Court of Appeals of Texas,
CITY OF LAREDO, Appellant,
Juan GARZA Jr., Appellee.
May 13, 2009.
Attorneys & Firms
*627 Robert D. Stokes, Flahive, Ogden & Latson, Austin, TX, for Appellant.
David E. Garcia, Law Office of David E. Garcia, P.C., Laredo, TX, for Appellee.
Sitting: REBECCA SIMMONS, Justice.
Opinion by KAREN ANGELINI, Justice.
The City of Laredo appeals the trial court’s judgment, which found that Juan Garza Jr.’s compensable injuries included L4–L5 and L5–S1 complex regional pain syndrome. The City argues that there is legally insufficient evidence that these injuries were caused by Garza’s on-the-job accident because no expert medical evidence of causation was presented at trial. In response, Garza argues that his own lay testimony is sufficient evidence of causation and that no expert testimony was needed. Because we hold that expert medical evidence was needed to prove causation under the facts of this case and because no such evidence was presented, we reverse and render.
For purposes of workers’ compensation, the City of Laredo is self-insured. On August 30, 2005, thirty-seven-year-old Garza had been a groundskeeper for the City of Laredo for two years when he was injured while putting a heavy carpet into a trash dumpster. It is undisputed that he broke his kneecap and complex regional pain syndrome.
At the administrative level, after a Benefit Contested Case Hearing, the hearing officer determined that Garza’s compensable injuries included his knee and his ankle, but not the injuries to his L4–L5 or L5–S1 lumbar disc herniations, L5–S1 complex regional pain syndrome. Garza appealed the hearing officer’s decision to the appeals panel, which allowed the hearing officer’s decision to become the final decision of the Texas Workers’ Compensation Commission. Garza then appealed to district court in Webb County. At the bench trial, four witnesses testified: (1) Garza; (2) Garza’s supervisor, Doroteo Vasquez; (3) the adjuster, Ronald Coleman; and (4) Dr. David Cruz.
Juan Garza Jr.
Garza testified that on August 30, 2005, he was standing on top of a utility trailer, helping two other employees put a heavy carpet, which weighed about 60–70 pounds, into a trash container, when “all of a sudden, the carpet came back toward me.” According to Garza, when he tried to move out of the way, his boot got caught on the side of the rail of the trailer, causing him to fall and break his knee. Garza testified that his knee “started to hurt a lot, and [his] back started to hurt, but not that much.” But, when his knee began to swell, he started to pay more attention to his knee. When asked how his back was hurt, Garza testified that when he fell, he twisted.
Garza immediately told Doroteo Vasquez, his supervisor, about the accident. Garza admitted that he did not tell Vasquez he had injured his back. When *628 asked why he failed to mention his back, Garza replied, “[Because] it didn’t hurt that much.”
On September 6, 2005, Garza spoke with the adjuster, Ronald Coleman. That conversation was recorded, and the transcript was admitted in evidence. The transcript shows that Garza did not mention his back to Coleman. And, Garza confirmed at trial that when he first spoke to Coleman, he did not tell Coleman about any back pain.
According to Garza, on September 29, 2005, a month after the accident, he started to complain to his doctors that his back hurt a lot. Garza testified that he had numbness in his leg and sharp pains. Garza also testified that he did not have any numbness in his leg before the accident.
Garza’s supervisor, Doroteo Vasquez, testified that on August 30, 2005, when Garza reported the accident, he said that he had fallen, twisting his ankle and injuring his knee. According to Vasquez, Garza did not report that any other body part had been injured. And, Garza did not say that he had twisted his back when he fell. According to Vasquez, it was not until the summer of 2007 that he learned from the City’s attorney that Garza was also claiming a back injury.
Ronald Coleman, a senior claims specialist, testified that he learned of Garza’s claim in September 2005, and on September 6, 2005, he spoke with Garza by telephone and got a recorded interview. Coleman testified that Garza did not mention that he had also injured his back. According to Coleman, it was not until November 10, 2005, when he received a call from Dr. Cruz that he learned Garza was also claiming a back injury. In December 2005, he went to see Garza at his home. After Coleman interviewed Garza, the City filed a formal dispute.
Dr. David Cruz
Dr. Cruz, Garza’s treating physician, testified that Garza first visited him on August 31, 2005, for complex regional pain syndrome.
In addition to the testimony of the above four witnesses, medical records were admitted in evidence without objection. At the conclusion of the bench trial, the trial court found that Garza’s injuries included L4–L5 and L5–S1 disc herniations, L5–S1 complex regional pain syndrome.
A. Standard of Review
At the administrative level, the hearing officer and appeals panel found that Garza’s compensable injuries did not include L4–L5 or L5–S1 lumbar disc herniations, L5–S1 410.303 (Vernon 2006).
On appeal, the City of Laredo argues that there is legally insufficient evidence that these injuries were caused by Garza’s on-the-job accident. We review the trial court’s findings in the same manner as jury findings. Guevara v. Ferrer, 247 S.W.3d 662, 665 (Tex.2007).
B. Was expert medical testimony necessary to establish causation under the facts of this case?
To be probative, expert testimony must be based on reasonable medical probability. Merrell Dow Pharms., Inc. v. Havner, 953 S.W.2d 706, 712 (Tex.1997). Here, the City argues that because there is no expert medical evidence to support the trial court’s findings that Garza’s injuries were caused by his on-the-job accident, the evidence is legally insufficient. Garza responds by arguing that expert medical evidence was not necessary and that he presented sufficient lay testimony of causation.
In discussing the exception to the general rule that expert testimony is needed to prove causation as to medical conditions, the supreme court noted the following:
In personal injury cases, trial evidence generally includes evidence of the pre-occurrence condition of the injured person, circumstances surrounding the occurrence, and the course of the injured person’s physical condition and progress after the occurrence. The record before us contains lay testimony about [the plaintiff]’s pre-accident physical condition, his activities and other events leading up to the accident, the accident, an investigating police officer’s report, and post-accident events including medical treatments. This type of evidence “establishing a sequence of events which provides a strong, logically traceable connection between the event and the condition” could suffice to support a causation finding between the automobile accident and basic physical conditions which (1) are within the common knowledge and experience of laypersons, (2) did not exist before the accident, (3) appeared after and close in time to the accident, and (4) are within the common knowledge and experience of laypersons, caused by automobile accidents.
However, the court warned that in light of Daubert and Robinson, which require trial judges to scrutinize evidence for reliability, temporal proximity alone does not meet the standards of scientific reliability and does not, by itself, support an inference of medical causation. Id. (emphasis added).
“Undoubtedly, the causal connection between some events and conditions of a basic nature (and treatment for such conditions) are within a layperson’s general experience and common sense.” Id.
In applying id. at 667.
In his brief, Garza claims that the following evidence establishes such a strong, logically traceable connection between his back injuries and his accident:
(1) Garza testified that he had never had a back injury before the accident.
(2) When asked whether Garza had had back problems before the accident, Garza’s supervisor, Doroteo Vasquez, replied: “Not that I know, sir.” Similarly, when asked if Garza had ever complained about his back before the accident, Vasquez replied, “No, sir.”
(3) When asked how he hurt his back, Garza testified, “When I fell, I twisted.”
(4) When asked why he did not report his back immediately, Garza replied, “[Because] it didn’t hurt that much ...”
(5) Dr. Cruz’s testimony that intense pain can mask other conditions.
(6) Dr. Cruz’s testimony that in November 2005 Garza might have suffered from a back problem.
We first note that there is an attenuation issue in this case. Unlike other cases finding lay testimony sufficient evidence of causation, Garza did not immediately tell anyone that he had hurt his back after his on-the-job accident. See Southwestern Bell Tel., L.P. v. Valadez, No. 02–07–00129–CV, 2008 WL 425746, at *4 (Tex.App.-Fort Worth 2008, no pet.) (holding that lay testimony of man who was knocked unconscious after falling in a hole made by telephone company and who, upon regaining consciousness, immediately felt pain to his left shoulder and for which he sought treatment, evaluation, and X-ray on the day of the accident, is within the layperson’s general experience and common sense). According to Garza, he waited a month before telling Dr. Cruz that his back hurt.
Further, at trial, Garza testified that he “twisted” his back and did not tell anyone that he hurt it because “it didn’t hurt that much.” We note that although Dr. Cruz testified that Garza’s radiculopathy. Because there was no expert causation evidence, we hold that there is legally insufficient evidence.
Lastly, we note that in addition to the disc herniations and complex regional pain syndrome.2
Because there is legally insufficient evidence of causation, we reverse the trial court’s judgment and render judgment that Garza’s compensable injury does not extend to and does not include L4–L5 and L5–S1 disc herniations, L5–S1 complex regional pain syndrome.
On cross-examination, Dr. Cruz admitted that these could be symptoms of a back injury.
Having held that there is legally insufficient evidence to support the trial court’s findings, we need not reach the City’s other issues.