Norberto Peralta, a window fabricator for 20 years, suffered a workplace injury in July 2020 while lifting an 80-pound window. His case wound through multiple hearings, as he required three cervical spine surgeries.

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  Jon L. Gelman

  First surgery (October 2020) — anterior cervical decompression and fusion, ruled compensable.
• Second surgery (April 2021) — posterior cervical fusion, ruled noncompensable.
• Third surgery (recommended) — revision surgery to address complications, the subject of this appeal.

The complexity arose from the medical interplay among the procedures. While the first surgery was clearly work-related, and the second was deemed unrelated to the accident, the third surgery presented a nuanced question: Was it necessitated by complications from the compensable first surgery, or was it solely related to the noncompensable second surgery?

Why appeals courts rarely reverse

The appellate court applied the well-established standard that "factual findings of the compensation court are entitled to substantial deference." This deference exists because trial judges are uniquely positioned to:

• Observe witness demeanor. They can assess credibility by watching how witnesses testify.
• Weigh competing medical opinions. Judges develop expertise in evaluating medical testimony.
• Consider the complete evidentiary record. They hear all testimony and review all evidence firsthand.

The court noted that appellate review is limited to determining whether findings "could reasonably have been reached on sufficient credible evidence present in the record." Importantly, appellate courts "may not substitute [their] own factfinding for that of the judge of compensation."

Expert witnesses under scrutiny

The trial judge's credibility determinations proved decisive. Petitioner's treating physician, who had examined and treated Peralta 10-15 times over two years and performed both surgeries, was found "extremely credible." His testimony received "considerable weight" because he explained how the interaction between the first two surgeries created the need for the third.

In contrast, the respondent's expert, who had examined Peralta only once three years earlier, saw his credibility severely damaged when cross-examination revealed he had:

• Written a book targeting insurance adjusters and defense attorneys.
• Derived 70% of his income from cases referred by claims adjusters.
• Omitted this publication from his curriculum vitae.

The judge found this expert's testimony "vague, overbroad and not rendered within a reasonable degree of medical probability," and questioned his "candidness and inherent bias."

Why prior rulings didn't bar the third surgery claim

Silver Line, the employer, argued that res judicata and collateral estoppel should prevent Peralta from claiming that the third surgery was compensable, since the second surgery had been ruled noncompensable. The court rejected this defense for a crucial reason: The issues were not identical.

The first trial addressed whether the second surgery itself was compensable. The second trial addressed whether the interaction between the first and second surgeries necessitated the third surgery. As the court explained:

The discrete issues adjudicated by the judge in the second trial concerned whether the interplay of the first and second surgeries necessitated the third surgery to stabilize petitioner's spine because of his work-related injury.

This distinction matters because collateral estoppel requires that the issue to be precluded "is identical to the issue decided in the prior proceeding." When medical complications create new issues that weren't previously litigated, injured workers aren't automatically barred from pursuing those claims.

Liberal construction in action

The court also invoked the Workers' Compensation Act's humanitarian purpose, noting that it is "humane social legislation designed to place the cost of work-connected injury upon the employer."

Even if all collateral estoppel factors had been met, the court stated it would have refused to apply the doctrine because doing so "would neither satisfy the humane purposes of the Workers' Compensation Act, nor would it be a fair result," given Peralta's continued suffering and deteriorated quality of life.

Key takeaways

• Substantial deference standard. Appellate courts rarely overturn workers' compensation trial judges' factual findings, especially regarding witness credibility and medical causation.
• Expert witness credibility matters. Financial relationships with insurance companies and failure to disclose bias can severely undermine expert testimony.
• Treating physician advantage. Doctors who have ongoing treatment relationships typically receive more credibility than one-time examining physicians.
• Issue identity requirement. Res judicata and collateral estoppel apply only when the exact same legal issue was previously decided, not merely related issues.
• Liberal construction principle. Workers' compensation law favors injured workers, and courts will consider the humanitarian purposes of the law when applying legal doctrines.
• Medical complexity. Subsequent surgeries necessitated by complications from compensable injuries may themselves be compensable, even if intervening, noncompensable procedures occurred.

The bottom line

This case reinforces that workers' compensation trial judges possess significant authority in making factual determinations, and appellate courts will respect those findings when supported by credible evidence.

For injured workers, it demonstrates that prior adverse rulings don't necessarily preclude recovery for related but distinct medical complications.

For employers and insurers, it underscores the importance of presenting unbiased, credible medical testimony and the difficulty of overturning trial court decisions on appeal.

The case is Peralta v Silver Line Building Products.

Claimants' attorney Jon L. Gelman is the author of "New Jersey Workers’ Compensation Law" and co-author of the national treatise "Modern Workers’ Compensation Law." He is based in Wayne, New Jersey. This blog post is republished with permission.