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Vega v. Iowa Beef Processors7/22/2005
Hendry, C.J., Wright, Connolly, Gerrard, Stephan, McCormack, and Miller-Lerman, JJ.
NATURE OF CASE
Between 1994 and 1996, Gonzalo Vega suffered four separate injuries while employed by Iowa Beef Processors, Inc. (IBP). A single judge of the Nebraska Workers' Compensation Court found these injuries to be compensable and ordered IBP to pay for future medical costs reasonably necessary as a result of Vega's accidents and resulting injuries.
In the instant case, the single judge entered an award in which it found that exploratory testing related to Vega's intestinal problems and Vega's need for back surgery were compensable medical expenses. The review panel affirmed the decision of the single judge with regard to medical expenses related to Vega's back surgery, but reversed regarding expenses related to his intestinal problems. The review panel also remanded the case to the single judge for his determination of whether certain medical expenses, which were not addressed in the single judge's order, were related to Vega's March 1996 accident. IBP appeals, and Vega cross-appeals, the review panel's decision.
BACKGROUND
In four separate accidents during 1994 and 1996, Vega suffered injuries to his right shoulder, right knee, left elbow, and lower back, all while employed with IBP. These injuries were found to be compensable by the single judge, and Vega was assigned permanent functional impairments for his right shoulder, right knee, and left elbow injuries, and a loss of earning capacity for his low-back injury . As a result of the single judge's findings, IBP was ordered to pay Vega permanent partial disability benefits for each of the injuries and current and future medical expenses which are reasonable and necessary. See Vega v. Iowa Beef Processors, 264 Neb. 282, 646 N.W.2d 643 (2002).
In the present appeal, the compensability of Vega's injuries and the single judge's 1998 award are not contested. Instead, the parties dispute the compensability of certain medical expenses related to Vega's back and digestive system.
In 1998, Vega sought medical treatment for gastrointestinal problems. Vega's medical records reflect that his physicians believed that his gastrointestinal problems were related to his diet and his weight. He was therefore advised to lose weight. Vega's medical records also reflect that he advised his physicians that he had been unable to take nonsteroidal, anti-inflammatory medication prescribed for his compensable right knee injury because the medication bothered his stomach. This in turn exacerbated Vega's compensable right knee injury. At the request of his physician, Vega underwent the following additional treatments: a right upper quadrant ultrasound; an endoscopic examination of his esophagus, stomach, and duodenum; a CAT scan of his upper abdomen; and a small bowel study. Following these tests, it was determined that Vega's gastrointestinal problems were caused by Vega's general state of obesity, not the medication he was taking for his right knee problems.
Between 1997 and June 2000, Vega did not seek additional treatment for compensable injuries other than his right knee. However, Vega's medical records reflect that in June 2000, he complained of back pain which began while he was playing with a child. At that time, Vega was given a low-back injection. The record is again silent with regard to Vega's back complaints until February 2001, when Vega was hospitalized following a motor vehicle accident in which he suffered a fracture of L2. Thereafter, Vega was seen by Dr. David Benavides, who noted that Vega complained of low-back problems which had been going on intermittently for several year
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