Brinks Global Services v. Labor Commission

2025 UT App 191

THE UTAH COURT OF APPEALS

BRINKS GLOBAL SERVICES AND ARCH INSURANCE COMPANY,
Petitioners,
v.
LABOR COMMISSION AND JAMES BEATY,
Respondents.

Opinion
No. 20240823-CA
Filed December 26, 2025

Original Proceeding in this Court

Brad J. Miller, Attorney for Petitioners
Phillip B. Shell, Attorney for Respondent James Beaty

JUDGE RYAN M. HARRIS authored this Opinion, in which
JUDGES GREGORY K. ORME and DAVID N. MORTENSEN concurred.

HARRIS, Judge:

¶1 James Beaty, a truck driver, was injured on the job when
his truck was involved in an accident. Beaty filed a claim for—and
was eventually awarded—workers’ compensation benefits,
including reimbursement for the cost of a lumbar spine surgery.
His employer, Brinks Global Services (Brinks), and its insurer
(collectively, the Company) challenge the award for the lumbar
spine surgery, asserting that the evidence presented does not
sufficiently support it. We decline to disturb the award.

BACKGROUND

¶2 In March 2020, Beaty was working for Brinks as a truck
driver. On the day in question, as he was asleep in the cabin of the
truck while his co-driver was driving, the truck was involved in
an accident. The impact threw Beaty to the back of the cabin and
Brinks v. Labor Commission

then forward, causing him to land on the floor. Beaty was
transported by ambulance to a hospital, where he was treated for
injuries to his lower back, right leg, abdomen, arm, and shoulder.

¶3 A few days after the accident, Beaty was treated for lower-
back pain, among other things, and he was released to work with
restrictions. A week later, Beaty underwent an MRI scan, which
showed signs of a lumbar spine injury.

¶4 In May 2020, a doctor (Treating Physician) evaluated Beaty
and reviewed the MRI results, and he concluded that Beaty had
“disc disease” in his lower back and “may well require surgical
treatment,” but he opined that Beaty was “presently . . . not a
surgical candidate due to his weight.” Treating Physician referred
Beaty to another doctor, who administered steroid injections to
address Beaty’s lower-back pain. Later that year, in August,
Treating Physician noted that Beaty had a “documented work
injury” and determined that Beaty would “require” surgical
intervention for his lower back in order to obtain “satisfactory
long-term relief.” Over the next several months, Beaty received
additional lower-back injections and attempted to reduce his
weight to qualify for the recommended surgery. These steps,
however, were unsuccessful.

¶5 After another round of lower-back injections, Treating
Physician noted in December 2020 that the injections had “helped
with [Beaty’s] back pain somewhat, although he continue[d]” to
have symptoms in his lower extremities. About a month later, a
physician assistant noted “an 80% decrease in [Beaty’s] lumbar
pain” but also noted “persisting . . . lower extremity pain.” Even
so, by January 2021, a different physician assistant (Physician
Assistant) noted that either “surgical intervention” or additional
MRI imaging was necessary on Beaty’s lumbar spine in order to
determine the extent of the damage from the work accident.

¶6 In February 2021, a physical therapist evaluated Beaty for
functional capacity regarding his work duties. During the

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evaluation, Beaty was able to lift thirty pounds from waist to
shoulder height, but he was unable to do so from floor to waist
height and could not pull a pallet with a 2,000-pound load the
length of a fifty-three-foot trailer more than three times, a normal
requirement for his job. The physical therapist concluded that
Beaty was unable to safely perform the essential duties of his job
but that he could return to light-duty work.

¶7 In July 2021, Beaty underwent gastric bypass surgery to
help reduce his weight and become a better candidate for
lumbar spine surgery. Later that year, in October, Beaty
“pull[ed] something in his back” during an incident at his home.
Physician Assistant documented this incident when, soon
thereafter, Beaty received treatment for pain and requested a
specific pain reliever.

¶8 By November 2021, Beaty’s body mass index was “within
range” to proceed with lumbar spine surgery. The next month,
Beaty had a consultation with a surgeon (Surgeon), who
recommended surgery—specifically, a microdiscectomy—on
Beaty’s lower back. This surgery was performed in January 2022
and is the lumbar spine surgery at issue in this case. By May of
that year, Beaty’s performance evaluation showed that he was
able to perform the essential duties of his job and that he was able
to return to work without restrictions.

¶9 At various points during Beaty’s treatment, the Company
retained medical consultants to perform their own evaluations of
Beaty’s condition. In March 2021, a doctor (Defense Expert 1)
evaluated Beaty’s lower back and determined that the “work
injury [was] not a contributing cause to the current diagnosis” and
that Beaty’s lower-back condition was “pre-existing in nature and
due to the chronic degenerative changes in his lumbar spine.”
Defense Expert 1 concluded that Beaty “was medically stationary
as of June 16, 2020,” and that he did “not require medical
maintenance with respect to the industrial injury.”

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¶10 However, another doctor retained by the Company in
April 2022 (Defense Expert 2) examined Beaty and opined as
follows: “I do feel the medical evidence supports that [Beaty] had
a work-related aggravation of his [pre-existing lower-back
condition].” And he further stated, “I do feel that the discectomy
. . . performed by [Surgeon] . . . was likely due to the effects of his
work injury.”

¶11 Beaty filed an application for a hearing with the Utah Labor
Commission, claiming entitlement to workers’ compensation
benefits in connection with his work incident and injury. The case
was assigned to an administrative law judge (the ALJ), who
referred the medical aspects of Beaty’s claim to a medical panel.
That panel—which at the outset did not include an orthopedic
surgeon—initially concluded that Beaty’s industrial injuries
became medically stable by December 31, 2020.

¶12 Beaty filed an objection to the medical panel’s report,
claiming that the panel should have included an orthopedic
surgeon. The ALJ agreed and requested a new report from a
modified medical panel that included an orthopedic surgeon. The
modified panel reviewed the records and concluded again that
Beaty’s industrial injuries became medically stable by December
31, 2020. According to the panel, Beaty had received complete
treatment for his work-related injuries by that date; in particular,
the panel opined that the lumbar spine surgery that followed was
not medically necessary to treat his work injury.

¶13 Beaty objected to this report also, arguing that his
condition had not stabilized before his lumbar spine surgery in
January 2022. Sustaining Beaty’s objection in part, the ALJ then
sent additional questions to the medical panel, asking (among
other questions) whether the accident aggravated Beaty’s pre-
existing condition to any degree, when Beaty returned to his “pre-
accident baseline,” and when Beaty “reach[ed] medical stability
for his lumbar condition.” The medical panel responded in a
written addendum, this time clarifying that the “accident

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aggravated [Beaty’s] pre-existing lumbar condition” but that
Beaty “was probably between 85-90% of his pre-incident baseline
by December 31, 2020.”

¶14 After reviewing the medical panel’s submissions and
considering the evidence, the ALJ issued findings of fact,
conclusions of law, and an order. In making that decision, the ALJ
considered evidence from a number of sources, including the
medical records, the medical panel reports (and addenda), and
the opinions of the other medical professionals, including those of
Treating Physician and Defense Expert 2 indicating that the work
incident medically caused Beaty’s need for lumbar spine surgery.

¶15 The ALJ relied on the medical panel’s conclusions in part,
explaining that the panel had “acknowledged that the industrial
accident slightly altered the anatomy of” Beaty’s pre-existing
lower-back condition and had also “acknowledged that [Beaty’s]
pre-existing lumbar condition did not return to his pre-accident
baseline.” But the ALJ also explained that while the panel found
some parts of the physical therapist’s February 2021 examination
significant, “a closer review” of that examination “show[ed] that
[Beaty] could not safely perform the essential demands of his job,”
and the ALJ therefore found that Beaty “was not medically stable
on December 31, 2020.” The ALJ also pointed out that the medical
panel’s conclusion was based on Surgeon’s recommendation for
surgery after Beaty injured his back during the home incident. But
the ALJ highlighted that Treating Physician had recommended
surgery as early as August 2020—over a year before the home
incident. The ALJ thus concluded that a “preponderance of the
medical records shows that [Beaty] required surgery as a result of
the . . . industrial accident.”

¶16 After the ALJ issued her ruling, the Company asked the
Labor Commission’s Appeals Board (the Board) to review the
ALJ’s ruling. In its motion for review, the Company claimed,
among other things, that the ALJ’s decision was “inconsistent
with the medical panel report” and that the ALJ “did not reject the

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medical panel but instead alleged that [the ALJ’s] opinions were
supported by the panel,” which, in the Company’s view, was “not
accurate.” In turn, the Company argued that the ALJ “should
have adopted” the opinions of the medical panel “or instead
explained in detail why the opinions were being rejected.”

¶17 The Board affirmed the ALJ’s ruling, in relevant part, and
concluded that Beaty’s work accident medically caused a
“permanent worsening of his pre-existing condition” and that
“the surgery on his lumbar spine was necessary to treat such
worsening.” The Board explained that the medical panel’s
“reasoning . . . appear[ed] to misconstrue the evidence.” Like the
ALJ, the Board pointed specifically to the panel’s failure to
acknowledge that Beaty’s performance evaluation in February
2021 showed that he “still lacked the strength and capacity to
perform his job duties.” The Board also pointed to Treating
Physician’s opinion, which drew “a medical causal connection” as
early as August 2020 “between [Beaty’s] work accident” and the
“appropriate surgical treatment.” The Board also rejected the
Company’s assertion that the home incident “was the medical
cause of his need for surgery,” because “there [was] no indication
[that] such incident resulted in more than a minor ‘pull’ in his
low[er] back.” The Board expressly concluded that “[t]he opinions
of [Defense Expert 2, Surgeon, and Physician Assistant] show that
the lumbar spine surgery was necessary to treat [Beaty’s] work-
related injury.” Thus, the Board affirmed the ALJ’s ruling as to the
lumbar spine surgery.

ISSUE AND STANDARD OF REVIEW

¶18 The Company now challenges the Board’s ruling regarding
the lumbar spine surgery. Specifically, the Company claims that
the Board’s determination regarding medical causation was not
supported by the evidence. “Whether the [Board] properly found
that medical causation exists is a question of fact we review for
substantial evidence.” YESCO v. Labor Comm’n, 2021 UT App 96,

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¶ 13, 497 P.3d 839. We discuss the parameters of the “substantial
evidence” standard of review more thoroughly below, but in
summary, this standard requires that “we defer to the agency if
there is a quantum and quality of relevant evidence that is
adequate to convince a reasonable mind to support a conclusion.”
Id. (cleaned up).

ANALYSIS

¶19 The Utah Workers’ Compensation Act governs the
provision of benefits to workers injured in accidents “arising out
of and in the course of” their employment. Utah Code § 34A-2-
401(1). “[T]he language ‘arising out of or in the course of
employment’ requires that there be a causal connection between
the injury and the employment.” Allen v. Industrial Comm’n, 729
P.2d 15, 18 (Utah 1986) (cleaned up). To demonstrate this
connection, a claimant “must prove both legal causation and
medical causation.” Cook v. Labor Comm’n, 2013 UT App 286, ¶ 12,
317 P.3d 464. To establish medical causation, a “claimant must
show by evidence, opinion, or otherwise that the stress, strain, or
exertion required by his or her occupation led to the resulting
injury or disability.” Id. (cleaned up).

¶20 The Company challenges the Board’s medical causation
determination, arguing that it is not supported by substantial
evidence and, specifically, that the Board erred in disregarding
the medical panel’s opinion that Beaty’s work accident did not
cause his need for lumbar spine surgery. The Company—as the
proponent of judicial review—bears the burden of persuading us
that no substantial evidence supports the Board’s medical
causation finding. See C.R. England Inc. v. Labor Comm’n, 2024 UT
App 170, ¶ 28, 561 P.3d 213 (“[I]t falls to the . . . proponent of
judicial review . . . to meet the burden of persuading us that no
substantial evidence supports the [Board’s] medical causation
finding.”), cert. denied, 564 P.3d 958 (Utah 2025). For the reasons
discussed herein, we reject the Company’s challenge. We begin by

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discussing the legal standards governing both “substantial
evidence” and “medical causation.” We then address the merits
of the Company’s challenge.

¶21 The “substantial evidence” standard is the metric appellate
courts use to evaluate the soundness of an administrative
agency’s factual findings, including determinations regarding
medical causation. See Provo City v. Utah Labor Comm’n, 2015 UT
32, ¶ 8, 345 P.3d 1242 (“[A] challenge to an administrative
agency’s finding of fact is reviewed for substantial evidence.”);
YESCO v. Labor Comm’n, 2021 UT App 96, ¶ 13, 497 P.3d 839
(noting that an agency’s determination that medical causation is
present “is a question of fact we review for substantial evidence”).
This standard is a deferential one: “in conducting a substantial
evidence review, we do not reweigh the evidence and
independently choose which inferences we find to be the most
reasonable.” Provo City, 2015 UT 32, ¶ 8 (cleaned up). “Instead, we
defer to an administrative agency’s findings because when
reasonably conflicting views arise, it is the agency’s province to
draw inferences and resolve these conflicts.” Id. (cleaned up); see
also YESCO, 2021 UT App 96, ¶ 19 (“Merely pointing to conflicting
facts and evidence is insufficient to undermine substantial
evidence supporting the finding.” (cleaned up)). Moreover,
“substantial evidence” need not necessarily constitute a
preponderance of the evidence—our supreme court has made
clear that substantial evidence is “more than a mere scintilla of
evidence though something less than the weight of the evidence.”
Martinez v. Media-Paymaster Plus, 2007 UT 42, ¶ 35, 164 P.3d 384
(cleaned up). In short, “a decision is supported by substantial
evidence if there is a quantum and quality of relevant evidence
that is adequate to convince a reasonable mind to support a
conclusion.” Provo City, 2015 UT 32, ¶ 8 (cleaned up).

¶22 And our “medical causation” inquiry is similarly broad: a
claimant need only “show that an industrial accident was a cause
of the condition or injury requiring treatment.” See YESCO, 2021
UT App 96, ¶ 15 (cleaned up); see also Cox v. Labor Comm’n, 2017

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UT App 175, ¶ 18, 405 P.3d 863 (stating that a claimant “satisfies
the medical causation standard” by “proving that the industrial
accident is a cause—as opposed to the cause—of the condition
requiring treatment”), modified on other grounds by Morris v. Labor
Comm’n, 2021 UT App 131, 503 P.3d 519. After all, the purpose of
the medical causation requirement “is to ensure that there is a
medically demonstrable causal link between” the work-related
incident and the employee’s injuries. Allen, 729 P.2d at 27. Thus,
“a correct formulation of this standard asks whether the industrial
accident contributed to the employee’s medical condition in any
degree, such as by aggravating a preexisting condition, or . . . by
aggravating other contributing non-industrial factors.” YESCO,
2021 UT App 96, ¶ 15 (cleaned up).

¶23 We have previously held that a medical panel’s
determination as to medical causation—even standing alone and
even when it conflicts with other evidence—can constitute
“substantial evidence” to support the Board’s medical causation
determination. See Hutchings v. Labor Comm’n, 2016 UT App 160,
¶ 32, 378 P.3d 1273 (“[T]he medical panel’s report alone provides
substantial evidence to support the [Board’s] medical causation
determination.” (emphasis added)); see also Cook, 2013 UT App
286, ¶¶ 14–20 (concluding that the medical panel’s report
constituted substantial evidence as to whether medical causation
existed); Utah Code § 34A-2-601(2)(e)(i) (stating that an
“administrative law judge may base” his or her “finding and
decision on the report of . . . a medical panel”).

¶24 For example, in Cook, the claimant contested the Board’s
medical causation finding by pointing to the opinion of two
physicians indicating that her employer’s refusal to allow her to
“immediately seek medical care aggravated her cancer.” 2013 UT
App 286, ¶ 16. But the medical panel opined to the contrary, and
we held that “the medical panel’s report constitute[d] substantial
evidence supporting the Board’s determination that no medical
causation existed.” Id. ¶ 14. In so holding, we explained that while
the claimant had “identified a possible conflict in the evidence, it

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[was] the province of the Board, not appellate courts, to resolve
conflicting evidence.” Id. ¶ 19 (cleaned up). And in Hutchings, the
claimant pointed to several pieces of evidence indicating that her
industrial accident aggravated a pre-existing lower back
condition, yet we still held that the medical panel’s report—which
conflicted with the other evidence upon which the claimant
relied—“constitute[d] substantial evidence in its own right” and
concluded that the Board’s decision was “supported by
substantial evidence in the whole record, including the medical
panel’s assessment.” 2016 UT App 160, ¶¶ 31–32, 36, 38. When the
Board follows a medical panel’s admissible opinion in making a
medical causation determination, that determination is supported
by substantial evidence.

¶25 We now clarify that the opposite is also true: when the
Board opts not to follow a medical panel’s opinion in making a
medical causation determination, but grounds that determination
in other admissible evidence from health care providers or
experts, that determination is also supported by substantial
evidence. Indeed, the Board’s “prerogative and duty is 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.” Id. ¶ 23 (cleaned up).
The Board is not compelled to follow the opinions of the medical
panel. See Utah Code § 34A-2-601(2)(e)(ii) (stating that “an
administrative law judge is not bound by [a medical panel’s report]
if other substantial conflicting evidence in the case supports a
contrary finding” (emphasis added)); see also Ramos v. Cobblestone
Centre, 2020 UT 55, ¶ 31, 472 P.3d 910 (stating that administrative
law judges “retain[] the discretion to reject the medical panel’s
recommendation”); Hutchings, 2016 UT App 160, ¶ 23 (“The
[Board] is the ultimate finder of fact, even if a medical panel is
convened.” (cleaned up)). As we have explained, the role of the
medical panel “is to evaluate medical evidence and advise an
administrative law judge with respect to the . . . judge’s ultimate
fact-finding responsibility,” but the factfinder “is not bound by

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the panel’s report.” Danny’s Drywall v. Labor Comm’n, 2014 UT
App 277, ¶ 14, 339 P.3d 624 (cleaned up). Simply put, the Board
“is neither bound to adopt the medical panel’s report, nor is it
obligated to base its findings and decisions on the report.”
Hutchings, 2016 UT App 160, ¶ 23.

¶26 Against this backdrop, it is clear that substantial evidence
supported the Board’s medical causation determination in this
case. The ALJ and the Board both pointed to Treating Physician’s
opinion—reached as early as August 2020, soon after the
accident—that the accident caused Beaty’s need for lumbar spine
surgery. The ALJ also relied on the Company’s own expert,
Defense Expert 2, who opined that the work accident was the
medical cause of the worsening of Beaty’s lumbar condition and
the need for lumbar spine surgery. And on review, the Board
expressly concluded that the opinion of Defense Expert 2—as well
as the opinions of Surgeon and Physician Assistant—“show[ed]
that the lumbar spine surgery was necessary to treat . . . Beaty’s
work-related injury.” These medical opinions constitute
substantial evidence justifying the Board’s decision.

¶27 The Company argues that the Board misinterpreted
Treating Physician’s and Defense Expert 2’s opinions and—if
properly interpreted—these opinions could not constitute
substantial evidence supporting the Board’s decision. 1
Specifically, the Company argues that the medical panel correctly
determined that Treating Physician’s August 2020 report did not
say that Beaty needed lumbar spine surgery on an industrial basis

1. The Company also argues that, for various reasons, Surgeon’s
and Physician Assistant’s opinions do not constitute substantial
evidence of medical causation. We disagree, but even assuming
that the Company’s arguments have merit, Treating Physician’s
and Defense Expert 2’s opinions constitute substantial evidence in
their own right to provide a basis for the Board’s medical
causation decision. Thus, we do not address the Company’s
arguments as to these other opinions.

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at that time. That report noted that “Beaty has a documented work
injury” and that “[h]e will require” surgery “for satisfactory long-
term relief.” As per the Company’s interpretation of that report,
Treating Physician “was not recommending surgery” and “did
not explain whether the surgery would be for the work incident
or the degenerative disc disease.”

¶28 The Board adopted a different interpretation of Treating
Physician’s report, viewing that report as drawing “a medical
causal connection” as early as August 2020 “between [Beaty’s]
work accident” and the “appropriate surgical treatment.” In our
view, both interpretations are reasonable, and we will not second
guess the Board’s judgment as the factfinder on this particular
question because “in conducting a substantial evidence review,
we do not . . . independently choose which inferences we find to
be the most reasonable.” Provo City, 2015 UT 32, ¶ 8 (cleaned up).
Indeed, “where inconsistent inferences can be drawn from the
same evidence, it is for the Board to draw the inferences,” not the
appellate courts. Cook, 2013 UT App 286, ¶ 19 (cleaned up).

¶29 As for Defense Expert 2, the Company argues that he never
actually opined, to a “reasonable medical probability,” that
Beaty’s need for surgery was medically caused by the accident.
On this point, the Company emphasizes the language Defense
Expert 2 used, and in particular these statements: “I do feel the
medical evidence supports that [Beaty] had a work-related
aggravation of his [pre-existing lower-back condition],” and “I do
feel that the discectomy . . . performed by [Surgeon] . . . was likely
due to the effects of his work injury.” (Emphasis added.) The
Company asserts, based on this language, that Defense Expert 2
was offering only his “feelings and thoughts” and was not
actually offering a medical opinion.

¶30 We are unpersuaded by the Company’s argument. The use
of the word “likely” later in the same sentence is a good indication
that Defense Expert 2 was offering an opinion based on a
reasonable medical probability. But even more broadly, courts

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have held that an expert’s use of phrases like “I feel” or “I felt” do
not serve to downgrade an opinion from a probability-based
construct to a possibility-based construct. See, e.g., Vickers v. Jessup,
629 A.2d 457, 460 (Conn. App. Ct. 1993) (stating that the preface
“I felt” or “I suspected” did not render a surgeon’s testimony
lacking as to a “reasonable medical certainty” and explaining that
the “use of certain colloquial phrases to begin a sentence does not
move the surgeon’s testimony into the realm of inadmissible
speculation”). We see nothing erroneous in the Board’s
interpretation of and reliance upon the medical opinion offered
by one of the Company’s own retained experts.

¶31 The Board was not bound by the medical panel’s report,
including its finding that Beaty had become medically stable by
December 2020. On this record, it was within the Board’s
discretion to reject the panel’s report entirely and rely on other
substantial evidence in the record. What’s more, the Board
explained why it was hesitant to rely on the panel’s report.
Specifically, the Board pointed out that the panel’s “reasoning . . .
appear[ed] to misconstrue the evidence” because the panel relied
on parts of Beaty’s February 2021 performance evaluation, which
showed some progress in his functional capacity, yet the panel
failed to acknowledge that the evaluation also showed that Beaty
“still lacked the strength and capacity to perform his job duties.”
In short, the Board not only relied on substantial evidence
supporting its decision, but it also took care to explain its reasons
for rejecting the medical panel’s opinions.

¶32 Under these circumstances, we cannot conclude that the
Board’s medical causation decision was unsupported by
substantial evidence. Our case law is clear that the Board is not
bound to follow the medical panel’s findings and that the Board
is the “ultimate finder of fact” in these cases. See Hutchings, 2016
UT App 160, ¶ 23. Accordingly, we reject the Company’s
challenge to the Board’s determination that Beaty’s work accident
medically caused his need for lumbar spine surgery.

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CONCLUSION

¶33 Substantial evidence exists, on this record, to support the
Board’s determination that Beaty’s work accident medically
caused the need for his lumbar spine surgery. The Board did not
err by rejecting the medical panel’s report and relying on other
admissible evidence in the record. We therefore decline to disturb
the Board’s award of benefits to Beaty.

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