Source: https://casetext.com/case/ana-vasquez-v-sweetheart-cup-co
Timestamp: 2019-04-24 16:17:58+00:00

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The insurer appeals an administrative judge's decision awarding the employee a closed period of weekly § 35 temporary partial incapacity benefits and ongoing weekly § 34 temporary total incapacity benefits. The insurer argues that, though it raised § 1(7A) and produced evidence of a pre-existing condition, the judge failed to apply the heightened causation standard of § 1(7A). We disagree that the judge was required to evaluate the case under § 1(7A), and affirm the decision.
Ms. Vasquez was approximately three months pregnant at the time of her accident, and delivered a baby by Caesarian section in February 2002. (Tr. 18; Employee Exh. 3 [February 8, 2002 report of Dr. Aubrey]).
If a compensable injury or disease combines with a pre-existing condition, which resulted from an injury or disease not compensable under this chapter, to cause or prolong disability or a need for treatment, the resultant condition shall be compensable only to the extent such compensable injury or disease remains a major but not necessarily predominant cause of disability or need for treatment.
Dr. Aubrey [sic] made no mention of there being any contribution from any pre-existing condition to the present state of the back diagnoses or the disability. He stated straightforwardly that the cause of the back condition was the work accident. Having adopted his opinion, and having rejected Dr. Abate's with respect to the employee's conditions and the cause(s) of the conditions diagnosed, I find that I do not have to reach a § 1(7A) question. Section 1(7A) comes into play only where the industrial injury combines with a pre-existing condition in creating the disability, and, here, the adopted opinion of Dr. Aubrey makes no mention of anything else combining with the industrial injury in causing the disability.
The insurer also argues that the employee's intervening pregnancy may have been the cause of her symptoms and inability to work. (Insurer br. 5.) However, where the judge has found that the employee suffered an industrial injury, her subsequent pregnancy does not break the causal chain between work and the employee's incapacity. Bemis v. Raytheon Corp., 15 Mass. Workers' Comp. Rep. 408, 412-413 (2001).
The insurer's argument ignores the requirement that the judge must find that "a pre-existing condition, which resulted from an injury or disease not compensable under this chapter" combines with the work injury. See G.L. c. 152, § 1(7A). Though the insurer arguably produced some evidence of a pre-existing condition through Dr. Abate's opinion that "age rather than any trauma" caused any findings in her MRI report (Dec. 5), the judge was not persuaded that the alleged condition combined with her undisputed work injury of July 24, 2001. Instead, he was persuaded by and adopted Dr. Awbrey's unequivocal opinion that "the cause" of the employee's back condition was the work injury. (Dec. 10.) As a result, the judge correctly analyzed the employee's ongoing incapacity under the simple causation standard. See Cook v.Stop Shop Co., 15 Mass. Workers' Comp. Rep. 252, 258 (2000);Fairfield v. Communities United, 14 Mass. Workers' Comp. Rep. 79, 82 (2000).
We do not address whether the pre-existing condition alleged by the insurer resulted from an "injury or disease" as required to trigger the application of § 1(7A), but simply point out that not all pre-existing conditions require § 1(7A)'s application. See Blais v. BJ's Wholesale Club, 17 Mass. Workers' Comp. Rep. 187 (2003) (employee's degenerative disc condition normal for a person of her age — age not a pre-existing illness or disease, therefore first element of § 1(7A)'s application missing); Errichetto v.Southeast Pipeline Contractors, 11 Mass. Workers' Comp. Rep. 88, 91 (1997) (age cannot be considered as a § 1(7A) "pre-existing condition"); Fairfield v.Communities United, 14 Mass. Workers' Comp. Rep. 79 (2000) (§ 1(7A) inapplicable because there was no medical evidence that obesity is a "disease").
In Cook, supra, we noted that the judge had erred by relying on the opinions of medical experts who were either unaware of or did not opine regarding the effects of a pivotal prior non-work-related motor vehicle accident. Id. at 258-259. The facts in Cook are distinguishable from those in the instant case. Here, there was no historical inaccuracy, merely a disagreement between Dr. Abate and Dr. Awbrey as to how the MRI should be interpreted in light of their different physical findings.
Thus, the judge did not err in applying the simple "as is" causation standard in evaluating the case. Since the opinion of Dr. Awbrey, which he was free to adopt over that of the § 11A examiner, see Blais, supra at 191, clearly satisfies this causation standard, we affirm the judge's decision.
Pursuant to § 13A(6), the employee's attorney is awarded a fee of $1,312.21.

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