Original Proceeding in this Court
Richard R. Burke, Attorney for Petitioner
R. Sumsion and Lori L. Hansen, Attorneys for Respondents Cody
Ekker Construction and Auto Owners Insurance Company
David N. Mortensen authored this Opinion, in which Judges
Michele M. Christiansen Forster and Ryan M. Harris concurred.
Gerald Benge injured his knee at work and ultimately
underwent three surgeries. Due to a dispute regarding whether
the latter two surgeries were medically caused by the work
injury and whether any permanent impairment was attributable
to the workplace incident, Benge filed a workers'
compensation claim. In making his claim, Benge tried to
sweeten his arguments by relying on Gunnison Sugar Co. v.
Industrial Commission of Utah, 275 P. 777 (Utah 1929).
However, the Utah Labor Commission denied Benge's claim.
We decline to disturb the Commission's order.
Work Injury and Three Surgeries
In 2013, while working for Cody Ekker Construction
(Employer), Benge was operating an excavator on a trailer
ramp. When the ramp suddenly tilted, he quickly got out of
the excavator onto the trailer and then jumped down from the
trailer to the ground. When he landed, his right knee
twisted, popped, and caused him immediate pain. Benge went to
the emergency room and was diagnosed with a torn meniscus and
a fracture of his tibial plateau. Soon after, a doctor
performed surgery (First Surgery) in which he made small
incisions, cleaned out dead and damaged tissue, removed part
of the meniscus, and shaved off and reshaped part of the
patella on Benge's right knee. During the First Surgery,
the operating doctor noted "some balled up tissue with
some obvious partial tearing of the ACL . . . [which] was
calcified representing probable older type tissue from an
older pathologic type tear." Benge was not happy with
the results of his treatment, however, so he requested a
change of doctors and began seeing Dr. Holmstrom.
Over the next two years, Benge underwent two more surgeries
on his right knee. In January 2014, as pain in Benge's
knee persisted and after discussing the details of his knee
with Dr. Holmstrom, Benge received a right knee ACL
reconstruction (Second Surgery). Then, in March 2015, Dr.
Holmstrom performed a total knee replacement (Third Surgery).
Dr. Holmstrom opined that all Benge's knee problems were
causally connected to the 2013 work injury. However,
Employer's medical consultant, Dr. Green, evaluated
Benge's injuries and partially disagreed with Dr.
Holmstrom's conclusion. Dr. Green agreed that the
injuries addressed in the First Surgery were causally
connected to the 2013 work injury, but he concluded that the
other knee problems addressed in the subsequent surgeries
were preexisting and unrelated to the 2013 work injury.
Benge then filed a claim for permanent total disability under
the Utah Workers' Compensation Act,  and an
administrative law judge (ALJ) held an evidentiary hearing.
During the hearing, Employer admitted that Benge sustained a
meniscus tear and tibial plateau fracture as a result of the
2013 incident-or in other words, Employer admitted that the
First Surgery was compensable by workers' compensation.
But Employer argued that Benge's ACL tear and conditions
that led to the Second Surgery and Third Surgery were not
related to the 2013 work injury, and thus not compensable.
Because of the doctors' contradictory opinions, the ALJ
referred the medical issues to a medical panel
(Panel). The Panel concluded that Benge's 2013
work injury did not medically cause the injuries addressed in
the Second Surgery and Third Surgery. The Panel specifically
reported that "neither the right tibial plateau fracture
nor the lateral meniscal tear impacted or accelerated Mr.
Benge's other right knee condition in any
degree." (Emphasis added.) The Panel also concluded
that Benge's 2013 work injury reached medical stability
by December 15, 2013, and did not result in permanent
After reviewing the Panel's reports, the ALJ adopted the
Panel's medical conclusions. Benge argued, however, based
on Gunnison Sugar Co. v. Industrial Commission of
Utah, 275 P. 777 (Utah 1929), that his knee problems
after the First Surgery were connected to the work-caused
injuries, as a matter of law. The ALJ rejected Benge's
argument, and explained that Benge's injuries related to
his First Surgery "did not impact or accelerate [his]
other knee conditions." Additionally, the ALJ explained
that Benge's "preexisting knee conditions and
treatment at all times based on the preponderance of the
medical evidence and medical opinions have existed
independently from" the 2013 work injury. The ALJ
further found that "the evidence show[ed] that
[Benge's] primary injury was not aggravated by medical or
surgical treatment." Benge also argued that Employer was
equitably estopped from denying compensability for the
subsequent surgeries, but the ALJ rejected this argument as
well, citing Olsen v. Industrial Commission of Utah,
776 P.2d 937 (Utah Ct. App. 1989). Consequently, the ALJ denied
Benge's claim regarding the Second Surgery, Third
Surgery, and permanent impairment.
Benge then filed a motion for agency review, and the
Commission issued an order agreeing with the ALJ's
decision. In its order, the Commission noted the disagreement
between Dr. Holmstrom's and Dr. Green's opinions as
to the medical cause of Benge's injuries addressed in the
Second Surgery and Third Surgery. The Commission further
acknowledged that the ALJ adopted the Panel's conclusion
that Benge's 2013 work injury warranted the First Surgery
but not the subsequent surgeries. Moreover, the Commission
specifically disagreed with Benge's argument that
Gunnison Sugar applied to his situation. And the
Commission stated that "a preponderance of the evidence
shows the  accident medically caused an injury that was
separate from other pathology in Mr. Benge's right knee
and unrelated to the [First ...