Eliot Wiener and Michael Maglieri successfully appealed an ALJ’s decision in a horseplay/scope of employment claim.  Claimant, a security guard, was injured while jumping from rooftop to rooftop of the building in which he worked.  The ALJ originally found that claimant was within the scope of his employment and that his actions did not arise to the level of horseplay or constitute a deviation from his work duties.  The ICAO agreed that claimant’s actions did, in fact, constitute horseplay which removed him from the course and scope of his employment, holding that there was no evidence to support the ALJ’s conclusion that his job duties required claimant to jump from rooftop to rooftop at the time he was injured.  This is an impressive victory for Eliot and Mike, given the factual nature of the ALJ’s original determination.  The case is Orist v. G4S Secure Solutions (USA), Inc., W.C. No. 4-866-126 (ICAO January 4, 2013).

Kim Starr won a full contest mold exposure claim.  The 61 year old claimant alleged mold exposure causing hypersensitivity pneunmonitis, a significant pulmonary condition.  Respondent presented evidence from a local pathologist and a world renowned pathologist from New York that claimant’s condition involves usual interstitial pneumonia.   Claimant’s experts, local physicians with occupational/pulmonary expertise, opined that claimant’s condition was hypersensitivity pneunmonitis and was inconsistent with usual interstitial pneumonia.   These physicians opined that since claimant reported exposure to mold at her work place and because there was no history of mold exposure elsewhere, claimant’s medical condition resulted from mold exposure at work.  Respondent’s industrial hygienist testified that claimant was not exposed to harmful amounts of mold at work.  The ALJ determined that because the mold exposure could not be fairly traced to claimant’s employment, it was almost impossible to say that claimant was not equally exposed to molds outside of the workplace, and denied compensability.

Bobby Wren recently won a full contest claim involving bilateral shoulder injuries with multiple surgeries.  Claimant alleged he was injured in 2010 when lifting a chair over his head.  He delayed seeking treatment for nearly a year after the injury.  After obtaining claimant’s extensive prior medical records, respondents discovered that claimant never mentioned the alleged work-related injury to any treating physician during nearly two years of treatment.  He did, however, consistently refer to a 2005 mountain biking shoulder injury as his only prior injury.  Respondents’ expert testified that claimant’s prior medical history, combined with his complete failure to mention the work incident to any treating physician, made it not medically probable that he injured his shoulder as a result of the work injury. The ALJ completely discredited claimant’s testimony and evidence in light of the prior medical records and respondents’ expert’s testimony, and denied and dismissed the claim.

Paul Krueger was successful in a recent claim involving out-of-state jurisdiction.  Employer is based in Colorado, but worked on job sites in North Dakota.  Claimant was severely injured in a work-related accident in North Dakota, and employer sought to have the injury covered.  Respondents presented evidence that claimant was not hired in Colorado nor did he ever work in Colorado.  Rather, the evidence showed that the only time claimant was in Colorado was when he had a layover at DIA on his way to the job site in North Dakota.  The ALJ found that the fact that claimant’s employment paperwork (completed in North Dakota) was faxed to employer in Colorado was insufficient to show that claimant was hired in Colorado, and therefore claimant’s injury did not fall under Colorado’s jurisdiction.