NOT FOR PUBLICATION WITHOUT THE
APPROVAL OF THE APPELLATE DIVISION
This opinion shall not "constitute precedent or be binding upon any court ." Although it is posted on the
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SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-2205-17T2
ALMA CAMARENA,
Petitioner-Appellant,
v.
SPRINT PCS,
Respondent-Respondent,
and
THE STATE OF NEW JERSEY
SECOND INJURY FUND,
Respondent.
Argued May 22, 2019 – Decided June 24, 2019
Before Judges Alvarez and Reisner.
On appeal from the Department of Labor, Division of
Workers' Compensation, Claim Petition No. 2001-
22510.
Mario Apuzzo argued the cause for appellant.
Michelle L. Duffield argued the cause for respondent
Sprint PCS (Capehart & Scatchard, PA, attorneys;
Michelle L. Duffield, on the brief).
Rebecca A. Glick, Deputy Attorney General, argued the
cause for respondent State of New Jersey Second Injury
Fund (Gurbir S. Grewal, Attorney General, attorney;
Melissa H. Raksa, Assistant Attorney General, of
counsel; Jennifer B. Pitre, Deputy Attorney General, on
the brief).
PER CURIAM
In 1999, while an employee of respondent Sprint PCS, petitioner Alma
Camarena suffered injuries from a work-related automobile accident. The
March 21, 2003 order approving settlement of her claim stated the workers'
compensation award was based on: "[p]ermanent orthopedic disability of [thirty
percent] of partial total for residuals for disc bulging at C6-C7 and disc
protrusion at L4-L5 and L5-S1." In 2005, petitioner filed for modification,
claiming her injuries had worsened since the initial award. The matter was tried
in 2016. Workers' Compensation Judge George H. Gangloff, Jr., dismissed the
petition with prejudice and dismissed the Second Injury Fund. 1 Petitioner
appeals and we affirm.
1
Plaintiff also filed a Second Injury Fund Verified Petition. See N.J.S.A. 34:15-
95. However, the trial before the judge of compensation was bifurcated and the
Second Injury Fund waived its appearance pending the outcome of the
proceedings.
A-2205-17T2
2
Petitioner alleged she suffered from pain and discomfort, mostly to the
right side of her body, as a result of the 1999 accident. MRIs dating back to that
time showed "[m]ulti level degenerative changes in the spine with interval
development of an annular tear and disc protrusion at C5-6. There has also been
interval relative normalization of the cervical lordosis."
In July 2002, petitioner was involved in another motor vehicle accident.
She had been the restrained driver of a small passenger rental car, and was hit
from behind by a Jeep Cherokee. She hit her knee and thigh against the steering
wheel and the steering wheel collapsed onto her knees. After the accident,
petitioner "reported continuous low back pain and knee pain, along with upper
back pain and mid-back pain" and "presented with substantially decreased
ranges of cervical and lumbar motion, with weaknesses noted in specific areas
of the upper and lower extremities."
Petitioner has fallen twenty-eight times between the 1999 accident and
May 2015. As a result of these falls, she has experienced increased pain in the
neck and back, broken bones and fractures. When she fell in 2013, she broke
her left hand, requiring surgery. She has undergone several other surgeries over
the years, in addition to receiving epidural injections for lower back pain,
injections of cortisone in her hands for carpal tunnel syndrome and neck pain,
A-2205-17T2
3
physical therapy, and rehabilitation. In her home state, petitioner is provided
with a health aide forty hours a week during the day, and twelve hours a week
at night.
Petitioner's medical expert opined she was totally disabled and thus unable
to work. He examined her in 2011, 2014, and 2016. On each occasion, he said
she complained of the same pain and symptoms.
The expert knew that petitioner had injured her right knee during a second
car accident in 2002, but he denied that her evolving complaints might be
attributable to events subsequent to the 1999 injuries. He was unaware that the
2002 motor vehicle accident resulted in injuries other than to her right knee.
When asked about a June 23, 2004 MRI showing a new disc herniation in
petitioner's neck, the expert said he did not know if it could have been caused
by the 2002 accident.
Petitioner also presented psychiatric testimony. Having evaluated
petitioner in 2011, 2014 and 2016, the expert found her to be exhibiting
psychotic symptoms that might be associated with bipolar disorder. The
psychiatric issues developed in 2002, however, and in the expert's opinion were
unrelated to the accident. The employer's psychiatric expert testified that
petitioner's mental health issues pre-dated the 1999 accident.
A-2205-17T2
4
The employer's orthopedic expert opined that petitioner's 2002 motor
vehicle accident and the medical treatment which followed, and the serious fall
in 2004, were unrelated to the 1999 accident. The expert testified that her
current medical conditions were far removed from the 1999 accident and she
was not in further need of treatment for those injuries.
The judge reviewed petitioner's extensive medical records, which he
described as being "approximately a foot thick." He discussed them in detail in
his written opinion. The judge observed that petitioner's orthopedic expert's
testimony strayed from the course of medical treatment charted in the medical
records. The expert was not familiar with the 2002 accident, and the treatment
for those injuries. Petitioner's treating physician's record indicated, however,
she suffered back, neck and leg injuries from the 2002 car accident. After the
2004 fall, petitioner obtained another MRI, which showed a "new left
paramedian to lateral component to this [C5-6] disc herniation." Thereafter
petitioner underwent surgery for a cervical discectomy
and fusion at C5-6 followed by physical therapy and
treatment for her right knee, low back and neck pain.
In a January 2007 report [] records documented that the
petitioner fell again and hurt her ribs on the left side.
An August 2007 MRI revealed an L4-5 disc herniation
along with an[] L5-S1 disc herniation. Petitioner began
taking prescribed oxycodone in that time period. In the
spring of 2007 petitioner underwent revision surgery of
her cervical spine fusion resulting in a fusion from C5-
A-2205-17T2
5
C7. Nine months later, in January 2008 [] petitioner
fell again resulting in "some exacerbation of her
radiating right arm symptoms as well as her neck pain."
She continued on oxycodone. In October 2008
petitioner underwent another cervical MRI. The history
noted on that report states, "Fall and neck pain."
The judge found that no causal connection existed between petitioner's
current condition and the 1999 accident. The psychiatric testimony established
that there were no psychiatric disabilities attributable to the accident. Contrary
to petitioner's testimony, the medical records established that she injured more
than just her knee during the 2002 motor vehicle accident. The judge considered
that contradiction in her testimony to be "of significant import as to causation."
In light of the conflicts between her testimony and the medical records, and the
diagnoses offered by her psychiatric expert, he found "little reliability in [her]
testimony."
Additionally, the medical records established re-injury to petitioner's
cervical spine from a fall in 2004, when her "right knee – which she injured in
the 2002 MVA – 'gave way.'" That fall resulted in "new disc pathology and
neurologic compromise in the petitioner's cervical spine." Since the judge did
not find a causal relationship between petitioner's current back issues or
psychiatric issues as a result of the 1999 work accident, she "failed in proving
her claim of permanent, total disability."
A-2205-17T2
6
Now on appeal, petitioner raises the following points:
POINT I
THE COMPENSATION COURT'S FINDING THAT
PETITIONER DID NOT PROVE BY A
PREPONDERANCE OF THE EVIDENCE THAT THE
1999 COMPENSABLE ACCIDENT IS A
PROXIMATE CAUSE OF HER INCREASED
DISABILITY THAT TODAY IS TOTAL AND
PERMANENT IS MANIFESTLY UNSUPPORTED
BY OR INCONSISTENT WITH THE COMPETENT
RELEVANT AND REASONABLE CREDIBLE
EVIDENCE IN THE RECORD AND OFFENDS THE
INTERESTS OF JUSTICE.
A. The Petitioner Proved By A Preponderance Of
The Evidence That Her Condition Worsened
Following The 1999 Accident Such That Today
She Is Totally and Permanently Disabled And
That The 1999 Accident Is A Proximate Cause Of
That Total Disability.
1. Petitioner proved by a preponderance
of the evidence that her disability increased
after the 2003 settlement making her
totally and permanently disabled.
2. The Court Erred In Finding That
Petitioner Did Not Prove By A
Preponderance Of The Evidence That Her
Increased Disability Which Has Made Her
Totally And Permanently Disabled Is
Related To Her Work-Related Accident Of
1999.
a. The court erred in finding that
petitioner's falls broke the chain of
A-2205-17T2
7
causation from the 1999 motor
vehicle accident.
b. The court erred in finding that the
2002 auto accident broke the chain
of causation from the 1999 motor
vehicle accident.
B. The Court Failed to Properly Consider
Petitioner's Pre-Existing Psychiatric Disability.
"Appellate review of workers' compensation cases is 'limited to whether
the findings made could have been reached on sufficient credible evidence
present in the record . . . with due regard also to the agency's expertise[.]'" Hersh
v. Cty. of Morris, 217 N.J. 236, 242 (2014) (quoting Sager v. O.A. Peterson
Constr., Co., 182 N.J. 156, 164 (2004)). "A judge of compensation's factual
findings are entitled to substantial deference." Bellino v. Verizon Wireless, 435
N.J. Super. 85, 94 (App. Div. 2014) (citing Ramos v. M & F Fashions, Inc., 154
N.J. 583, 594 (1998)).
We do not substitute our own factfinding for that of the judge of
compensation. Lombardo v. Revlon, Inc., 328 N.J. Super. 484, 488 (App. Div.
2000). The appellate court must defer to the factual findings made by the judge
of compensation "considering the proofs as a whole, with due regard to the
opportunity of the one who heard the witnesses to judge their credibility."
A-2205-17T2
8
Lindquist v. City of Jersey City Fire Dep't, 175 N.J. 244, 262 (2003) (quoting
Close v. Kordulak Bros., 44 N.J. 589, 599 (1965)).
This deference is owed to the judge of compensation's findings "unless
they are 'manifestly unsupported by or inconsistent with competent relevant and
reasonably credible evidence as to offend the interests of justice.'" Id. at 262-
63 (quoting Perez v. Monmouth Cable Vision, 278 N.J. Super. 275, 282 (App.
Div. 1994)). However, the judge of compensation's legal conclusions are "not
entitled to any deference and, thus, are reviewed de novo." Hersh, 217 N.J. at
243 (citing Williams v. A & L Packing & Storage, 314 N.J. Super. 460, 464
(App. Div. 1998)). The petitioner has the burden of proving by a preponderance
of the evidence that the work-related condition or incident was a substantial
contributing factor of his or her occupational disease. Lindquist, 175 N.J. at
263.
Judges of compensation have "expertise with respect to weighing the
testimony of competing medical experts and appraising the validity of [a
petitioner's] compensation claim." Ramos, 154 N.J. at 598. We are also
"required to defer to the judge of compensation's expertise in analyzing medical
testimony and abide by the long-standing principle that a 'judge of compensation
is not bound by the conclusional opinions of any one or more, or all of the
A-2205-17T2
9
medical experts.'" Kaneh v. Sunshine Biscuits, 321 N.J. Super. 507, 511 (App.
Div. 1999) (quoting Perez v. Capitol Ornamental, Concrete Specialties, Inc., 288
N.J. Super. 359, 367 (App. Div. 1996)).
In this case, the judge made detailed findings of fact after his careful and
thorough review of the medical records. Relying on his own knowledge of
petitioner's medical history, he rejected the testimony of petitioner's orthopedic
expert because that individual knew so little about the 2002 accident and the
2004 fall. The judge relied upon the employer's expert because he had a more
accurate and complete understanding of those same records petitioner's expert
had reviewed. The judge's rationale for weighing the experts' testimony
differently was eminently reasonable.
Petitioner has the burden of establishing both legal and medical causation.
Lindquist, 175 N.J. at 259. She has established neither. The 2002 motor vehicle
accident was an independent intervening cause. As a result of that injury in
2004, her knee later gave out causing her to fall and again worsen her injuries –
for reasons unrelated to the 1999 incident. The 2002 motor vehicle accident and
her numerous falls were clearly intervening independent causes which broke the
chain of causation from the 1999 accident to the present.
Affirmed.
A-2205-17T2
10
ALMA CAMARENA VS. SPRINT PCS (DIVISION OF WORKERS' COMPENSATION)
Combined Opinion