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Hartgrave v. City of Twin Falls

Supreme Court of Idaho

March 5, 2018

CHARLES LEROY HARTGRAVE, Claimant-Appellant,
v.
CITY OF TWIN FALLS, Employer, and STATE INSURANCE FUND, Surety, Defendants-Respondents.

         2018 Opinion No. 18

         Appeal from the Industrial Commission.

         Appeal from Industrial Commission ruling, affirmed.

          L. Clyel Berry, Chartered, Twin Falls, for appellant. L. Clyel Berry argued.

          Augustine Law Offices, PLLC, Boise, for respondents. Paul J. Augustine argued.

          BURDICK, CHIEF JUSTICE.

         Charles Leroy Hartgrave brings this appeal from the Idaho Industrial Commission (the Commission). Hartgrave sustained injuries to his left knee while working for the City of Twin Falls (the City) on February 3, 2009, and August 23, 2012. Although Hartgrave's left knee injuries and corresponding treatments were covered by Idaho's Workers Compensation Act, Hartgrave contends the left knee injuries aggravated preexisting degenerative joint disease in his right knee and ultimately required a total knee arthroplasty (TKA) in his right knee. The Commission rejected Hartgrave's position and ruled that Hartgrave's right TKA was not compensable. Hartgrave timely appeals that ruling and we affirm.

         I. FACTUAL AND PROCEDURAL BACKGROUND

         Hartgrave has worked for the City's Street Department since 1978. While working on February 3, 2009, Hartgrave injured his left knee. As Hartgrave explained the injury,

[he] was doing a pavement survey with a couple of other guys. [He] was outside of the truck. [He] was running a measuring wheel down the road, and [he] stepped on a piece of uneven blacktop there. [He] didn't see it, and [he] stepped on it. As soon as [he] did, [he] felt his knee pop.

         Hartgrave initially "didn't think too much about it[, ]" but as the day progressed, "it got much worse." As a result, Hartgrave visited Dr. Douglas Stagg, M.D., on February 17, 2009. Dr. Stagg noted that Hartgrave "ambulate[d] favoring the left knee enough that it affect[ed] his gait with a slight limp[, ]" cleared Hartgrave for normal work, and prescribed a brace, "lot[s] of ice, " and "Motrin 600 mg t.i.d." Due to persistent pain in his left knee, Hartgrave visited Dr. Stagg twice more before he was referred to Dr. Tyler McKee, D.O., for an orthopedic evaluation.

         Dr. McKee performed that evaluation on March 13, 2009, diagnosed a meniscal tear in Hartgrave's left knee, and recommended an "arthroscopy of the left knee with partial lateral meniscectomy." Although that visit arose from the injury to Hartgrave's left knee, Dr. McKee evaluated Hartgrave's right knee and noted no tenderness or instability and full strength and range of movement in the right knee. However, after reviewing bilateral x-rays, Dr. McKee discovered that Hartgrave suffered from "pretty severe" osteoarthritis in his right knee, and, in fact, Hartgrave was actually "bone on bone" in his right knee at that time. As such, during the March 13, 2009, visit, Dr. McKee inquired whether Hartgrave was interested in a right TKA at that time, but Hartgrave responded that he had no pain in his right knee and did not want to pursue the procedure. Regarding his left knee, Hartgrave obtained worker's compensation approval from the Idaho State Insurance Fund (ISIF) and underwent Dr. McKee's recommended left knee surgery on May 6, 2009. He returned to work sometime during June or July 2009.

         Hartgrave, however, continued suffering from persistent pain in his left knee and hip. He visited Dr. James Retmier, M.D., on August 30, 2010, for a second opinion of his left knee. Dr. Retmier surmised that Hartgrave had "failed all forms of conservative care and is a candidate for [(a left TKA)]" and, accordingly, further noted that "we will ask [worker's compensation] for authorization and then plan on proceeding."

         In response to Dr. Retmier's evaluation, ISIF enlisted Dr. Brian Tallerico, D.O., to perform an independent medical examination (IME), which occurred on December 16, 2010. After evaluating Hartgrave's left knee, Dr. Tallerico concluded "[t]here is absolutely no need for a [(left TKA)] in this individual, and it certainly is not related to the industrial injury of February 3, 2009." Although that visit arose from the injury to Hartgrave's left knee, Dr. Tallerico noted that Hartgrave expressed having "problems with the right knee in the past (open meniscectomy in 1971 with ongoing swelling and symptoms)[.]" Dr. Tallerico further noted that, "[i]nterestingly enough, [Hartgrave's] right knee is in much worse shape than his left knee with significant lateral compartment collapse and loss of cartilage interval." Dr. Tallerico ultimately concluded that the "[p]reexisting history of bilateral knee degenerative joint disease [was] unrelated to the [February 3, 2009, accident] on a more-probable-than-not basis and not aggravated by it." Thereafter, ISIF denied Dr. Retmier's recommendation for a left TKA, and Hartgrave returned to work.

         While working on August 23, 2012, Hartgrave sustained another injury to his left knee. As Hartgrave explained, "[he] was running a water truck. [He] went to get out of the truck. [He] was holding onto a bar here, and [his] foot slipped off the bottom step of the truck. When [he] hit the ground, [he] twisted around; and it hurt the [left] knee." Hartgrave visited Dr. McKee for treatment. Dr. McKee conducted x-rays that revealed "degenerative joint disease of the lateral compartment of both knees. It is worse on the right than the left." Dr. McKee ultimately recommended a left TKA. After obtaining worker's compensation approval, Hartgrave underwent the procedure on March 13, 2013.

         Hartgrave spent approximately six weeks on crutches after the left TKA. He attended several follow-up visits with Dr. McKee, but he never complained of pain in his right knee and instead only complained of pain in his left knee and hip. On August 9, 2013, Dr. McKee concluded Hartgrave had reached maximum medical improvement and authorized him to return to work with restrictions of no squatting, kneeling, or lifting weight in excess of fifty pounds.

         On November 8, 2013, Hartgrave visited Dr. McKee and reported pain in his right knee. Dr. McKee diagnosed "[s]evere degenerative joint disease of the right knee with a lesser degree on the left." Even though Hartgrave had never before complained of right knee pain to Dr. McKee, and even though Dr. McKee had never noticed Hartgrave limping with regard to the right leg, Dr. McKee and Hartgrave discussed treatment options and decided to proceed with a right TKA. That procedure was performed on November 25, 2013. Hartgrave initially did not seek worker's compensation approval for the right TKA and instead billed his health insurer. Hartgrave later testified he did not know why he did not seek worker's compensation approval for the right TKA.

         Thereafter, on January 23, 2014, Hartgrave filed two worker's compensation complaints. In the first, Hartgrave cited the February 3, 2009, accident and sought relief of permanent partial impairment, disability benefits, medical benefits for the "injury to right knee, culminating in right TKA, " and attorney fees. In the second, Hartgrave cited the August 23, 2012, accident and sought relief identical to that requested in his first complaint. The City and ISIF (collectively, Respondents) answered both complaints and denied liability, and the Commission consolidated both cases.

         The parties eventually entered into a settlement agreement that resolved most issues, but the settlement agreement expressly left unresolved whether Hartgrave's right TKA is compensable. When that issue was submitted to the Commission, the Referee's recommendation reasoned that an "accident" did not aggravate the preexisting degenerative joint disease in Hartgrave's right knee and concluded that Hartgrave's right TKA is not compensable. The Commission agreed with the Referee's ultimate conclusion that Hartgrave's right TKA is not compensable, but employed different reasoning. As the Commission reasoned, Hartgrave's right TKA "was necessitated by the natural progression of his arthritis and unrelated to the industrial injuries." Hartgrave timely appeals that ruling.[1]

         II. ISSUES ON APPEAL

         1. Is the Commission's ruling that Hartgrave's right TKA is not compensable based on substantial, competent evidence?

         2. Should attorney fees be awarded on appeal?

         III. STANDARD OF REVIEW

         In an appeal from the Commission,

this Court reviews "whether the Commission's findings of fact are supported by substantial and competent evidence, " but freely reviews its legal conclusions. Shubert v. Macy's W., Inc., 158 Idaho 92, 98, 343 P.3d 1099, 1105 (2015), abrogated on other grounds by Chavez v. Stokes, 158 Idaho 793, 353 P.3d 414 (2015). "Substantial and competent evidence is relevant evidence which a reasonable mind might accept to support a conclusion." Id. "We will not disturb the Commission's findings on the weight and credibility of the evidence unless those conclusions are clearly erroneous, " id. nor will this Court "re-weigh the evidence or consider whether we would have drawn a different conclusion from the evidence presented." Watson v. Joslin Millwork, Inc., 149 Idaho 850, 854, 243 P.3d 666, 670 (2010). All facts and inferences are viewed in the "light most favorable to the party who prevailed before the Commission." Hamilton v. Alpha Servs., 158 Idaho 683, 688, 351 P.3d 611, 616 (2015). However, workers' compensation laws are liberally construed "in favor of the employee, in order to serve the humane purpose" behind the law. Id.

Estate of Aikele v. City of Blackfoot, 160 Idaho 903, 908, 382 P.3d 352, 357 (2016).

         IV. ...


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