Opinion ID: 1949722
Heading Depth: 2
Heading Rank: 1

Heading: The Reduction in Nixon's Disability Benefits

Text: In arguing that the ALJ's and CRB's decisions are not supported by substantial evidence in the record, Nixon points to the ALJ's finding that the District, Nixon's employer, met its burden of demonstrating a change in [Nixon's] medical condition  (italics added) and to the CRB's agreement that the District demonstrate[d] that there was a change in [Nixon's] medical condition to justify a modification in her benefits. (Italics added). Nixon contends that, contrary to these findings, the medical evidence in the record proves that there was no significant change in the condition of [her] foot that would support a change or reduction in disability benefits. She cites both her own testimony that the condition of her foot has not improved for the better and physician reports in the record that confirm that she reached maximum medical improvement in 1998  meaning, Nixon argues, that there was no change in her medical condition in 2004, the year when the District determined to reduce her benefits. The issue before the ALJ, however, was whether there was a change in Nixon's medical condition from the time when it was previously determined that she qualified for temporary total disability benefits. The record shows that a DOES Hearings and Appeals Examiner found in October 1997 that Nixon had not reached maximum medical improvement [2] following her January 1996 work-related injury and that the District had failed to prove that Nixon was no longer disabled from that injury. But when DOES announced nearly seven years later, in September 2004, that it would reduce Nixon's benefits, the change on which it relied was that Nixon had reached maximum medical improvement in the years between 1997 and 2004, and no longer was totally disabled. More specifically, DOES relied on an April 23, 2004 letter from Independent Medical Evaluator (IME) Dr. Noel Gressieux, opining that Nixon had reached maximum medical improvement and was capable of returning to sedentary type of work; and on a July 8, 2004 letter from IME Dr. Robert Smith, who agreed that Nixon had reached maximum medical improvement with regard to orthopedic treatment and any type of surgery and opined that, with some continued limited treatment to control her pain syndrome on a permanent basis, she could do a sedentary type job, full time with standing and walking limited to 10 minutes out of every hour. Both IMEs concluded that five sedentary positions identified in a Labor Market Survey and Job Search conducted by Vocational Assessment Services were commensurate with Nixon's limitations. The ALJ found that with the foregoing evidence, the District had met its burden of proof with respect to a modification of benefits and that the burden therefore shifted to Nixon to bring forth medical evidence to show that she [was] not able to return to not only her regular duties but the identified sedentary duties as well. Nixon attempted to meet that burden by offering a March 24, 2006 letter from her treating physician, Dr. Howard Horowitz, but Dr. Horowitz corroborated the IMEs' opinions that Nixon had reached maximum medical improvement and that there [was] no impediment to her engaging in [sedentary] employment so long as certain restrictions [regarding the amount of time she spent standing or walking per hour were] observed. We think there can be no serious disagreement that the foregoing reports constituted substantial evidence supporting the ALJ's finding and the CRB's conclusion that there was a change in Nixon's condition that justified the reduction in her benefits.