Name

Pelletier v. Twin Rivers Paper

Insurance Company

Sedgwick Claims Management Services

Date Decided

November 7, 2016

Panel Members

Elizabeth Elwin

Glen Goodnough

Sue Jerome

Categories

Res Judicata

Tags

Incapacity Medical Evidence Res Judicata

File Size

164 KB

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Summary from the Troubh Heisler Attorneys

Pelletier had previously filed petitions that the ALJ denied because she failed to prove the extent of her incapacity. Pelletier then got additional medical evidence showing a partial incapacity and labor market evidence showing that work was unavailable to her within that capacity. She filed petitions for restoration, and Twin Rivers argued that the prior decision was res judicata and required her to present comparative evidence showing a change of circumstances since the last WCB decision.

Judge Pelletier granted her petitions without requiring comparative evidence, and he derived an earning capacity based on the labor market evidence, awarding Pelletier a fixed rate of partial benefits as of the date of her recent labor market survey. Twin Rivers appealed, but the Appellate Division affirmed Judge Pelletier's decision, stating that in the previous litigation he had not actually determined the level of her incapacity but instead had expressly declined to make findings regarding her incapacity, thus "keeping the issue open for future litigation."

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