Name

Tina Bouchard v. Central Maine Medical Center

Insurance Company

Futurecomp

Date Decided

July 29, 2022

Panel Members

Elizabeth Elwin

David Hirtle

Evelyn Knopf

Categories

Board IME Pre-Existing Injury Board IME Pre-Existing Injury

Tags

File Size

165 KB

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Summary from the Troubh Heisler Attorneys

CMMC appealed a decision of the ALJ granting Ms. Bouchard's petition for award alleging a gradual right hand injury and awarding ongoing partial benefits. Ms. Bouchard worked as an ultrasound technician which required her to grip and maneuver a transponder for prolonged periods of time with her right hand, which "froze" up on February 27, 2018. Dr. Donovan completed a Board IME report opining that the employee had right thumb arthritis and neuritis, which was significantly aggravated by her work. He recommended restriction on the number of days per week and scans per day she could perform and offered that it was his "opinion that Ms. Bouchard is at baseline condition".

The ALJ found that the 312 IME use of the word "baseline" was ambiguous in that it was unclear whether it referred to a pre-injury state, or a new post-injury condition. Based on the doctor recommending ongoing restrictions the ALJ found that baseline referred to her new restricted physical condition. In the alternative the ALJ ruled that even if baseline referred to pre-injury state, clear and convincing evidence to the contrary of that conclusion existed in the record based on the ongoing symptoms and work restrictions.

CMMC argued the ALJ erred in finding the work "baseline" ambiguous and awarding ongoing partial incapacity benefits. It argued "baseline" has a standard meaning in workers' compensation cases addressing work related aggravations- it signals an endpoint of compensability.

The Appellate Division disagreed and affirmed the decision. It concluded that while baseline often refers to a return to pre-injury state, it is susceptible to more than one meaning and was ambiguous as used by Dr. Donovan. It was appropriate for the ALJ to look at the larger context of the case when interpreting the ambiguous phrase in the 312 IME report. Because it upheld the ALJ's interpretation, the panel found it unnecessary to address the alternative finding of clear and convincing evidence to the contrary.

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