SSA Terminals & Homeport Ins. v. Carrion, No. 13-72929 (9th Cir. 2016)
Annotate this CaseRobert Carrion sustained a severe knee injury while working as a chassis mechanic, and continued to work at his physically demanding job for the next fifteen years before retiring early. After Carrion’s former employer ceased paying for treatment, he filed for disability under the Longshore and Harbor Workers’ Compensation Act (LHWCA or the Longshore Act), 33 U.S.C. 901 et seq. The court affirmed the BRB’s decision upholding the ALJ’s conclusion that Carrion timely filed his claim against SSA where the ALJ and the BRB, in determining whether the one-year statute of limitations on disability claims was met pursuant to 33 U.S.C. 913(a), correctly looked to the date when Carrion became aware that his work for SSA caused a second, cumulative traumatic injury resulting in an impairment of his earning power. The court held that the prospect of a hypothetical future surgery and its anticipated benefits can not transform an otherwise permanent disability into a temporary one for purposes of the Longshore Act. In this case, Carrion's knee injury is a permanent disability. The court explained that evaluating an individual’s condition based on the presumed effect of a theoretical future treatment makes scant sense. Accordingly, the appropriate question to ask is not whether a future surgery would ameliorate Carrion’s knee condition, but whether there was actual or expected improvement to his knee after a normal and natural healing period. Finally, the court concluded that the doctrines of exhaustion and waiver are inapplicable because Carrion presented his claim of permanent disability well before the conclusion of the administrative process and neither SSA nor the agency were blindsided by the argument. Accordingly, the court denied SSA's petition for review of the BRB's decision and granted Carrion's cross-petition for review.
Court Description: Longshore and Harbor Workers’ Compensation Act. The panel denied an employer/insurer’s petition for review, and granted a claimant’s cross-petition for review of a decision by the Benefits Review Board, in an action brought by a claimant seeking disability benefits under the Longshore and Harbor Workers’ Compensation Act. The administrative law judge (“ALJ”) determined that claimant’s claim was timely filed under the Longshore Act, and determined that the disability was temporary because the claimant was contemplating knee replacement surgery that would likely alleviate his symptoms. The Benefits Review Board affirmed. SSA TERMINALS & HOMEPORT INS. V. CARRION 3 The panel held the claimant timely filed his claim against his employer. In determining whether the one-year statute of limitations on disability claims was met, pursuant to 33 U.S.C. § 913(a), the panel held that the ALJ and the Benefits Review Board correctly looked to the date when the claimant became aware that his work for the employer caused a second, cumulative traumatic injury resulting in an impairment of his earning power. The panel held that claimant’s knee injury was a permanent, rather than a temporary, disability. The panel held that evaluating an individual’s condition based on the presumed effect of a theoretical future treatment was error. The panel held that the appropriate question is not whether a future surgery would ameliorate claimant’s knee condition, but whether there was actual or expected improvement to his knee after a normal and natural healing period. Finally, the panel held that the doctrines of exhaustion and waiver were inapplicable because claimant presented his claim of permanent disability well before the conclusion of the administrative process and neither the employer nor the agency was blindsided by the argument. 4 SSA TERMINALS & HOMEPORT INS. V. CARRION
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