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Courts Must Construe Evidence Favorably to the Party Prevailing Before the State Board of Workers' Compensation

October 25, 2017

            In the Court of Appeals of Georgia, Appellant, Autozone, Inc., sought review of a judgment that reversed a ruling of the State Board of Workers' Compensation (the “Board”), which denied certain benefits to the Appellee, Eulalia Mesa.  Autozone, Inc. v. Mesa, 2017 WL 3994457 (Ga. Ct. App. 2017).  In November 2010, Appellee was working for Appellant as a clerk and delivery driver.  While out on a delivery, the truck that Appellee was driving was “rear-ended” by another car, injuring her back and neck.  Shortly after the accident, Appellee returned to light-duty status with Appellant, and in January 2011, a treating physician cleared her to resume her delivery duties.  In January 2012, Appellee was examined by Dr. Jonathan Hyde, who recommended surgery and classified her as “off work status.”  Appellee continued to work for Appellant until March 2012.

 

            Over the next two and a half years, Appellee had three appointments with Dr. Hyde. After each examination Dr. Hyde noted that “[t]his patient is fully capable of working within the restrictions given. There is no change in restrictions.”  However, in December 2014, Dr. Hyde recommended another surgery to address pain in Appellee’s right-side.  As a result, Appellant sent the Appellee for an independent medical evaluation (“IME”) with Dr. Peter Millheiser.  Dr. Millheiser reviewed all of Appellee’s medical history and conducted a physical examination of Appellee.  Dr. Millheiser concluded that Appellee was able to do regular daily activities and regular work without restrictions; therefore, she was at the “endpoint” in her treatment. 

 

            Based on the IME, Appellant denied responsibility for Appellee's surgery, and the parties agreed to have the ALJ resolve the matter as to whether the surgery was reasonable and necessary. The ALJ based his finding on Dr. Millheiser's opinion and denied Appellee’s request for benefits.  Appellee appealed to the Board, and the Board found that the ALJ was in the best position to determine the credibility and weight of evidence in the record.  Appellee then sought review in the superior court, which set aside the Board’s decision, finding that Dr. Hyde’s opinion should have carried more weight because Dr. Millheiser did not perform “medical testing of any kind” on the Appellee, but, instead, relied only upon a physical examination of the Appellee and his review of her medical records and test results.

 

            The superior court also found that the decision of the ALJ and the Board was contrary to OCGA § 34–9–200 (a)6, which requires an employer to provide benefits for treatment to injured workers that is prescribed by a licensed physician in order to provide relief for work-related injuries. Id. at *3.  On appeal, the Court of Appeals of Georgia held that while Dr. Millheiser did not conduct any “objective” medical tests on the Appellee, it is undisputed that he examined her and reviewed all of her medical records and test results, including the results of Dr. Hyde’s examinations.  Id. at *5.  Additionally, in reviewing an award of workers' compensation benefits, courts must construe the evidence in a light most favorable to the party prevailing before the Board.  Id. at *4.  Consequently, the court concluded that the superior court exceeded its authority when it substituted itself as the factfinder in lieu of the ALJ and the Board. Id. at *5.  Therefore, the Court reversed the superior court’s ruling and affirmed the Board.

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