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New Jersey employers like reopener claims about as much as homeowners like back-to-back blizzards. The general view is that employers have virtually no defenses and have to pay more with each reopener. The truth is that employers can win reopener cases where the petitioner’s expert cannot really prove the petitioner’s condition has worsened since the prior award. Garces v. Mid-State Lumber Corp, A-4199-15T4 (App. Div. April 10, 2018) provides a good example.
Petitioner suffered two compensable accidents on October 16, 2009 and December 11, 2009 leading to an order approving settlement for 66.67 percent partial permanent disability described as orthopedic and neurologic in nature for residuals of a herniated disc L3-4 and L4-5 status post lumbar laminectomy and fusion. Respondent received a credit of 27.5% for previous disability.
On June 15, 2013, some fifteen months after entry of the award of 66.67% petitioner filed to reopen his case. Petitioner testified in the reopener, and he produced two experts. Dr. Becan was petitioner’s orthopedic expert, and Dr. Peter Crain was petitioner’s psychiatric expert. The treating surgeon, Dr. Carl Giordano, saw petitioner and concluded petitioner needed no further treatment.
Dr. Becan saw petitioner twice, once in 2011 before the first award and again in 2014 for the reopener examination. He raised his estimate to 90% of partial total. On the reopener exam he wrote that petitioner’s disability had increased by 20% of partial total. When asked about the objective findings that supported the increase, he said petitioner “walked with a guarded and antalgic gait pattern,” “had a noticeable limp on the right,” and “was unable to heal or to walk on his right leg.” He also found “right-sided sacroiliac joint tenderness.” He noted restrictions when he put petitioner through various maneuvers like straight leg raising.
On cross examination, Dr. Becan conceded that many if not most of his restrictions were the same as they were in 2011. The two reports were compared, and it turned out that petitioner’s range of motion tests were actually better in 2014 than in 2011. Petitioner’s muscle strength testing of the quadriceps and hamstring was better. The right ankle jerk reflex had improved. Backward extension was the same, and straight leg raising improved.
The Judge of Compensation examined the two reports closely and concluded that Dr. Becan’s findings on the new 2014 examination were not worse at all. He further noted that while Dr. Becan said petitioner could not return to work, the doctor did not know what petitioner’s job duties were. The Judge concluded that Dr. Becan had simply offered a net opinion, which is an opinion not supported by any evidence. The Judge also noted that petitioner’s psychiatric expert, Dr. Crain, had done the same thing. He also failed to offer any objective evidence of worsening.
The Judge of Compensation dismissed petitioner’s reopener claim and petitioner appealed. The Appellate Division made short work of the appeal and commented that there was sufficient credible evidence to support the dismissal of petitioner’s case.
The case illustrates an important point. In valuing a reopener claim, practitioners often focus on the percentage increase that the expert for the claimant offers. But the better way to value a reopener case is to look beyond the mere estimate of increased disability and compare the pre- and post- award reports side by side. If the actual measurements, range of motion and findings are the same or better on reopener, it doesn’t matter that the claimant’s doctor raised his or her estimate. The percentage of increase in an IME means nothing if the actual test results appear to be the same. There are other ways to win reopeners as well, such as proving that a new non-work event or new employment has worsened the petitioner’s condition. All of these approaches do give respondents a fighting chance in defending reopeners.
John H. Geaney, Esq., is an Executive Committee Member and a Shareholder in Capehart Scatchard's Workers’ Compensation Group. Mr. Geaney concentrates his practice in the representation of employers, self-insured companies, third-party administrators, and insurance carriers in workers’ compensation, the Americans with Disabilities Act and Family and Medical Leave Act. Should you have any questions or would like more information, please contact Mr. Geaney at 856.914.2063 or by e‑mail at firstname.lastname@example.org.