aggravated a preexisting back condition, but that the injury was not a
substantial contributing cause of appellant's current condition. The
appeals officer determined that Dr. Vater's report was credible and that
respondent had met her burden under NRS 616C.150 to establish that her
injury was industrial. The appeals officer then reversed the hearing
officer's decision and ordered appellant to provide appropriate treatment
for an accepted claim of lumbar sprain/strain, but noted that "[w]hether
the diagnosed aggravation of the Claimant's pre-existing back condition is
a temporary condition is something to be determined after conservative
medical treatment/investigation proceeds under her claim for, an accepted
lumbar sprain/strain." In making this determination, the appeals officer
did not address Dr. Vater's conclusion that the injury was not a
substantial contributing cause of appellant's current condition.
Appellant subsequently filed a petition for judicial review in
the district court." The district court granted the petition and remanded
the matter to the appeals officer to make specific findings as to whether
respondent's injury was a substantial contributing cause of her current
condition and to address the implications of NRS 616C.175, which sets
forth an exception to the insurer's liability in cases involving the
aggravation of a preexisting nonindustrial condition, in precluding
compensation.
On remand, the appeals officer issued a supplemental decision
and order, which clarified that he could not at that time determine
whether respondent's industrial injury had "more than temporarily
'Appellant did not provide the briefing associated with either of its
petitions for judicial review in its appendix on appeal.
2
aggravated her preexisting condition and whether it is a substantial
contributing cause of the entirety of her resulting condition," and he
ordered the claim accepted for a lumbar sprain/strain, but deferred a
determination on the NRS 616C.175 issue until "further medical
investigation and conservative care is provided. . . ."
Appellant filed another petition for judicial review of the
supplemental decision and order, asserting that the appeals officer's
decision was an abuse of discretion. The district court denied the petition,
concluding that, under NRS 616C.330, the appeals officer had the
authority to require appellant to pay for continuing treatment of
respondent's injury to resolve the question regarding her preexisting back
condition. This appeal followed. On appeal, appellant argues, among
other things, that the appeals officer erred by not addressing the NRS
616C.175 issue when he ordered the acceptance of respondent's claim for
lumbar sprain/strain. We agree, and we therefore reverse the district
court's decision.
DISCUSSION
This court reviews an appeals officer's decision in a workers'
compensation matter for clear error or abuse of discretion. NRS
233B.135(3); Vredenburg v. Sedgwick CMS, 124 Nev. 553, 557, 188 P.3d
1084, 1087 (2008). Judicial review is confined to the record before the
appeals officer, and on issues of fact and fact-based conclusions of law, the
appeals officer's decision will not be disturbed if it is supported by
substantial evidence. Vredenburg, 124 Nev. at 557, 188 P.3d at 1087-88;
Grover C. Dils Med. Ctr. v. Menditto, 121 Nev. 278, 283, 112 P.3d 1093,
1097 (2005). An appeals officer's determinations on pure issues of law,
however, are reviewed de novo. Roberts v. State Indus. Ins. Sys., 114 Nev.
364, 367, 956 P.2d 790, 792 (1998).
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When an employee suffers an industrial injury that
aggravates a preexisting nonindustrial condition, the compensability of
that employee's workers' compensation claim requires a two-part
evaluation. See NRS 616C.150(1) (setting forth the injured employee's
initial burden to establish that workers' compensation benefits are
warranted); NRS 616C.175(1) (explaining when a preexisting condition
may preclude an injured employee from receiving workers' compensation
benefits for his or her current injury). First, an injured employee is
required to establish that his or her injury occurred within the course of
employment in order to obtain workers' compensation benefits. NRS
616C.150(1). Second, if the injured employee meets his or her burden
under NRS 616C.150, the burden shifts to the insurer to prove that the
injury, which aggravated, precipitated, or accelerated a preexisting
nonindustrial condition, is not a substantial contributing cause of the
employee's current condition and that the insurer is therefore not liable
for workers' compensation benefits. NRS 616C.175(1); see also Ross v.
Reno Hilton, 113 Nev. 228, 229, 931 P.2d 1366, 1367 (1997).
Here, the appeals officer determined that respondent had met
her burden under NRS 616C.150 of showing that her injury was industrial
and that the injury had aggravated a preexisting back condition. This
determination is supported by substantial evidence in the record. See
Vredenburg, 124 Nev. at 557 11.4, 188 P.3d at 1087 n.4 ("Substantial
evidence is evidence that a reasonable person could accept as adequately
supporting a conclusion."). The appeals officer erred, however, in ordering
the acceptance of respondent's claim while deferring a determination
regarding respondent's preexisting condition. If appellant can show that
respondent's current lumbar sprain/strain injury is not a substantial
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contributing cause of her present back pain condition, then respondent's
claim will not be accepted and no benefits for her injury will be paid.
Thus, the appeals officer's order that appellant accept respondent's lumbar
sprain/strain claim and provide conservative medical treatment before any
determination regarding appellant's NRS 616C.175 argument was
premature and is a legal error. See NRS 616C.175(1) (recognizing that if
the insurer meets its burden under NRS 616C.175(1), the injured
employee's claim is not compensable); see also NRS 616C.155 (stating that
lain insurer shall not provide compensation to or for an employee . . .
before the compensation is required to be paid pursuant to the provisions
of [NRS Chapters 616A to 616D1").
The appeals officer stated that he did not have sufficient
evidence to make a determination regarding NRS 616C.175, but NRS
616C.330(3) specifically allows the appeals officer to order additional
evidence when it is necessary to resolve a medical question concerning an
injured employee's condition. 2 Accordingly, we reverse the district court's
order denying judicial review and direct the district court to grant the
petition and remand this matter to the appeals officer to resolve the
2 In
denying the petition for judicial review, the district court pointed
to NRS 616C.330(3) as authorizing the appeals officer to order the
acceptance of the claim and direct that conservative medical treatment be
provided before making any determination regarding appellant's NRS
616C.175 arguments. The parties did not address that statute on appeal.
Under these circumstances, and given our conclusion that 616C.175(1) and
NRS 616C.155 preclude the appeals officer from making such a
determination without first resolving the NRS 616C.175 issue, we need
not address the district court's conclusion in this regard.
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question of whether appellant has met its burden under NRS 616C.175, so
as to preclude its liability for respondent's industrial injury.
It is so ORDERED.
Fl& , J.
Douglas
J.
Saitta
cc: Hon. Linda Marie Bell, District Judge
William F. Buchanan, Settlement Judge
Lewis Brisbois Bisgaard & Smith, LLP/Las Vegas
Nevada Attorney for Injured Workers/Las Vegas
Eighth District Court Clerk
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