Can workers receive temporary disability benefits without contemporaneous medical restrictions? Velasco v. Labor Commission Explained

Background and Facts

Israel Velasco suffered a serious laceration to his right index finger while working for Response Team 1 LLC in July 2018. After surgery and treatment, Dr. Burrows released Velasco to full unrestricted work on October 15, 2018. However, following that appointment, Velasco’s pain increased and his finger function decreased. When Velasco attempted to schedule follow-up care, he was told his medical bills hadn’t been paid and Dr. Burrows wouldn’t see him unless he accepted financial responsibility. Unable to afford out-of-pocket costs, Velasco couldn’t obtain further medical care.

Velasco returned to full duty work until October 26, when he quit due to frustration with the billing issues. He found temporary work but discovered construction work was too painful with his hand condition. He eventually found restaurant work in March 2019, but the pain interfered with his duties. When Velasco finally saw a new doctor, Dr. Warren, in March 2019, amputation was recommended.

Key Legal Issues

The central issue was whether the Labor Commission could deny temporary total disability benefits for the period between October 15, 2018, and March 24, 2019, solely because Velasco lacked contemporaneous medical evidence of his work restrictions during that time.

Court’s Analysis and Holding

The Utah Court of Appeals found the Labor Commission’s approach legally erroneous. The court noted that while Dr. Burrows’s release initially supported a finding that Velasco could work, the Commission’s own findings demonstrated that Velasco’s condition deteriorated significantly during the disputed period. The Commission found that construction work proved “too painful” and restaurant work “interfered with his ability to perform all his duties.” The court emphasized that temporary disability exists when a worker cannot “perform work of the general character [they were] performing when injured, or any other work which a [person] of [their] capabilities may be able to do.”

The court rejected the Commission’s “elevation of contemporaneous medical evidence to the exclusion of all other evidence,” noting this approach was “inconsistent with our jurisprudence and also objectively unreasonable.” Medical diagnosis often depends on subjective reports of pain and impairment, and while lack of contemporaneous medical evidence could undermine a claim, it cannot foreclose one when other substantial evidence supports disability.

Practice Implications

This decision provides important guidance for workers’ compensation practitioners. It establishes that temporary disability can be proven through various forms of evidence beyond contemporaneous medical restrictions. Practitioners should document functional limitations, work attempts, and pain reports even when medical documentation is unavailable due to payment disputes or other barriers to care.