Brashar v. Univ. of Calif. Regents , 2014 NMCA 68 ( 2014 )


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    New Mexico Compilation
    Commission, Santa Fe, NM
    '00'04- 15:02:56 2014.07.02
    Certiorari Denied, June 18, 2014, No. 34,699
    IN THE COURT OF APPEALS OF THE STATE OF NEW MEXICO
    Opinion Number: 2014-NMCA-068
    Filing Date: April 9, 2014
    Docket No. 32,246
    LYNDA BRASHAR,
    Worker-Appellant,
    v.
    REGENTS OF THE UNIVERSITY OF
    CALIFORNIA d/b/a LOS ALAMOS
    NATIONAL LABORATORIES,
    Employer/Insurer-Appellee.
    APPEAL FROM THE WORKERS’ COMPENSATION ADMINISTRATION
    Terry S. Kramer, Workers’ Compensation Judge
    Lynda R. Brashar
    Ohkay Owingeh, NM
    Pro Se Appellant
    Allen, Shepherd, Lewis, & Syra, P.A.
    Kimberly A. Syra
    Albuquerque, NM
    for Appellee
    OPINION
    VIGIL, Judge.
    {1}     Lynda Brashar (Worker) filed a claim for workers’ compensation benefits, alleging
    she suffered from heavy metal toxicity due to toxic exposure she experienced in her employ
    as a chemistry technician at the Los Alamos National Laboratories (Employer). The
    workers’ compensation judge (WCJ) denied her claim. Worker appeals, arguing, among
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    other things, that the WCJ erred in admitting the testimony of Dr. Don Fisher, the only
    expert testimony supporting no workplace causation. Worker contends that Dr. Fisher’s
    testimony was inadmissable because he was neither her treating physician nor a health care
    provider who provided an independent medical examination (IME). We agree with Worker
    and reverse.
    BACKGROUND
    {2}     The following facts are undisputed. Worker worked as a chemistry technician at Los
    Alamos National Laboratories. Her duties included analyzing samples to determine the
    concentration of materials in the samples, including testing for the presence of heavy metals.
    Worker notified Employer as early as June 5, 1997, that she was concerned she might be
    experiencing symptoms from workplace exposure to mercury. Worker’s symptoms began
    on April 10, 1997, when she experienced an episode of fecal incontinence while at work.
    She was then hospitalized for three days beginning April 14, 1997, for a kidney infection.
    Between 1997 and 2006, Worker sought treatment from several providers and was seen
    twenty-three times in Employer’s occupational medicine unit to address numerous problems
    including night sweats, possible menopause, depression, severe fatigue, weight loss, mood
    swings, anxiety, urinary tract infection, candida, diarrhea, and fever. She also took several
    medical leaves of absence between August 1997 and October 2005, until she was no longer
    able to work beginning November 2005.
    {3}    A formal hearing was held on February 17, 2012, to address Worker’s claim. Dr.
    Ralph Luciani, Dr. Deborah Werenko, and Dr. Fisher testified by deposition.
    {4}     Worker started seeing Dr. Luciani in 1997 regarding her heavy metal toxicity
    concerns. He testified that the symptoms she complained of including lethargy, depression,
    yeast infections, irritable bowel syndrome, slightly elevated anti-nuclear antibody tests, night
    sweats, periodic diarrhea, and insomnia could be attributed to heavy metal toxicity. Dr.
    Luciani stated that based on the elevated mercury levels in Worker’s urine after a chelation
    treatment he ordered, he concluded that she probably had some significant exposure to
    mercury from a source unknown to him. He testified that, in his opinion, Worker was
    probably exposed to a toxic substance prior to her hospitalization in April 1997, and her
    toxic injury was a result of her employment with Employer.
    {5}     Dr. Werenko, who began seeing Worker in November 2006, testified that she had
    diagnosed Worker with heavy metal toxicities including mercury, cadmium, and lead. She
    explained that at her recommendation, Worker had undergone x-ray fluorescent testing to
    determine the level of lead in her bones and that the results showed an amount of lead
    outside the normal range. Dr. Werenko also reviewed files containing information on the
    actual samples Worker handled during the period of possible exposure. She testified that in
    her opinion, Worker suffered from long-term toxic exposure to heavy metals that occurred
    while performing chemical analyses between 1995 and April 1997.
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    {6}     Dr. Fisher testified that he found no evidence of overexposure to mercury or lead.
    Worker had seen Dr. Fisher one time on November 18, 2005, at the recommendation of Dr.
    William Brady, the medical director for Employer’s occupational medicine unit. After his
    examination, Dr. Fisher concluded in his report that he found no evidence whatsoever that
    Worker had ever had mercury or lead or other metal poisoning. Dr. Fisher testified that, in
    his opinion, Worker’s broad subjective complaints were consistent with the other possible
    causes of depression and chronic fatigue.
    {7}     The WCJ found that the medical opinions regarding causation varied, with “some”
    relating symptoms to work and “[o]ther medical providers,” concluding that Worker’s
    symptoms were more consistent with depression and chronic fatigue and unrelated to work.
    The WCJ found that “[t]he medical opinions based on work related exposures assume that
    Worker inhaled vapors or otherwise introduced heavy metals into her body despite no direct
    evidence to support the same.” The WCJ concluded that Worker had failed to meet her
    burden and denied her claim.
    INADMISSIBILITY OF DR. FISHER’S TESTIMONY
    {8}     On appeal, Worker contends that the testimony of Dr. Fisher consisting of his report
    and his depositions was improperly admitted by the WCJ because Dr. Fisher was neither a
    treating physician nor a doctor that had performed an IME. Worker filed a motion in limine
    to exclude Dr. Fisher’s testimony on the same grounds, which the WCJ addressed at the
    opening of the formal hearing. The WCJ heard arguments from both parties and, although
    he advised that he was inclined to admit all medical records and testimony, he deferred
    making his ruling until he issued his order. The compensation order states that the
    depositions of Dr. Fisher were admitted, as was the exhibit containing all Worker’s medical
    records. Because we agree with Worker that Dr. Fisher’s testimony was inadmissable and
    that issue is dispositive, we decline to address Worker’s other arguments she raises on
    appeal. Further pertinent facts relevant to this issue are discussed below.
    {9}     “With respect to the admission or exclusion of evidence, we generally apply an abuse
    of discretion standard where the application of an evidentiary rule involves an exercise of
    discretion or judgment, but we apply a de novo standard to review any interpretations of law
    underlying the evidentiary ruling.” Dewitt v. Rent-A-Ctr., Inc., 2009-NMSC-032, ¶ 13, 
    146 N.M. 453
    , 
    212 P.3d 341
    . “In reviewing a WCJ’s interpretation of statutory requirements,
    we apply a de novo standard of review.” 
    Id. ¶ 14.
    {10} In Hall v. Carlsbad Supermarket/IGA, 2008-NMCA-026, ¶ 10, 
    143 N.M. 479
    , 
    177 P.3d 530
    , we stated that the Workers’ Compensation Act (the Act), NMSA 1978, §§ 52-1-1
    to -70 (1929, as amended through 2013), “limits the testimony that can be provided by
    medical experts at a workers’ compensation hearing to testimony by a treating physician or
    a health care provider who has provided an [IME] pursuant to the Act.” (internal quotation
    marks and citation omitted); see § 52-1-51(C). In 1997 when Worker notified Employer of
    her concerns, Section 52-1-51(A) provided in pertinent part, “In the event of a dispute
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    concerning any medical issue, if the parties cannot agree upon the use of a specific
    independent medical examiner, either party may petition a workers’ compensation judge for
    permission to have the worker undergo an [IME].” 1990 N.M. Laws (2d S.S.), ch. 2, § 22
    (emphasis added). Section 52-1-51(A) was amended in 2005. In pertinent part, the
    amendment changed the circumstances under which an IME is authorized, permitting the use
    of an IME “[i]n the event of a dispute between the parties” concerning any medical issue,
    including a dispute about “the cause of an injury.” 2005 N.M. Laws, ch. 150, § 1; see Grine
    v. Peabody Natural Res., 2006-NMSC-031, ¶ 26, 
    140 N.M. 30
    , 
    139 P.3d 190
    (explaining
    that the 1997 version of Section 52-1-51(A) requires a dispute regarding a medical issue
    between authorized health care providers and that prior to the 2005 amendment, an IME was
    not authorized to resolve an issue of causation).
    {11} In this case, both Worker and Employer cite to the 2005 version of Section 52-1-
    51(A). As we previously explained in Hall: “This Court only applies revised provisions of
    the Act prospectively, including procedural provisions, absent an express mandate by the
    [L]egislature to apply the provision retroactively or a compelling reason for doing so.” Hall,
    2008-NMCA-026, ¶ 10 n.1. Although Worker saw Dr. Fisher on November 18, 2005, after
    the July 2005 amendment, the WCJ found that Worker had notified Employer as early as
    June 5, 1997, that she was concerned she might be experiencing symptoms from workplace
    exposure to mercury giving Employer legally sufficient notice of Worker’s claim. Thus, her
    claim accrued prior to the 2005 amendment. See Aragon v. Furr’s, Inc., 1991-NMCA-080,
    ¶ 5, 
    112 N.M. 396
    , 
    815 P.2d 1186
    (explaining that a claim accrues either on the date of
    injury or, if “there is a period of time between the date of the accident or the date of the
    injury and the date that the injury becomes compensable” then the claim accrues when the
    “claimant knows or should know that the injury is compensable”). Since Worker’s claim
    accrued prior to the effective date of the 2005 amendment, only the 1997 version of the
    statute applies here. Thus, all subsequent references to Section 52-1-51(A) are to the 1997
    version unless otherwise indicated.
    {12} Employer does not argue that Dr. Fisher was a treating physician. Rather, Employer
    contends that Dr. Fisher was an IME doctor by agreement. Worker asserts that Dr. Fisher
    was not an IME doctor as a matter of law because there was no medical dispute at the time
    she saw Dr. Fisher, nor any evidence that the parties agreed Dr. Fisher would address a
    medical dispute with an IME. We agree with Worker that Dr. Fisher was not an IME doctor
    for several reasons.
    {13} First, at the time Worker saw Dr. Fisher, Section 52-1-51(A) was inapplicable
    because she had not yet filed a claim for workers’ compensation benefits. By its terms, the
    process for selecting an IME outlined in Section 52-1-51 occurs within the context of a
    claim. The purpose of an IME is to assist the WCJ in deciding which way to rule in the case
    of a dispute among authorized health care providers. Thus, an IME cannot take place unless
    a claim has been filed. Worker saw Dr. Fisher on November 18, 2005, and she did not file
    her claim for compensation until November 1, 2006. Accordingly, the evaluation by Dr.
    Fisher was not an IME under Section 52-1-51(A).
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    {14} Second, there was no dispute as to a medical issue among authorized health care
    providers when Dr. Fisher examined Worker as required by Section 52-1-51(A). A letter
    written to Worker from Employer explains the circumstances under which Worker saw Dr.
    Fisher. The letter states that Dr. Brady recommended she be evaluated by Dr. Fisher. The
    letter does not use the term “independent medical evaluation” nor does it reference that the
    purpose of the evaluation by Dr. Fisher was to resolve a dispute among health care providers
    regarding a medical issue. It indicates that her possible work-related exposure had been
    addressed in 2001 and was deemed not work-related, but that Employer wanted to revisit her
    concerns in light of new information in order to make a decision regarding whether her
    medical problems were compensable. On its face, this letter demonstrates only that
    Employer desired to further investigate Worker’s medical issues.
    {15} Finally, even if Worker had filed a claim and there was evidence of a dispute among
    health care providers concerning a medical issue, Section 52-1-51(A) requires that the
    parties agreed on the selection of an independent medical examiner, in the absence of an
    appointment of an IME doctor by the WCJ. Employer does not argue nor refer to any
    evidence that the WCJ appointed Dr. Fisher to conduct an IME. Instead, Employer relies on
    the provision in Section 52-1-51(A) that provides for the option for parties to agree on the
    selection of an independent medical examiner to imply that Worker agreed to see Dr. Fisher
    for an IME. As this Court has previously noted, “Although Section 52-1-51 appears to
    contemplate circumstances in which parties may enter into agreements to have an IME
    conducted, the Act provides no provisions specifically addressing what must be contained
    in the agreement.” Hall, 2008-NMCA-026, ¶ 12.
    {16} Although it remains unclear what is required in the agreement, there is no evidence
    of any formal agreement between the parties here. Employer contends that “Dr. Fisher
    viewed his role as that of an IME” and that “Worker willingly participated in the IME.” To
    the extent that Employer is arguing that because it viewed Dr. Fisher as an independent
    medical examiner and Worker agreed to see him, he is therefore an independent medical
    examiner, we disagree. The letter to Worker that we referenced above informs Worker that
    Dr. Brady recommended she see Dr. Fisher, and the letter specifically states that Employer
    had not authorized payment for any other evaluation or treatment besides by Dr. Fisher. The
    Act does not permit the unilateral selection of an independent medical examiner. See
    generally § 52-1-51; see, e.g., Jurado v. Levi Strauss & Co., 1995-NMCA-129, ¶ 19, 
    120 N.M. 801
    , 
    907 P.2d 205
    (“Section 52-1-51(A) does not allow the worker to make a unilateral
    decision as to which doctor to see for an IME.”). On the contrary, we conclude that there
    must be evidence that the parties mutually agreed to the selection of a particular independent
    medical examiner specifically, with the understanding that the doctor selected would be
    conducting an IME. Employer cites to no evidence of an agreement between Worker and
    Employer to select Dr. Fisher as an IME doctor under Section 52-1-51(A).
    {17} For these reasons, we conclude that because Dr. Fisher was not a treating physician
    nor an IME doctor, his testimony was inadmissable. See Grine, 2006-NMSC-031, ¶ 26
    (holding that the testimony of a doctor who was neither a treating physician nor an IME
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    doctor was inadmissable); Jurado, 1995-NMCA-129, ¶¶ 20-24 (excluding a doctor’s written
    evaluation report, which was considered testimony, because the employer did not agree to
    an IME by the doctor, and the worker did not petition the WCJ for permission to undergo
    another IME).
    CONCLUSION
    {18} The compensation order is reversed, and the case is remanded to the Workers’
    Compensation Administration for further proceedings consistent with this Opinion.
    {19}   IT IS SO ORDERED.
    ____________________________________
    MICHAEL E. VIGIL, Judge
    WE CONCUR:
    ____________________________________
    JAMES J. WECHSLER, Judge
    ____________________________________
    JONATHAN B. SUTIN, Judge
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