Nebraska Supreme Court Opines on Sufficiency of Medical Evidence
The Nebraska Supreme Court issued its decision in Hintz v. Farmers CO-OP Assn. 297, Neb. 903 on September 29. This important decision reversed the Court of Appeals and reiterated that medical expert testimony derived solely from a review of medical records is competent and admissible.
The claimant (Hintz) was involved in a work accident on November 13, 2014, when a tire exploded in front of him. Afterwards, Hintz reported pain in his legs, hips, and groin. Hintz stayed home the next day (Friday) and returned to work on Monday. On December 4, 2014, Hintz tripped while walking upstairs at his home. He sought medical treatment the next day, from a Dr. James Gallentine. Hintz reported pain in his right leg and that the pain began after he tripped. Hintz mentioned the November 13 work accident, but also told Dr. Gallentine that he had returned to work after the incident and had recently been jumping in and out of trucks without difficulty. At doctor’s appointments from December 2014 through February 2015, Hintz said that his leg pain started after he tripped and fell at home.
Farmers terminated Hintz’s employment in March 2015, because he had not been to work in three months. At his next medical appointment after termination (March 2015), Hintz said, for the first time, that his pain began after the work accident. Hintz maintained this version of events going forward and filed a petition in Nebraska Workers’ Compensation Court on April 21, 2015.
At trial, three medical experts provided written testimony. Dr. Gallentine, who initially examined Hintz. Dr. Harris, who performed a hip arthroscopy, and Dr. Bozarth, who reviewed medical records of other providers but did not personally examine Hintz. Dr. Harris opined that the injury was more likely caused by the work incident. Dr. Gallentine deferred to Dr. Harris’ opinion. Dr. Bozarth concluded it was more likely than not that the fall at home caused Hintz’ hip issues. The compensation court relied on Dr. Bozarth’s opinion and entered an order denying Hintz compensation.
At the first level of appeal, the Court of Appeals concluded that the compensation court was clearly wrong in finding that Dr. Harris’ opinion lacked a credible foundation. The Court of Appeals decided that Dr. Harris’ opinion was credible medical evidence that Hintz’ injuries resulted from the work accident. As part of this discussion, the Court of Appeals noted that Dr. Harris’ was “the only doctor who was able to observe Hintz’ actual injuries closely and thoroughly.” Second, the Court of Appeals concluded that Dr. Bozarth’s opinion was not competent medical testimony because it was not based “on any medical conclusions.” The court did not elaborate on what qualified as a “medical conclusion,” instead implying that Dr. Bozarth’s opinion was less valuable because he reviewed medical records instead of personally examining Hintz.
The Nebraska Supreme Court reversed the Court of Appeals and reinstated the compensation court’s opinion. The Supreme Court then rebuked the Court of Appeals for reweighing the evidence provided by Drs. Harris and Bozarth. The Supreme Court made clear that the compensation court may determine which, if any, expert witnesses to believe. Second, the Supreme Court made it clear that medical expert opinions based on a review of medical records are admissible and competent evidence. Thus, Dr. Bozarth’s opinion was competent evidence of equal value to Dr. Harris’.
The most significant point of this decision was the Supreme Court’s recognition that “[t]he Court of Appeals misstated our prior jurisprudence when it concluded that Bozarth’s expert medical opinion was not competent because he merely reviewed Hintz’ medical records.” Point being that medical records reviews can have sufficient foundation to support a decision on compensability. In this case, Dr. Bozarth was the only physician who reviewed all applicable records and therefore his opinion had more weight – even absent a physical examination.
On a side note, Dr. Bozarth recently passed away. He was a valued member of the medical community and a good man. Baylor Evnen sends condolences to his family.