Idaho High Court Points to Worker’s Obesity for Back Problems

Case File

While Idaho's workers' compensation commission might have gone too far in assessing a worker's credibility, its decision regarding his injury withstood scrutiny by the state's top court. Simply Research subscribers can find the full text of the decision on the Idaho state page.

Case: Nelson v. State of Idaho, Industrial Special Indemnity Fund, No. 50485-2023 (Idaho 08/06/24).

What happened: A worker for an auto sales company bent down to lift a garage door and felt a pop in is back. He awoke the next day with significant back pain that radiated down his left leg. An x-ray revealed multilevel degenerative disease in the worker's lumbar spine.

The worker filed a workers' compensation claim, and over the next several months underwent diagnostic testing. The doctor opined that the worker, who weighed over 390 pounds, triggered a flare up of arthritis and a possible disk bulge in his back when he lifted the garage door.

The company arranged for an independent medical exam, and the doctor conducting it opined that the worker's back problems were caused by his morbid obesity and were not industrially related. The doctor concluded that the back pain was likely due to shifting epidural fat related to the worker's restlessness while sleeping.

Another doctor concurred on the weight-related causes for the worker's back problem, but a fourth determined that the garage door injury causes a permanent impairment, and this doctor assigned an 11% permanent partial impairment for the worker's back injury.

The worker underwent weight loss surgery and eventually trimmed down to 269 pounds.

On the worker's claim for benefits, the referee found that the worker, who had pleaded guilty to insurance fraud in1996, was not credible due to inconsistent testimony and varied reports regarding his injuries.

The referee recommended that the worker failed to demonstrate that he was totally and permanently disabled under either the 100% or odd lot methods, and the commission adopted the recommendation.

The worker appealed to the Idaho Supreme Court.

Rule of law: In Idaho, a claimant can recover total and permanent disability benefits when he has a preexisting impairment that combines with a work-related injury to cause total and permanent disability. To do so, per Aguilar v. Indus. Special Indem. Fund, 436 P.3d 1242 (Idaho 2019), the claimant must show:

What the Idaho Supreme Court said: The commission's decision that the worker was not totally and permanently disabled was supported by substantial and competent evidence, so the court affirmed.

While the court took issue with some of the commission's credibility findings, it nonetheless agreed with the commission on the issue of disability.

"This finding was predicated on more than just credibility," the court wrote. "There was substantial and credible evidence in the record that ... supported the commission's finding."

The court found that it was within the commission's authority to credit the report a vocational expert over that of another, and the expert the commission found more reliable concluded that the worker suffered between 0% and 70% loss of access to the labor market. As a result, this expert found that the worker was not an odd-lot worker because "even under the most restrictive limitations imposed," the expert was able to identify a labor market for the worker.

The court noted that worker did not offer arguments attacking the commission's finding regarding total and permanent disability and noted that state law allows the commission to determine which medical experts to rely on.

Takeaway: Even if the Idaho Supreme Court takes issue with one aspect of commission's decision, that doesn't automatically mean its conclusion regarding total and permanent disability will not stand.

Share This Article: