Eugenie Hopkins v. Sebasticook Family Health

Insurance Company

Cross Insurance

Date Decided

August 30, 2022

Panel Members

Evelyn Knopf

Tom Pelletier

Mike Stovall


Pre-Existing Injury


File Size

159 KB


Summary from the Troubh Heisler Attorneys

Hopkins v. Sebasticook Family Health (attached)- Sebasticook conceded the employee sustained work-related injuries to his low back of January 13, 2016 and January 21, 2018 but argued the ALJ erred in granting the petitions for award because the employee failed to meet her burden under sec. 201(4) to show her employment made a significant contribution to the disability where the 312 IME opined that each injury contributed 12.5% to the disability. In Hopkins v. Sebasticook Family Health, Dec. No. 22-27, the employee had long standing pre-existing degenerative lumbar disc disease and was diagnosed with herniated disc at L4-5 resulting from the two injuries. The employer argued that as a matter of law 12.5% cannot be considered a significant contribution. It urged the panel to adopt a “bright line” rule that the employment contribution must exceed 50%. Finding no authority for this proposition the panel rejected the argument. There was competent evidence for the ALJ to find the employment contributed to the disability in a significant manner by causing persistent symptoms that required treatment, in addition to the 12.5% estimate provided by the 312 IME.

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