, 
 
     v. 
 
Labor and Industry Review Commission, Wal-Mart 
Associates, Inc. and New Hampshire Insurance 
Company c/o Claims Management, Inc., 
 
          Defendants-Respondents-Petitioners. 
 
 
 
FILED 
 
JUN 30, 2017 
 
Diane M. Fremgen 
Clerk of Supreme Court 
 
 
 
 
REVIEW of a decision of the Court of Appeals.  Reversed. 
 
¶1 
DANIEL KELLY, J.   Tracie L. Flug suffered from two 
medical conditions——a soft-tissue strain, and a degenerative 
disc disease.  The first was work-related (and has since 
resolved), the second is not.  She underwent surgery in the 
belief it was necessary to treat her work-related soft-tissue 
strain. 
 
In 
actuality, 
it 
was 
treating 
the 
unrelated 
degenerative disc disease.  The procedure left her with a 
permanent partial disability.  Ms. Flug tells us Wal-Mart (her 
employer) must compensate her for this permanent partial 
No.  2015AP1989 
 
 
 
2 
disability because she believed, in good-faith, that the 
disability-causing surgery was necessary to treat her work-
related condition.  We review the decision of the Labor and 
Industry Review Commission (the "Commission") denying Ms. Flug's 
claim for permanent partial disability benefits. 
I. 
BACKGROUND 
A. 
Ms. Flug's Injury and Surgery 
¶2 
Ms. Flug worked as a store supervisor at the Chippewa 
Falls Wal-Mart.  In February of 2013 she was using a 25-ounce 
price scanner in the store's shoe department.  After scanning an 
item above her head, she felt pain in her neck and right arm as 
she lowered the scanner.  Ms. Flug sought medical treatment from 
Dr. Sabina Morissette.  Dr. Morissette diagnosed Ms. Flug with a 
"right arm and shoulder strain with possible relation to the 
cervical spine itself." 
¶3 
Ms. Flug was referred to Dr. Andrew Floren, an 
occupational 
medicine 
specialist, 
with 
whom 
she 
met 
the 
following month.  Dr. Floren's notes state that on the date of 
her injury Ms. Flug "developed a severe sudden pain in her right 
upper back area.  This pain went down the posterior shoulder and 
arm to the wrists."  At the time of the visit, Ms. Flug stated 
that her symptoms were "slowly resolving," but that she had an 
"aching burning pain in her upper back" that "radiat[ed] into 
the posterior right shoulder and down the arm just a bit."  Dr. 
Floren also noted that a cervical spine x-ray showed "mild 
degenerative changes," but he drew no connection between that 
condition and her work injury.  He concluded that Ms. Flug had 
No.  2015AP1989 
 
 
 
3 
right upper back and shoulder pain with no sign of cervical 
involvement. 
¶4 
Ms. Flug's condition improved in some ways over the 
next few months, but not in others, so Dr. Floren referred her 
to Dr. Eduardo Perez, a neurosurgeon.  Dr. Perez recommended an 
anterior cervical discectomy with fusion/fixation at the C5-C6 
and C6-C7 levels.  Ms. Flug had the surgery on June 4, 2013.  A 
month later, she met with Dr. Perez and reported that she was 
"doing excellent" and was feeling "almost 100 [percent]."  Dr. 
Floren released Ms. Flug back to work on July 17, 2013, with a 
lifting restriction that was eventually eliminated.  Dr. Floren 
declared that Ms. Flug reached a healing plateau by November of 
2013, and assessed her (at that time) as having a limited 
permanent partial disability. 
B. 
Ms. Flug's Application for Benefits 
¶5 
Wal-Mart agreed that Ms. Flug had suffered a work-
related injury, and its worker's compensation insurance carrier 
paid medical expenses up to May 9, 2013, and disability benefits 
up to June 22, 2013.  But because the insurance carrier did not 
agree the degenerative disc disease was attributable to Ms. 
Flug's work injury, it refused further compensation for medical 
expenses or disability benefits. 
¶6 
Ms. Flug filed her worker's compensation claim with 
the Wisconsin Department of Workforce Development on August 16, 
2013.  She sought compensation from Wal-Mart for continuing 
medical 
expenses, 
additional 
temporary 
disability 
benefits 
No.  2015AP1989 
 
 
 
4 
through August 8, 2013, as well as benefits for a 20 percent 
permanent partial disability consequent to her back surgery. 
¶7 
Wal-Mart asked Dr. Morris Soriano to perform an 
Independent Medical Examination (IME) of Ms. Flug's injury.  In 
a report submitted in February of 2014, Dr. Soriano said that 
Ms. Flug's records contained evidence of two unrelated medical 
issues.  He diagnosed Ms. Flug's condition as a "post cervical 
strain" 
(the 
work-related 
injury), 
and 
"preexisting 
mild 
degenerative disc disease C6-7 and C5-6." 
¶8 
Dr. Soriano opined that the only injury Ms. Flug 
suffered from the February 14, 2013, work-related incident was a 
"soft tissue cervical and shoulder strain."  He said this 
condition "reached an end of healing within a four to six-week 
period," long before Ms. Flug underwent her back surgery.  
Because that was a reasonable amount of time within which to 
recover from such a strain, Dr. Soriano said it would be proper 
to conclude that Ms. Flug suffered temporary disability during 
that period. 
¶9 
The disc degeneration, however, was an entirely 
different matter.  Dr. Soriano said this was a pre-existing 
condition and there was never any anatomical or medical 
relationship between it and Ms. Flug's soft-tissue strain.  In 
fact, he said "[i]t is not probable or even possible that the 
accident of February 14, 2013, [caused Ms. Flug's] disc 
degeneration."  Considering the nature of the work Ms. Flug was 
performing at the time of her injury, Dr. Soriano also said 
"[i]t is not probable or even possible that reaching up with a 
No.  2015AP1989 
 
 
 
5 
25-ounce scanner over a period of time" could have "cause[d] any 
disability by precipitating, aggravating or accelerating the 
preexisting condition."  He also noted that Dr. Floren had 
offered no objective evidence of any cervical disability related 
to the accident.  He concluded, therefore, that the surgery was 
not "reasonable, necessary or related" to Ms. Flug's work 
injury. 
C. 
Review of Ms. Flug's Claim 
¶10 On April 1, 2014, an Administrative Law Judge held a 
hearing on Ms. Flug's claims.  Dr. Floren submitted a report and 
addendum stating that although Ms. Flug's work activities had 
not caused her degenerative condition, it was "medically 
probable" that they precipitated, aggravated, or accelerated 
that preexisting condition beyond its normal progression.  Dr. 
Floren found the surgery and all medical treatment received 
since February 14, 2013, reasonable and necessary to treat the 
consequences of Ms. Flug's work-related injury. 
¶11 Dr. Soriano also submitted a report.  He said Ms. Flug 
suffered from "multilevel moderate degenerative disc disease," 
though the condition wasn't aggravated or exacerbated by her 
work activity on the date of injury.  While Dr. Soriano said 
that Ms. Flug's medical treatment prior to June 4, 2013 was 
reasonable and necessary to treat her soft-tissue strain, the 
surgery performed was "unrelated to the work incident or work 
exposure."  Dr. Soriano also said "[i]t is not physically 
possible that scanning a product on a shelf could have 
aggravated or worsened two levels of a previously arthritic 
No.  2015AP1989 
 
 
 
6 
condition at C5-C6 and C6-C7 to the point where it became 
symptomatic," 
and 
that 
the 
surgery 
"clearly 
ha[d] 
no 
relationship 
to 
any 
documentable, 
repetitive, 
objective 
neurological findings." 
¶12 The ALJ1 acknowledged that Ms. Flug suffered an injury 
at work, but said there was a "legitimate doubt as to the 
compensability of the claim as a traumatic injury beyond that 
already conceded and paid by [Wal-Mart]."  Because the ALJ 
concluded Ms. Flug had already received all compensation due to 
her prior to the surgery, he dismissed the claim.  Ms. Flug 
appealed the ALJ's determination, following which the Commission 
adopted the ALJ's factual findings and order as its own.  The 
Commission affirmed the ALJ's decision stating specifically that 
Ms. Flug was not entitled to permanent partial disability 
benefits because the ALJ had expressed a "legitimate doubt as to 
whether [Ms. Flug] suffered any work injury." 
¶13 Ms. Flug sought review of the Commission's decision in 
the Chippewa County circuit court.  There, the Commission 
recognized and admitted it had mistakenly concluded the ALJ had 
found no work injury at all.  It argued the court should 
nonetheless affirm the Commission's decision because Ms. Flug's 
surgery was unrelated to her compensable injury.  The circuit 
court2 assumed the existence of Ms. Flug's workplace injury, but 
                                                 
1 Roy L. Sass, presiding. 
2 The Honorable James M. Isaacson, presiding. 
No.  2015AP1989 
 
 
 
7 
concluded the Commission/ALJ had a sufficient factual basis to 
deny the claim for benefits, and so affirmed.  Ms. Flug 
appealed. 
¶14 In an unpublished opinion, the court of appeals 
reversed the circuit court.3  Its analysis focused on whether the 
disability-creating treatment must be undertaken to treat a 
compensable injury to qualify the employee for benefits.  Based 
on its reading of Wis. Stat. § 102.42(1m) (2013-14),4 the court 
of appeals concluded no such relationship between injury and 
treatment was required.  Instead, it said the employee only need 
have a good faith belief that the treatment was so related.  The 
court remanded the matter to the Commission to inquire into Ms. 
Flug's beliefs. 
¶15 The Commission's timely petition for review presented 
this single issue:  "Does Wis. Stat. § 102.42(1m) make an 
employer 
liable 
for 
disability 
resulting 
from 
invasive 
treatment, when the claimant has not established that the 
treatment in fact treated a compensable work injury?"  We 
granted the petition, and now affirm the Commission's order 
dismissing Ms. Flug's claim for disability benefits. 
                                                 
3 Flug v. LIRC, No. 2015AP1989, unpublished slip. op. (Wis. 
Ct. App. June 21, 2016). 
4 All subsequent references to the Wisconsin Statutes are to 
the 2013-14 version unless otherwise indicated. 
No.  2015AP1989 
 
 
 
8 
II. STANDARD OF REVIEW 
¶16 In cases involving administrative agencies we review 
the decision of the agency.  Estate of Szleszinski v. LIRC, 2007 
WI 106, ¶22, 304 Wis. 2d 258, 736 N.W.2d 111. The court has, at 
times, deferred to an agency's interpretation of a statute.  
Harnischfeger Corp. v. LIRC, 196 Wis. 2d 650, 659, 539 N.W.2d 98 
(1995).  But we need not address the issue of deference here 
because, based on its mistaken belief that Ms. Flug had suffered 
no compensable injury at all, the Commission did not answer the 
question presented for our review. Thus, as is our tradition 
with questions of law, we review the meaning of Wis. Stat. 
§ 102.42(1m) de novo.5 
¶17 The Commission's findings of fact, however, are 
normally beyond question:  "The findings of fact made by the 
commission acting within its powers shall, in the absence of 
fraud, be conclusive."  Wis. Stat. § 102.23(1)(a)1.  Ms. Flug 
does not challenge the Commission's findings of fact here, so we 
accept them as presented by the Commission. 
                                                 
5 Because we affirm the Commission's decision, the question 
of deference is immaterial to the outcome of the case. 
No.  2015AP1989 
 
 
 
9 
III. ANALYSIS 
¶18 Whether Ms. Flug is entitled to compensation depends 
on how Wis. Stat. § 102.42(1m) applies to her pre-existing 
medical condition, her compensable injury, her treatment, and 
her resulting disability.  The statute provides the following: 
Liability for unnecessary treatment. If an employee 
who has sustained a compensable injury undertakes in 
good faith invasive treatment that is generally 
medically acceptable, but that is unnecessary, the 
employer shall pay disability indemnity for all 
disability incurred as a result of that treatment. 
Wis. Stat. § 102.42(1m).  The parties agree Ms. Flug sustained a 
compensable injury while working for Wal-Mart, she subsequently 
underwent an invasive treatment, and she suffered a permanent 
partial disability as a direct result of the treatment.  They 
disagree on what it means for a treatment to be "generally 
medically acceptable, but . . . unnecessary." 
A. 
The Terms of the Argument 
¶19 The 
disagreement 
centers 
on 
the 
necessary 
relationship, or lack thereof, between the treatment and the 
employee's compensable injury.  The Commission says an invasive 
treatment is "unnecessary" within the meaning of this statute if 
its purpose is to treat the compensable injury, but it fails to 
cure the injury, or relieve its effects.  If an employee 
undergoes such a treatment in good faith, the Commission says, 
this statute makes the employer liable for benefits when the 
treatment causes a disability.  The court of appeals, on the 
other hand, concluded it does not matter whether the invasive 
procedure was actually directed at a compensable injury, so long 
No.  2015AP1989 
 
 
 
10 
as the employee had a good faith belief that it was.  Flug, No. 
2015AP1989, ¶32 ("[W]e conclude that, to establish good faith 
under Wis. Stat. § 102.42(1m), an employee must show that he or 
she 
reasonably 
believed 
the 
proposed 
treatment 
was 
both 
necessary and the result of a compensable injury.").  Thus, the 
court of appeals held that this statute can make an employer 
liable for benefits even when the injury and its treatment had 
nothing to do with the workplace. 
¶20 Contrary to what one might expect, Ms. Flug's argument 
neither 
directly 
refutes 
the 
Commission's 
position, 
nor 
champions the court of appeals' analysis.6  Whereas both the 
Commission and the court of appeals base their competing 
analyses on the shared understanding that Ms. Flug's surgery had 
nothing to do with her compensable injury, Ms. Flug does not.7  
Instead, she characterizes her dispute with the Commission as a 
disagreement over the extent of benefits available for the 
                                                 
6 The extent of Ms. Flug's assessment of the court of 
appeals' reasoning was to misinterpret it as rejecting a 
requirement that the invasive procedure "was actually necessary 
to treat her work injury."  That is not what the court of 
appeals said.  What it said was that there need be no 
relationship between the disability-causing treatment and a 
compensable injury:  "By arguing that an employee must show his 
or her treatment was the result of a compensable injury, the 
Commission reads an additional causation requirement into the 
statute."  Flug, No. 2015AP1989, ¶30. 
7 To the extent this sentence refers to the Commission, it 
is a characterization of its argument here——Justice Ann Walsh 
Bradley misunderstands it as referring to the Commission's 
decision under review.  See Justice Ann Walsh Bradley's dissent, 
¶129. 
No.  2015AP1989 
 
 
 
11 
treatment of a compensable injury:  "The key to the statute is 
whether the injured employee undergoes surgery for a compensable 
injury in good faith——here, reasonably believing, based on her 
doctors' advice, that it was necessary to cure and relieve Flug 
from the continuing symptoms that began with her work injury."  
She says the relevant medical testimony establishes that "[t]he 
surgery, 
undertaken 
for 
the 
injury, 
was 
'reasonable 
and 
necessary to cure and relieve' [her] from the effects of 
cervical disability which began at work." 
¶21 Out of the several cases Ms. Flug addressed in her 
argument, there are two that provide particularly helpful 
insight on the nature of her argument.  The first is Spencer v. 
LIRC, 55 Wis. 2d 525, 200 N.W.2d 611 (1972).  Indeed, Ms. Flug 
dedicated the bulk of her argument to the proposition that Wis. 
Stat. § 102.42(1m) is, in the main, a codification of Spencer, 
and that we can resolve this case by reprising that analysis 
here.8  Spencer, as Ms. Flug acknowledges, concerned an 
employer's liability for the harmful side-effects of a procedure 
that unquestionably treated a compensable injury.  There, we 
said "[t]he employer is responsible for the consequences not 
only of the injury, but the treatment" and we observed the 
                                                 
8 Ms. Flug introduced her argument with the assertion that 
"[t]he holding in Spencer is the central focus of this case."  
She said Wis. Stat. § 102.42(1m) is significant only in that it 
limited Spencer to circumstances in which the disability-causing 
treatment is invasive (whereas Spencer required payment of 
benefits even when the procedure was non-invasive). 
No.  2015AP1989 
 
 
 
12 
employer was liable because Mr. Spencer "now has a stiff knee 
resulting from the original injury."  Id. at 532.9  Ms. Flug says 
§ 102.42(1m) maintains this understanding, and that "[e]mployers 
remain liable for the good faith treatment an injured employee 
receives for a compensable injury." 
¶22 The second case providing insight on Ms. Flug's 
argument is City of Wauwatosa v. LIRC, 110 Wis. 2d 298, 328 
N.W.2d 882 (Ct. App. 1982).  Her treatment of this case confirms 
that she believes her dispute with the Commission is about the 
extent of available benefits consequent upon treatment of a 
compensable injury, not about whether benefits are available 
when there is no relationship between the disability-causing 
treatment and her compensable injury.  The City of Wauwatosa 
court denied benefits because there was no connection between 
the employee's treatment and his compensable injury.  The court 
concluded that "the Spencer rationale applies only to cases 
involving treatment for an undisputed compensable industrial 
injury."  Id. at 301.  In a particularly revealing passage in 
Ms. Flug's brief, she said this case "is not helpful in our 
                                                 
9 There was an obvious, and direct, line of causation that 
started with the workplace injury and ended with the stiff knee.  
The "treatment" to which we referred in the Spencer v. LIRC, 55 
Wis. 2d 525, 200 N.W.2d 611 (1972), quote was not just any 
treatment, it was treatment of the compensable injury.  And it 
was the treatment of the compensable injury that ended in a 
stiff knee.  This relationship is as important to our analysis 
of Wis. Stat. § 102.42(1m) as it was in Spencer. 
No.  2015AP1989 
 
 
 
13 
analysis because it doesn't address the extent of treatment 
undertaken, in good faith, for a compensable injury." 
¶23 Thus, Ms. Flug's argument assumes her surgery was, in 
fact, 
"for" 
the 
compensable 
injury, 
and 
that 
the 
real 
controversy is over how much treatment was necessary to relieve 
her of the symptoms caused by that injury.10  Ms. Flug's 
assumption, however, is not warranted.  The ALJ and the 
Commission found——as a factual matter——that the surgery didn't 
treat Ms. Flug's compensable injury.11  Thus, because the 
Commission eliminated the factual predicate for Ms. Flug's 
argument, we would not be able to engage it unless we first 
rejected the Commission's findings on this point.  Ms. Flug does 
not assert the findings of fact are the result of fraud, or that 
the Commission acted outside of its powers, so the findings are 
                                                 
10 This is a continuation of the argument Ms. Flug made in 
the court of appeals, where she unequivocally stated she 
"sustained a compensable injury and . . . underwent surgery for 
a compensable injury."  Ms. Flug maintained this position even 
through oral argument here.  Her counsel was asked to 
acknowledge 
the 
surgery 
was 
not 
necessary 
to 
treat 
her 
compensable injury, but he elected not to concede the point. 
11 Although Ms. Flug's "good faith" belief about the 
necessity of the back surgery is important, as we discuss below, 
it cannot change the objective fact that the treatment had 
nothing to do with her compensable injury. 
No.  2015AP1989 
 
 
 
14 
conclusive.12  And that puts Ms. Flug's argument beyond our 
reach.  
¶24 Justice Ann Walsh Bradley experienced some difficulty 
with this.  She says there is a "procedural morass" in this case 
that stymies her ability to assess the ALJ and Commission's 
factual findings.  Justice Ann Walsh Bradley's dissent, ¶¶107-
10.  The relevant facts, however, are just not that complicated.  
For purposes of this analysis, we must know whether the ALJ and 
the Commission believed the surgery addressed Ms. Flug's 
compensable injury, or instead her pre-existing condition.  The 
ALJ found no injury beyond that for which Wal-Mart had already 
                                                 
12 Justice Ann Walsh Bradley says Ms. Flug did challenge the 
findings of fact here.  Although Ms. Flug may have done so 
before the circuit court and court of appeals, she did no such 
thing here.  Justice Bradley finds a factual challenge in Ms. 
Flug's argument that she acted in good faith in obtaining the 
surgery.  See Justice Ann Walsh Bradley's dissent, ¶123.  But 
that was Ms. Flug's argument about the law; it was not a 
challenge to the Commission's findings of fact.  Ms. Flug based 
her argument on the assumption that the surgery treated her 
compensable injury.  An assumption, however, is neither an 
argument nor a challenge.  A challenge to the Commission's 
factual findings would involve marshalling the facts supporting 
her argument, juxtaposing them against the facts supporting the 
Commission/ALJ's findings, and then demonstrating the credible 
and substantial evidence does not support the Commission's 
decision.  That effort is wholly absent from Ms. Flug's argument 
here.  
So Justice Bradley bobbles twice.  First, she confounds 
legal and factual challenges.  And second, she promotes 
assumptions to arguments.  We will neither distort nor re-write 
Ms. Flug's brief to make it say something it clearly does not. 
 
No.  2015AP1989 
 
 
 
15 
compensated Ms. Flug.  He said there was "a legitimate doubt as 
to the compensability of the claim as a traumatic injury beyond 
that already conceded and paid by the respondents."  Flug v. 
Wal-Mart Assocs. Inc., No.2013-006010, at 4 (LIRC Apr. 30, 2014) 
(Sass, ALJ).  The ALJ also rejected the argument that her 
workplace activity caused the injury the surgery treated.  Id. 
("While Dr. Floren also reported the appreciable workplace 
exposure was causative, this was not developed at hearing 
particularly 
given 
the 
inconsistency 
in 
history 
of 
injury . . . .").  There were only two medical conditions at 
issue, and if the workplace activity did not cause the injury 
the surgery treated, then by process of elimination we can 
confidently conclude that the surgery treated Ms. Flug's pre-
existing 
condition. 
 
This 
is 
also 
the 
Commission's 
determination:  "Based on its review, the commission agrees with 
the decision of the ALJ, and it adopts the findings and order in 
that decision as its own."  Flug v. Wal-Mart Assocs., Inc., WDC 
No. 201300610 (LIRC Feb. 23, 2015).  If there is a procedural 
morass here, it's not bad enough to keep us from doing our 
duty.13 
                                                 
13 Justice Ann Walsh Bradley also accuses us of getting the 
facts wrong.  See Justice Ann Walsh Bradley's dissent, ¶¶125-30.  
She disagrees, in particular, with our statement that Ms. Flug 
believed the surgery was treating her soft-tissue strain.  She 
bases this assertion, apparently, on an argument she created for 
Ms. Flug ex nihilo——that the work injury exacerbated her pre-
existing condition beyond its normal progression, and that the 
surgery was necessary to treat that exacerbated condition.  
Maybe Ms. Flug's counsel should have adopted Justice Bradley's 
litigation strategy.  But he didn't——perhaps because the ALJ and 
(continued) 
No.  2015AP1989 
 
 
 
16 
B. 
What it Means to be "Unnecessary" 
¶25 Still, we must determine what it means for a treatment 
to 
be 
"unnecessary" 
within 
the 
meaning 
of 
Wis. 
Stat. 
§ 102.42(1m) so that we can determine whether the Commission 
properly denied Ms. Flug's application for benefits.14  We begin 
with the statutory language.  State ex rel. Kalal v. Cir. Ct. 
for Dane Cty., 2004 WI 58, ¶45, 271 Wis. 2d 633, 681 N.W.2d 110 
("[S]tatutory interpretation 'begins with the language of the 
statute.  If the meaning of the statute is plain, we ordinarily 
stop the inquiry.'" (quoting Seider v. O'Connell, 2000 WI 76, 
¶43, 236 Wis. 2d 211, 232, 612 N.W.2d 659)).  We understand the 
language "in the context in which it is used; not in isolation 
but as part of a whole; in relation to the language of 
surrounding or closely-related statutes; and reasonably, to 
avoid absurd or unreasonable results."  Id., ¶46.  When this 
process produces a plain, clear meaning, we go no further.  Id. 
¶26 The statute we are considering is part of Wisconsin's 
comprehensive Worker's Compensation program.  This is "a 
legislatively enacted compromise designed to bring employers and 
employees 
together 
in 
a 
mutually 
beneficial 
scheme 
of 
                                                                                                                                                             
Commission 
had 
already 
determined 
there 
was 
insufficient 
evidence to conclude this had occurred, and he had chosen not to 
challenge the factual findings before this court. 
14 Although we are reviewing the Commission's decision, not 
that of the court of appeals, we refer to the court of appeal's 
reasoning to assist us in determining the proper interpretation 
of this statute. 
No.  2015AP1989 
 
 
 
17 
guaranteeing benefits in the event of work-related injury [or] 
disease."  Nelson v. Rothering, 174 Wis. 2d 296, 302, 496 
N.W.2d 87 (1993).  It "provides a broadly applicable method for 
compensating persons who suffer work-related physical and mental 
injuries."  Byers v. LIRC, 208 Wis. 2d 388, 395, 561 N.W.2d 678 
(1997).  By relieving employers from tort liability, the 
Worker's Compensation program "mak[es] employers strictly liable 
for injuries encompassed within the Act, but limit[s] the 
liability to compensation established by the statute."  Id.  
These limits are important because the program is not supposed 
to be "a blanket insurance policy to provide benefits for 
disabilities which may become manifest while on the job but are 
in no way caused by or related to the employment."  Lewellyn v. 
Indus. Comm'n, 38 Wis. 2d 43, 61, 155 N.W.2d 678 (1968).  It 
serves an important, but limited, purpose:  "It was never 
intended to make the Workmen's Compensation Law an accident 
insurance or health insurance measure."  Id. (quoting Newman v. 
Indus. Comm'n, 203 Wis. 358, 360, 234 N.W. 495 (1931)). 
¶27 Compensation under the Worker's Compensation program 
is available only when the employee satisfies the statutorily-
defined eligibility requirements.  Broadly speaking, an employee 
is eligible for compensation under this program if he sustains 
an injury that arises out of his employment. See Wis. Stat. 
§ 102.03(1).  Upon the occurrence of such an injury, the 
employer is responsible for supplying "such medical, surgical, 
chiropractic, psychological, podiatric, dental, and hospital 
treatment . . . as may be reasonably required to cure and 
No.  2015AP1989 
 
 
 
18 
relieve from the effects of the injury . . . ."  Wis. Stat. 
§ 102.42(1).  An employer must also pay the employee benefits 
"if the injury causes disability."  Wis. Stat. § 102.43.  Thus, 
in the general scheme of the program, medical expenses and 
disability benefits are payable only when they are attributable 
to a qualifying injury. 
¶28 This context informs our inquiry into the meaning of 
Wis. Stat. § 102.42(1m), the nucleus of which says that "[i]f an 
employee who has sustained a compensable injury undertakes in 
good faith invasive treatment that is generally medically 
acceptable, but that is unnecessary, the employer shall pay 
disability indemnity for all disability incurred as a result of 
that treatment."  As we described above, we must discern the 
statutory 
relationship 
between 
Ms. 
Flug's 
pre-existing 
condition, her work-related injury, her surgery, and her partial 
permanent disability. 
¶29 There are two logical ways of reading a statutory 
provision like Wis. Stat. § 102.42(1m).  One can read it as a 
sentence (as it was written), paying attention to rules of 
grammar, syntax, and diction to tease out its meaning.  Or one 
might dice it up into its constituent parts and treat each 
resulting element as an independent requirement that neither 
qualifies nor is qualified by the others.  The court of appeals 
favored the second approach.  It said Ms. Flug is entitled to 
disability benefits if she meets five distinct elements, which 
it defined as follows: 
No.  2015AP1989 
 
 
 
19 
(1) the employee sustained a compensable injury;  
(2) he or she undertook invasive medical treatment;  
(3) the treatment was undertaken in good faith;  
(4) the treatment was generally medically acceptable, 
but unnecessary; and  
(5) the employee incurred a disability as a result of 
the treatment. 
Flug, No. 2015AP1989, ¶30.  This, of course, is not what the 
legislature wrote.  It is simply how the court of appeals chose 
to frame its analysis.  While this is a legitimate method of 
approaching statutory language, it does present peculiar risks.  
When translating a sentence into discrete elements, it is easy 
to lose critical information by neglecting to propagate the 
proper relationship between the parts of the sentence into the 
list.  And that is what happened here. 
¶30 Careful examination of the elements above reveal that 
the court of appeals maintained the relationship between the 
"treatment" and other parts of the sentence in elements three 
through five.  But in the first two elements, the court of 
appeals set up "compensable injury" and "treatment" as having 
nothing to do with each other.  This relegated the "compensable 
injury" 
provision 
to 
a 
mere 
gatekeeper 
role 
that, 
once 
satisfied, could be ignored for the balance of the analysis.  
Consequently, the court of appeals' translation was outcome-
determinative.15  That is to say, the court inadvertently baked 
the outcome into the structure it created for the analysis——it 
assumed there need be no relationship between the compensable 
                                                 
15 As is Chief Justice Roggensack's dissent.  Chief Justice 
Roggensack's dissent, ¶87. 
No.  2015AP1989 
 
 
 
20 
injury and the treatment.  So when the Commission asserted a 
necessary link between the two, the court of appeals criticized 
the argument as "read[ing] an additional causation requirement 
into the statute."  It did not say why the Commission's posited 
relationship between the treatment and the compensable injury 
was inapposite, as a textual matter, other than by referring to 
how it had diced the statutory language.  It is true that the 
Commission's asserted relationship finds no reflection in the 
court of appeals' analytical construct, but that is a fault only 
if the court of appeals accurately translated the statute into a 
list of elements.  That is the question we must now answer. 
¶31 Instead of separating the statute into separate 
elements, we will analyze the sentence as written, using our 
standard toolbox to help us derive its meaning.  The court of 
appeals properly recognized the centrality of "treatment" to the 
meaning of the statute——the term appears in four of the five 
elements it culled from the statutory language.  So some 
attention to the dictional provenance of this term will help us 
determine its proper place and function in the statute.  
"Treatment" is the nominal form of the verb "to treat."  
"Treat," of course, is a transitive verb, which means it 
requires a direct object on which to act.  That is, one does not 
simply "treat," one treats something——a person, a condition, a 
disease, etc.  Nominalizing the verb doesn't remove its 
transitive property:  "Treatment" is the "[a]dministration or 
No.  2015AP1989 
 
 
 
21 
application of remedies to a patient or for a disease or an 
injury; medicinal or surgical management; therapy."16  Regardless 
of whether the word takes its nominal or verbal form, it must 
still be understood as operating on something. 
¶32 With that understanding of this central term, we can 
now let the rules of grammar direct our understanding of Wis. 
Stat. § 102.42(1m).  Our first goal is discovering the objective 
of the "treatment."  We begin with the part of the statute that 
says "[i]f an employee who has sustained a compensable injury 
undertakes . . . invasive 
treatment . . . ." 
 
Without 
considering more of the statute, "treatment" could operate on 
one of two possible objects——the employee, or the compensable 
injury.  It is plausible, both textually and logically, that the 
employee could be the object of the term "treatment."  The 
phrase "who has sustained a compensable injury" could be 
understood as simply identifying the employee who undertook the 
treatment, leaving "employee" as the only possible object of the 
"treatment."17 
¶33 There are, however, more qualifications to the term 
"treatment," and they prevent the employee from serving as the 
object.  The statutory language, with the qualifiers included, 
                                                 
16 Treatment, The American Heritage Dictionary of The 
English Language (3d ed. 1992) (emphases added). 
17 If a treatment treats the "employee," then the object of 
the treatment comprises any malady from which the employee might 
suffer.  In this case, that would include Ms. Flug's non-
compensable degenerative disc disease. 
No.  2015AP1989 
 
 
 
22 
says this:  "If an employee who has sustained a compensable 
injury undertakes . . . invasive treatment that is generally 
medically acceptable, but that is unnecessary . . . ."  The 
requirement 
that 
the 
treatment 
be 
"generally 
medically 
acceptable," on its own, could direct us with equal ease to 
either the employee or the compensable injury, and so it 
provides no help in identifying the object on which it is to 
operate; we will return to it later.  The phrase "but that is 
unnecessary," on the other hand, tells us that the object of the 
treatment must be the compensable injury. 
¶34 Ms. Flug tells us she fits within the statute because 
the treatment——her surgery——was unnecessary.  But unnecessary to 
what?  If the object of the treatment is the employee (as 
opposed to the compensable injury), then it wasn't unnecessary 
at all.  In fact, it was quite the opposite.  Ms. Flug herself 
reported that the treatment brought her back to nearly 100 
percent.  Neither Ms. Flug nor the court of appeals has 
explained 
how 
a 
treatment 
can 
be 
that 
effective 
while 
simultaneously being unnecessary.  If, on the other hand, the 
statute makes the object of the treatment the compensable 
injury, then one must determine whether the treatment was 
directed——as a factual matter——at that particular injury.  
Either way, Ms. Flug's claim must end here.  If the object of 
"treatment" is the employee, Ms. Flug cannot succeed because the 
treatment was clearly necessary——it cured her condition.  If, 
instead, the object of "treatment" is the compensable injury, 
she can proceed no further because the Commission has already 
No.  2015AP1989 
 
 
 
23 
found (and we must accept) that the object of Ms. Flug's surgery 
was not her compensable injury.18 
¶35 The only way to reach the court of appeals' conclusion 
would be to allow the object of the treatment to flicker between 
the employee and the compensable injury, depending on whether we 
are considering (a) what the treatment was treating, or (b) the 
treatment's necessity.  The court of appeals' formulation would 
make Ms. Flug the object of "treatment" when considering what 
the surgery was treating, but flit to the compensable injury in 
assessing its necessity.  Only if such grammatical instability 
is possible may one conclude that the treatment was treating Ms. 
Flug, but was unnecessary because it was not treating the 
compensable injury.  However, there is no grammatical rule that 
allows the object of the treatment to flicker like that. 
¶36 We return now to the requirement that the treatment in 
question be "generally medically acceptable."  Because the 
phrases "generally medically acceptable" and "but that is 
unnecessary" both act as delimiters on the term "treatment," the 
treatment must partake of both qualities.  And because we have 
already concluded that the proper object of "treatment" is the 
                                                 
18 Chief Justice Roggensack faults us for eliding "good 
faith" from this part of our analysis.  
Chief Justice 
Roggensack's dissent, ¶85.  We do so because our task at this 
stage is to discover what the "treatment" is supposed to be 
treating.  The employee's "good faith" in accepting the 
treatment provides no information useful to that inquiry.  Ms. 
Flug's subjective beliefs cannot affect the statute's grammar, 
regardless of the sincerity with which they are held. 
No.  2015AP1989 
 
 
 
24 
compensable injury, we must also conclude that the treatments 
contemplated by the statute are those that are generally 
medically acceptable as a treatment of the compensable injury. 
¶37 The statute has one further requirement, which we have 
not yet addressed——"good faith."  And although it does not budge 
"compensable 
injury" 
from 
its 
place 
as 
the 
object 
of 
"treatment," it is important to a complete understanding of how 
the statute functions.  The portion of Wis. Stat. § 102.42(1m) 
that describes eligibility for benefits says, in full:  "If an 
employee who has sustained a compensable injury undertakes in 
good faith invasive treatment that is generally medically 
acceptable, but that is unnecessary . . . ."  This provision 
exists against the backdrop of a Worker's Compensation program 
that requires payment of medical expenses only to the extent 
they are "reasonably required" to "cure and relieve from the 
effects of the [compensable] injury,"19 and disability benefits 
only for incapacities caused by a work-related injury.20  An 
unnecessary medical treatment is not "reasonably required" to 
treat the compensable injury.  And a disability caused by a 
treatment is not a disability caused by an injury.  It is here 
that § 102.42(1m) intervenes, requiring disability benefits when 
a treatment for a compensable injury that turns out to not be 
reasonably required (that is, unnecessary) causes a disability.  
                                                 
19 Wis. Stat. § 102.42(1). 
20 Wis. Stat. § 102.43. 
No.  2015AP1989 
 
 
 
25 
Without this, there would be no statutory liability for such an 
event.  So § 102.42(1m) extended the employer's statutory 
liability, and the "good faith" requirement acts as a limit on 
that extension.  If the disability-creating treatment turns out 
not to have been necessary to treat her compensable injury, she 
still receives disability benefits so long as she undertook the 
treatment in good faith.  We need not explore this concept 
further because we have already concluded Ms. Flug's treatment 
does not qualify under the statute's extension of liability.21 
C. 
Consistency 
¶38 Ms. Flug says Wis. Stat. § 102.42(1m) codified Spencer 
(but for one aspect not relevant here), and all parties urge us 
to apply that statute consistently with cases decided before its 
adoption.  This opinion fits neatly into our canon. 
¶39 Spencer addressed itself to an employee who injured 
his knee while on the job; everyone agreed he was entitled to 
compensation.  Mr. Spencer had his kneecap removed, but he 
continued to suffer.  He sought the advice of a different 
                                                 
21 In light of our holding that this statute extends 
liability only to treatments that are directed at a compensable 
injury, Chief Justice Roggensack asks this eminently reasonable 
question:  "What then of the context in which an employee who in 
good faith believed that the invasive treatment she undertook 
would treat her compensable injury?"  Perhaps employees in such 
circumstances ought to receive benefits, but they must direct 
their petition for relief to the legislature——not the court.  We 
can only apply the law as the legislature created it.  The 
statute, as it currently exists, extends liability based on the 
reality of what the treatment addresses, not the employee's 
belief about what it addresses. 
No.  2015AP1989 
 
 
 
26 
doctor, who recommended an arthrodesis.22  His original doctor 
disagreed, saying such a procedure would not be reasonably 
necessary.  Nonetheless, Mr. Spencer opted for the arthrodesis, 
which left him with a stiff leg.  The administrative agency 
found the arthrodesis was not reasonably necessary, and so 
rejected 
payment 
of 
expenses 
related 
to 
that 
procedure.  
Spencer, 55 Wis. 2d at 527–28.  The circuit court set aside the 
agency's decision, ruling that "where an employee, in good 
faith, accepts the recommendation of treatment of one doctor, 
with whom another doctor disagrees, the commission cannot 
disregard the consequences of treatment (increased period of 
temporary 
total 
disability, 
increased 
permanent 
partial 
disability and the expense of the arthrodesis) because they find 
the treatment was either unnecessary or unreasonable."  Id. at 
532.  We agreed with the circuit court, and held that "[t]he 
employer is responsible for the consequences not only of the 
injury, but the treatment."  Id.  Although not explicit, our 
juxtaposition of "injury" and "treatment" in that sentence can 
lead to no conclusion but that the treatment we were considering 
was for the compensable injury.  Because we conclude today that 
the "treatment" identified in Wis. Stat. § 102.42(1m) must treat 
the compensable injury to qualify for benefits, our holding is 
consistent with what we said in Spencer. 
                                                 
22 Arthrodesis is "[t]he stiffening of a joint by operative 
means."  Arthrodesis, Stedman's Medical Dictionary (28th ed. 
2006). 
No.  2015AP1989 
 
 
 
27 
¶40 The court of appeals subsequently considered an 
injured employee's situation that closely tracks that of Ms. 
Flug in City of Wauwatosa v. LIRC, 110 Wis. 2d 298, 328 
N.W.2d 882 (Ct. App. 1982).  There, a police officer had slipped 
off a curb while on duty, and incurred a compensable hip injury.  
Id. at 299.  The officer's treating doctor diagnosed him as also 
having a pre-existing hip condition that his work-related 
accident aggravated, and recommended surgery.  The insurance 
carrier's doctor disagreed, opining that the fall "had not 
aggravated nor accelerated the preexisting [] condition, but 
merely brought the condition to the attention of the surgeon."  
Id.  The hearing examiner resolved the disputed testimony 
against the officer, finding no aggravation.  The Commission 
disagreed, and so awarded benefits related to the surgery for 
the pre-existing, but aggravated, hip injury.  Id. at 300.  The 
circuit court affirmed, citing Spencer.  The court of appeals 
acknowledged 
that 
the 
key 
question 
was 
whether 
Spencer 
controlled, but concluded that our holding in that case "applies 
only to cases involving treatment for an undisputed compensable 
industrial injury."  Id. at 301.  The court of appeals was 
correct, and its conclusion is reflected in our holding here. 
¶41 Finally, we consider Honthaners Restaurants, Inc. v. 
LIRC, 2000 WI App 273, 240 Wis. 2d 234, 621 N.W.2d 660.  An 
employee suffered a compensable injury to her arm, and received 
disability benefits for just under six months as well as accrued 
medical expenses during that period.  Id., ¶3.  She subsequently 
sought benefits for an additional year of treatment.  The 
No.  2015AP1989 
 
 
 
28 
Commission found that she had been "overdiagnosed and over-
treated," because she continued to receive treatments long after 
her compensable injury had resolved.  However, because she had 
sought the extended treatment in "good faith," the Commission 
said she was entitled to continued benefits.  Id., ¶7.  Agreeing 
with the Commission, the court of appeals said "Spencer teaches 
that as long as the claimant engaged in the unnecessary and 
unreasonable 
treatment 
in 
good 
faith, 
the 
employer 
is 
responsible for payment."  Id., ¶15.  It distinguished Spencer 
and City of Wauwatosa on the basis that "[i]n Spencer, the 
parties disputed medical treatment, not cause."  Id., ¶21.  The 
court of appeals concluded that the Spencer rule applied because 
the treatment the employee received was directed at her 
compensable injury, even though it turned out not to have been 
necessary.  Comparing the employee's situation to Spencer, the 
Honthaners Restaurant court said:   
Both cases involve no dispute that the claimants 
suffered 
a 
compensable 
injury. 
Both 
deal 
with 
differing medical opinions on diagnosis and treatment. 
Both 
cases 
have 
a 
claimant 
who 
continued 
the 
unnecessary treatment in good faith. Thus, we conclude 
the Commission properly relied on Spencer and [the 
employee] is entitled to additional benefits. 
Id., ¶22.  That conclusion is consistent with our holding today, 
which requires that the treatment in question was directed at 
the compensable injury. 
* * * 
¶42 Our opinion today tracks the language of Wis. Stat. 
§ 102.42(1m) and is consistent with prior opinions delivered by 
No.  2015AP1989 
 
 
 
29 
the courts of this state.  It is also consistent with the nature 
of Wisconsin's Worker's Compensation system.  Indeed, any other 
conclusion would represent a sharp break with the "legislatively 
enacted compromise" between employers and employees for the 
payment of expenses and benefits consequent upon "work-related 
injury [or] disease."  Nelson, 174 Wis. 2d at 302.  And it would 
represent a significant step towards making the Worker's 
Compensation system "a blanket insurance policy to provide 
benefits for disabilities which may become manifest while on the 
job but are in no way caused by or related to the employment."  
Lewellyn, 38 Wis. 2d at 61.  There is nothing in the text of 
Wis. Stat. § 102.42(1m) to suggest such a momentous change, and 
even if that change is warranted, we are not the proper branch 
of government to prescribe it.  Thus, we will not adopt an 
understanding of this statute that would extend employer 
liability to injuries and diseases that have nothing to do with 
the workplace.23 
                                                 
23 The court of appeals, Ms. Flug, and the Chief Justice 
discuss whether the compensable injury must "cause" a treatment 
to qualify for benefits——a proposition they all reject.  See, 
e.g., Chief Justice Roggensack's dissent, ¶¶85-87, 90.  It is 
difficult to know what to do with this construct (which finds no 
place in the statutory language) because injuries, of course, do 
not "cause" treatments.  They certainly need them.  And they 
frequently won't cure without them.  But if treatments are 
caused by anything, they are caused by those skilled in the 
healing arts.  In any event, nothing in this opinion should be 
construed as requiring that a compensable injury "cause" a 
treatment.  Our opinion is simply that a qualifying treatment is 
one that treats a compensable injury. 
No.  2015AP1989 
 
 
 
30 
IV. CONCLUSION 
¶43 We hold today that an employee is not eligible for 
benefits under Wis. Stat. § 102.42(1m) if the disability-causing 
treatment was directed at treating something other than the 
employee's compensable injury.  Because Ms. Flug's surgery 
treated her pre-existing condition, not her compensable injury, 
her claim must be disallowed.  We reverse the court of appeals 
because it should have affirmed the Commission's decision. 
By the Court.—The decision of the court of appeals is 
reversed and the case is dismissed. 
 
 
No.  2015AP1989.pdr 
 
1 
 
¶44 PATIENCE DRAKE ROGGENSACK, C.J.   (dissenting).  This 
review arises from an unpublished decision of the court of 
appeals1 reversing the circuit court's decision, which affirmed 
the Labor and Industry Review Commission's (LIRC) order denying 
Tracie 
Flug 
(Flug) 
disability 
benefits 
under 
Wis. 
Stat. 
§ 102.42(1m).   
¶45 I conclude that Flug, who has sustained a compensable 
(work-related) injury from which began a continuing course of 
pain and who underwent surgery upon the advice of her medical 
doctor to alleviate that pain, is entitled to compensation 
pursuant to Wis. Stat. § 102.42(1m) if she accepted the 
physician's advice and undertook surgery with the good faith 
belief that surgery would treat her work-related injury, even 
though surgery was unnecessary treatment for that injury.  
Neither LIRC nor the Administrative Law Judge (ALJ) made factual 
findings in regard to Flug's good faith belief, or the lack 
thereof, in undertaking surgery.  Therefore, I would remand the 
matter to LIRC to make the requisite finding and complete its 
obligations under § 102.42(1m).     
¶46 Accordingly, I would affirm the court of appeals' 
decision reversing LIRC and remanding the matter for additional 
fact-finding on the issue of good faith, and if necessary for a 
determination of the damages to which Flug is entitled.  Because 
the majority opinion fails to recognize the factual nature of 
                                                 
1 Flug v. LIRC, No. 2015AP1989, unpublished slip op. (Wis. 
Ct. App. June 21, 2016).  
No.  2015AP1989.pdr 
 
2 
 
good faith, its importance to the plain meaning of Wis. Stat. 
§ 102.42(1m) and avoids addressing good faith in the context in 
which it arises, I respectfully dissent from the majority 
opinion.  
I.  BACKGROUND 
¶47 The majority opinion ably sets forth the underlying 
facts.  Therefore, I shall relate only those facts necessary to 
attune the reader to the discussion that follows.   
¶48 On February 14, 2013, while engaged in work for Wal-
Mart, Flug felt a sudden pain in her neck that radiated down her 
right arm.  She had not experienced pain before this incident.  
Because the pain continued, on February 20, 2013, she sought 
medical treatment from Dr. Sabina Morissette.  Dr. Morissette 
diagnosed Flug with "[r]ight arm and shoulder strain with 
possible relation to the cervical spine itself."  Dr. Morissette 
released Flug back to work, with restrictions on the tasks she 
could perform.  
¶49 Because the pain continued, on February 25, 2013, Flug 
sought physical therapy from Debra Stow.  Stow's records show: 
[Flug] presents with the diagnosis of right shoulder 
pain.  Patient stated that on Thursday, February 14 
she started work without any pain . . . .  When she 
woke up Friday morning she had a lot of really intense 
pain and had to leave work early. . . .  [T]he pain 
starts in her neck and goes down the back portion of 
her shoulder down into her arm. 
¶50 On March 6, 2013, Flug saw Dr. Andrew Floren.  
Dr. Floren noted that Flug "was doing a good deal of overhead 
work scanning some boxes in the Shoes Department.  She developed 
No.  2015AP1989.pdr 
 
3 
 
a severe sudden pain in her right upper back area.  This pain 
went down the posterior shoulder and arm to the wrists."  On 
March 22, 2013, Floren's notes indicate that Flug's neck and 
back were slowly getting better, but the pain in her shoulder 
was not improving.  In addition, she had begun to have numbness 
in her right hand and fingers.  
¶51 On April 2, 2013, Flug had a follow-up appointment 
with Dr. Floren and said that her pain was not improving.  
Floren 
recommended 
a 
steroid 
injection, 
which 
Flug 
had.  
However, it did not alleviate her pain.  
¶52 Because of the continuing pain, on May 2, 2013, Floren 
referred Flug to Dr. Eduardo Perez, a neurosurgeon.  Dr. Perez 
recommended surgery to alleviate her pain.  Specifically, 
Dr. Perez 
recommended 
Flug 
undergo 
an 
"anterior 
cervical 
dis[c]ectomy with fusion/fixation at the C5-C6, C6-C7 levels."  
Dr. Perez stated:  "given time and overall severity of the 
symptoms and the lack of response to nonsurgical management make 
[Flug] a surgical candidate."    
¶53 On June 4, 2013, Dr. Perez performed a discectomy.  At 
a follow-up approximately one month after the surgery, Flug told 
Dr. Perez that she was "doing excellent" and almost back to full 
health.  Dr. Floren allowed Flug to return to work on July 17, 
2013, 
but 
gave 
her 
a 
twenty-pound 
lifting 
restriction.  
Eventually, that restriction was increased to thirty-pounds 
before being eliminated entirely in November 2013.   
¶54 Initially, Wal-Mart paid Flug worker's compensation 
disability benefits.  However, subsequent to Flug's surgery, 
No.  2015AP1989.pdr 
 
4 
 
Wal-Mart retained its own physician, Dr. Morris Soriano, to 
conduct an independent review of Flug's medical records.  
Dr. Soriano concluded that the surgery was not necessary to 
treat Flug's work-related injury.  Based on these findings, Wal-
Mart notified Flug that it was terminating her disability 
benefits as of June 22, 2013.   
¶55 On August 16, 2013, Flug filed a worker's compensation 
claim 
against 
Wal-Mart 
with 
the 
Department 
of 
Workforce 
Development.  Flug sought disability benefits through August 8, 
2013, including benefits related to the surgery, as well as 22% 
permanent partial disability benefits and medical expenses.   
¶56 Flug submitted a "Practitioner's Report on Accident or 
Industrial Disease in Lieu of Testimony" signed by Dr. Floren.  
Dr. Floren opined that given the sudden onset of Flug's symptoms 
while at work, it was "medically probable" that the work-related 
injury 
caused 
a 
cervical 
disability, 
which 
required 
the 
recommended surgery to eliminate her pain.  In contrast, 
Dr. Soriano opined that Flug's discectomy was "not reasonable, 
necessary or related to the injury of February 14, 2013."  Flug 
did not have Dr. Soriano's opinion prior to undertaking surgery.   
¶57 Flug was the only witness to testify in-person at the 
hearing.  She testified that she felt a "[p]ain, instant pain, 
just shooting down from my neck down into my shoulder and into 
my arm" while scanning a box above her head.  She further 
testified that she believed all of the medical treatment she 
subsequently received was necessary to relieve the continuing 
pain she sustained due to the work-related injury.    
No.  2015AP1989.pdr 
 
5 
 
¶58 The ALJ reasoned that the medical history provided by 
Flug to Dr. Floren was inconsistent, and therefore, the ALJ 
discounted his testimony.  As a result, the ALJ denied Flug's 
application for disability benefits.  
¶59 LIRC 
adopted 
the 
factual 
findings 
of 
the 
ALJ.  
However, contrary to what the ALJ had found, LIRC then concluded 
that Wis. Stat. § 102.42(1m) did not apply to Flug's claims 
because she had not suffered a compensable work-related injury.  
The circuit court affirmed LIRC.  
¶60 Before the court of appeals, LIRC argued that Wis. 
Stat. § 102.42(1m) requires a causal link between an employee's 
compensable injury and his or her invasive treatment.  The court 
of appeals reasoned that LIRC, by requiring "that an employee 
must show his or her treatment was the result of a compensable 
injury, the Commission reads an additional causation requirement 
into the statute."2  Therefore, the court of appeals concluded 
that LIRC's interpretation of the statute was unreasonable.  We 
granted review.  I would affirm the court of appeals.  
II.  DISCUSSION 
A. Standard of Review 
¶61 "When reviewing a worker's compensation claim, we 
review LIRC's decision, not the decisions of the circuit court 
or court of appeals."  DeBoer Transp., Inc. v. Swenson, 2011 WI 
                                                 
2 Flug v. LIRC, No. 2015AP1989, unpublished slip op. (Wis. 
Ct. App. June 21, 2016). 
No.  2015AP1989.pdr 
 
6 
 
64, ¶29, 335 Wis. 2d 599, 804 N.W.2d 658 (citing Cty. of Dane v. 
LIRC, 2009 WI 9, ¶14, 315 Wis. 2d 293, 759 N.W.2d 571).   
¶62 This appeal turns on the interpretation of Wis. Stat. 
§ 102.42(1m).  The interpretation of a statute presents a 
question of law that we generally review independently.  Cty. of 
Dane, 315 Wis. 2d 293, ¶14 (citing Watton v. Hegerty, 2008 WI 
74, ¶6, 311 Wis. 2d 52, 751 N.W.2d 369).   
¶63 There are times when an agency's interpretation of a 
statute is entitled to deference.  Id. (citing Clean Wis., Inc. 
v. Pub. Serv. Comm'n of Wis., 2005 WI 93, ¶37, 282 Wis. 2d 250, 
700 N.W.2d 768).  However, in the present case, LIRC did not 
interpret Wis. Stat. § 102.42(1m).  Instead of construing the 
statute, LIRC said that Flug "failed to present credible medical 
evidence to establish that she suffered a work-related injury 
because the history upon which Dr. Floren relied when making his 
determination as to whether the incident on February 14, 2013, 
resulted in a work injury was incorrect."3  Accordingly, there is 
no statutory interpretation by LIRC to which deferral could 
apply.   
¶64 Except in very limited circumstances not present in 
the case now before us, we accept LIRC's factual findings as 
conclusive.  Wis. Stat. § 102.23(1)(a)1.  However, neither LIRC 
nor the ALJ made a factual finding in regard to whether Flug had 
                                                 
3 Tracie Flug v. Wal-Mart Assoc., Inc., ERD No. 2013-006010 
(LIRC, Feb. 23, 2015).   
No.  2015AP1989.pdr 
 
7 
 
a good faith belief that surgery would treat her work-related 
injury.   
¶65 Accordingly, 
I 
interpret 
and 
apply 
Wis. 
Stat. 
§ 102.42(1m) under well-established principles of statutory 
interpretation.  And, as did the court of appeals, I make no 
factual findings, but refer the lack of a finding in regard to 
whether Flug had a good faith belief that undertaking surgery 
would treat her work-related injury to LIRC so that it can 
complete its obligations under § 102.42(1m). 
B. Statutory Interpretation, General Principles 
¶66 "It is, of course, a solemn obligation of the 
judiciary to faithfully give effect to the laws enacted by the 
legislature, and to do so requires a determination of statutory 
meaning."  State ex rel. Kalal v. Circuit Court for Dane Cty., 
2004 WI 58, ¶44, 271 Wis. 2d 633, 681 N.W.2d 110.  For this 
reason, "statutory interpretation 'begins with the language of 
the statute.  If the meaning of the statute is plain, we 
ordinarily stop the inquiry.'"  Id., ¶45 (quoting Seider v. 
O'Connell, 2000 WI 76, ¶43, 236 Wis. 2d 211, 612 N.W.2d 659).  
"Statutory language is given its common, ordinary, and accepted 
meaning, except that technical or specially-defined words or 
phrases are given their technical or special definitional 
meaning."  Id. (citing Bruno v. Milwaukee Cty., 2003 WI 28, ¶¶8, 
20, 260 Wis. 2d 633, 660 N.W.2d 656).  
¶67 Additionally, "[c]ontext is important to meaning."  
Id., ¶46.  As a result, "statutory language is interpreted in 
the context in which it is used; not in isolation but as part of 
No.  2015AP1989.pdr 
 
8 
 
a whole; in relation to the language of surrounding or closely-
related 
statutes; 
and 
reasonably, 
to 
avoid 
absurd 
or 
unreasonable results."  Id.  And, if "statutory language is 
unambiguous, there is no need to consult extrinsic sources of 
interpretation, such as legislative history."  Id. (citing 
Bruno, 260 Wis. 2d 633, ¶7). 
¶68 It is under these principles that I interpret Wis. 
Stat. § 102.42(1m).   
C. Interpretation of Wis. Stat. § 102.42(1m) 
¶69 "A purpose of the worker's compensation statute is to 
'provide prompt justice for injured workers and to prevent, as 
far as possible, the delays that might arise from protracted 
litigation.'"  Cty. of Dane, 315 Wis. 2d 293, ¶34 (quoting Bosco 
v. LIRC, 2004 WI 77, ¶48, 272 Wis. 2d 586, 681 N.W.2d 157).  
And, "an injured employee is guaranteed 'recovery irrespective 
of his own fault and irrespective of the employer's absence of 
fault.'"  Id. (quoting Mulder v. Acme-Cleveland Corp., 95 
Wis. 2d 173, 180, 290 N.W.2d 276 (1980)).  "However, in exchange 
for this guarantee, the employee is obliged to accept a limited 
and scheduled compensation award."  Id. (internal quotations 
omitted).  "As a result, the statute must be broadly construed 
in order to best promote its statutory purposes."  Id. (citation 
omitted); see also Johnson v. Wis. Lumber & Supply Co., 2003 
Wis. 304, 310, 234 N.W.2d 506 (1931) ("It has been said over and 
over again in workmen's compensation cases that the act should 
be liberally construed . . . ."). 
No.  2015AP1989.pdr 
 
9 
 
¶70 As part of Wisconsin's worker's compensation scheme, 
employers4 are required to compensate employees for certain 
injuries when "the employee is performing service growing out of 
and incidental to his or her employment."  Wis. Stat. 
§ 102.03(1)(c)1. 
 
And, 
under 
Wis. 
Stat. 
§ 102.42(1), 
an 
"employer shall supply such medical, surgical, chiropractic, 
psychological, 
podiatric, 
dental, 
and 
hospital 
treatment, 
medicines, medical and surgical supplies, crutches, artificial 
members, appliances, and training in the use of artificial 
members and appliances . . . medicines, and medical supplies, as 
may be reasonably required to cure and relieve from the effects 
of the injury."  § 102.42(1).   
¶71 In addition to the obligation to pay certain medical 
expenses, an employer also may be liable for disability 
indemnity if an employee becomes disabled as a result of an 
injury or treatment for the effects of an injury.  Under certain 
circumstances, the employer's obligation includes payment for 
unnecessary, invasive medical treatment that causes an employee 
to become disabled.  See, e.g., Wis. Stat. § 102.42(1m).  
¶72 Wisconsin 
Stat. 
§ 102.42(1m) 
renders 
an 
employer 
liable for disability indemnity when an employee undergoes 
invasive treatment that is later discovered to have been 
                                                 
4 Employer is defined by Wis. Stat. § 102.04 and includes, 
in relevant part, any "person who usually employs 3 or more 
employees for services performed in this state, whether in one 
or more trades, businesses, professions, or occupations, and 
whether in one or more locations."  Wis. Stat. § 102.04(1)(b)1.  
No.  2015AP1989.pdr 
 
10 
 
unnecessary 
to 
treat 
the 
work-related 
injury. 
 
Section 
102.42(1m) provides, in relevant part:  
LIABILITY FOR UNNECESSARY TREATMENT.  If an employee who has 
sustained a compensable injury undertakes in good 
faith invasive treatment that is generally medically 
acceptable, but that is unnecessary, the employer 
shall pay disability indemnity for all disability 
incurred as a result of that treatment.  An employer 
is not liable for disability indemnity for any 
disability incurred as a result of any unnecessary 
treatment undertaken in good faith that is noninvasive 
or not medically acceptable.  
¶73 To receive disability indemnity from his or her 
employer under Wis. Stat. § 102.42(1m), an employee must meet a 
number of statutory criteria:  (1) a compensable (work-related) 
injury; 
(2) good 
faith 
in 
undertaking 
invasive 
medical 
treatment; 
(3) medically 
acceptable 
treatment 
that 
is 
unnecessary for the work-related injury; (4) disability incurred 
because of the treatment.  § 102.42(1m).   
¶74 Here, LIRC does not dispute that Flug suffered a 
compensable injury, even though it did so in the opinion we 
review.  "Injury" is defined by Wis. Stat. § 102.01(c), in 
relevant part, as any "mental or physical harm to an employee 
caused by accident or disease."  And the types of injuries for 
which an employer is liable are enumerated in Wis. Stat. 
§ 102.03.  
¶75 Good faith is the touchstone of a plain meaning 
interpretation 
of 
Wis. 
Stat. 
§ 102.42(1m). 
 
Stated 
more 
completely, whether the employee undertakes invasive treatment 
No.  2015AP1989.pdr 
 
11 
 
with the good faith belief that it would treat her work-related 
injury is a central focus of § 102.42(1m).   
¶76 Good faith is a state-of-mind question; accordingly, 
whether one has acted in good faith is a question of fact.  
Schmitz v. Firstar Bank of Milwaukee, 2003 WI 21, ¶34, 260 
Wis. 2d 24, 658 N.W.2d 442 ("the question of whether Firstar 
acted in good faith or in accordance with reasonable commercial 
standards under Wis. Stat. § 403.419(3)(1993-94) was a question 
of fact that would need to be tried"); Tang v. C.A.R.S. 
Protection Plus, Inc., 2007 WI App 134, ¶41, 301 Wis. 2d 752, 
734 N.W.2d 169 ("Whether a party to a contract has breached its 
implied duty of good faith is a question of fact.").   
¶77 Good faith is not defined in Wis. Stat. § 102.42.  
Therefore, we apply its ordinary meaning such as may be found in 
a dictionary.  Kalal, 271 Wis. 2d 633, ¶53.  The current version 
of Black's Law Dictionary defines good faith, in part, as "[a] 
state of mind consisting in . . . honesty in belief or purpose."  
Good Faith, Black's Law Dictionary 808 (10th ed. 2014).  
Accordingly, an employee must act with an honest "belief or 
purpose" in order to act with good faith.  
¶78 The legislature has tied the employee's good faith 
obligation to the employee's undertaking invasive treatment 
because good faith modifies the verb "undertakes" pursuant to 
the plain meaning of the terms employed in Wis. Stat. 
§ 102.42(1m).  ("If an employee . . . undertakes in good faith 
invasive treatment.")   
No.  2015AP1989.pdr 
 
12 
 
¶79 Moreover, the employee's treatment must be generally 
medically acceptable, but unnecessary to treat a compensable 
work-related injury.  Wisconsin Stat. § 102.42(1m) does not 
mandate that the treatment be unnecessary for any medical 
reason; it requires only that it be unnecessary to treat a 
compensable injury.  
¶80 Finally, the employee must show that the invasive 
treatment resulted in the employee's disability.  This is the 
only aspect of Wis. Stat. § 102.42(1m) that requires an employee 
to show causation.  
¶81 The terms of Wis. Stat. § 102.42(1m) must be read in 
context.  The obligation for the employee to act with a good 
faith belief that the invasive treatment is treatment for her 
work-related injury limits the employee's treatment choices and 
in so doing, protects the employer.  However, as long as an 
employee acts with a good faith belief that undertaking 
medically invasive treatment will treat her work-related injury, 
the employer is liable for disability even when the treatment 
was medically unnecessary to treat a work-related injury.  This 
good faith obligation protects employers from an employee 
seeking medical treatment that the employee knows is unnecessary 
to treat a compensable injury.   
¶82 Importantly, all Wis. Stat. § 102.42(1m) requires is 
that an employee act with a good faith belief that undertaking 
invasive treatment is treatment for her work-related injury.  
Nothing in the plain language of the statute can reasonably be 
No.  2015AP1989.pdr 
 
13 
 
construed as requiring the employee to know that medical advice 
for invasive treatment should not be taken.   
¶83 Nevertheless, LIRC and the majority opinion5 contend 
that the work-related injury must be medically connected to the 
employee's invasive treatment that resulted in disability.  
According to the majority opinion and LIRC, without that direct 
connection, Wis. Stat. § 102.42(1m) does not apply.  Their 
narrow statutory interpretation gives the employee the burden to 
know whether the medical treatment that was recommended by 
treating physicians to alleviate on-going pain should be 
accepted or rejected.   
¶84 The majority opinion's statutory interpretation reads 
good faith out of the statute in the context of the employee who 
undertakes invasive, unnecessary treatment with a good faith 
belief that the compensatory injury is being treated.  For 
example, the majority opinion repeatedly substitutes an ellipsis 
for the words "good faith" when it quotes portions of the 
statute, as it makes what it believes are winning statutory 
constructs.6  Furthermore, when the majority opinion finally gets 
around to addressing good faith it says, "If the disability-
creating treatment turns out not to have been necessary to treat 
her compensable injury, she still receives disability benefits 
                                                 
5 Majority op. ¶¶32-33.  The statute requires causation only 
insofar 
as 
the 
invasive 
treatment 
must 
have 
caused 
the 
disability.   
6 See majority op., ¶¶31, 32.   
No.  2015AP1989.pdr 
 
14 
 
so long as she undertook the treatment in good faith."7  The 
majority opinion then continues to avoid the central issue of 
the employee's good faith by saying, "We need not explore this 
concept further because we have already concluded Ms. Flug's 
treatment does not qualify under the statute's extension of 
liability."8  Is this because the majority opinion's reasoning 
requires that the work-related injury caused the treatment?  The 
majority 
opinion 
would 
permit 
recovery 
under 
Wis. 
Stat. 
§ 102.42(1m) only for invasive treatment directed solely at the 
compensable injury.  What then of the context in which an 
employee who in good faith believed that the invasive treatment 
she undertook would treat her compensable injury?    
¶85 While the majority opinion's grammatical arguments are 
interesting, they do not explain why the legislature did not 
include a provision requiring the employee to show that the 
work-related injury caused the treatment, if the legislature had 
wanted to include that requirement.  See Kalal, 271 Wis. 2d 633, 
¶44 ("We assume that the legislature's intent is expressed in 
the statutory language."); cf. Ott v. Peppertree Resort Villas, 
Inc., 2006 WI App 77, ¶25 n.11, 292 Wis. 2d 173, 716 N.W.2d 127 
("We are not permitted to re-write the statute, however, and we 
conclude the difference in language the legislature chose to use 
in the two subsections supports our conclusion that it did not 
                                                 
7 Majority op., ¶37. 
8 Id.  
No.  2015AP1989.pdr 
 
15 
 
intend to impose the causation-of-pecuniary-loss requirement on 
private plaintiffs who bring a claim under [Wis. Stat.] 
§ 707.57(1).").  It chose not to do so.  
¶86 In addition, requiring an employee show the work-
related injury caused the invasive treatment would lead to 
unreasonable results.  See Kalal, 2004 WI 58, ¶46 (we interpret 
statutes in such a way as "to avoid absurd or unreasonable 
results").  It would force an employee to know, at the time of 
an invasive treatment whether the invasive treatment she is 
undertaking is to alleviate pain from a compensable injury or, 
whether it would alleviate pain from a pre-existing injury or 
both.  But see Brown v. Dibbell, 227 Wis. 2d 28, 51, 595 N.W.2d 
358 (1999) (reasoning, "a patient is not in a position to know 
treatment options and risks and, if unaided, is unable to make 
an informed decision").  
¶87 We do not expect lay people to have knowledge of when 
medical practices or procedures should be employed.  See 
generally Martin v. Richards, 192 Wis. 2d 156, 170, 531 N.W.2d 
70 (1995) ("The average patient has little or no understanding 
of the medical arts, and ordinarily has only his physician to 
whom he can look for enlightenment with which to reach an 
intelligent decision." (quoting Canterbury v. Spence, 464 F.2d 
772, 780 (D.C. Cir. 1972))).  For this reason, an interpretation 
of Wis. Stat. § 102.42(1m) that presumes an employee is capable 
of possessing such knowledge is unreasonable.  Cf. Hanson v. Am. 
Family Mut. Ins. Co., 2006 WI 97, ¶20, 294 Wis. 2d 149, 716 
N.W.2d 866 (reasoning, "when a tortfeasor causes an injury to 
No.  2015AP1989.pdr 
 
16 
 
another person who then undergoes unnecessary medical treatment 
of those injuries despite having exercised ordinary care in 
selecting her doctor, the tortfeasor is responsible for all of 
that person's damages arising from any mistaken or unnecessary 
surgery").  
¶88 Our decision in Spencer v. DILHR, 55 Wis. 2d 525, 200 
N.W.2d 611 (1972), illustrates this principle.9  In Spencer, we 
held that an employee is not "to be faulted because he chose to 
follow erroneous medical advice . . . as long as he did so in 
good faith."  Id. at 532.  Spencer was predicated on good faith; 
and based on good faith, we concluded it was eminently 
reasonable for an employee to rely on the advice of a physician 
when deciding whether to undergo invasive treatment.  Id. 
("There is no evidence to show that in accepting arthrodesis 
Spencer did so other than in good faith.  The employer is 
responsible for the consequences not only of the injury, but the 
treatment."); see also Honthaners Restaurants, Inc. v. LIRC, 
2000 WI App 273, ¶15, 240 Wis. 2d 234, 621 N.W.2d 660 ("In 
                                                 
9 Spencer v. DILHR, 55 Wis. 2d 525, 200 N.W.2d 611 (1972) 
predated the passage of Wis. Stat. § 102.42(1m).  In Spencer, 
the employee suffered an injury at work and underwent surgery.  
Id. at 526-27.  After the surgery, the employee suffered a 15% 
partial permanent disability.  Id.  The doctor that performed 
the surgery determined that further treatment was unnecessary.  
Id.  However, the employee saw another physician, who concluded 
that the employee should undergo another surgery.  Id.  The 
subsequent surgery left the employee with partial permanent 
disability of 40%.  Id.  
 
No.  2015AP1989.pdr 
 
17 
 
Spencer, 
the 
supreme 
court 
allowed 
recovery 
for 
medical 
treatment and expenses that were incurred when the injured 
employee followed what, in hindsight, appeared to be erroneous 
medical advice.  Spencer teaches that as long as the claimant 
engaged in the unnecessary and unreasonable treatment in good 
faith, the employer is responsible for payment." (internal 
citations omitted)).  
¶89 Accordingly, all that Wis. Stat. § 102.42(1m) requires 
the employee to prove in order to come within the statutory 
provisions is that at the time when the employee undertakes an 
invasive procedure he or she had a good faith belief that the 
procedure would treat a compensable injury and that the invasive 
treatment resulted in a disability.  The employee need not show 
that the compensable work injury caused the employee to undergo 
invasive treatment.   
D. Application 
¶90 In the present case, Flug provided proof to the ALJ in 
the form of Dr. Floren's written report and she testified.  
Dr. Floren was one of her treating physicians.  Wal-Mart 
provided the report of Dr. Soriano, who did not review Flug's 
medical records until after she had surgery.    
¶91 It is undisputed that Flug suffered a compensable 
injury and underwent an invasive treatment, a discectomy.  It is 
also undisputed that she did not have pain prior to the work-
related injury on February 14, 2013.  Furthermore, it is 
undisputed that her pain continued as she went from health care 
provider to health care provider in search of effective 
No.  2015AP1989.pdr 
 
18 
 
treatment for pain and the pain continued until after she 
underwent a discectomy on June 4, 2013.   
¶92 Dr. 
Soriano's 
report 
opines 
that 
surgery 
was 
unnecessary to treat her work-related injury.  However, Flug did 
not have the benefit of his opinion at the time she undertook 
invasive treatment.  Finally, it is undisputed that Flug's 
unnecessary treatment caused the disability for which she now 
seeks benefits.      
¶93 Moreover, Dr. Soriano's opinion that the work-related 
injury 
did 
not 
necessitate 
invasive 
treatment 
is 
of 
no 
relevance.  Dr. Soriano's opinion speaks to whether the need for 
invasive treatment was caused by her work-related injury.  
However, Dr. Soriano gave his opinion after Flug's surgery.   
¶94 Post-hoc examinations like Dr. Soriano's are not 
relevant when determining whether Flug acted with a good faith 
belief at the time she undertook surgery that it would alleviate 
the pain she had suffered since her work-related injury on 
February 14, 2013.  Flug's good faith belief is her state of 
mind at the moment when she undertook the invasive treatment.  
And, it is her state of mind at the time she undertook surgery 
that the majority opinion avoids discussing.     
¶95 In 
sum, 
Flug 
satisfied 
most 
of 
Wis. 
Stat. 
§ 102.42(1m)'s criteria.  She sustained a compensable (work-
related) injury.  Based on medical advice to treat pain, she 
underwent a discectomy, an invasive and medically acceptable 
treatment that was unnecessary to treat her work-related injury.  
And, she sustained a disability as a result of the surgery.  If 
No.  2015AP1989.pdr 
 
19 
 
she undertook the discectomy with the good faith belief that it 
would treat her work-related injury, Wis. Stat. § 102.42(1m) 
requires nothing more.  However, as I explained above, good 
faith is a fact question that appellate courts do not decide.  
Accordingly, a remand to LIRC is necessary.  
III.  CONCLUSION 
¶96 I conclude that Flug, who has sustained a compensable 
(work-related) injury from which began a continuing course of 
pain and who underwent surgery upon the advice of medical 
doctors to alleviate that pain, is entitled to compensation 
pursuant to Wis. Stat. § 102.42(1m) if she accepted the 
physician's advice and undertook surgery with the good faith 
belief that surgery would treat her work-related injury, even 
though surgery was unnecessary treatment for that injury.  
Neither LIRC nor the ALJ made factual findings in regard to 
Flug's good faith belief, or the lack thereof, in undertaking 
surgery.  Therefore, I would remand the matter to LIRC to make 
the requisite finding and complete its obligations under 
§ 102.42(1m).     
¶97 Accordingly, I would affirm the court of appeals' 
decision reversing LIRC and remanding the matter for additional 
fact-finding on the issue of good faith, and if necessary for a 
determination of the damages to which Flug is entitled.  Because 
the majority opinion fails to recognize the factual nature of 
good faith, its importance to the plain meaning of Wis. Stat. 
§ 102.42(1m) and avoids addressing good faith in the context in 
No.  2015AP1989.pdr 
 
20 
 
which it arises, I respectfully dissent from the majority 
opinion. 
 
No. 2015AP1989.awb   
 
1 
 
¶98  ANN WALSH BRADLEY, J.   (dissenting).  There is a 
reason that the court of appeals issued an unpublished decision 
here.  And it likely is the messy record, which certainly does 
not represent LIRC's finest hour. 
¶99 There is one, and only one, LIRC decision that was 
ever issued in this case.  It is dated February 23, 2015, and it 
is the decision we review today.  DeBoer Transp., Inc. v. 
Swenson, 2011 WI 64, ¶29, 335 Wis. 2d 599, 804 N.W.2d 658 ("When 
reviewing a worker's compensation claim, we review LIRC's 
decision, not the decisions of the circuit court or court of 
appeals."); see also Stoughton Trailers, Inc. v. Labor and 
Indus. Review Comm'n, 2007 WI 105, ¶26, 303 Wis. 2d 514, 735 
N.W.2d 477. 
¶100 The majority has forthrightly acknowledged that we owe 
no deference to LIRC's conclusion of law set forth in that 
decision because, as even LIRC has now confessed, its conclusion 
is clearly erroneous.  Majority op., ¶16.  Likewise, the 
majority has acknowledged that the issue it decides today was 
never addressed by the Commission because of "its mistaken 
belief that Ms. Flug had suffered no compensable injury at all."  
Id. 
¶101 So what is this case doing here?   
¶102 The problem, of course, arises from LIRC's February 
23, 2015, decision where it misstated or misunderstood the 
essential conclusion of law it was supposed to be reviewing. 
Rather than issuing an order modifying the Feb 23, 2015, 
decision or issuing a new decision from which appeal rights 
No. 2015AP1989.awb   
 
2 
 
attend,1 appellate counsel for LIRC attempts to change horses in 
midstream.  
¶103 The Department of Justice, representing LIRC on 
appeal, now argues that although LIRC misstated the only 
conclusion of law it was supposed to be reviewing, such an 
impediment presents no obstacle to our review because this error 
was "inconsequential."  It contends that because LIRC adopted 
the ALJ's findings of fact and conclusions of law in full, that 
this court is bound by those findings of fact.  
¶104 However, in its February 23, 2015, decision, LIRC 
expressed one important caveat concerning findings of fact that 
excludes any potential for reliance on Dr. Soriano's report——a 
report relied upon in the majority opinion——the ALJ "did not 
adopt the findings of Dr. Soriano."  Flug v. Wal Mart Assocs., 
Inc., WCD No. 201300610 (LIRC, Feb. 23, 2015).  Consequently, 
LIRC also did not adopt those findings. 
¶105 Additionally, appellate counsel's argument flies in 
the face of well-established precedent on administrative agency 
review.  Counsel is trying to do now what LIRC did not do. 
However, appellate counsel is stuck with the facts of the case, 
which consist of a clearly erroneous February 23, 2015, LIRC 
decision.  "[T]his court cannot accept appellate counsel's post 
                                                 
1 Wisconsin Stat. § 102.23(1)(a)2., provides in relevant 
part that "[w]ithin 30 days after the date of an order or award 
made by the commission, any party aggrieved by the order or 
award may commence an action in circuit court for review of the 
order or award by serving a complaint as provided in par. (b) 
and filing the summons and complaint with the clerk of the 
circuit court."  
No. 2015AP1989.awb   
 
3 
 
hoc rationalization for agency action.  If an agency's order is 
upheld, it must be on the same basis articulated in the order by 
the agency itself."  Illinois v. United States, 666 F.2d 1066, 
1077 (7th Cir. 1981) (citing Fed. Power Comm'n v. Texaco, Inc., 
417 U.S. 380, 397, 94 S. Ct. 2315 (1974); Burlington Truck Lines 
v. United States, 371 U.S. 156, 168-69, 83 S. Ct. 239 (1962)). 
See also Bagdonas v. Dep't of Treasury, 93 F.3d 422, 426 (7th 
Cir. 1996) ("It is, of course, well settled that courts cannot 
accept counsel's post hoc rationalization for agency action."). 
¶106 Rather than acknowledge and address the procedural 
morass into which this court has waded, the majority skirts the 
issue, contending that it must accept LIRC's findings of facts:  
"the Commission has already found and we must accept [the 
findings]." Majority op., ¶34. 
¶107 What factual finding is there that the majority feels 
so enslaved to uphold? 
¶108 It cannot be any factual finding based on Dr. 
Soriano's report because as stated above, the LIRC decision 
specifically observed that it did not adopt those findings. 
¶109 It cannot be any of the asserted factual findings 
relied upon by the majority because they do not exist.  For 
example, the majority asserts that the ALJ and the Commission 
specifically found that "the surgery didn't treat Ms. Flug's 
compensable injury."  Majority op., ¶23.  Likewise, the majority 
contends that LIRC made a factual finding about the object of 
the surgery:  "we must accept" the Commission's factual finding 
No. 2015AP1989.awb   
 
4 
 
that the "object of Ms. Flug's surgery was not her compensable 
injury, but her pre-existing condition."  Majority op., ¶34. 
¶110 Attached to this writing are the findings of fact of 
the ALJ as well as the February 23, 2015, decision of LIRC.  As 
the reader will be able to observe, neither the ALJ nor LIRC 
made such findings. 
¶111 The majority uses the clearly erroneous LIRC decision 
and nonexistent findings of fact as a springboard to avoid the 
real issue in this case:  whether the event of February 14, 
2013, aggravated and accelerated beyond normal progression a 
progressively deteriorating condition.  In doing so, the 
majority makes errors in both what it says and what it fails to 
say. 
¶112 Contrary to the majority, I would remand this case to 
LIRC for a new hearing so that it can weigh the competing 
medical opinions and then, based on those opinions, issue 
findings of fact and a conclusion of law that is not clearly 
erroneous.2 
Accordingly, I respectfully dissent. 
                                                 
2 I would reverse and remand LIRC's decision for a 
determination of the threshold issue of whether Ms. Flug's work 
injury aggravated and accelerated her preexisting condition 
beyond its normal progression.  With one exception, I also join 
Chief Justice Roggensack's dissent addressing Flug's alternative 
argument on the issue of good faith.  As set forth herein, the 
majority opinion contains a number of factual missteps and 
therefore 
I 
cannot 
join 
the 
sentence 
in 
Chief 
Justice 
Roggensack's dissent that states "[t]he majority opinion ably 
sets forth the underlying facts."  Chief Justice Roggensack's 
dissent, ¶47. 
No. 2015AP1989.awb   
 
5 
 
I. 
¶113 This case started out as a somewhat routine worker's 
compensation case.  Ms. Flug has a conceded work injury of 
February 14, 2013, which she sustained while repeatedly raising 
her right arm to scan boxes at Walmart.  She initially treated 
with her primary care physician, who referred her to an 
occupational specialist, Dr. Andrew Floren. 
¶114 After a two month period of treatment, Dr. Floren 
referred Ms. Flug for an evaluation by a neurosurgeon, Dr. 
Eduardo Perez.  He found that she had a degenerative disc 
disease and that a discectomy and fusion was needed at two 
levels in the cervical spine.  Dr. Perez recommended that she 
have surgery.  He "discussed all these findings with Ms. Flug," 
and "entered into an informed consent discussion regarding 
anterior cervical discectomy with fusion/fixation at the C5-6, 
C6-7 levels." 
¶115 The surgery that Ms. Flug underwent on June 4, 2013, 
was apparently successful.  Under worker's compensation law, 
this particular procedure is a scheduled injury, which means a 
pre-determined minimum amount of disability attributable to the 
limitations that arise from the nature of the surgery itself. 
¶116 In a follow up exam, Ms. Flug reported that she "was 
doing excellent" and felt almost 100 percent better.  That's the 
good news for Ms. Flug.  Now the bad news. 
¶117 After 
Ms. 
Flug 
underwent 
surgery, 
the 
worker's 
compensation 
carrier 
hired 
Dr. 
Morris 
Soriano 
to 
do 
an 
independent medical exam.  He never met with Ms. Flug, but upon 
No. 2015AP1989.awb   
 
6 
 
a review of her records, filed a report one year after the 
injury and 9 months after the surgery, opining that the February 
14, 2013, event did not aggravate beyond normal progression her 
pre-existing spinal condition. 
¶118 On the other hand, Dr. Floren opined that it did.  He 
stated that he "strongly disagree[d]" with Dr. Soriano's 
statement, observing that "[t]he patient's history, clinical 
examination, and radiologic studies all support her need of 
surgery; which decision was also shown appropriate by her 
response to that surgery." 
¶119 Competing medical opinions in worker's compensation 
cases are standard fare.  Ms. Flug does not contend that the 
event of February 14, 2013, caused her degenerative spinal 
condition.  Of course it did not.  Nor does she assert that the 
event simply aggravated her spinal condition, because a mere 
aggravation of a pre-existing condition is insufficient to be 
compensable under worker's compensation law.  See Lewellyn v. 
Indus. Comm'n, 38 Wis. 2d 43, 59, 155 N.W.2d 678 (1968).  The 
aggravation and acceleration beyond normal progression of a 
progressively deteriorating condition, however, is compensable 
and that was the basis of her claim before LIRC.  Id. 
¶120 At the administrative hearing, the case was presented 
as a battle between written expert medical opinions.  One 
determined that the February 14, 2013, injury aggravated and 
accelerated beyond normal progression the pre-existing condition 
and the other concluded that it did not. 
No. 2015AP1989.awb   
 
7 
 
¶121 The ALJ's decision set forth the information provided 
in the written reports of both Dr. Floren and Dr. Soriano, 
however, it relied on neither.  As the LIRC decision explains, 
the ALJ's decision is not based on the findings of Dr. Soriano.  
And it certainly is not based on Dr. Floren's opinion because it 
is contrary to it.   
¶122 If the ALJ's decision was based on neither the medical 
opinion of Dr. Floren nor on that of Dr. Soriano, then on what 
medical expert opinion did the ALJ base its conclusion?  
Apparently, the ALJ engaged in its own sojourn into the medical 
records and determined that no additional compensation was due. 
II 
¶123 Having set forth the facts, I turn to address both 
what the majority opinion has erroneously stated and what of 
import it has failed to state. 
¶124 From the outset, the majority gets the facts wrong.3  
It states that Ms. Flug "underwent surgery in the belief it was 
necessary 
to 
treat 
her 
work-related 
soft-tissue 
strain."  
Majority op., ¶1. 
                                                 
3 Additionally, the majority states that the parties agree 
that Flug "suffered a permanent partial disability as a direct 
result of the treatment."  Majority op., ¶18.  Walmart concedes 
that Ms. Flug suffered a temporary disability due to her 
cervical strain.  However, it does not agree that Ms. Flug 
suffered a permanent partial disability because it contests that 
Ms. Flug is entitled to worker's compensation benefits as a 
result of her surgery. 
 
No. 2015AP1989.awb   
 
8 
 
 The majority is incorrect.  Ms. Flug did not undergo 
surgery because she believed it necessary to treat a 
strain. The record reflects that prior to recommending 
surgery, Ms. Flug's surgeon, Dr. Perez, diagnosed Ms. 
Flug with "right-sided C7 radiculopathy associated 
with C6-7 disk osteophyte complex and degenerative 
disk disease at the C5-6 level."  Dr. Perez "discussed 
all these findings with Ms. Flug," and "entered into 
an informed consent discussion regarding anterior 
cervical discectomy with fusion/fixation at the C5-6, 
C6-7 levels." 
¶125  The majority again errs when it contends that the ALJ 
and the Commission specifically found that "the surgery didn't 
treat Ms. Flug's compensable injury."4  Majority op., ¶23.  
 No such finding exists.  
¶126 Likewise, the majority asserts that we must accept the 
Commission's factual finding that the "object of Ms. Flug's 
surgery was not her compensable injury."  Majority op., ¶34. 
 No such finding exists. 
¶127 The majority further asserts that Ms. Flug's argument 
is beyond its reach, because she "does not assert the findings 
                                                 
4 The ALJ found as a factual matter that there was a 
variance in the history Ms. Flug gave her treating physicians.  
Based on this factual finding, the ALJ made the conclusion of 
law that "there is a legitimate doubt as to the compensability 
of the claim as a traumatic injury beyond that already conceded 
and paid by the respondents."   
 
No. 2015AP1989.awb   
 
9 
 
of fact are the result of fraud, or that the Commission acted 
outside of its powers."  Majority op., ¶23.  
 Ms. Flug has consistently argued that the Commission 
acted outside of its powers.  In her appeal to the 
circuit court she argued that "LIRC acted without and 
in excess of its powers as described in Wis. Stat. 
§ 102.23."  She continued this argument in the court 
of appeals, which explained that "Flug argues the 
Commission acted in excess of its powers in three 
respects."  Flug v. Labor & Indus. Review Comm'n, No. 
2015AP1989, ¶24, unpublished slip op. (Wis. Ct. App. 
June 21, 2016). 
 The majority contradicts itself when it asserts that 
Flug does not argue here that LIRC acted in excess of 
its powers.  What does "acted in excess of its powers" 
means in the context of worker's compensation?  It is 
well-settled that "when a decision by LIRC is not 
supported by credible and substantial evidence, the 
decision is in excess of LIRC's authority."  Xcel 
Energy Serv. Inc., v. Labor and Indus. Review Comn'n, 
2013 WI 64, ¶55, 349 Wis. 2d 234, 833 N.W.2d 665.    
 And 
yet, 
that 
is 
precisely 
what 
the 
majority 
acknowledges is advanced here.  The majority describes 
Ms. Flug's arguments as "a continuation of the 
argument Ms. Flug made in the court of appeals, where 
she unequivocally stated she "'sustained a compensable 
injury and . . . underwent surgery for a compensable 
No. 2015AP1989.awb   
 
10 
 
injury.'  Ms. Flug maintained this position even 
through oral argument here."  The basis of Ms. Flug's 
argument is that LIRC's decision was not supported by 
the relevant evidence of record:  "She says the 
relevant 
medical 
testimony 
establishes 
that 
the 
surgery for the injury was reasonable and necessary" 
and that "her surgery was, in fact, for a compensable 
injury."   Majority op., ¶¶20, 23. 
¶128 Attempting to explain the reasoning of LIRC and the 
court of appeals, the majority offers that "both the Commission 
and the court of appeals base their competing analyses on the 
shared understanding that Ms. Flug's surgery had nothing to do 
with her compensable injury."  Majority op., ¶20.   
 The Commission could not have based its analysis on 
the understanding that her surgery had nothing to do 
with her compensable injury because it concluded that 
she had no compensable injury.   
 The court of appeals never determined whether Ms. 
Flug's surgery was related to her compensable injury.  
Instead, as the majority earlier acknowledged the 
court of appeals didn't need to decide "whether the 
invasive 
procedure 
was 
actually 
directed 
at 
a 
compensable injury, so long as the employee had a good 
faith belief that it was."  Majority op., ¶19. 
¶129  Having set forth some of the majority's errors in 
what it says, I address next what it fails to say.  It is only 
by relying on some of these errors that the majority is able to 
No. 2015AP1989.awb   
 
11 
 
remain silent, refraining from addressing Ms. Flug's essential 
argument. 
¶130 Although the majority acknowledges that Ms. Flug's 
true argument is that her surgery was necessitated by the 
February 14, 2013, event because it aggravated and accelerated 
beyond 
normal 
progression 
a 
progressively 
deteriorating 
condition, it insists that it cannot discuss it.  The majority 
contends that it is precluded from addressing Ms. Flug's 
argument 
regarding 
the 
nature 
of 
her 
injury 
because 
of 
nonexistent findings of fact.  Majority op., ¶23 ("Thus, because 
the Commission eliminated the factual predicate for Ms. Flug's 
argument, we would not be able to engage it unless we first 
rejected the Commission's finding on this point.").  It declares 
that "Ms. Flug's argument [is] beyond our reach."  Id. 
¶131 The majority is likewise silent about the extent of 
Ms. Flug's disability.  It emphasizes in its recitation of facts 
that at a one month post surgery appointment Ms. Flug stated 
that "she was doing 'excellent' and feeling 'almost 100 
[percent]'".  Majority op., ¶4.  The picture that the majority 
paints makes the reader wonder whether Ms. Flug has any 
disability whatsoever.  Nowhere in the majority opinion is the 
reader advised that the surgery causes permanent limitations. 
The worker's compensation administrative rules recognize that a 
minimum disability for each level of a discectomy/fusion is 10 
No. 2015AP1989.awb   
 
12 
 
percent permanent partial disability.5  Ms. Flug had procedures 
at two levels of her cervical spine.  
¶132 Finally, the majority says nothing about that part of 
LIRC's February 23, 2015, decision where it excluded any 
potential for reliance on Dr. Soriano's report.  The majority 
relies on the report despite LIRC's determination that the ALJ 
"did not adopt the findings of Dr. Soriano."  Flug v. Wal Mart 
Assocs., Inc., WCD No. 201300610 (LIRC, Feb. 23, 2015).  
¶133 In sum, because the February 23, 2015, decision of 
LIRC is clearly erroneous and not supported by any findings of 
fact, I would remand this case to LIRC for a new hearing, 
providing an opportunity to weigh the competing medical opinions 
and then, based on those opinions, issue new findings of fact 
and a conclusion of law that is not clearly erroneous. 
¶134 Accordingly, I respectfully dissent. 
¶135 I am authorized to state that Justice SHIRLEY S. 
ABRAHAMSON joins this dissent. 
                                                 
5 Ms. Flug had surgery on both the C-5/C-6 level and the C-
6/C-7 level.  The Department of Workforce Development rule 
governing a scheduled worker's compensation injury provides in 
relevant part that "[t]he disabilities set forth in this section 
are the minimums for the described conditions."  DWD 80.32(1) 
(2015-16); see also Wis. Stat. § 102.52.  The minimum permanent 
partial disability rating for a discectomy and fusion is 10% per 
level.  DWD 80.32(11). 
 
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