Ky. Top Court Upholds ALJ’s Psychological Impairment Conclusion

Case File

A contingent MMI finding regarding a worker's psychological injury was a reasonable basis for an ALJ to set a 20% impairment rating despite other evidence showing a conflicting possibility. Simply Research subscribers have access to the full text of the decision.

Case

Smith v. Laboratory Corp of America, 2024 WL 3929871 (Ky. 08/22/24).

What Happened?

A Labcorp phlebotomist was injured at work when a shelving unit fell onto his head and knocked him to the ground. The phlebotomist sustained acute injuries to his lower back and underwent surgery. Surgery did not alleviate the phlebotomist's symptoms, and he experienced burning pains in his legs, mechanical back pain, urinary urgency, urinary leakage, back stiffness, and inability to sleep. The doctor who performed surgery assessed a 24% permanent impairment rating relative to the back injury, apportioning 5% to preexisting injuries and 19% to the work-related injury.

Later, another doctor agreed with that rating, but a third physician disagreed, finding that the phlebotomist was uncooperative, confrontational, and displayed "significant" magnification of his symptoms. This physician found that the phlebotomist had a Lumbar diagnosis-related estimate Category III 10% impairment, which he attributed to a pre-existing active condition.

The phlebotomist had psychological complaints as well, and the doctor who evaluated him for these diagnosed him with adjustment disorder with mixed anxiety and depressed mood, moderate to severe. This doctor assessed a 20% impairment rating for the phlebotomist's psychological condition and concluded that he had reached maximum medical improvement as he was unable to obtain payment from Labcorp for mental health treatment.

A later evaluation concluded that the phlebotomist did not have a psychological impairment relative to his work injury and assessed him a 0% impairment rating.

An administrative law judge issued an award and determined that:

(1) 5% of the phlebotomist's impairment was attributable to a preexisting condition.

(2) The phlebotomist had a 5% impairment rating for the work-related back injury.

(3) The phlebotomist suffered a work-related psychological impairment with a 20% impairment rating.

On appeal, the Board affirmed and so did the Court of Appeals, prompting Labcorp to take the case to the Kentucky Supreme Court, arguing that the ALJ's reliance on the impairment rating for the phlebotomist's psychological injury was misplaced and not based on the AMA Guides and the Board and Court of Appeals erred in affirming that reliance.

Rule of Law

As announced in Plumley v. Kroger, Inc., 557 S.W. 3d 905 (Ky. 2018), for an impairment rating to be properly based on, or "grounded in the Guides is not a strict adherence to the Guides, but rather a general conformity with them."

What the Kentucky Supreme Court Said

The Kentucky Supreme Court affirmed the lower bodies' decisions, noting that the contingent finding of MMI was premised on the phlebotomist not receiving mental health treatment, for which Labcorp refused and the phlebotomist was unable to pay.

The court also noted that while evidence could have supported a different decision, "the ALJ weighed conflicting medical testimony, determined the quality, character, and substance of the evidence, and assessed what it believed to be an appropriate impairment."

Just because it wasn't the only possible outcome, the ALJ's decision wasn't unplausible in the court's analysis.

"The ALJ's decision was supported by substantial evidence, was not clearly erroneous, and therefore should not be disturbed," the court wrote.

Thus, the ALJ's findings stood and the phlebotomist was entitled to medical expenses and a permanent partial disability benefits of:

(1) 5% impairment for work-related back injury.

(2) 20% impairment for work-related psychological injury.

The Takeaway

An ALJ is free to draw reasonable inferences and choose which parts of the evidence are more credible than others in making a decision regarding impairment ratings.

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