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WCB App Div Affirms Meds Award, Based on Res Judicata

The Maine Workers Compensation Board Appellate Division has just issued its first decision of 2017, affirming an award of medical benefits based on res judicata and a prior �§312 IME.

In Dawn Stoliker v. Northern Maine Medical Center, Stoliker had pre-existing back problems but further injured her back at work in 2006. In a 2012 WCB decision, the ALJ adopted the medical findings in Dr. Bradford's �§312 exam opinion, finding that the 2006 work injury was a "significant and continuing event," and that, although her condition "responded well" to lumbar steroid injections, the effects of the work injury had not ended but were instead continuing.

Stoliker later filed another petition seeking payment for additional injections. In response, NMMC had Stoliker examined by Dr. Curtis per �§207, and he said that her back problems since 2009 ��" before the initial 2012 WCB decision ��" were not caused by the 2006 aggravation injury but were instead caused solely by her pre-existing back condition.

Judge Pelletier declined to adopt Dr. Curtis’s opinion, however, both because res judicata prohibited a re-litigation of the 2009 causation issue and because Dr. Bradford did not have Dr. Curtis's �§207 opinion when he rendered his own �§312 opinion, so it could not constitute "clear and convincing evidence to the contrary" under the express terms of �§312.

NMMC appealed, but the Appellate Division panel affirmed Judge Pelletier's decision. The panel pointed out that NMMC failed to produce "comparative medical evidence" to overcome the findings in the prior decree, and that Dr. Curtis's contrary opinion did not qualify. NMMC also argued that Judge Pelletier had erroneously excluded Dr. Curtis’s report from evidence altogether, but the panel disagreed, pointing out that his decision expressly referred to that opinion, in spite of language in his decision indicating that he was "excluding it.”

If you have any questions about this or any other decision, please let us know.

Thomas Getchell
Daniel Gilligan
Michael Richards
Attorneys at Law