Court determined that claimant’s brain injury was permanently disabling. Arias v. U.S. Concrete, Inc., No. 2021-05379 (N.Y. App. Div. Oct. 7, 2021)

Arias v. U.S. Concrete, Inc., No. 2021-05379 (N.Y. App. Div. Oct. 7, 2021) is a workers’ compensation case involving a maintenance worker who sustained multiple injuries, including a traumatic brain injury, while on the job. In a workers’ compensation case, an injured worker files a claim with their employer’s workers’ compensation insurance. The case is reviewed by the Workers’ Compensation Board, which evaluates medical evidence and testimonies to determine eligibility for benefits. If either the claimant or the employer disagrees with the Board’s decision, they can appeal to the Workers’ Compensation Law Judge (WCLJ). Further disagreements can be appealed to the full Workers’ Compensation Board. If either party is still unsatisfied with the outcome, they can then appeal the Board’s decision to the Supreme Court of New York, Appellate Division. In Arias v. U.S. Concrete, Inc., , the employer appealed the decision of the WCLJ.

Background Facts
The claimant, a maintenance worker, filed for workers’ compensation benefits following an incident in December 2016. He alleged injuries to his right arm, head, face, jaw, ear, and tooth after being struck by a vehicle at work. The claim initially covered injuries to his jaw, neck, back, and right shoulder, later expanding to include post-traumatic stress disorder. Over the course of his claim, the claimant received medical care from Dr. Seth Schran and underwent independent medical examinations by Dr. Paul Kleinman.

During a March 2019 hearing, the claimant sought classification as permanently totally disabled, citing a traumatic brain injury. Although the Workers’ Compensation Law Judge (WCLJ) found evidence of the brain injury, the examiner did not directly address it. However, the WCLJ amended the claim to include the brain injury, basing the decision on reports from Schran and Kleinman, which together established that the claimant was permanently totally disabled. The employer and its workers’ compensation carrier appealed, challenging the medical evidence and the classification.

The employer argued that the injury was not permanent based on the findings of their medical examiner. They contended that the medical evidence did not support a total disability classification, emphasizing that the claimant could occasionally engage in activities like sitting, standing, and walking. The company also highlighted that the claimant’s brain injury was not conclusively addressed in the independent medical examination, arguing that the existing medical restrictions did not entirely preclude all forms of employment.

Issue
Whether the Workers’ Compensation Board’s decision to classify the claimant as permanently totally disabled was supported by substantial evidence.

Holding
The Supreme Court upheld the Workers’ Compensation Board’s decision, confirming the claimant’s classification as permanently totally disabled

Rationale
The Supreme Court upheld the Workers’ Compensation Board’s decision based on substantial evidence from medical evaluations. The Board relied on reports from Dr. Schran and Dr. Kleinman, who both concluded that the claimant had reached maximum medical improvement and sustained significant permanent injuries. Dr. Schran found the claimant had severe impairments in his mandible, cervical and lumbar spines, right shoulder, and wrist, alongside psychiatric injuries and a brain concussion. Dr. Kleinman agreed on the claimant’s severe limitations, noting the claimant could perform less than sedentary work but with significant restrictions. The Supreme Court noted the consistency in the medical opinions and found no meaningful distinction between them. Therefore, the evidence supported the finding that the claimant was incapable of gainful employment, justifying the permanent total disability classification. Thus, the claimant will receive the appropriate workers’ compensation benefits to support him due to his inability to return to work.

Conclusion
If you or someone you know is struggling with complications from a workplace injury, including traumatic brain injuries, it is crucial to seek expert legal guidance. Workers’ compensation claims can be complex, and navigating the legal system without professional assistance can be daunting. An experienced New York brain injury lawyer can help ensure that you receive the rightful benefits for your injuries under the workers’ compensation system. Protecting your rights and securing your future starts with having a knowledgeable advocate on your side.