Name
Franklin Gallup v. Keystone Automotive Industries
Insurance Company
Sedgwick Claims Management Services
Date Decided
March 26, 2021
Panel Members
Timothy Collier
David Hirtle
Mike Stovall
Categories
Res JudicataTags
File Size
108 KB
DownloadSummary from the Troubh Heisler Attorneys
Franklin Gallup v. Keystone Automotive Ind. (attached) - Gallup had a pre-existing shoulder condition and aggravated it at work in 2008. He had surgery and was out of work for several months. After a §312 IME, Keystone stipulated to a decree finding “a significant aggravation of an underlying condition.” Gallup had a second surgery in 2010, and in 2017 he had shoulder replacement surgery.
Gallup then filed petitions for incapacity and medicals, but Dr. Donovan’s § IME found Gallup’s current problems were “the natural progression of his re-existing shoulder problems, rather than the work injury or the surgeries.” Judge Knopf adopted Dr. Donovan’s opinion and denied Gallup’s petitions.
Gallup appealed, arguing that the new IME findings conflict with the prior decree, but the panel found no conflict. ALJ Collier, writing for the panel:
The 2009 Stipulated Decree does not address, much less actually decide, the issue of the precise medical nature of Mr. Gallup’s underlying shoulder condition. It contains no language describing Mr. Gallup’s underlying medical condition, nor does it expressly adopt the prior IME’s medical conclusions or even mention the examination. The lone reference to the underlying condition is one sentence stating that he “suffered a right shoulder injury which represented a significant aggravation of an underlying condition on 01/16/08.” That conclusion is entitled to res judicata effect. Dr. Donovan acknowledged that the 2008 work injury aggravated a preexisting condition, causing disability. His medical findings regarding Mr. Gallup’s present condition, as being caused by the natural progression of the underlying degenerative condition rather than the employment, do not contradict this established fact.
CONCLUSION
The 2009 Stipulated Decree does not contain preclusive language that establishes that the current right shoulder condition was caused by the employment rather than the natural progression of the underlying condition, and we are unable to supply such language by implication.
Finding Judge Knopf’s application of the law to the facts neither arbitrary nor without rational basis, the panel affirmed her decision.