Your Treating Physician Can Gut Your Idaho Workers’ Compensation Claim

By Fred Lewis

In Fairchild v. Kentucky Fried Chicken, 159 Idaho 208 (2015), on November 13, 2004 16 year old Terence Fairchild was employed by Kentucky Fried Chicken as a cook. He was carrying garbage to a dumpster when he slipped on ice and fell, striking his knees on a concrete barrier. He sought medical care for his knee injury and finally ended up in the office of Dr. Simms, an orthopedic surgeon. Dr. Simms diagnosed Terence with a posterior cruciate ligament injury to his right knee. He did not believe that surgery was needed and gave the claimant a 3% whole person impairment rating. The independent medical evaluator hired by the workers’ compensation insurance company opined that Terence’s right knee was stable and he sustained no permanent partial impairment. In 2011, Terence’s lawyer sent him to another physician to conduct another impairment rating. This new physician gave the claimant a 7% whole person impairment rating. None of the doctors gave the claimant any type of physical restrictions.

The Idaho Industrial Commission found that Terence was not a credible witness based on observations during the hearing and the differences between his hearing testimony and his prior statements during depositions, interviews, and appointments with medical providers. The Commission entered an order awarding the 3% whole person impairment rating with no disability in excess of the impairment rating since there were no restrictions.

On appeal, Terence’s attorney argued the Commission’s findings regarding observational credibility were clearly erroneous because the Commission failed to cite to any facts to support its findings. Terence’s lawyers also challenged the Commission’s findings regarding disability in excess of impairment. He argued that, as a matter of law, if an employee has a permanent impairment “then he must have physical limitations and restrictions”. A unanimous Supreme Court held that there was no such legal requirement. The Court reemphasized its holding in Graybill v. Swift and Co. 115 Idaho 293 (1988) that a disability rating is based upon permanent impairment and pertinent non-medical factors, and that a disability rating need not be bigger than an impairment rating when a consideration of non-medical factors indicated that a probable future to engage in gainful activity is accurately by the impairment rating.

The takeaway from this case comes down to your treating doctor controls the outcome of your Idaho workers’ compensation case. If your treating doctor gives you no restrictions, the Idaho Industrial Commission is not going to award you any disability in excess of your impairment. Even if you hire your own doctor to testify, the Commission is probably still going to find your treating physician to be the most persuasive. Choose your treating physician carefully. They will decide the outcome of your Idaho Workers’ Compensation case.

This website includes general information about legal issues and developments in the law. Such materials are for informational purposes only and may not reflect the most current legal developments. These informational materials are not intended, and must not be taken, as legal advice on any particular set of facts or circumstances. You need to contact a lawyer for advice on specific legal issues.

 

Contact Information