Fastenal v. Labor Commission , 2020 UT App 53 ( 2020 )


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    2020 UT App 53
    THE UTAH COURT OF APPEALS
    FASTENAL AND PHOENIX INSURANCE,
    Petitioners,
    v.
    LABOR COMMISSION AND RONALD STONE,
    Respondents.
    Opinion
    No. 20180196-CA
    Filed April 2, 2020
    Original Proceeding in this Court
    Mark R. Sumsion and Lori L. Hansen, Attorneys
    for Petitioners
    Phillip B. Shell, Attorney for Respondent
    Ronald Stone
    JUDGE DAVID N. MORTENSEN authored this Opinion, in which
    JUDGES JILL M. POHLMAN and DIANA HAGEN concurred.
    MORTENSEN, Judge:
    ¶1      Having concluded that putting the pedal to the metal
    repeatedly for up to eleven hours a day while driving semi-
    trucks for Fastenal caused Ronald Stone’s foot ulcer, the Labor
    Commission determined that Stone was entitled to workers’
    compensation benefits. Fastenal asserts that the Commission
    violated its right to due process in several ways, most
    significantly by omitting certain pieces of evidence from the
    medical panel’s (Panel) consideration in its determination of
    medical causation. Fastenal also contends that the Commission
    erred in determining legal causation. We decline to disturb the
    Commission’s order.
    Fastenal v. Labor Commission
    BACKGROUND 1
    ¶2      From April 2013 to July 2014, Stone worked for Fastenal
    driving semi-trucks that operated on a manual transmission
    with fifteen gears. Stone’s work schedule included driving for
    eleven hours per day to make deliveries in various
    cities throughout the country. During one of his driving trips,
    Stone discovered a pressure ulcer on the heel of his left foot.
    Stone’s doctor opined that Stone’s significant hours driving
    caused the ulcer and treated it with cleanings and bandages for
    several months.
    ¶3     Stone brought a claim for workers’ compensation
    benefits for his medical expenses and temporary total disability.
    During discovery, another doctor designated by Fastenal
    (Doctor) diagnosed Stone with peripheral neuropathy,
    concluded that the condition had existed for seven-and-a-half
    years, and opined that Stone’s driving did not cause the pressure
    ulcer. A biomechanical expert (Expert) retained by Fastenal
    issued a report in which Expert determined that the semi-truck
    clutch required sixty-seven pounds of pressure to be fully
    engaged. The report also explained that this required force was
    more than that required to operate the clutch of consumer
    vehicles such as a Mini Cooper, a Ford F-150, and a Jeep
    Wrangler. After assessing Expert’s report, Doctor still opined in
    a second letter that Stone’s injury was not work-related. In
    coming to this opinion, Doctor explained that the pressure of
    engaging the semi-truck clutch “would be much less than what
    would be expected with walking” and concluded that “[t]his
    would be considered a normal activity of daily living and not an
    industrial exposure.” (Emphasis added.) On April 6, 2015, Stone
    1. “We state the facts and all legitimate inferences drawn
    therefrom in the light most favorable to the agency’s findings.”
    ABCO Enters. v. Utah State Tax Comm'n, 
    2009 UT 36
    , ¶ 2 n.1, 
    211 P.3d 382
     (cleaned up).
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    Fastenal v. Labor Commission
    underwent surgery on his left foot to reconstruct a rigid cavus
    deformity. 2
    ¶4      Thereafter, a hearing was held at which Fastenal
    presented testimony from Expert. In relevant part, Expert’s
    testimony outlined the same information regarding pounds of
    force used in engaging a semi-truck clutch as compared to the
    force required to engage the clutch of the assortment of
    consumer vehicles. His testimony at the hearing, however, also
    included a comparison of force among driving the semi-truck,
    standing, and walking. Expert explained that the latter two
    activities imposed more force, suggesting that Stone could have
    developed the ulcer from one of these ordinary daily activities.
    The standing-walking-driving-comparison testimony was not in
    Expert’s written report.
    ¶5      For his part, Stone testified about driving the semi-trucks.
    In pertinent part, he testified about how he used his left foot to
    engage the clutch, saying, “I would use the instep 60% of the
    time and use the ball of my foot 40% of the time.” Stone also
    testified about his April 6, 2015 surgery. The medical records
    regarding the surgery were not provided at the hearing.
    ¶6     After the hearing, the administrative law judge (Initial
    ALJ) who presided over the hearing retired, and a new
    administrative law judge (Replacement ALJ) was assigned to the
    case. The Replacement ALJ issued an interim order, concluding
    that legal causation had been proven and referring the matter to
    the Panel to determine medical causation. The order did not
    2. A cavus deformity “is an abnormal elevation of the medial
    longitudinal arch of the foot. . . . The deformity is typically
    flexible at first and then becomes rigid.” Cavus Foot, Pediatric
    Orthopaedic Soc’y of N. Am., https://posna.org/Physician-
    Education/Study-Guide/Cavus-Foot         [https://perma.cc/LY92-
    8GJ6].
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    reference Expert’s testimony about the walking-standing-driving
    comparison of force.
    ¶7     Fastenal then filed an interlocutory motion for review
    with the Commission. In its motion, Fastenal argued that the
    Replacement ALJ’s conclusion regarding legal causation was
    incorrect, and Fastenal sought the inclusion of the omitted
    evidence: Expert’s full testimony, specifically the amount of
    force exerted on an individual’s feet while standing and walking,
    and the medical records related to the surgery. Stone agreed that
    the evidence should be included. Reasoning that Fastenal could
    renew its objection “if necessary depending on the specifics of
    the [P]anel’s report,” the Commission dismissed Fastenal’s
    motion in its entirety. The evidence was never provided to the
    Panel for its consideration of medical causation.
    ¶8     The Panel assessed the evidence provided to it and issued
    its report. In it, the Panel noted that Stone suffered from a
    preexisting condition of peripheral neuropathy, which meant
    “he had a loss of protective sensation in his foot” and “was 7
    times more likely to suffer a foot ulcer than the general
    population.” The Panel also noted that Stone “underwent
    surgery in April 2015 to help with foot realignment.” Ultimately,
    the Panel determined that operating the semi-truck clutch
    medically caused Stone’s pressure ulcer: “This repetitive
    pressure resulted in micro trauma and eventually ulceration
    secondary to [Stone’s] known peripheral neuropathy.” No party
    objected to the Panel’s report. In the absence of any objection, the
    Replacement ALJ adopted the Panel’s report. The Replacement
    ALJ then issued updated findings, conclusions, and an order.
    ¶9     While Fastenal did not file an objection to the Panel’s
    report, Fastenal did file a motion asking the Commission to
    direct the Panel to review Expert’s testimony and the medical
    documentation of Stone’s surgery. In support, Fastenal included
    Doctor’s report concluding that the walking-standing-driving
    comparison of force showed that pushing the semi-truck clutch
    would not have caused Stone’s ulcer. Doctor also opined that the
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    surgery was not work-related, as it was to address the cavus
    deformity. The Commission denied Fastenal’s motion and
    upheld the Replacement ALJ’s order, awarding Stone the
    benefits. In its order, the Commission pointed out that the Panel
    was aware of Stone’s April 2015 surgery, and the Commission
    assessed Expert’s testimony regarding force.
    ¶10   Fastenal now seeks judicial review.
    ISSUES AND STANDARDS OF REVIEW
    ¶11 There are two issues for us to decide. First, we consider
    whether the Commission properly determined legal causation,
    which we review for correctness. Provo City v. Utah Labor
    Comm’n, 
    2015 UT 32
    , ¶ 17, 
    345 P.3d 1242
     (“[W]e review the law
    applied to these facts for correctness.”).
    ¶12 Then, we review whether the Commission violated
    Fastenal’s right to due process. “Constitutional issues, including
    questions regarding due process, are questions of law that we
    review for correctness.” Salt Lake City Corp. v. Jordan River
    Restoration Network, 
    2012 UT 84
    , ¶ 47, 
    299 P.3d 990
     (cleaned up).
    ANALYSIS
    ¶13 In order to obtain workers’ compensation benefits, it is
    incumbent upon a claimant to prove that his or her injury
    occurred by accident and arose out of and in the course of his or
    her employment. Utah Code Ann. § 34A-2-401(1) (LexisNexis
    2019). 3 Under Allen v. Industrial Commission, 
    729 P.2d 15
     (Utah
    3. The parties do not dispute whether Stone’s injury meets the
    “by accident” element of a workers’ compensation claim. See
    Utah Code Ann. § 34A-2-401(1) (LexisNexis 2019). Therefore, we
    need not decide the issue. And because the statutory provisions
    (continued…)
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    Fastenal v. Labor Commission
    1986), and its progeny, this requires a claimant to “establish that
    the conditions or activities of his job were both the medical cause
    and the legal cause of his injury.” Murray v. Utah Labor Comm’n,
    
    2013 UT 38
    , ¶ 45, 
    308 P.3d 461
    ; see also Allen, 729 P.2d at 25–28.
    Here, we first address the Commission’s conclusion on legal
    causation. Then, we turn our focus to Fastenal’s due process
    claims related to medical causation.
    I. Legal Causation
    ¶14 “If an employee does not have a preexisting condition
    that causally contributed to his injury, then the medical and legal
    causation requirements are one and the same, and the employee
    need only prove medical causation.” Murray, 
    2013 UT 38
    , ¶ 45.
    However, when an employee brings a causally contributing
    preexisting condition to the equation, as is indisputably true
    here, 4 the employee must meet the more stringent Allen test: “the
    employment contributed something substantial to increase the
    risk he already faced in everyday life because of his condition.”
    Allen, 729 P.2d at 25. This heightened test “is not meant to
    prevent workers with preexisting conditions from recovering
    benefits.” Nyrehn v. Industrial Comm’n of Utah, 
    800 P.2d 330
    , 335
    (Utah Ct. App. 1990); see also Peterson v. Labor Comm’n, 
    2016 UT App 12
    , ¶ 12, 
    367 P.3d 569
     (“Just because a person suffers a
    preexisting condition, he or she is not disqualified from
    obtaining compensation.” (cleaned up)). Rather, it “serves to
    offset the preexisting condition of the employee as a likely cause
    (…continued)
    we cite have not changed in any material way, we cite the
    current version of the code throughout this opinion for
    convenience.
    4. The Replacement ALJ specifically found that Stone suffered
    from the preexisting condition of peripheral neuropathy. The
    parties do not dispute that Stone had this causally contributing
    preexisting condition.
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    of the injury, thereby eliminating claims for impairments
    resulting from a personal risk rather than exertions at work.”
    Allen, 729 P.2d at 25. Therefore, “we must determine whether
    this activity is objectively unusual or extraordinary” under the
    totality of the circumstances. Murray, 
    2013 UT 38
    , ¶ 48 (“We
    compare the activity that precipitated the employee’s injury with
    the usual wear and tear and exertions of nonemployment life.”
    (cleaned up)).
    ¶15 Repetition of a workplace activity can constitute an
    objectively unusual or extraordinary exertion. See id. ¶ 51 (“Utah
    courts have deemed employment activities to be ‘unusual’ or
    ‘extraordinary’ when they require an employee to endure
    jumping, lifting great weight, or repetition.” (emphasis added));
    Nyrehn, 
    800 P.2d at 336
     (“When an accident is the climax of
    repeated exertions . . . [it] is the aggregate exertion of the
    repetitive exertions that establish the accident.”); see also Chase v.
    Industrial Comm’n of Utah, 
    872 P.2d 475
    , 479–80 (Utah Ct. App.
    1994) (holding that legal causation was met as a “result of
    repetitive physical stress associated with performing machinists’
    tasks for extended periods”).
    ¶16 For example, in Miera v. Industrial Commission of Utah, 
    728 P.2d 1023
     (Utah 1986), our supreme court held that an
    employee’s repeated “jumps into an eight-foot hole from a four-
    foot platform at thirty-minute intervals constitute[d] a
    considerably greater exertion than that encountered in non-
    employment life and [were] therefore legally sufficient” to
    establish legal causation. 
    Id.
     at 1024–25. Similarly, in Stouffer
    Foods Corp. v. Industrial Commission of Utah, 
    801 P.2d 179
     (Utah
    Ct. App. 1990), this court concluded that “applying repeated or
    constant pressure to the grips of high-pressure hoses” was
    objectively unusual or extraordinary. 
    Id. at 183
    . In so holding,
    this court narrowed its focus on the repetitive nature of the
    activity, explaining that “while occasionally using a . . . hose may
    be fairly regarded as typical of everyday life, applying repeated
    or constant pressure to the grips of high-pressure hoses . . . for
    hours at a time is not a typical non-employment activity.” 
    Id.
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    Fastenal v. Labor Commission
    (cleaned up). Finally, in Nyrehn, this court focused on the
    repetitious nature of the work-related exertion as well. 
    800 P.2d at 336
    . The employee lifted “a tub of merchandise weighing
    between 15 and 40 pounds . . . 30 to 36 times a day for two and a
    half months.” 
    Id.
     Even though it was only a “moderately
    strenuous” activity, the lifting amounted to an objectively
    unusual exertion because it was performed repeatedly. 
    Id.
    ¶17 Stone’s employment activity meets this same standard.
    Even though people are generally expected to endure some
    pressure on their feet in everyday life, the period and extent of
    the repeated pressure on Stone’s left foot, in the aggregate,
    amounted to an unusual exertion. Stone drove a semi-truck over
    an extended period of time—from April 2013 to July 2014.
    Driving the semi-truck required even more force to operate the
    clutch than that of an assortment of consumer vehicles. And
    Stone had to drive for approximately eleven hours per day on
    the days he worked. Moreover, there was testimony that Stone
    used the instep of his foot to shift about 60% of the time in a
    somewhat awkward angle. 5 Cf. Peterson, 
    2016 UT App 12
    , ¶¶ 15–
    17 (holding that “the unusual and awkward manner in which
    the employee lifted an otherwise-manageable amount of weight
    resulted in an injury” and constituted an unusual or
    extraordinary exertion). Analogous to the repetitious activities in
    Stouffer and Nyrehn, operating the semi-truck clutch under these
    repetitive circumstances was sufficient to meet the higher
    standard of legal causation described in Allen. Accordingly, we
    decline to disturb the Commission’s determination that legal
    causation was met. 6
    5. Another Fastenal employee testified at the hearing that using
    the instep of the foot, rather than the ball of the foot, would be
    awkward.
    6. Fastenal argues that the Commission erred in not assessing the
    comparative forces required to stand and walk versus that
    (continued…)
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    Fastenal v. Labor Commission
    II. Medical Causation—Due Process
    ¶18 The Commission ultimately concluded that driving the
    semi-truck was the medical cause of Stone’s injury. Fastenal
    contends that the manner in which the Commission came to its
    conclusion on medical causation violated its right to due process.
    Fastenal props up this contention with a claim that it did not
    receive a fair hearing based on the replacement of the Initial ALJ.
    Fastenal also argues that the Commission prejudicially omitted
    evidence from the Panel important to its determination of
    medical causation. Finally, Fastenal argues that the Commission
    (…continued)
    required to operate the semi-truck’s clutch. We disagree. First,
    the Commission noted the amount of force required to engage a
    semi-truck clutch exceeded that of vehicles’ clutches typically
    used in everyday non-employment life. The Commission also
    noted the repetition and awkwardness of the activity, which
    would be different from everyday life. And importantly here, it
    was not the amount of force but the repetitiveness and
    awkwardness of the activity that were the key factors. Although
    Fastenal is correct that the proper analysis is a totality of the
    circumstances test in assessing the workplace injury, see Murray
    v. Utah Labor Comm’n, 
    2013 UT 38
    , ¶¶ 47–48, 
    308 P.3d 461
    , the
    Commission is not required to compare every activity offered by
    the parties in its analysis of whether the exertion is unusual or
    extraordinary; rather, it may focus on apt comparisons, as it did
    here, see id. ¶ 53 (focusing on apt comparisons of everyday life to
    the individual’s boating activity, such as carrying luggage
    heavier than the individual’s belt and life jacket and
    encountering bumpy rides in planes or buses similar to the small
    wave that rocked the individual’s boat). Requiring every
    comparison would allow any party to complain merely because
    the Commission did not adopt that party’s desired comparisons,
    and the Commission could be stuck in a never-ending chasm of
    required analogies.
    20180196-CA                     9                 
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    Fastenal v. Labor Commission
    erroneously asserted that the “Panel consisted of experts in
    force.”
    ¶19 “At a minimum, due process requires timely and
    adequate notice and an opportunity to be heard in a meaningful
    way.” Salt Lake City Corp. v. Jordan River Restoration Network, 
    2012 UT 84
    , ¶ 50, 
    299 P.3d 990
     (cleaned up). “Due process is flexible
    and, being based on the concept of fairness, should afford the
    procedural protections that the given situation demands.” Dairy
    Product Services, Inc. v. City of Wellsville, 
    2000 UT 81
    , ¶ 49, 
    13 P.3d 581
     (cleaned up).
    ¶20 In the context of Labor Commission adjudications, “the
    Commission is afforded broad discretion in determining how
    best to conduct its inquiry into each case.” JP’s Landscaping v.
    Labor Comm’n, 
    2017 UT App 59
    , ¶ 48, 
    397 P.3d 728
     (cleaned up).
    “In this regard, the Commission ‘may make its investigation in
    such manner as in its judgment is best calculated to ascertain the
    substantial rights of the parties and to carry out justly the spirit
    of the Workers’ Compensation Act.’” 
    Id.
     (quoting Utah Code
    Ann. § 34A-2-802(1)) (cleaned up). And “while principles of due
    process extend to administrative hearings, it is well established
    that such hearings need not have all the formality of judicial
    procedure.” Nelson v. City of Orem, 
    2013 UT 53
    , ¶ 36, 
    309 P.3d 237
    (cleaned up). Indeed, an appellate court “shall grant relief only
    if, on the basis of the agency’s record, it determines that the
    agency action constituted an abuse of the discretion delegated to
    the agency by statute and that the person seeking judicial review
    has been substantially prejudiced as a result.” Foye v. Labor
    Comm’n, 
    2018 UT App 124
    , ¶ 19, 
    428 P.3d 26
     (cleaned up); see also
    Utah Code Ann. § 63G-4-403(4) (LexisNexis 2019). With this legal
    framework in mind, we address Fastenal’s arguments in turn.
    A.     ALJ Replacement
    ¶21 Fastenal claims that the replacement of the Initial ALJ was
    unfair because the Replacement ALJ did not review the hearing
    transcript. Fastenal’s only support for this claim is that the
    20180196-CA                      10                 
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    Fastenal v. Labor Commission
    Replacement ALJ did not mention Expert or his testimony in the
    interim order to the Panel. This argument is unpersuasive.
    ¶22 To begin with, Fastenal’s argument is contrary to
    precedent. See Utah Auto Auction v. Labor Comm’n, 
    2008 UT App 293
    , ¶¶ 16–17, 
    191 P.3d 1252
     (holding that the assignment of a
    workers’ compensation claim to a new ALJ upon the retirement
    of another ALJ who presided over the initial hearing did not
    deny a party its right to due process). In Utah Auto Auction, this
    court concluded that a materially indistinguishable argument
    was “without merit because the Commission is the final body to
    review the ALJ’s decision and does so without the benefit of
    having been present at the original hearing.” Id. ¶ 17. Fastenal
    “is appealing from the Commission’s decision, not the
    [Replacement] ALJ’s decision; the Commission had the benefit of
    the full record at the time it reviewed this case; and without any
    indication to conclude otherwise, we presume that the
    Commission did in fact review the record.” See id. Except here
    we don’t even need to resort to this presumption. In its final
    order, the Commission explicitly addressed the Expert’s hearing
    testimony that Fastenal complains was not mentioned by the
    Replacement ALJ. Consequently, Fastenal’s argument is
    unavailing.
    ¶23 To add to this, the Administrative Procedure Act cuts
    against Fastenal’s argument. It specifically allows for the
    substitution of administrative law judges and other presiding
    officers in adjudicative proceedings: “If fairness to the parties is
    not compromised, an agency may substitute one presiding
    officer for another during any proceeding.” Utah Code Ann.
    § 63G-4-103(1)(h)(ii). And the record does not support Fastenal’s
    claim that fairness was compromised by the substitution.
    ¶24 And last, but not least, the facts of this case undermine
    Fastenal’s argument as well. In his interim order to the Panel, the
    Replacement ALJ included a footnote explicitly stating that he
    had reviewed the hearing record. Contrary to Fastenal’s
    assertion, the Replacement ALJ in fact did refer to Expert in the
    20180196-CA                     11                
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    Fastenal v. Labor Commission
    order—specifically Expert’s testimony about the sixty-seven
    pounds of pressure required to engage the semi-truck clutch,
    which exceeded that of comparison consumer vehicles. The
    Commission also noted that the Replacement ALJ’s order
    included “testimony of Fastenal’s expert witness.” Fastenal
    points out that the same evidence referenced by the Replacement
    ALJ is in Expert’s report. But simply pointing this out does not
    meet Fastenal’s burden of showing that the replacement caused
    Fastenal substantial prejudice. See 
    id.
     § 63G-4-403(4). In short,
    Fastenal has not proven a due process violation based on the fact
    that the Replacement ALJ merely did not mention the particular
    piece of testimony that Fastenal wishes.
    B.    Omitted Evidence
    ¶25 Next, Fastenal maintains that its constitutional due
    process rights were violated by the Replacement ALJ not
    expressly directing the Panel to consider Expert’s hearing
    testimony on forces experienced by people when walking and
    standing. As outlined, see supra ¶¶ 6–7, before the Panel
    conducted its review of the case, Fastenal filed an interlocutory
    motion for review, which attacked the Replacement ALJ’s
    conclusion regarding legal causation and sought inclusion of
    two things: Expert’s full testimony regarding force exerted on an
    individual’s feet while standing and walking and medical
    records of Stone’s surgery. The motion for review was denied,
    partially on the basis that depending on how the case
    progressed, the issues raised might very well become moot. The
    Panel then undertook its review and issued a report. As the
    Replacement ALJ noted in his subsequent order, Fastenal did not
    object to the Panel’s report: “None of the parties filed written
    objections to the . . . [P]anel report.”
    ¶26 Fastenal does not explain why no objection was filed,
    which seems odd in the context of the claims made before us.
    Here, the applicable statutory and rule scheme provides a
    specific process for Fastenal to address the issues it raises. But
    Fastenal has chosen not to employ that process at all.
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    Fastenal v. Labor Commission
    Nevertheless, Fastenal claims a constitutional lack of due
    process. We reject this attempt.
    ¶27 Section 34A-2-601(2)(d)(ii) of the Utah Code expressly
    provides that parties may file objections to a medical panel
    report with the ALJ. And the next subsection states, “If no written
    objection is filed within the period described in Subsection
    (2)(d)(ii), the report is considered admitted in evidence.” Utah
    Code Ann. § 34A-2-601(2)(d)(iii). Furthermore, rule R602-2-
    2(B)(4) of the Utah Administrative Code expressly provides that
    the objection can request that a medical panel clarify a medical
    panel report or ask an ALJ to have a medical panel consider new
    conflicting medical evidence. See also, e.g., Right Way Trucking,
    LLC v. Labor Comm’n, 
    2015 UT App 210
    , ¶¶ 10–20, 
    357 P.3d 1024
    (demonstrating that objections as to whether a medical panel
    should review certain documents are submitted to the ALJ).
    Here, medical records—specifically those related to Stone’s 2015
    surgery—could have been addressed by way of an objection
    submitted to the Replacement ALJ, but Fastenal did not avail
    itself of that process. Likewise, as to consideration of Expert’s
    hearing testimony, Fastenal could have attempted to seek a
    clarification of the Panel’s report, but again, it did not. Instead of
    asking the Replacement ALJ, Fastenal incorrectly attempted to
    ask the Commission to order the Panel to review these pieces of
    evidence. Thus, Fastenal’s procedural complaints regarding the
    omitted evidence are unfounded because they should have been
    addressed in an objection submitted to the Replacement ALJ.
    ¶28 Additionally, the Commission is the ultimate factfinder
    endowed with the prerogative and duty to consider all the
    evidence. See Utah Auto Auction, 
    2008 UT App 293
    , ¶ 17; see also,
    e.g., Bade-Brown v. Labor Comm’n, 
    2016 UT App 65
    , ¶ 19, 
    372 P.3d 44
     (“It is the province of the Commission—not the medical
    panel—to view all the evidence submitted as a whole and then
    make an appropriate determination . . . that substantial evidence
    supported one determination more than another.” (cleaned up));
    Danny’s Drywall v. Labor Comm’n, 
    2014 UT App 277
    , ¶ 14, 
    339 P.3d 624
     (“It is the prerogative and the duty of the Commission
    20180196-CA                      13                
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    Fastenal v. Labor Commission
    to consider not only the report of the medical panel, but also all
    of the other evidence and to draw whatever inferences and
    deductions fairly and reasonably could be derived therefrom.”
    (cleaned up)). In Bade-Brown, we addressed a petitioner’s
    argument that “the ALJ abused its discretion by admitting the
    medical panel report into evidence despite glaring deficiencies in
    the report.” 
    2016 UT App 65
    , ¶ 6. We explained that “the
    medical panel’s role is to assist the Commission by evaluating
    medical evidence and advising the Commission with respect to
    its ultimate fact-finding responsibility.” Id. ¶ 12 (cleaned up). We
    further clarified that not all objections “are of sufficient
    significance to justify the time and expense” of the requested
    remedy. Id. ¶ 14. In rejecting the petitioner’s argument,
    we reasoned that “the Commission in essence concluded that
    the medical panel’s flawed [maximum medical improvement]
    finding was harmless because the preponderance of the evidence
    still indicated” that the petitioner was not entitled to benefits.
    Id. ¶ 16.
    ¶29 And here, the Commission assessed and weighed all
    the evidence in coming to its conclusion that Stone’s
    work activity medically caused his injury. The Commission
    explicitly addressed Expert’s testimony regarding force. 7 It
    also accurately explained that the Panel was aware of Stone’s
    April 2015 surgery. Indeed, the Panel specifically noted that
    Stone “underwent surgery in April 2015 to help with foot
    realignment.”
    7. The Panel also had Doctor’s second letter in which he noted
    that the pressure of engaging the semi-truck clutch “would be
    much less than what would be expected with walking.” The
    Panel was also aware of Expert’s report including the
    comparisons of force required to operate the different clutches.
    While this report did not include the exact details of the pounds
    of force involved in walking and standing, it did bring the issue
    of force to the Panel’s attention.
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    ¶30 Fastenal does not contend that there was any evidence
    that it could not bring before the Replacement ALJ or the
    Commission. Nor does Fastenal claim that there were any
    arguments it was precluded from making. And when these
    issues were presented to the Commission, the Commission
    determined that even if the Panel would have had the
    information Fastenal claims it should have had, it would not
    have changed the outcome. Accordingly, under these
    circumstances, we perceive no due process deprivation; these
    proceedings provided Fastenal a sufficient opportunity to be
    heard, given the Commission’s “broad discretion in determining
    how best to conduct its inquiry into each case.” See JP’s
    Landscaping, 
    2017 UT App 59
    , ¶ 48 (cleaned up). 8
    C.    Panel Expertise
    ¶31 Fastenal also argues that the Commission erroneously
    asserted that the “Panel consisted of experts in force.” But
    more precisely, the Commission said that the members of
    the Panel, “as trained experts, were aware of the difference
    in exertion between standing and walking and the repetitive
    use of one’s foot to engage a [semi-]truck clutch.” This
    distinction is meaningful. And we have no reason to suspect
    that the Commission’s statement is inaccurate, where one
    Panel member is an expert in occupational medicine, 9 and the
    8. Moreover, Fastenal does not point to specific details in the
    surgical report that would have affected the Panel’s analysis,
    especially where the Panel was already aware of Stone’s April
    2015 surgery. Thus, as to that piece of evidence, Fastenal does
    not meet its burden of showing substantial prejudice. See Utah
    Code Ann. § 63G-4-403(4) (LexisNexis 2019).
    9. Occupational medicine “is a board-certified specialty . . . that
    focuses on the diagnosis and treatment of work-related injuries
    and illnesses. . . . [Specialists] are the leading experts in the
    complex web of factors that affect health in the workplace,
    (continued…)
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    other is a sports-medicine specialist. 10 Indeed, the Panel
    report recites, and Fastenal has not disputed, that one doctor “is
    a board certified occupational medicine physician with
    experience in injuries and illnesses sustained in the industrial
    setting” and that the other “is board certified in internal
    medicine with a specialty in sports medicine.” We simply reject
    the premise that medical doctors, particularly those who
    specialize in occupational medicine or sports medicine, are
    incompetent to opine as to the operation of the human body and
    to consider activities of the workplace in comparison to walking
    or standing.
    ¶32 In any event, the statute does not require the members of
    the panel to be experts in force; it requires them “to specializ[e]
    in the treatment of the disease or condition involved in the
    claim.” Utah Code Ann. § 34A-2-601(1)(c); accord Foye, 
    2018 UT App 124
    , ¶ 21. Thus, because the members of the Panel easily fit
    this bill, we see no due process violation, as complained of by
    Fastenal, especially given the Commission’s explicit review of
    the evidence of force in its final order. See Bade-Brown, 
    2016 UT App 65
    , ¶ 19.
    (…continued)
    helping all types of organizations ensure the health of their
    employees, productivity of the workplace, and advancement of
    the overall economy.” What is Occupational Medicine?, Am. Coll.
    of Occupational & Envtl. Med., http://acoem.org/Careers/What-
    Is-OEM [https://perma.cc/9GGL-UD6M].
    10. Sports medicine involves “significant specialized training in
    both the treatment and prevention of illness and injury. . . .
    Sports medicine physicians specialize in the non-operative
    treatment of musculoskeletal conditions.” What is a Sports
    Medicine Physician – Sports Medicine Today, Am. Med. Soc’y for
    Sports    Med.,    https://www.sportsmedtoday.com/what-is-a-
    sports-medicine-physician.htm [https://perma.cc/J5VA-JYQY].
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    Fastenal v. Labor Commission
    CONCLUSION
    ¶33 We hold that the Commission’s determination of legal
    causation was correct, and we have discerned no violation of
    Fastenal’s right to due process on this record. Accordingly, we
    decline to disturb the Commission’s order.
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