Case Title: IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF: PAUL D. GLAZE V. STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION

Citation: 

Docket Number: S-08-0231

State: wyoming

Court: Wyoming Supreme Court

Date: 2009-08-19T00:00:00Z

Document:
IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF: PAUL D. GLAZE V. STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION2009 WY 102214 P.3d 228Case Number: S-08-0231Decided: 08/19/2009
APRIL 
TERM, A.D. 2009

 
 
IN 
THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF:PAUL D. 
GLAZE,Appellant(Claimant-Petitioner),v.STATE OF 
WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION 
DIVISION,Appellee(Objector-Respondent).

 
 
Appeal 
from the District Court of Sublette County

The 
Honorable Norman E. Young, Judge

 
 

Representing 
Appellant:

James 
R. Salisbury of Riske, Salisbury & Kelly, P.C., Cheyenne, 
Wyoming.

 
 

Representing 
Appellee:

Bruce 
A. Salzburg, Wyoming Attorney General; John W. Renneisen, Deputy Attorney 
General; and James Michael Causey, Senior Assistant Attorney 
General..

 
 
Before 
VOIGT, C.J., and GOLDEN, HILL, KITE, and BURKE, 
JJ.

 
 

HILL, 
Justice.

 
 
[¶1]      Paul Glaze 
appeals from the district court's order affirming the Medical Commission's 
ruling that he was not entitled to additional temporary total disability 
benefits.  The Medical Commission 
determined that Mr. Glaze failed to meet his burden of proving that, after he 
had been awarded permanent partial disability benefits, he had suffered an 
increase in incapacity due solely to his work related injury.  After reviewing the entire record in 
accordance with our standard of review, we conclude that the Medical 
Commission's decision was contrary to the overwhelming weight of the 
evidence.  Consequently, we reverse 
and remand.

 
 
ISSUES

 
 
[¶2]      Mr. Glaze 
presents related issues on appeal:

 
 
A.        
Whether the Medical Commission committed an error of law by denying [Mr. 
Glaze] temporary total disability benefits subsequent to his award and receipt 
of permanent partial disability benefits.

 
 
B.        
Whether the decision of the Medical Commission is 

supported 
by substantial evidence.

 
 
1.         
Whether the determination by the Medical Commission that [Mr. Glaze] 
failed to show that the surgery at issue was solely related to the work-place 
injury is supported by substantial evidence.

2.         
Whether the determination by the Medical Commission that [Mr. Glaze] 
failed to show an increase in incapacity is supported by substantial 
evidence.

 
 
Although 
phrased more generally, the State of Wyoming ex rel. Wyoming Workers' Safety and 
Compensation Division (Division) propounds a similar 
issue.

 
 
FACTS

 
 
[¶3]      Mr. Glaze 
suffered a work related back injury in 2002 and underwent surgery to fuse the 
herniated disc at level L5-S1.  The 
Division paid medical benefits and temporary total disability benefits.  In 2003-2004, Mr. Glaze received 
permanent partial impairment benefits and a permanent partial disability award 
pursuant to Wyo. Stat. Ann. § 27-14-405 (LexisNexis 2009).  Although his physician, Mary Neal, M.D., 
released him to return to light duty work, he did not work after the 2002 
injury.

 
 
[¶4]      On February 9, 
2005, Mr. Glaze underwent surgery to repair damage to the segment adjacent to 
the fused segment, L4-5.  Dr. Neal 
certified that Mr. Glaze was unable to work as a result of the surgery, and he 
applied for temporary total disability benefits.  The Division issued a final 
determination, denying Mr. Glaze's request for benefits pursuant to Wyo. Stat. 
Ann. § 27-14-404(b) (LexisNexis 2009) because he had already received permanent 
partial disability benefits and had not returned to gainful 
employment.

 
 
[¶5]      On March 3, 2005, 
Mr. Glaze filed an objection to the Division's final determination.  He requested that the matter be referred 
to the appropriate administrative agency for contested case proceedings.  His notice of objection also 
stated:

 
 
It 
is the position of Mr. Glaze that he has suffered an increase of incapacity 
solely related to his work related injury and therefore his current claims for 
temporary total disability benefits are compensable under the Wyoming Workers' 
Compensation Act.  Please consider 
this correspondence as a petition for modification of benefits pursuant to W.S. 
§ 27-14-605.

 
 
The 
Division referred the case to the Medical Commission.

 
 
[¶6]      On April 29, 
2005, Glaze filed, with the Medical Commission, a formal petition for 
modification of benefits under Wyo. Stat. Ann. § 27-14-605(a) (LexisNexis 2009), 
which allows additional benefits if the claimant has suffered an increase of 
incapacity due solely to the work related injury.

 
 
[¶7]      The hardware used 
to fuse the L4-5 segment in February of 2005 failed, and Mr. Glaze underwent 
another surgery on May 27, 2005 to repair the problem.  Dr. Neil continued to certify that Mr. 
Glaze was temporarily totally disabled until October 1, 
2005.

 
 
[¶8]      After a contested 
case hearing, a Medical Commission hearing panel ruled that Mr. Glaze was not 
entitled to additional temporary total disability benefits because he had not 
shown that he had suffered an increase of incapacity due solely to his work 
related injury.  The district court 
affirmed the Medical Commission's decision, and Mr. Glaze 
appealed.

 
 
STANDARD 
OF REVIEW

 
 
[¶9]      When we consider 
an appeal from a district court's review of an administrative agency's decision, 
we give no deference to the district court's decision.  Instead, "we review the case as if it 
had come directly to us from the administrative agency.'"  Newman v. State ex. rel Wyoming Workers' 
Safety and Compensation Division, 2002 WY 91, ¶ 7, 49 P.3d 163, 166 
(Wyo.2002) (quoting French v. Amax Coal 
West, 960 P.2d 1023, 1027 (Wyo.1998) (citation omitted)).  Our review is governed by Wyo. Stat. 
Ann. § 16-3-114 (c) (LexisNexis 2009), which states in relevant 
part:

 
 
(c)  To 
the extent necessary to make a decision and when presented, the reviewing court 
shall decide all relevant questions of law, interpret constitutional and 
statutory provisions, and determine the meaning or applicability of the terms of 
an agency action. In making the following determinations, the court shall review 
the whole record or those parts of it cited by a party and due account shall be 
taken of the rule of prejudicial error. The reviewing court 
shall:

(i)  Compel 
agency action unlawfully withheld or unreasonably delayed; 
and

(ii)  Hold 
unlawful and set aside agency action, findings and conclusions found to 
be:

 
 
. 
. . .

 
 
(E)  Unsupported by substantial evidence in a case 
reviewed on the record of an agency hearing provided by 
statute.

 
 
[¶10]   We recently refined our substantial 
evidence standard of review in Dale v. S 
& S Builders, LLC, 2008 WY 84, ¶ 22, 188 P.3d 554, 561 (Wyo. 
2008):

 
 
If 
the hearing examiner determines that the burdened party failed to meet his 
burden of proof, we will decide whether there is substantial evidence to support the 
agency's decision to reject the evidence offered by the burdened party by 
considering whether that conclusion was contrary to the overwhelming weight of 
the evidence in the record as a whole. 

 

As 
always, we review an agency's conclusions of law de novo, and "[w]e will affirm an 
agency's legal conclusion only if it is in accordance with the law.'"  Diamond B Servs., Inc. v. Rohde, 2005 WY 
130, ¶ 12, 120 P.3d 1031, 1038 (Wyo. 2005) (quoting DC Prod.  Serv.  v. Wyo. Dep't of Employment, 2002 WY 
142, ¶ 7, 54 P.3d 768, 771 (Wyo. 2002)).

 
 
DISCUSSION

 
 
[¶11]   Mr. Glaze challenges the Medical 
Commission's ruling that he did not meet his burden of proving that he was 
entitled to receive additional temporary total disability benefits pursuant to § 
27-14-605.  Temporary total 
disability is defined as

 
 
that 
period of time an employee is temporarily and totally incapacitated from 
performing employment at any gainful employment or occupation for which he is 
reasonably suited by experience or training.

 
 
Wyo. 
Stat. Ann. § 27-14-102(a)(xviii) (LexisNexis 2009).  Temporary total disability benefits are 
governed by Wyo. Stat. Ann. § 27-14-404 (LexisNexis 2009), which states in 
relevant part:

 
 
(a)  If 
after a compensable injury is sustained and as a result of the injury the 
employee is subject to temporary total disability as defined under W.S. 
27-14-102(a)(xviii), the injured employee is entitled to receive a temporary 
total disability award . . . 

(b)  Any 
employee awarded benefits under W.S. 27-14-405 [permanent partial disability 
benefits] or 27-14-406 is not eligible for benefits under subsection (a) of this 
section unless the employee has returned to gainful employment and following 
employment, undergoes additional surgery not reasonably contemplated before the 
award for permanent impairment or disability and then only for a reasonable 
period of recuperation, confinement for medical care during the actual period of 
confinement or unless application is made and an award is granted under W.S. 
27-14-605.

 
 
[¶12]   The last part of § 27-14-404(b) 
allows additional temporary total disability benefits after a permanent partial 
disability award if the claimant qualifies for additional benefits under § 
27-14-605.  The pertinent part of 
that provision states:

 
 
(a)  If 
a determination is made in favor of or on behalf of an employee for any benefits 
under this act, an application may be made to the division by any party within 
four (4) years from the date of the last payment for additional benefits or for 
a modification of the amount of benefits on the ground of increase or decrease 
of incapacity due solely to the injury, or upon grounds of mistake or fraud. The 
division may, upon the same grounds and within the same time period, apply for 
modification of medical and disability benefits to a hearing examiner or the 
medical commission, as appropriate.

 
 
[¶13]   The dispute in this case focused on 
whether or not Mr. Glaze had suffered an increase of incapacity due solely to 
his work related injury.  As with 
other workers' compensation claims, the claimant has the burden of proving he is 
entitled to additional benefits under § 27-14-605(a).  See, In re Hernandez, 8 P.3d 318, 322-23 
(Wyo. 2000); Lehman v. State ex rel. 
Wyoming Workers' Safety and Compensation Division, 752 P.2d 422, 425 (Wyo. 
1988).  The extent and duration of 
an injured worker's disability are questions of fact.  Lehman, 752 P.2d  at 
425.

 
 
[¶14]   The Medical Commission found: 

 
 
35.  Mr. 
Glaze has not met his burden of proof for entitlement to additional TTD benefits 
under W.S. § 27-14-605(a).  Mr. 
Glaze has not proven either an increase in incapacity nor has he proven that any 
alleged increase in incapacity was due solely to his original injury of January 
3, 2002.

 
 
As 
to whether the alleged increase in incapacity was due solely to the work injury 
in question, in 1992 he sustained an injury to his back and had surgery at his 
L5-S1 level which was the removal of a part of his disc.  He continued to have some degree of 
symptoms after that surgery.  After 
the work injury in January of 2002, x-rays and radiographic studies of his low 
back showed pre-existing degenerative changes at L3-4 and L5-S1.  His back at the L4-5 level was 
normal.  A discogram procedure 
showed degenerative changes at L3-4 and L5-S1.  The L4-5 level was again normal.  Surgery was performed in August of 2002 
at the L5-S1 level.  He never 
returned to work.  Surgery in 
February and May of 2005 included surgery to the L4-5 disc space which was 
previously noted as normal.  This 
disc has degenerated with the passage of time, possibly accelerated by the prior 
surgery as opined by Dr. Neal.  
Radiographic studies showed a progressive degeneration of the L4-5 disc 
space over the years which lead to surgery at this level.  Incapacity caused by the natural 
degeneration of a condition and accelerated by a work accident is not incapacity 
due solely to a compensable injury. Through leading questions counsel for the 
Employee/Claimant was able to get Dr. Neal to state the 2005 surgeries were 
directly related to the work injury.  
Being "directly related" and "solely related" are not the same.  Dr. Neal testified the 2005 surgery at 
L4-5 was necessary due to degeneration.

 
 
Dr. 
Neal's opinion is further disregarded in that it appears she never actually 
examined Mr. Glaze.  While she would 
take a history and review radiographic studies, she never performed an actual 
"hands on" examination.  She further 
appears to be acting as an advocate for her patient and she may well be 
concerned with ongoing payment for her treatment of Mr. Glaze which may well 
impact her opinions in this matter.

 
 
            
36.  As to the claimed increase in incapacity, Mr. Glaze's pain 
has remained essentially the same since the August 2002 surgery although it has 
waxed and waned.  Following the 2002 
surgery he received a very high impairment rating of 24%.  He testified his restrictions in terms 
of sitting, standing[,] lifting and walking are the same now as they were after 
his August 2002 surgery.  In July of 
2004 he filled out an application for permanent partial disability which 
indicated he was essentially incapable of doing anything.  He signed this form certifying his 
answers were true.  He never 
returned to any type of work.  His 
condition before and after the February 2005 and May 2005 surgery has remained 
essentially plateaued, although he appears to have had less symptoms after these 
surgeries.   By July of 2005, 
he was doing very well and reporting no pain. He was then in a car accident 
which, according to the records, resulted in increased pain for an extended 
period of time.  His condition now 
is better than it was after the January 2002 work injury.  The evidence does not reflect an 
increase in incapacity.

 
 
[¶15]   In Parnell v. State ex rel. Wyoming Workers' 
Compensation Division, 735 P.2d 1367, 1368 (Wyo. 1987) (citations omitted), 
we discussed the types of disability benefits contemplated by the Wyoming 
Worker's Compensation Act:

 
 
In 
the usual case, temporary total disability will be awarded for a single initial 
period of recovery and stabilization.  
Once stabilization occurs, the extent of permanent disability, whether 
partial or total, should be determined and the employee should receive an 
appropriate award. Such an award is "subject to the concept of 
finality."

 
 
Ideally, 
an injured employee will not return to a condition of temporary total disability 
after receiving a permanent partial disability award. But some cases, like the 
present case, do not follow the ideal pattern. Realizing this, the legislature 
enacted § 27-12-606, W.S.1977, [now §27-14-605] which allows an employee to 
apply for "additional benefits" . . . 
on the ground of increase 
of incapacity[.]

. 
. . .

 
 
The 
Act does not define the term "increase of incapacity." We think it is clear, 
however, that when an employee's condition changes from permanent partial 
disability to temporary total disability, his incapacity is 
increased.

 
 
See 
also, Hernandez, 8 P.3d  at 322.  Thus, under § 27-14-605(a), a claimant 
may be entitled to temporary total disability benefits even if his permanent 
partial disability has not increased.

 
 
[¶16]   A physician's certification that a 
claimant is temporarily totally disabled is evidence of an increase in 
incapacity; however, it is not determinative.  State ex rel. Wyoming Workers' Compensation 
Division v. Henriksen, 2001 WY 42, ¶¶ 8-9, 21 P.3d 1185, 1187 (Wyo. 
2001).  Thus, in order to meet his 
burden of proof, the claimant must present evidence showing an increase in his 
incapacity since the permanent partial disability award.  Britton v. Halliburton Services, 895 P.2d 45, 48 (Wyo. 1995).

 
 
[¶17]   Mr. Glaze received a permanent 
partial impairment rating of 24% of the whole person in 2003 and accepted an 
award based upon that rating.  He 
subsequently received a permanent partial disability award to compensate him for 
loss of earning capacity.  As part 
of his application for permanent partial disability benefits, Mr. Glaze stated 
that he could not bend, stoop, twist, squat, kneel, crouch or crawl, although he 
could occasionally climb stairs and ladders.  He also could not work with heavy 
machinery and he was restricted from carrying, pushing or pulling anything over 
20 pounds.  The physical capacities 
questionnaire prepared by Mr. Glaze's physicians indicated that he was probably 
capable of performing full time work so long as appropriate restrictions were 
respected.

 
 
[¶18]   Dr. Neal released Mr. Glaze to 
light duty work with restrictions.1  Mr. Glaze testified that he looked for 
work, but nobody would hire him.

 
 
[¶19]   Dr. Neal certified that Mr. Glaze 
was temporarily totally disabled from February 8, 2005 (the day before the first 
2005 surgery) through October 1, 2005.  
Dr. Neal testified that Mr. Glaze was unable to perform any gainful 
employment following the surgery.  
She testified that the typical period of recuperation after surgery is 4 
to 6 months, although it could extend to one year.  Dr. Neal also testified that Mr. Glaze 
was temporarily totally disabled after the May 2005 surgery to fix the hardware 
malfunction from the February 2005 surgery.  Again, she testified the recuperation 
period may take one year.  Mr. Glaze 
testified that he was "laid up" after the 2005 surgeries and underwent physical 
therapy for a period of time.

 
 
[¶20]   In Parnell, the claimant's physician 
explained the relationship between the claimant's surgery and his ability to 
work.  The physician wrote a letter 
stating that his surgery rendered him temporarily totally disabled because of 
his need to use crutches while he was recuperating.  Parnell, 735 P.2d  at 1369.  Similarly, in Henriksen, ¶¶ 4, 9, 21 P.3d  at 
1186-87, evidence was presented showing that the claimant's physician advised 
her to rest and not to work while he treated her.

 
 
[¶21]   As the definition of temporary 
total disability makes clear, the right to such benefits depends upon a 
claimant's ability to perform gainful employment.  Looking at the evidence presented about 
Mr. Glaze's ability to work, the record demonstrates that he was released to 
light duty work around the time he received permanent partial disability 
benefits.  Although he did not 
return to work because he could not find a job with his restrictions, the 
documents associated with the permanent partial disability ratings and awards 
indicated that he had the physical ability to do so.  Dr. Neal testified that, after 
undergoing surgery in February of 2005, Mr. Glaze was unable to perform any 
gainful employment.  The Medical 
Commission's finding that he had not suffered any increased incapacity focused 
on his reported pain levels in the months after his 2005 surgeries and his 
permanent physical restrictions, which did not appear to be significantly 
different at the time of the hearing than they were when he was rated for 
permanent partial impairment and disability purposes.  The Commission did not concentrate on 
the temporary incapacity occasioned by the two surgeries.  The hearing panel's questions to Mr. 
Glaze at the hearing and its decision seem to have pertained to determining 
whether Mr. Glaze had an increase in permanent disability.  For example, the panel asked several 
questions about how he felt at the time of the hearing in comparison to how he 
felt before and after the 2002 surgery.  
Those questions did not help in determining whether he was temporarily 
totally disabled while recuperating from his 2005 
surgeries.

 
 
[¶22]   Parnell and Hernandez specifically stated that the 
claimant is not required to show that his level of permanent disability 
increased.  He simply must show 
that, after receiving a permanent partial disability award, he went through a 
period of time in which he was incapable of performing any gainful 
employment.  In this case, the 
overwhelming weight of the evidence establishes that Mr. Glaze's incapacity 
increased following his surgeries.2

 
 
[¶23]   The Medical Commission also found 
that Mr. Glaze had not established any alleged increase in incapacity was due 
solely to his work related injury because the medical evidence showed the 
surgery to L4-5 was necessitated by natural degeneration.  The evidence of the progression of his 
symptoms at the L4-5 level is aptly recounted in the Medical Commission Finding 
No. 35, above.  However, the Medical 
Commission's conclusion that the degeneration was natural is not supported by 
the evidence.  The undisputed 
evidence clearly established that Mr. Glaze did not have any problem with his 
back at level L4-5 until after the fusion of L5-S1, which was necessitated by 
the 2002 work related injury.  Dr. 
Neal testified it is well-documented that a fusion at one level places 
additional force on the level above the fusion, resulting in degeneration of the 
disc at the higher level.  She 
stated that the adjacent segment degeneration process normally takes 10 to 15 
years, but in Mr. Glaze's case it happened in an extraordinarily short 
time.  Dr. Neal stated unequivocally 
that the degeneration process in the L4-5 segment would not have occurred if he 
had not undergone the L5-S1 fusion in 2002.

 
 
[¶24]   The Medical Commission cited to Lehman, in support of its ruling that 
Mr. Glaze was not entitled to additional temporary total disability 
benefits.  In that case, we agreed 
that Mr. Lehman had not met his burden of proving he had suffered an increase in 
incapacity due solely to his work related injury.  752 P.2d  at 424-26.  Mr. Lehman's neurosurgeon testified that 
his "condition was degenerative, and that the changes he observed . . . were a 
part of the continuum of his basic problem of degeneration accelerated by the 
accident."  Id. at 424.  That testimony stands in marked contrast 
to Dr. Neal's unequivocal testimony that Mr. Glaze would not have suffered 
degeneration at L4-5 if he had not undergone fusion of the lower level segment, 
L5-S1, as a result of his work related accident.  Thus, Lehman does not support the Medical 
Commission's decision that Mr. Glaze failed to prove that his 2005 surgeries and 
incapacity resulted solely from the 2002 work related 
injury.

 
 
[¶25]   The Medical Commission decision 
also emphasizes that Dr. Neal did not testify that his increased incapacity was 
due solely to the work related injury.  In April of 2005, Dr. Neal responded to 
questions posed by the claimant's attorney in correspondence by stating that the 
February 9, 2005 surgery was reasonable, necessary, and related to the work 
related accident of January 3, 2002.  
Dr. Neal testified that the May 27, 2005 surgery was necessary because 
the hardware implanted during the February 9, 2005 surgery had failed.  She stated:

 
 
Q.  . . . Doctor, 
do you have an opinion based upon a reasonable degree of medical probability of 
whether that May 27, 2005 surgery was solely and directly related to Mr. Glaze's 
work related accident or the treatment of that work related 
accident?

 
 
A.  What 
was the beginning of the question, do I feel that it was directly related?  Yes.

 
 
The 
attorney did not follow up to clarify whether she believed the May 27, 2005 
surgery was due solely to the work related injury.

 
 
[¶26]   Dr. Neal then went on to discuss 
her recommendation for a future surgery to address the nonunion of the fusion 
which occurred "some months" following the May 27, 2005 surgery.  She testified:

 
 
            
Q.  . . . Dr. Neal, with respect to your 
recommendation of future surgery, do you feel that that recommended surgery is 
reasonable and necessary and solely related to the work related accident of 2002 
or the treatment of that injury?

 
 
            
A.  Yes.

 
 
[¶27]   As we have stated in the context of 
a claim for workers' compensation benefits for an aggravation of a pre-existing 
injury, the medical expert is not required to utter any particular magic words 
to establish the requisite causation.  
See State ex rel. Wyoming Workers' 
Safety and Compensation Division v. Slaymaker, 2007 WY 65, ¶ 18, 156 P.3d 977, 984 (Wyo. 2007); In re Boyce, 
2005 WY 9, ¶ 11, 105 P.3d 451, 455 (Wyo. 2005).  So long as the medical expert's 
testimony contains sufficient information, the fact that she did not use the 
exact statutory language is irrelevant.  
Dr. Neal testified that a future surgery to repair a nonunion of the 
fusion performed in the 2005 surgeries was solely related to the 2002 
accident.  Obviously, then, the 2005 
surgeries and the incapacity occasioned by those surgeries would be solely 
related to the work related accident.  
The fact that the physician fumbled a little on the question about the 
2005 surgeries and did not specifically state that they were solely related to 
the work related accident is not fatal to Mr. Glaze's claim when the evidence 
clearly established that, in the physician's opinion, the 2005 surgeries and the 
associated incapacity were due solely to the 2002 work related injury and the 
treatment thereof.

 
 
[¶28]   The Medical Commission decision 
also intimates that a prior back injury in 1992 really caused Mr. Glaze's 2005 
problems.  However, the medical 
evidence and Dr. Neal's testimony do not lead to that conclusion.  Although Mr. Glaze first injured his 
back in 1992, he returned to work after he was treated for that injury with no 
permanent restrictions.  It is clear 
from the record that level L4-5 was normal from 1992 until after the 2002 work 
related accident and fusion of L5-S1.  
Thus the evidence clearly shows that the adjacent segment breakdown at 
L4-5 that led to the 2005 surgeries and associated incapacity occurred after the 
2002 surgery.

 
 
[¶29]   Finally, we address the Medical 
Commission's statement that it did not consider Dr. Neal's testimony that Mr. 
Glaze's increase in incapacity was solely related to the injury to be 
credible.  We defer to the agency's 
determination of witness credibility unless it is clearly contrary to the 
overwhelming weight of the evidence.  
Bush v. State ex rel. Wyoming 
Workers' Safety and Compensation Division, 2008 WY 117, ¶ 19, 193 P.3d 260, 265-66 (Wyo. 2008).  The 
Medical Commission determined that Dr. Neal was not credible because 1) the 
records did not indicate that she physically examined Mr. Glaze, but, instead, 
only reviewed the radiographic studies and took his history; and 2) she appeared 
to be acting as an advocate for her patient and "may well be concerned with 
ongoing payment for her treatment" of Mr. Glaze.  The second reason could be said of any 
treating physician and, consequently, does not justify a wholesale disregard of 
her testimony.  As to the fact that 
she did not physically examine the patient, the Medical Commission does not 
explain how a physical examination would have aided Dr. Neal in determining 
whether the 2005 surgeries and incapacity were solely due to the work related 
injury.  Her explanation of the 
propensity of adjacent segments to degenerate and the fact that there was no 
evidence of an intervening cause renders the Medical Commission's conclusion 
that Dr. Neal was not credible clearly contrary to the overwhelming weight of 
the evidence.  The Medical 
Commission's criticisms of Dr. Neal are especially perplexing because it 
frequently relies on "paper reviews" made by physicians who never saw the 
patient, but still provide opinions about the patient that directly contradict 
information provided by the 
treating physician.

 
 
[¶30]   The Medical Commission's finding 
that Mr. Glaze did not meet his burden of proving that he was entitled to 
additional TTD benefits under §§ 27-14-605(a) and 27-14-404(b) is contrary 
to the overwhelming weight of the evidence.  Consequently, its ruling is not 
supported by substantial evidence.

 
 
[¶31]   Reversed and remanded with 
directions that benefits be awarded to Glaze consistent with this 
opinion.

 
 
FOOTNOTES

 
 

1Dr. Neal testified on cross examination that Mr. Glaze was not capable of 
performing any type of work after the August 2002 surgery.  However, that statement was not made 
with reference to any time period.

 
 

2The Medical Commission did not rule on any term of 
incapacity.