Case Title: QUALITY DISTRIBUTION, INC. V. JAMES R. HILL, ET AL.

Citation: 

Docket Number: 2008-SC-000279-WC

State: kentucky

Court: Kentucky Supreme Court

Date: 2009-01-22T00:00:00Z

Document:
IMPORTANT NOTICE NOT TO BE PUBLISHED OPINION THIS OPINION IS DESIGNATED "NOT TO BE PUBLISHED." PURSUANT TO THE RULES OF CIVIL PROCEDURE PROMULGATED BY THE SUPREME COURT, CR 76.28(4)(C), THIS OPINION IS NOT TO BE PUBLISHED AND SHALL NOT BE CITED OR USED AS BINDING PRECEDENT IN ANY OTHER CASE IN ANY COURT OF THIS STATE ; HOWEVER, UNPUBLISHED KENTUCKY APPELLATE DECISIONS, RENDERED AFTER JANUARY 1, 2003, MAY BE CITED FOR CONSIDERATION BY THE COURT IF THERE IS NO PUBLISHED OPINION THAT WOULD ADEQUATELY ADDRESS THE ISSUE BEFORE THE COURT . OPINIONS CITED FOR CONSIDERATION BY THE COURT SHALL BE SET OUT AS AN UNPUBLISHED DECISION IN THE FILED DOCUMENT AND A COPY OF THE ENTIRE DECISION SHALL BE TENDERED ALONG WITH THE DOCUMENT TO THE COURT AND ALL PARTIES TO THE ACTION . ~s~tyrQZrrQ ~aurf of "pru 2008-SC-000279-WC MEMORANDUM OPINION OF THE COURT AFFIRMING RENDERED : JANUARY 22, 2009 NOT TO BE PUBLISHED L.- -. oil ,-aaw P? c . QUALITY DISTRIBUTION, INC . APPELLANT ON APPEAL FROM COURT OF APPEALS V. CASE NO . 2007-CA-002398-WC WORKERS' COMPENSATION BOARD NO . 03-88007 JAMES R. HILL; HONORABLE MARCEL SMITH, ADMINISTRATIVE LAW JUDGE; AND WORKERS' COMPENSATION BOARD APPELLEES An Administrative Law Judge (ALJ) awarded permanent partial disability benefits for the claimant's work-related neck and shoulder injury based on a 34% permanent impairment rating . The Workers' Compensation Board (Board) affirmed the decision, and the Court of Appeals affirmed the Board. Appealing, the employer asserts that the ALJ erred by failing to exclude the permanent impairment rating that a previous neck injury warranted. We affirm because substantial evidence indicated that the 34% rating included no impairment from the previous neck injury . The claimant injured his neck and shoulder on March 29, 2003, while dragging a heavy, industrial-size hose in the course of his work . He testified at the hearing that he felt his neck pop and knew immediately that a cervical disk had herniated. He explained that he had undergone surgery for a herniated cervical disk previously, in 1996 . It is unclear whether the 1996 herniation was work-related . When asked if he filed a workers' compensation claim or other lawsuit, the claimant replied that he had no need to do so because he recovered completely and was able to work without restrictions until after the 2003 injury . He testified that his present complaints included weakness in his left arm, continuous pain between his shoulder blades, and difficulty sleeping . The 2003 injury occurred at C5-6 and required a fusion. Medical evidence indicated that the 1996 herniation and fusion surgery occurred at C6-7 . Dr . Davies performed both the 1996 and 2003 neck surgeries . He assigned a 25% permanent impairment rating based on the cervical spine under DRE category IV . He attributed 50% of the rating to pre-existing cervical disk degeneration, which was dormant and non-disabling until the 2003 injury . He attributed the remaining 50% to the injury, itself. Dr. Stodgill performed shoulder surgery based on a left shoulder MRI that showed early impingement of the supraspinatus muscle and tendon, tendonitis, and degenerative changes in the AC joint . He later assigned a 9% permanent impairment rating . Dr. Kelly evaluated the claimant for the employer. He received a history of the 1996 cervical disk herniation and surgery as well as the 2003 neck and shoulder injury . He also performed a physical examination and reviewed medical records concerning the 2003 injury . Dr . Kelly reported that the C5-6 herniation and shoulder condition were "solely due to the March 27, 2003, injury," noting that the claimant performed heavy physical labor for the employer for about a year before the injury occurred. He assigned a 26% permanent impairment rating to the C5-6 herniation, stating that the prior fusion dictated the use of the range of motion method . He assigned an 11 rating to the shoulder condition. Using the combined values table, he arrived at an overall impairment rating of 34% for the neck and shoulder injury . Dr. Kelly noted that the pre-existing herniation and fusion surgery at C6-7 warranted a 25% permanent impairment rating under the AMA Guides to the Evaluation of Permanent Impairment (Guides ) despite the excellent outcome. The employer argued that the ALJ must deduct the 25% rating that Dr . Kelly assigned to the 1996 herniation from the 26% rating that he assigned to the 2003 herniation, then consult the combined values table and re-determine the overall impairment rating for the neck and shoulder injury. The claimant maintained that a deduction was inappropriate because Dr. Kelly stated explicitly that the 26% rating included only impairment from the 2003 injury . He also maintained that the proper use of the Guides is a medical question and that no medical evidence showed Dr . Kelly's statement to be erroneous under the Guides. The ALJ found the 2003 injury to be only partially disabling and relied on the 34% permanent impairment rating that Dr. Kelly assigned . Rejecting the employer's argument, the ALJ explained that the 26% rating did not include impairment from the 1996 herniation . Therefore, the impairment need not be excluded from the claimant's award. KRS 342 .730(1)(b) bases a partial disability award on the permanent impairment rating that an injury causes as determined by the latest edition of the AMA Guides. The employer asserts that the ALJ erred by failing to deduct a 25% impairment rating from the 26% impairment rating that Dr . Kelly assigned to the 2003 cervical disk herniation and fusion surgery . The argument relies on selected portions of Chapters 1 and 2 of the Fifth Edition the Guides, which indicate that pre-existing impairment is deducted when apportioning a permanent impairment rating.' The argument also KRS 342.730(1)(e), which states as follows : For permanent partial disability, impairment for nonwork-related disabilities, conditions previously compensated under this chapter, conditions covered by KRS 342.732, and hearing loss covered in KRS 342.7305 shall not be considered in determining the extent of disability or duration of benefits under this chapter. relies on An employer has the burden to prove any defenses to liability, such as the extent to which an impairment rating includes impairment attributable a pre-existing, non-compensable condition . 2 As the party seeking to exclude 2 See Wolf Creek Collieries v . Cr-um, 673 S .W.2d 735, 736 (Ky . App . 1984) . 4 of 1 Chapter 1 .6b, pages 11-12, also indicate that apportionment is appropriate only when the current impairment rating is greater as a result of a documented prior impairment and there is evidence that the prior impairment probably caused or contributed to the current impairment . It also notes that "most states have their own customized methods for calculating apportionment." impairment due to the pre-existing cervical condition, the employer had the burden to convince the ALJ that the 26% permanent impairment rating Dr. Kelly assigned "solely due" to the 2003 injury was erroneous under the Guides or included impairment for which KRS 342.730(1)(e) prohibits compensation . Having failed to meet that burden, the employer must show on appeal that the evidence compelled a favorable decision . The employer's interpretation of the Guides is irrelevant. Assigning a permanent impairment rating under the Guides is a medical determination that may be made only by a medical expert . 3 No medical evidence showed an error in Dr . Kelly's statements about the 2003 injury . His testimony constituted substantial evidence that the Guides required use of the range of motion model for determining the impairment caused by the 2003 neck injury because the claimant had undergone a prior fusion . KRS 342.730(1) (e) excludes compensation for non-work-related or previously-compensated impairment. It does not affect the principle that a worker is entitled to be compensated for the entire impairment that an injury causes . 4 Roberts Brothers Coal Company v . Robinson , 113 S.W.3d 181, 183 (Ky. 2003), states that "an exclusion from a partial disability award must be based upon pre-existing impairment." It does not require pre-existing impairment to be deducted from a rating that includes no pre-existing impairment . Nor does KRS 342 .730(1)(e) .Thus, Dr . Kelly's testimony that the 3 See Kentucky River Enterprises, Inc . v . Elkins , 107 S .W.3d 206 (Ky. 2003) . 5 COUNSEL FOR APPELLANT, QUALITY DISTRIBUTION, INC . : David Michael Andrew Hemmer Pangburn DeFrank, PLLC 250 Grandview Drive, Suite 200 Ft . Mitchell, KY 41017 COUNSEL FOR APPELLEE, JAMES R. HILL : William F. McGee, Jr. P.O . Box 39 Smithland, KY 42081 pre-existing cervical condition warranted a 25% impairment rating did not require a deduction because the rating he assigned to the 2003 injury included no pre-existing impairment. His testimony constituted substantial evidence that the 2003 neck injury, by itself, produced a 26% permanent impairment rating . It is immaterial under the circumstances whether Caldwell Tanks v. Roark, 104 S.W.3d 753, 757 (Ky. 2003), would have permitted the ALJ to deduct pre-existing, non-compensable impairment and then read the combined values table to re-determine the overall impairment rating . The decision of the Court of Appeals is affirmed . All sitting. All concur . 4 Beech Creek Coal Co . v . Cox, 314 Ky . 743, 744, 237 S.W.2d 56 (1951) . 6