Death benefits case for independent medical review remanded

The Supreme Court of New Mexico on Monday ruled an independent medical review of medical records is admissible in a death benefits case involving a school art teacher whose family says died of mold-related lung cancer after exposure to mold in the classroom.  

Upon being diagnosed with breast cancer in 1997, Patricia Lewis’s treatment included a biopsy of her lung tissue which revealed the presence of aspergillus, a type of mold, but her physicians reported "no residual aspergillus" after the breast cancer treatment and after the cancer went into remission, according to documents in Michael D. Lewis, as surviving spouse of Patricia A. Lewis, deceased v. Albuquerque Public Schools, filed in Albuquerque.

In 1999, she started working as a teacher at Manzano High School, assigned to teach art in a classroom that “had a history of roof leaks and a ‘clay trap’ which, by appearances, was lined with mold,” documents state.

“Worker, who suffered from asthma, began experiencing respiratory problems soon after she started teaching (there) and notified her supervisors and appropriate personnel of the respiratory problems she was having,” documents state.

She sought treatment in 2011, after which a doctor concluded her lung problems were related to her working in that classroom, according to records. The doctor wrote two letters to the school district, stating the health issue was “quite severe and potentially life threatening,” informing them that Ms. Lewis “was suffering from severe asthma which was exacerbated by her exposure to dust and environmental allergens in her new classroom,” documents state.

The school district subsequently tested the classroom for the mold, finding “more aspergillus spores were collected inside room… than outside room,” documenting specific dates where as much as 78% of mold spores collected were found in that classroom.

In 2012, Ms. Lewis was diagnosed with the lung condition allergic bronchopulmonary aspergillosis. That same year she was also diagnosed with breast cancer again, according to documents. In 2013 she retired, the same month she filed a workers compensation claim “alleging that her exposure to aspergillus mold in (her classroom) resulted in her ABPA and ensuing disability,” documents state.

She died in 2014 after complaining of a fever and “breathing issues.” Weeks later, a workers compensation judge ruled her injury as compensable. In 2015, her husband filed for death benefits, which the school district denied, claiming her death was not caused by her lung condition and that the case was time-barred.

Both a workers compensation judge and the Court of Appeals ruled the case was not time-barred but disagreed on the admission of evidence – an independent medical review of records, paid for by the employer after Ms. Lewis died – to prove something other than a lung condition killed her.

In stating the Court of Appeals erred in interpreting state law barring the medical evidence, the state’s Supreme Court remanded the case back to lower court, ordering that the medical evidence be weighed: “Because the worker in a death benefits case is deceased, the expert's IME necessarily consists of an examination of pertinent medical records and other relevant data in determining the causal relationship if any between the worker's injury and the worker's death. The testimony of the independent medical examiner who is agreed upon by the parties or appointed by the WCJ is therefore admissible” under state law.