report, Dr. Monroe responded to the questions contained in the appeals 

officer's order and opined that he could not find, within a degree of 

reasonable medical probability, that Nortier's right ankle injury was 

causally related to her industrial injury. Because Nortier failed to bring 

her MRI of her left knee to the initial visit, Dr. Monroe also issued an 

addendum finding that her left knee injury was more consistent with 

arthritis rather than a work related injury. 

The appeals officer ultimately denied Nortier's request to 

expand her worker's compensation claim to include her right ankle. The 

appeals officer relied on Dr. Monroe's two reports and addendum, finding 

the reports to be credible in showing Nortier had an extensive preexisting 

condition that was not aggravated by her industrial injury. Nortier filed a 

petition for judicial review that was denied by the district court. This 

appeal followed. 

"Like the district court, we review an appeals officer's decision 

in a workers' compensation matter for• clear error or an abuse of 

discretion." Vredenburg v. Sedgtvick CMS, 124 Nev. 553, 557, 188 P.3d 

1084, 1087 (2008); see NRS 233B.135(3). While the appeals officer's legal 

determinations are reviewed de novo, "the appeals officer's fact-based legal 

conclusions are entitled to deference and will not be disturbed if they are 

supported by substantial evidence." Dickinson v. Am. Med. Response, 124 

Nev. 460, 465-66, 186 P.3d 878, 882 (2008). Although the appeals officer 

misstated the findings in Dr. Monroe's addendum, 1substantial evidence 

1The appeals officer found that Dr. Monroe reviewed scans of 

Nortier's right ankle and that based off those scans, he determined that 

her right ankle condition was not related to the industrial injury. 

However, Dr. Monroe only reviewed an MRI scan of Nortier's left knee and 

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nonetheless supports the appeals officer's decision and order. Nortier's 

medical records indicate three previous surgeries and medical attention to 

her right Achilles tendon dating back to 2003. Moreover, Nortier's medical 

records show a pattern of sudden onset Achilles tendon pain without any 

instance of trauma or injury. Finally, Dr. Monroe documented in his 

report that a previous surgeon noted in Nortier's medical record that the 

previous debridement surgeries made the right ankle prone to weakness 

and rerupture. 2We therefore affirm the district court's order denying 

judicial review. 

It is so ORDERED. 

teeA J. 

Hardesty 

ima J. 

Douglas 

...continued 

determined that the injury to her left knee was not related to the 

industrial injury. 

2Nortier also argues that the reports of Dr. Monroe are 

contradictory, such that they cannot constitute substantial evidence. We 

conclude that this argument lacks merit. 

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cc: Hon. Timothy C. Williams, District Judge 

Persi J. Mishel, Settlement Judge 

Greenman Goldberg Baby & Martinez 

Lewis Brisbois Bisgaard & Smith, LLP/Las Vegas 

Eighth District Court Clerk 

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