Title: JAMES COMBS V. CORRECTIONS CORPORATION OF AMERICA D/B/A LEE ADJUSTMENT CENTER, ET AL.

State: kentucky

Issuer: Kentucky Supreme Court

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IMPORTANT NOTICE NOT TO BE PUBLISHED OPINION THIS OPINION IS DESIGNATED "NOT TO BE PUBLISHED." PURSUANT TO THE RULES OF CIVIL PROCEDURE PROMULGATED BY THE SUPREME COURT, CR 76.28(4){C), THIS OPINION IS NOT TO BE PUBLISHED AND SHALL NOT BE CITED OR USED AS BINDING PRECEDENT IN ANY OTHER CASE IN ANY COURT OF THIS STATE; HOWEVER, UNPUBLISHED KENTUCKY APPELLATE DECISIONS, RENDERED AFTER JANUARY 1, 2003, MAY BE CITED FOR CONSIDERATION BY THE COURT IF THERE IS NO PUBLISHED OPINION THAT WOULD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 OPINIONS CITED FOR CONSIDERATION BY THE COURT SHALL BE SET OUT AS AN UNPUBLISHED DECISION IN THE FILED DOCUMENT AND A COPY OF THE ENTIRE DECISION SHALL BE TENDERED ALONG WITH THE DOCUMENT TO THE COURT AND ALL PARTIES TO THE ACTION. RENDERED: AUGUST 29, 2019 NOT TO BE PUBLISHED 2018-SC-000463-WC JAMES COMBS APPELLANT ON APPEAL FROM COURT OF APPEALS V. CASE NO. 2017-CA-000240-WC WORKERS’COMPENSATION BOARD NO. 13-WC-59455 CORRECTIONS CORPORATION OF AMERICA D/B/A LEE ADJUSTMENT CENTER; HON. WILLIAM RUDLOFF, ADMINISTRATIVE LAW JUDGE; AND WORKERS’ COMPENSATION BOARD APPELLEES MEMORANDUM OPINION OF THE COURT AFFIRMING AND REMANDING James Co mbs so ught wo rkers’ c o mpensatio n benefits fo r l o wer bac k and nec k injuries he attributed to a wo rk-rel ated inc ident. The Administrative Law Judge (ALJ), having heard the evidenc e and l egal arguments, c o nc l uded that Co mbs was entitl ed to permanent partial disabil ity benefits. The Wo rkers’ Co mpensatio n Bo ard (Bo ard) vac ated and remanded, direc ting the ALJ to make additio nal findings as to c ausatio n and whether Co mbs had a pre-existing c o nditio n. The Co urt o f Appeal s affirmed the Bo ard’s dec isio n and an appeal to this Co urt fo l l o wed. Having c o nc l uded that the ALJ fail ed to pro vide suffic ient expl anatio n fo r his findings, we affirm the Co urt o f Appeal s and remand to the ALJ fo r further findings c o nsistent with this Opinio n. FACTS AND PROCEDURAL HISTORY In 2013, James Co mbs wo rked as a c o rrec tio ns o ffic er and c riminal investigato r fo r Co rrec tio ns Co rpo ratio n o f Americ a (CCA). His typic al duties inc l uded c o ntro l l ing inmates, investigating disc ipl inary matters, and pro viding tec hnic al suppo rt. He primaril y wo rked at a desk, but o c c asio nal l y c arried printers weighing appro ximatel y 75 po unds. In No vember 2012, Co mbs injured his l umbar spine when he l ifted a deer after hunting. As a resul t o f this injury, Dr. Ro bert Owens, a neuro surgeo n, perfo rmed a L4-L5 l aminec to my and disc ec to my in April 2013.1 Dr. Owens repo rted that the surgery was suc c essful despite Co mbs’s repo rt that he experienc ed o c c asio nal bac k pain. In May 2013 Co mbs suffered two additio nal bac k injuries — o ne fro m having to resc ue his do gs fro m a fl o o d and the o ther fro m hel ping his so n l ift a generato r. Co mbs returned to ful l , unrestric ted duties at wo rk o n June 18, 2013, but stil l experienc ed so me bac k pain and stiffness. On June 28, 2013, Co mbs was injured at wo rk when he l ifted a bo x, raising up and striking his l o wer bac k o n a shel f, resul ting in a six-c entimeter- l o ng c ut o n the l eft side o f his bac k. Co mbs visited the o nsite nurse, who 1 “Laminec to my is a surgery that c reates spac e by remo ving the l amina — the bac k part o f a vertebra that c o vers the spinal c anal . Al so kno wn as dec o mpressio n surgery, l aminec to my enl arges the spinal c anal to rel ieve pressure o n the spinal c o rd o r nerves.” Laminectomy, Mayo Clinic (June 13, 2018) https://www.mayo c l inic .o rg/tests-pro c edures/l aminec to my/abo ut/pac -20394533 . A disc ec to my is a “surgic al pro c edure to remo ve the damaged po rtio n o f a herniated disk in yo ur spine. Diskectomy, Mayo Clinic (June 22, 2018) https://www.mayo c l inic .o rg/tests-pro c edures/diskec to my/abo ut/pac -20393837 . A herniated disk c an irritate o r c o mpress nearby nerves. Id. Al tho ugh the so urc e c ited spel l s disc ec to my with a “k,” thro ugho ut the rec o rd it is predo minantl y spel l ed with a “c ” and therefo re we use that spel l ing in this Opinio n. 2 c l eaned the c ut, and he returned to wo rk. Three and a hal f mo nths l ater, Co mbs so ught medic al treatment fro m Dr. Sal em Hanna and an immediate c are c enter. Co mbs c o mpl ained o f l o wer bac k and l eft l eg pain but did no t repo rt any nec k pain. Dr. Hanna diagno sed him with l o wer bac k pain, rec o mmended o ver-the-c o unter pain medic atio n, and referred him bac k to Dr. Owens. On Oc to ber 29, 2013, Co mbs visited Dr. Owens c o mpl aining o f l o wer bac k pain and l eft l eg pain. He al so , fo r the first time, c o mpl ained o f l eft arm pain. MRIs were perfo rmed a mo nth l ater, and the c ervic al (nec k) MRI reveal ed disc pro trusio n at C5-C6 resul ting in steno sis and l eft side pro trusio ns at C3- C4, C4-C5, and C6-C7. The l umbar (l o wer bac k) MRI reveal ed the surgery Dr. Owens previo usl y perfo rmed with no rec urrent disc pro trusio n. At the Oc to ber 29, 2013 visit to Dr. Owens, Co mbs repo rted bac k, arm and l eg pain but spec ific al l y denied any nec k pain. Co mbs initiated a wo rkers’ c o mpensatio n c l aim in Marc h 2014, c l aiming injury to his bac k, l eft sho ul der, and l eft arm. CCA stipul ated that Co mbs sustained a wo rk-rel ated injury in June 2013 but argued that the injury did no t resul t in an impairment rating meriting an award o f inc o me benefits. CCA al so c hal l enged whether the wo rk inc ident c aused injury to his c ervic al spine, l eft sho ul der and l eft arm. Bo th parties submitted Independent Medic al Exams (IMEs). On April 26, 2014, Dr. Jeffrey Uzzl e c o nduc ted an IME and o pined that Co mbs suffered a permanent who l e perso n impairment o f 9%, attributing 6% to the 3 radic ul o pathy c o mpl aints in the c ervic al spine and 3% to the l umbar radic ul o pathy. In additio n, Dr. Uzzl e stated that Co mbs suffered a 10% l umbar impairment due to a pre-existing c o nditio n. In his medic al repo rt, Dr. Uzzl e stated that the wo rk injury was the c ause o f Co mbs’s c o mpl aints, but, no tabl y, l eft the “expl anatio n o f c ausal rel atio nship” sec tio n — where the examiner is direc ted to expl ain ho w the wo rk-rel ated injury c aused the harmful c hange in the human o rganism — bl ank. No ting the c o mpl exity o f the c ase, Dr. Uzzl e stated that he fo und Co mbs to be c redibl e given his histo ry, examinatio n and the straightfo rwardness o f his presentatio n. He determined that Co mbs did no t retain the physic al c apac ity to return to the type o f wo rk perfo rmed at the time o f his injury. Dr. Mic hael Best examined Co mbs o n April 29, 2014, and stated that Co mbs sustained an abrasio n/c o ntusio n to the l umbar spine as a resul t o f the June 28 wo rk injury. Ho wever, Dr. Best c o nc l uded that the wo rk injury did no t pro duc e a permanent harmful c hange in the human o rganism, and that Co mbs was ful l y c apabl e o f returning to his wo rk duties. He al so fo und no c ausal rel atio nship between the injury and Co mbs’s nec k c o mpl aints, whic h were first do c umented appro ximatel y three and a hal f mo nths after the injury. Whil e Co mbs did have an ac tive impairment, the impairment was attributabl e to the deer hunting injury and surgery, no t the wo rk injury. Dr. Best o pined that Co mbs retained the physic al c apac ity to return to the type o f wo rk he perfo rmed at the time o f the injury with no restric tio ns. 4 CCA fil ed suppl emental c o rrespo ndenc e fro m Dr. Best, whic h he prepared after reviewing Dr. Uzzl e’s repo rt. Dr. Best again no ted that Co mbs c o mpl ained o f and so ught treatment fo r his c ervic al spine three and a hal f mo nths after the wo rk injury, and that no c ause and effec t rel atio nship was establ ished between the inc ident and the injury. Dr. Best al so disagreed with Dr. Uzzl e’s finding o f radic ul o pathy, no ting that ac c o rding to Americ an Medic al Asso c iatio n (AMA) guidel ines, c ertain c riteria, suc h as l o ss o f refl ex, strength defic it, and atro phy, must be met and were no t present in Co mbs’s c ase. The ALJ c o nduc ted a hearing o n Jul y 25, 2014. On review o f Co mbs’s c l aim fo r wo rkers’ c o mpensatio n benefits, the ALJ c o nc l uded that Co mbs was entitl ed to permanent partial disabil ity benefits fro m the date o f the ac c ident and c o ntinuing fo r 425 weeks. The ALJ determined that Co mbs was a c redibl e witness and rel ied o n the IME perfo rmed by Dr. Uzzl e in determining that Co mbs c o ul d no t return to the type o f wo rk he perfo rmed at the time o f the wo rk injury. The ALJ rel ied o n Dr. Uzzl e’s finding that Co mbs suffered a 9% who l e perso n permanent partial impairment as a resul t o f the wo rk injury. CCA petitio ned fo r rec o nsideratio n, requesting additio nal findings suppo rting the ALJ’s c o nc l usio n that the wo rkpl ac e injury c aused Co mbs’s nec k c o nditio n. CCA further argued that the ALJ erred in finding Co mbs had no pre-existing ac tive c o nditio n o r impairment o f his l o wer bac k in l ight o f his rec ent l umbar surgery. Additio nal l y, CCA requested additio nal findings regarding Co mbs’s entitl ement to an enhanc ed benefits award. 5 On rec o nsideratio n, the ALJ stated that CCA was simpl y trying to reargue the c ase, but o ut o f c autio n he el ec ted to disc uss the c ase again. The ALJ reiterated muc h o f what he inc l uded in his first o pinio n and o rder, and denied CCA’s petitio n fo r rec o nsideratio n. CCA then appeal ed to the Bo ard o n Oc to ber 20, 2014. On February 27, 2015, the Bo ard issued an o pinio n vac ating and remanding, and direc ting the ALJ to pro vide spec ific evidentiary findings to suppo rt his determinatio n regarding c ausatio n o f the c ervic al c o nditio n, the determinatio n o f no pre-existing ac tive impairment o r c o nditio n, and the appl ic atio n o f the three-mul tipl ier. The Bo ard no ted that the evidenc e in this c ase may very wel l suppo rt an award o f permanent partial disabil ity benefits, but that the ALJ fail ed to pro vide a suffic ient anal ysis suppo rting his award. Additio nal l y, the Bo ard rec o gnized that the ALJ, as fac t-finder, is granted so l e disc retio n in determining the c harac ter, qual ity and substanc e o f evidenc e, but that the ALJ must al so pro vide findings suffic ient to info rm the parties o f the basis fo r his dec isio n to al l o w fo r meaningful review. Paramount Foods, Inc. v. Burkhardt, 695 S.W.2d 418 (Ky. 1985); Big Sandy Cmty. Action Program v. Chaffins, 502 S.W.2d 526 (Ky. App. 1973). On June 26, 2015, the ALJ issued an amended o pinio n and o rder awarding the same benefits as in the initial dec isio n. The ALJ again fo und Co mbs’s testimo ny and Dr. Uzzl e’s medic al o pinio n persuasive and rel ied o n Dr. Uzzl e’s determinatio n that Co mbs’s diagno ses were due to the wo rk injury. The ALJ al so fo und that the c ervic al injury was asso c iated with a herniated 6 disc at the C5-C6 l evel and no ted the c o mpl exity o f the c ase. CCA fil ed ano ther petitio n fo r rec o nsideratio n, whic h the ALJ again denied o n August 4, 2015. CCA appeal ed to the Bo ard a sec o nd time, c hal l enging the ALJ’s findings regarding the wo rk-rel ated c ervic al injury, the l ac k o f a pre-existing l o wer bac k impairment and the appl ic atio n o f the three-mul tipl ier.2 The Bo ard again vac ated the ALJ’s dec isio n and remanded fo r additio nal findings o n these issues. Co mbs appeal ed the Bo ard’s dec isio n to the Co urt o f Appeal s, arguing that the Bo ard erred as a matter o f l aw and substituted its o pinio n fo r that o f the ALJ. In a 2-1 dec isio n, the Co urt o f Appeal s affirmed the Bo ard’s o pinio n and fo und that the Bo ard did no t substitute its o pinio n fo r the ALJ’s, but rather direc ted the ALJ to expl ain the evidentiary basis fo r his findings. In her dissent, Judge Jo nes o pined that no additio nal findings were nec essary and the Bo ard sho ul d no t reweigh the evidenc e. This appeal fo l l o wed. ANALYSIS Co mbs argues that the Co urt o f Appeal s erred as a matter o f l aw in affirming the dec isio ns o f the Bo ard. Spec ific al l y, he argues that the Bo ard erred in vac ating the ALJ’s dec isio n and remanding fo r additio nal findings regarding c ausatio n and whether he suffered fro m a pre-existing c o nditio n at the time o f the injury. He c l aims that the ALJ’s findings are adequate to suppo rt his dec isio n and that by requiring additio nal fac tual findings, the 2 The appl ic atio n o f the three-mul tipl ier is no t at issue in this present appeal . 7 Bo ard is substituting its o pinio n fo r that o f the ALJ. Parties to a wo rkers’ c o mpensatio n c ase are “entitl ed to a suffic ient expl anatio n by the ALJ o f the basis fo r the dec isio n.” Whittaker v. Rowland, 998 S.W.2d 479, 481 (Ky. 1999) In reviewing the appel l ate c o urt’s affirmanc e o f the Bo ard’s remand to the ALJ fo r findings regarding the c ervic al injury and the pre-existing bac k injury, we agree that the ALJ did no t pro vide a suffic ient expl anatio n fo r his findings o n these two issues. In c o nc l uding that Co mbs’s c ervic al c o nditio n is wo rk rel ated, the ALJ rel ied so l el y o n Dr. Uzzl e. As the Bo ard c areful l y expl ained: The ALJ rel ied so l el y upo n Dr. Uzzl e’s o pinio n to c o nc l ude Co mbs’ c ervic al c o nditio n is wo rk-rel ated, whic h is the o nl y medic al o pinio n in the rec o rd attributing the c o nditio n to the wo rk inc ident. Co mbs repo rted to Dr. Uzzl e that his c ervic al c o mpl aints aro se a few days after the wo rk inc ident. Dr. Uzzl e al so reviewed a No vember 27, 2013 c ervic al MRI whic h reveal ed a herniated disc at C5-6. Based o n the MRI and Co mbs’ desc riptio n o f the o nset o f his sympto ms, Dr. Uzzl e c o nc l uded Co mbs’ nec k c o mpl aints are asso c iated with the herniated disc at C5-6 l evel . In c o mpl eting his eval uatio n fo rm, Dr. Uzzl e l eft bl ank a po rtio n whic h requested him to “expl ain ho w the wo rk-rel ated injury c aused the harmful c hange in the human o rganism.” In a narrative po rtio n o f the repo rt, Dr. Uzzl e ac kno wl edges the c o mpl exity o f Co mbs’ c ase but reaso ns “his histo ry, exam and straightfo rwardness o f his presentatio n l ead to inc reased c redibil ity o f these diagno sis (sic ) and his c o mpl aints.” Dr. Uzzl e then c o nc l udes Co mbs’ c ervic al c o nditio n is rel ated to a herniated disc at C5-6 whic h was c aused by the wo rk inc ident, but pro vided no further expl anatio n fo r this c o nc l usio n. In sho rt, Dr. Uzzl e’s o pinio n as to c ausatio n is based so l el y o n the histo ry Co mbs pro vided to him, inc l uding the assertio n his c ervic al c o mpl aints began a few days after the wo rk inc ident. Co mbs simil arl y testified. Ho wever, we al so no te Co mbs never desc ribed any trauma to his nec k o r sho ul der in the inc ident repo rt, and he ac kno wl edged that he had experienc ed nec k spasms sinc e the deer l ifting inc ident. Furthermo re, it is no t c l ear whether 8 Dr. Uzzl e reviewed the medic al rec o rds fro m earl y Oc to ber 2013, whic h c o ntain no referenc e to an injury o r treatment fo r any c o nditio n o ther than the l o w bac k. Mo st impo rtantl y, Dr. Uzzl e pro vides no expl anatio n o f ho w the wo rk injury to his l umbar spine c aused a herniated c ervic al disc . When the c ause o f a c o nditio n is no t readil y apparent to a l ay perso n, medic al testimo ny suppo rting c ausatio n is required. Medic al c ausatio n must be pro ven by medic al o pinio n within “reaso nabl e medic al pro babil ity.” The mere po ssibil ity o f wo rk-rel ated c ausatio n is insuffic ient. . . . [T]he c irc umstanc es o f Co mbs’ nec k injury are unusual , given that he struc k o nl y his l o w bac k during the wo rk ac c ident, simul taneo usl y wo rked as a l etter c arrier, and had experienc ed nec k spasms sinc e his hunting ac c ident. Due to these c irc umstanc es, it is insuffic ient fo r the ALJ to merel y state he fo und Dr. Uzzl e’s o pinio n persuasive. CCA is entitl ed to an o pinio n whic h weighs the testimo ny and pro o f, and o ffers a suffic ient basis fo r the finding o f a wo rk-rel ated nec k injury. Jan. 20, 2017 Bd. Op. at 10-13 (internal c itatio ns o mitted). We disc uss the c ervic al injury and pre-existing bac k injury in turn. I. The Court of Appeals did not err in affirming the Board’s remand to the ALJ for findings on causation and the cervical injury. Kentuc ky Revised Statute (KRS) 342.0011(1) defines a c o mpensabl e injury as “any wo rk-rel ated traumatic event. . . whic h is the pro ximate c ause pro duc ing a harmful c hange in the human o rganism evidenc ed by o bjec tive medic al findings.” As a wo rkers’ c o mpensatio n c l aimant, Co mbs has the burden o f pro ving al l el ements o f his c l aim. Wolf Creek Collieries v. Crum, 673 S.W.2d 735, 736 (Ky. App. 1984). The ALJ is c harged with fac t-finding and has the so l e autho rity to determine the qual ity, c harac ter and substanc e o f the evidenc e. Square D Co. v. Tipton, 862 S.W.2d 308, 309 (Ky. 1993). On review o f the ALJ’s dec isio n, the issue is whether there is substantial evidenc e suppo rting his findings, defined as “so me evidenc e o f substanc e and 9 rel evant c o nsequenc e, having the fitness to induc e c o nvic tio n in the minds o f reaso nabl e men.” Rowland, 998 S.W.2d at 481-82. Co mbs argues that the ALJ’s finding o f a wo rk-rel ated c ervic al injury was suppo rted by his o wn testimo ny, and the repo rt o f Dr. Uzzl e, whic h pro vided substantial evidenc e that he retains a permanent impairment as a resul t o f the c ervic al injury. But after reviewing Co mbs’s depo sitio n and his hearing testimo ny, we find no thing to suggest he stated he injured his nec k during the June 28 injury, o ther than testimo ny o f a l ater o nset o f nec k pain. Further, despite the o bjec tive medic al evidenc e o f Co mbs’s injury at C5-C6, the ALJ fail ed to establ ish the c ausal rel atio nship between the c ervic al injury and the wo rk inc ident. As the Co urt o f Appeal s stated, “[i]t is this disc o nnec t c o upl ed with the unique fac tual po sture o f this c ase that gave the Bo ard pause.” Here, the Bo ard determined that it was insuffic ient fo r the ALJ to merel y state he fo und Dr. Uzzl e’s o pinio n persuasive, no ting that CCA is entitl ed to an o pinio n whic h weighs the testimo ny and pro o f, and o ffers a suffic ient basis fo r the determinatio n o f a wo rk-rel ated injury. In affirming the Bo ard, the Co urt o f Appeal s no ted that Co mbs did no t testify that he struc k his nec k during the ac c ident (even tho ugh he l ater repo rted c ervic al radic ul o pathy beginning a few days after the event). In fac t, Co mbs affirmativel y testified that he did not strike his nec k. The Co urt o f Appeal s further o bserved that Dr. Uzzl e fail ed to expl ain ho w Co mbs “sc raping his l o w bac k o n a shel f caused a herniated disc .” (Emphasis in o riginal ). Rel iabl e expert pro o f is required o n issues suc h as 10 medic al c ausatio n when it is no t apparent to a l ayperso n. Kingery v. Sumitomo Elec. Wiring, 481 S.W.3d 492, 499 (Ky. 2015). Here, the Bo ard was no t reweighing the evidenc e o r substituting its o pinio n fo r that o f the ALJ, but merel y highl ighting the ALJ’s fail ure to pro vide “suffic ient expl anatio n” fo r his finding o f permanent partial disabil ity as a resul t o f the June 28, 2013 inc ident. Therefo re, a remand fo r further findings and expl anatio n is appro priate. II. The Court of Appeals did not err in affirming the Board’s remand to the ALJ for findings on the pre-existing back injury. Co mbs al so argues that the Bo ard substituted its o pinio n fo r that o f the ALJ when it required the ALJ to expl ain adequatel y the evidentiary basis fo r his finding that Co mbs did no t have a pre-existing c o nditio n. A pre-existing c o nditio n must be impairment ratabl e and sympto matic immediatel y prio r to the wo rk-rel ated injury. Finley v. DBM Tech., 217 S.W.3d 261 (Ky. App. 2007). In determining the ALJ’s anal ysis was insuffic ient, the Bo ard o bserved as fo l l o ws: Ho wever, the ALJ seems to have so l el y rel ied o n the rel ease to return to wo rk by Dr. Owen [fo l l o wing the April 2013 l umbar surgery] whic h do es no t equate to the l umbar c o nditio n being asympto matic . The rel ease standing al o ne is an insuffic ient basis to c o nc l ude Co mbs had no pre-existing ac tive impairment. Co mbs testified that he was sympto matic and c o ntinued to treat fo r the l o w bac k c o nditio n whic h had resul ted in surgery just ten weeks prio r to the wo rk inc ident. Further, the ALJ’s determinatio n o f no pre-existing ac tive impairment fo r the l o w bac k and rel ianc e o n the impairment rating o f Dr. Uzzl e is c o ntradic to ry. Dr. Uzzl e c l earl y indic ated 10% o f the 13% impairment rating he assigned fo r the l o w bac k was rel ated to a pre-existing c o nditio n, and desc ribed the wo rk ac c ident as “an 11 aggravatio n” o f the prio r c o nditio n. He o pined o nl y 3% was attributabl e to the wo rk injury. Dr. Best assigned a range o f 10% to 13% impairment attributabl e to the deer c arrying inc ident. Given the c o ntradic tio n between the ALJ’s findings and the . medic al o pinio ns regarding pre-existing l umbar c o nditio n, it was inc umbent upo n the ALJ to mo re tho ro ughl y expl ain his reaso ning. Bd. o p. at 14-15. The Bo ard to o k c o nsiderabl e c are to expl ain that it was no t seeking to usurp the ALJ’s ro l e as fac t-finder, but instead was seeking c l arific atio n. The Bo ard al so no ted that if, o n remand, the ALJ determined there was a pre-existing ac tive impairment, the evidenc e c o ul d stil l suppo rt the o riginal finding that the inc ident pro duc ed a 3% inc rease in the l o w bac k impairment rating. In affirming the Bo ard’s anal ysis, the Co urt o f Appeal s no ted “[i]t is c o ntradic to ry to find no pre-existing c o nditio n, but then rel y o n a medic al o pinio n [Dr. Uzzl e’s] that based its impairment rating o n the aggravatio n o f a pre-existing c o nditio n.” We agree. Whil e it is within the ALJ’s disc retio n to rel y o n parts o f a witness’s testimo ny and disregard o ther parts, the ALJ’s findings regarding the pre-existing c o nditio n were inc o nsistent with his prio r rel ianc e o n Dr. Uzzl e’s impairment rating. Caudill v. Maloney’s Disc. Stores, 560 S.W.2d 15, 16 (Ky. 1977). Given the evidenc e presented, a remand fo r further findings and expl anatio n is appro priate to pro vide the parties with a suffic ient expl anatio n fo r the ALJ’s dec isio n. CONCLUSION Fo r the fo rego ing reaso ns, we affirm the Co urt o f Appeal s and remand to 12 the ALJ fo r further findings c o nsistent with this Opinio n. Al l sitting. Minto n, C.J.; Buc kingham, Hughes, and VanMeter, JJ., c o nc ur. Lambert, J., dissents by separate o pinio n in whic h Kel l er and Wright, JJ., jo in. LAMBERT, J., DISSENTING: Respec tful l y, I dissent. Our ro l e in reviewing a dec isio n o f the Bo ard “is to c o rrec t the Bo ard o nl y where the Co urt perc eives the Bo ard has o verl o o ked o r misc o nstrued c o ntro l l ing statutes o r prec edent, o r c o mmitted an erro r in assessing the evidenc e so fl agrant as to c ause gro ss injustic e.”3 Assessment o f the c redibil ity o f the witnesses and the persuasive weight o f the evidenc e is entirel y within the ALJ’s autho rity.4 The ALJ, no t the Bo ard, is empo wered “to determine the qual ity, c harac ter, and substanc e o f the evidenc e.”5 The ALJ is al so free to rejec t testimo ny, Id., and “to bel ieve part o f the evidenc e and disbel ieve o ther parts o f the evidenc ef.]”6 Fo r these reaso ns, the Bo ard sho ul d no t be permitted to “substitute its judgment fo r that o f the administrative l aw judge as to the weight o f evidenc e o n questio ns o f fac t.”7 3 W. Baptist Hosp. v. Kelly, 827 S.W.2d 685, 687-88 (Ky. 1992). 4 KRS 342.285 (l )-(2): “An award o r o rder o f the administrative l aw judge as pro vided in KRS 342.275...shal l be c o nc l usive and binding as to al l questio ns o f fac t[...]The bo ard shal l no t substitute its judgment fo r that o f the administrative l aw judge as to the weight o f evidenc e o n questio ns o f fac t.” 5 Am. Greetings Corp. v. Bunch, 331 S.W.3d 600, 602 (Ky. 2010) (fo o tno te o mitted). 6 Caudill v. Maloney's Disc. Stores, 560 S.W.2d 15, 16 (Ky. 1977). 7 FEI Installation, Inc. v. Williams, 214 S.W.3d 313, 316 (Ky. 2007). 13 regarding c ausatio n between Co mbs’ wo rkpl ac e ac c ident and c ervic al spine injury and whether he suffered fro m a pre-existing c o nditio n at the time o f his wo rkpl ac e ac c ident. With regard to what the Bo ard and the Co urt o f Appeal s perc eived as a disc repanc y between the c irc umstanc es surro unding Co mbs’ wo rkpl ac e ac c ident and the injury to his c ervic al spine, KRS 342.0011(1) defines a c o mpensabl e injury as “a wo rk-rel ated traumatic event...whic h is the pro ximate c ause pro duc ing a harmful c hange in the human o rganism evidenc ed by o bjec tive medic al findings.”8 Medic al c ausatio n by a medic al pro fessio nal do es no t need to be stated with abso l ute c ertainty, reaso nabl e pro babil ity is suffic ient.9 Co mbs’ testimo ny c o nc erning the c irc umstanc es o f injury went as fo l l o ws: I was bo xing up so me o l d IP pho nes that weren’t wo rking, preparing to ship them. I was in an el ec tric al c l o set where I had them sto red. This c l o set is where o ur DVR’s fo r the c amera system were set up, and o n the shel f with the DVR’s, yo u’ve go t a pul l -o ut shel f with a mo nito r and a keybo ard. And that’s what I c aught the c o mer o f. As I was pic king the bo x up, I c aught the c o rner o f the shel f with the c enter o f my bac k. I twisted and it just sc raped al l ac ro ss, fro m the c enter to the l eft side o f my bac k. It was pro babl y abo ut fo ur, five, maybe 6 inc hes. And I went to my knees after that. I stayed that way fo r pro babl y abo ut a hal f-ho ur o r so . It was just a l o t o f pain. I went straight after that to the HR o ffic e. And fro m there, I 8 See also Sweeney v. King’s Daughters Med. Ctr., 260 S.W.3d 829, 832 (Ky. 2008). 9 Lexington Cartage Co. v. Williams, 407 S.W.2d 395, 396 (Ky. App. 1966). 14 went to o ur medic al department where I was examined by o ne o f o ur nurses. Co mbs further testified that sinc e his wo rk ac c ident he has suffered radiating l eft l eg pain, l o w bac k pain, nec k pain, sho ul der pain, numbness in his ring and pinky fingers, and musc l e spasms. He further testified that he devel o ped pain in his upper sho ul ders radiating do wn his l eft arm, and numbness fro m his nec k to the fingers o f his l eft hand in the days after the ac c ident. Dr. Jeffrey Uzzl e c o nduc ted an independent medic al examinatio n (IME) o n Co mbs in April o f 2014. Pertinent to o ur review, Dr. Uzzl e c o nc l uded that the wo rkpl ac e ac c ident c aused Co mbs’ C5-C6 disc herniatio n. “The C5-C6 spinal mo tio n segment (l o c ated in the l o wer c ervic al spine just abo ve the C7 vertebra) pro vides fl exibil ity and suppo rt to muc h o f the nec k and the head abo ve. Due to its high l o ad-bearing func tio n, the C5-C6 mo tio n segment is frequentl y affec ted by po o r po sture, degeneratio n, disc herniatio n, radic ul ar pain, and trauma.”10 He al so diagno sed Co mbs with a l umbar sprain o r strain with an aggravatio n o f l eft l o wer extremity radic ul o pathy rel ative to the pre­ existing l umbar injury and surgery. Co mbs’ desc riptio n o f the wo rkpl ac e ac c ident, in c o njunc tio n with Dr. Uzzl e’s c o nc l usio ns fo l l o wing the IME, adequatel y suppo rted the ALJ’s finding o f c ausatio n between the wo rkpl ac e ac c ident and the injury to Co mbs’ nec k. Dr. Uzzl e was entitl ed to base his o pinio n as to c ausatio n o n the histo ry 10 https://www.spine-heal th.c o m/c o nditio ns/spine-anato my/al l -abo ut-c 5-c 6- spinal -mo tio n-segment (June 2019). 15 pro vided by the patient, and to give an o pinio n abo ut c ausatio n based upo n that histo ry. Here, Co mbs testified his nec k and sho ul der sympto ms devel o ped sho rtl y after the wo rk inc ident, whic h bo th Dr. Uzzl e and the ALJ fo und c redibl e. The ALJ, as the so l e determiner o f the “qual ity, c harac ter and substanc e o f the evidenc e,”11 was entitl ed to rel y upo n Dr. Uzzl e’s medic al o pinio n c o nc erning c ausatio n in finding that Co mbs’ wo rkpl ac e ac c ident resul ted in his c ervic al spine injury. Further, the Bo ard and the Co urt o f Appeal s erred by requiring the ALJ to further expl ain the evidentiary basis fo r its finding that Co mbs did no t have a pre-existing c o nditio n. “[A] pre-existing c o nditio n that is bo th asympto matic and pro duc es no impairment prio r to the wo rk-rel ated injury c o nstitutes a pre-existing do rmant c o nditio n.”12 The wo rk-rel ated aro usal o f a pre-existing do rmant c o nditio n into disabl ing real ity is c o mpensabl e. Id. Ho wever, a pre-existing ac tive c o nditio n is no t c o mpensabl e. Id. To be ac tive, an underl ying pre-existing c o nditio n must be sympto matic and impairment ratabl e under the AMA Guidel ines immediatel y prio r to the wo rk-rel ated injury. Id. Further, when a wo rk-rel ated event aggravates o r exac erbates a pre-existing c o nditio n, a wo rker "sustains a new and separate ‘injury’ within the meaning o f KRS 342.0011(1)[.]"13 11 Am. Greetings Corp., 331 S.W.3d at 602. 12 Finley v. DBM Techs., 217 S.W.3d 261, 265 (Ky. App. 2007). 13 Ford Motor Co. v. Curtsinger, 511 S.W.3d 922, 927 (Ky. App. 2017). 16 Dr. Best indic ated in his medic al repo rt that Co mbs "did no t have an active impairment prio r to this injury." He further no ted in his repo rt that Co mbs’ treating neuro surgeo n al l o wed Co mbs to return to ful l and unrestric ted wo rk duties prio r to the wo rk inc ident. This was suffic ient evidenc e to sustain the ALJ’s finding that Co mbs did no t have a preexisting injury. And whil e Co mbs testified that his bac k was o ften stiff and he was taking presc riptio n medic atio n to regul ate his pain just prio r to the wo rkpl ac e injury, it is within the ALJ’s disc retio n to rel y o n parts o f a witnesses testimo ny and disregard o ther parts.14 As suc h, I am persuaded that the ALJ ac ted within his disc retio n in determining Co mbs did no t have a preexisting injury at the time he inc urred his wo rkpl ac e injury. Based o n the fo rego ing, I wo ul d reverse the Co urt o f Appeal s and reinstate the ALJ’s o rder. Kel l er and Wright, JJ., jo in. 14 Maloney’s, 560 S.W.2d at 16. 17 COUNSEL FOR APPELLANT: Mc Kinnl ey Mo rgan MORGAN COLLINS YEAST & SALYER COUNSEL FOR APPELLEE: Al l iso n Marie Hel singer MOORE INGRAM JOHNSON & STEELE, LLP 18