Court Opinion

ID: 9402196
Source: CourtListenerOpinion
Date Created: 2023-06-15 15:08:03.320935+00
Date Added: 2024-06-11T17:19:58.356688
License: Public Domain

IMPORTANT NOTICE
        NOT TO BE PUBLISHED OPINION

THIS OPINION IS DESIGNATED “NOT TO BE PUBLISHED.”
PURSUANT TO THE RULES OF CIVIL PROCEDURE
PROMULGATED BY THE SUPREME COURT, CR 76.28(4)(C),
THIS OPINION IS NOT TO BE PUBLISHED AND SHALL NOT BE
CITED OR USED AS BINDING PRECEDENT IN ANY OTHER
CASE IN ANY COURT OF THIS STATE; HOWEVER,
UNPUBLISHED KENTUCKY APPELLATE DECISIONS,
RENDERED AFTER JANUARY 1, 2003, MAY BE CITED FOR
CONSIDERATION BY THE COURT IF THERE IS NO PUBLISHED
OPINION THAT WOULD ADEQUATELY ADDRESS THE ISSUE
BEFORE THE COURT. OPINIONS CITED FOR CONSIDERATION
BY THE COURT SHALL BE SET OUT AS AN UNPUBLISHED
DECISION IN THE FILED DOCUMENT AND A COPY OF THE
ENTIRE DECISION SHALL BE TENDERED ALONG WITH THE
DOCUMENT TO THE COURT AND ALL PARTIES TO THE
ACTION.
                                                    RENDERED: JUNE 15, 2023
                                                       NOT TO BE PUBLISHED

               Supreme Court of Kentucky
                               2022-SC-0427-WC

RICHARD COLE                                                         APPELLANT

                  ON APPEAL FROM COURT OF APPEALS
V.                         NO. 2022-CA-0558
                WORKERS’ COMPENSATION NO. WC-13-67013

KY FUELS CORP.; HONORABLE                                            APPELLEES
JONATHAN ROBERT WEATHERBY,
JR., ADMINISTRATIVE LAW JUDGE;
AND WORKERS’ COMPENSATION
BOARD

                  MEMORANDUM OPINION OF THE COURT

                                  AFFIRMING

      This workers’ compensation matter has a lengthy procedural history and

is before this Court for a second time since the initial claim was reopened in

2017. We are again tasked with determining whether the Court of Appeals

correctly affirmed the Workers’ Compensation Board’s (Board) opinion vacating

and remanding the Administrative Law Judge’s (ALJ) decision that Richard

Cole was permanently totally disabled due to a work-related injury. Following

a careful review, we affirm the Court of Appeals.
      Because this matter has been thoroughly litigated and the facts have

been previously set forth in three separate appellate decisions,1 we provide only

a truncated factual and procedural history necessary for resolution of the sole

issue presented. Cole sustained a work-related injury in 2013 while working

for KY Fuels Corp. In 2015, Cole’s initial workers’ compensation claim was

resolved upon a finding by ALJ Thomas Polites that the work-related injury

aroused a pre-existing dormant degenerative spine issue into a disabling

reality. He was awarded permanent partial disability (PPD) benefits based on a

10% impairment rating enhanced by the three-multiplier as required by KRS2

342.730(1).

      In 2017, the claim was reopened on the grounds Cole’s condition had

worsened to the point that he was totally disabled. ALJ Jonathan Weatherby

concluded in 2018 that Cole’s worsening symptoms had increased his

functional impairment sufficiently to grant an award of permanent total

disability benefits (PTD). KY Fuels appealed to the Board which found that

although Cole’s condition had worsened, the ALJ had failed to provide a

sufficient analysis under Ira A. Watson Dep’t Store v. Hamilton, 34 S.W.3d 48

(Ky. 2000), to substantiate a PTD award. The Board remanded for further

findings relative to the work-relatedness of Cole’s worsening condition.

      1  KY Fuels Corp. v. Cole, No. 2019-CA-1519-WC, 2020 WL 6112924 (Ky. App.
Oct. 16, 2020); Cole v. KY Fuels Corp., No. 2020-SC-0548-WC, 2021 WL 4489018 (Ky.
Sept. 30, 2021); Cole v. KY Fuels Corp., No. 2022-CA-0558-WC, 2022 WL 3721740 (Ky.
App. Aug. 26, 2022).

      2   Kentucky Revised Statutes.

                                        2
      On remand, the ALJ provided a somewhat more detailed analysis on the

work-relatedness of Cole’s worsened condition and reached the same result as

it had previously. KY Fuels again appealed to the Board which affirmed upon

concluding the ALJ’s supplemental findings were “minimally sufficient.” KY

Fuels petitioned the Court of Appeals to review the Board’s decision. The Court

of Appeals reversed, holding the ALJ failed to appropriately distinguish between

Cole’s work-related injury and his other non-compensable medical conditions.

Further, it noted the ALJ had cited no medical opinion on causation supporting

the award of PTD. Thus, the Court of Appeals vacated the PTD award,

remanded to the ALJ, and specifically ordered additional findings supported by

expert medical evidence determining whether the work-related injury caused

Cole’s total disability. Cole then appealed to this Court. A majority of this

Court affirmed on the basis that the Court of Appeals correctly concluded the

ALJ’s determination was unsupported by substantial evidence and the Board

was directed to remand to the ALJ to make specific findings regarding the

work-relatedness of Cole’s total disability.

      In early 2022, the ALJ entered an amended opinion ostensibly

addressing the findings required by our remand. Although the factual findings

and legal conclusions were somewhat more complete than in prior orders, KY

Fuels believed the ALJ had not complied with the instructions set forth in the

opinions of this Court and the Court of Appeals because the ALJ did not cite

medical proof substantiating Cole’s worsening was due to the work-related

injury rather than his other non-compensable medical issues. After the ALJ

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denied a petition to reconsider, KY Fuels appealed to the Board which

concluded the ALJ had, in fact, failed to address Cole’s nonwork-related

conditions in reaching its decision. Acknowledging Cole’s impairment had

increased, the Board vacated the ALJ’s order and remanded “to make findings

and an award based on the 13% impairment rating and the increase in

permanent partial disability benefits.”

      Cole petitioned the Court of Appeals to once again review the Board’s

determination. After recounting the procedural history of the matter, the Court

of Appeals noted

      [t]he issue which the ALJ has been charged with since 2017 is whether
      there has been a showing ‘by objective medical evidence of worsening or
      improvement of impairment due to a condition caused by the injury since
      the date of the award or order.’ KRS 342.125(1)(d). That issue remains
      to be resolved[.]

      Cole v. KY Fuels Corp., 2022 WL 3721740 at *3. The Court of Appeals

held the ALJ had failed to follow the five-part test set forth in City of Ashland v.

Stumbo, 461 S.W.3d 392, 396-97 (Ky. 2015), to determine whether Cole was

permanently totally disabled.3 As to each step, the court concluded the ALJ

had not linked Cole’s worsening to the work-related injury nor had it addressed

his nonwork-related conditions. Because the ALJ failed to make the requisite

      3  Under Stumbo, to find a claimant is totally disabled, an ALJ must first
determine whether a claimant suffered a work-related injury. They must then
determine what impairment rating a claimant has, if any. Third, a determination
must be made of a claimant’s permanent disability rating. Fourth, the ALJ is tasked
with determining if a claimant is unable to perform any type of work. Finally, there
must be an explicit finding that the total disability is the result of the work-related
injury.

                                            4
findings, the Court of Appeals concluded the Board had not overlooked or

misconstrued the applicable law nor erroneously assessed the evidence, and

therefore affirmed. Cole then filed the instant appeal.

      Cole argues the Board and the Court of Appeals improperly decided the

various appeals before them and subsequently ignored this Court’s directives

on remand.4 He contends the ALJ appropriately specified evidence relied upon

to determine Cole’s worsened difficulties are work related, as mandated by this

Court, yet the Board and Court of Appeals erroneously found to the contrary.

We disagree.

      The Court of Appeals conducts a review of the Board with the purpose of

“[correcting] the Board only where the Court perceives the Board has

overlooked or misconstrued controlling statutes or precedent, or committed an

error in assessing the evidence so flagrant as to cause gross injustice.” W.

Baptist Hosp. v. Kelly, 827 S.W.2d 685, 687-88 (Ky. 1992). Further review by

this Court of the decisions of the Court of Appeals and the Board is meant “to

address new or novel questions of statutory construction, or to reconsider

precedent when such appears necessary, or to review a question of

constitutional magnitude.” Id. at 688. “As a reviewing court, we are bound

      4   Cole also raises a “res judicata” argument, asserting the initial finding by ALJ
Polites that the work-related injury aroused a preexisting dormant condition into a
disabling reality forecloses further litigation regarding whether substantial evidence
supports a finding the worsening of his condition renders him totally disabled.
However, a majority of this Court previously discussed and rejected the same
argument in our 2021 decision. Cole’s attempt to relitigate the issue at this late stage
is plainly improper. Therefore, no further comment on Cole’s contention of error is
warranted.
                                            5
neither by an ALJ’s decisions on questions of law or an ALJ’s interpretation

and application of the law to the facts. In either case, our standard of review is

de novo.” Bowerman v. Black Equip. Co., 297 S.W.3d 858, 866 (Ky. App. 2009).

      This Court has held parties in workers’ compensation actions are

“entitled to a sufficient explanation by the ALJ of the basis for the decision.”

Whittaker v. Rowland, 998 S.W.2d 479, 481 (Ky. 1999). More specifically,

“workers’ compensation litigants are entitled to know the evidentiary basis for

an ALJ’s findings of fact and conclusions of law, and an ALJ’s opinion must

summarize the conflicting evidence concerning disputed facts, weigh the

evidence to make findings of fact, and determine the legal significance of those

findings.” Miller v. Go Hire Emp’t Dev., Inc., 473 S.W.3d 621, 630 (Ky. App.

2015) (citing Arnold v. Toyota Motor Mfg., 375 S.W.3d 56, 61-62 (Ky. 2012)).

      As noted by the Court of Appeals, since 2017 the ALJ has been charged

with citing objective medical evidence establishing Cole’s worsened and now

totally disabling condition was causally related to his work-related injury. At

every stage of review since that time, KY Fuels Corp. has argued the ALJ has

failed to fulfill this charge. The Board, the Court of Appeals, and this Court

have agreed. Yet, after multiple remands setting forth explicit instructions to

do so, the ALJ has failed to either identify the required medical proof of record

establishing the causal connection necessary for an award of increased income

benefits relative to the claimant’s reopening or, in the absence thereof, to revisit

the PTD award.

                                         6
      This case presents a sympathetic claimant suffering from myriad

maladies—some work-related and others not. The ALJ has provided sufficient

citation to evidence of record which supports its finding that Cole’s worsened

condition now renders him permanently and totally disabled. What remains

missing, however, is a designation of medical evidence within the record which

would support a finding that Cole’s permanent and total disability has resulted

from a worsened work-related injury exclusive of any consideration of

nonwork-related conditions as required by KRS 342.730(1)(a).5 Without a

specific citation to required medical evidence of record establishing such a

causal connection, no award of PTD benefits is permissible because the ALJ

would be unable to complete the five-step process mandated in Stumbo.

      Therefore, we are again constrained to remand this matter to the Board

with directions to remand to the ALJ for additional findings. Upon such

remand, the ALJ must enter findings sufficient to identify the particular

objective medical evidence establishing the causal connection discussed herein

which would authorize an award of PTD benefits. If no such medical evidence

exists, the ALJ must reassess the claim based solely on the evidence of record,

excluding consideration of any nonwork-related conditions.

      Based on the foregoing, we must again affirm the decision of the Court of

Appeals and remand for further proceedings consistent with this opinion.

      5  KRS 342.730(1)(a) states, in pertinent part: “Nonwork-related impairment
and conditions compensable under KRS 342.732 and hearing loss covered in KRS
342.7305 shall not be considered in determining whether the employee is totally
disabled for purposes of this subsection.”

                                         7
      VanMeter, C.J.; Bisig, Conley, Keller, Lambert and Nickell, sitting. All

concur. Thompson, J., not sitting.

COUNSEL FOR APPELLANT:

Randy G. Clark

COUNSEL FOR APPELLEE:

Steven L. Kimbler
Pohl, Aubrey, Gray, P.S.C.

ADMINISTRATIVE LAW JUDGE:

Hon. Jonathan Robert Weatherby, Jr.

WORKERS’ COMPENSATION BOARD:

Michael Wayne Alvey

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