| Opinion: | Anatolia Restaurant v. Burton, 2022 OK CIV APP 8 |
| Subject Matter: | Specificity of Injury for Workers’ Comp |
| Date Decided: | March 4, 2022 |
| Trial Court: | Oklahoma Workers’ Compensation Commission; Administrative Law Judge |
| Route to this Court: | Appeal of order from ALJ |
| Facts: | Claimant testified that “her feet [came] right out from underneath [her]” on the icy sidewalk outside her place of employment — a restaurant — where she had been working the night shift. She stated the fall occurred after she “turned around [to] make sure [the doors] were locked” after “closing up.” She was Claimant was subsequently examined by Dr. Christopher Jordan on January 15, 2019 who “thought [she] had suffered valgus stress with external rotation of the knee”; whether he placed Claimant “in a knee immobilizer in the ER and . . . diagnosed a Grade 3 sprain of the MCL and possible or probable medial meniscus tear and recommended an MRI”; whether he read the MRI as “documenting a bone contusion of the lateral femoral condyle and fluid around the ACL insertion”; and whether he recommended physical therapy. After 6 months of physical therapy, Claimant still experience pain and swelling. Dr. Jordan declared Claimant “maximum medical improvement.” In response, Claimant affirmed that she wanted to seek the opinion of another physician. Claimant has filed a CC Form A to request a change of treating physician. Claimant requests [Employer] identify potential physicians for a CC Form A Order.” The ALJ rejected Employer’s assertion that Claimant fell in an area that was “not owned[,] maintained [and] operated by [Employer].” Instead, the ALJ found that “the sidewalk where [Claimant] fell was [Employer’s] premises.” Employer requested at the hearing before the ALJ that there be provided “a specific finding of what the injury is.” But “[t]he questions presented at trial were whether claimant was acting in the course and scope of her employment at the time of the fall, and whether claimant suffered any injury to her left knee in the fall.” The ALJ concluded that, “[b]ased upon Dr. Jordan’s reports, claimant sustained an injury to the left knee.” The ALJ also found Claimant “is entitled to a change of physician via Form A Order.” |
| Standard of Review: | Appellate review of the order in this case is therefore set forth in the Administrative Workers’ Compensation Act (AWCA), 85A O.S. §§ 1-125.2 Title 85A O.S. Supp. 2014 § 78(C). The issue raised on appeal by Employer regarding the lack of a more precise finding regarding the injury sustained by Claimant raises the issue of the applicability of § 78(C)(8) (“Missing findings of fact on issues essential to the decision”). Employer also asserts the lack of such a finding has deprived Employer “of its due process rights to adequately defend the case,” thus raising the issue of the applicability of § 78(C)(1) (“In violation of constitutional provisions”). The issues raised by Employer present issues of law only, and issues of law are reviewed de novo. |
| Analysis: | The Court first addressed the specificity of compensability finding in response to Employer’s assertion that the Commission failed to properly specify the compensable injury. The AWCA provides that “[a]dministrative law judges are required to make specific, on-the-record findings of ultimate facts responsive to the issues shaped by the evidence as well as conclusions of law on which its judgment is to be rested.” 85A O.S. Supp. 2014 § 72(A)(4). Because of this requirement, it is not necessary for a party to request specific findings. The Oklahoma Supreme Court has explained that, “Findings of an administrative agency . . . should contain a recitation of basic or underlying facts drawn from the evidence sufficiently stated to enable the reviewing court to intelligently review the decision and ascertain if the facts upon which the order is based create a reasonable basis for the order.” Jackson v. Indep. Sch. Dist. No. 16 of Payne Cnty., 1982 OK 74, ¶13. If there is only one injury that Claimant could have been found to have sustained, then the ALJ’s finding that “Claimant sustained a compensable injury to the LEFT KNEE as a result of a single incident accident occurring in the course and scope of employment” is not in need of further specification to enable this Court to intelligently review the decision. Section 72(A)(4) does not require the ALJ to set fort descriptions in its findings beyond what is essential to its decision. There is also no requirement that the ALJ employ language or medical terms beyond what is essential to its decision. The second issue the Court addressed was Employer’s claim that there was a substantive due process issue with the indefiniteness of the injury described in that it could not present a valid defense to it. One problem with Employer’s argument is that, as discussed in the preceding section, “[a]dministrative law judges are required to make specific, on-the-record findings of ultimate facts responsive to the issues shaped by the evidence as well as conclusions of law on which its judgment is to be rested.” 85A O.S. Supp. 2014 § 72(A)(4). Employer showed concern as to whether Claimant had sustained an injury to the same knee during the appeals process that required surgery. Even if Claimant were to sustain another injury to her left knee, § 50 contains mechanisms intended to resolve such issues. If any dispute becomes more than merely abstract, the AWCA provides that a hearing may be requested. 85A O.S. Supp. 2014 § 111(C). |
| Outcome: | Sustained order of the ALJ. |
| Vote: | 3-0. Fischer, C.J., Hixon, J., and Barnes, P.J. (author), concur. |
| Other: | N/A |