Title: EAGLE CARRIERS V. TROY GREGORY; HON. J . KEVIN KING, ADMINISTRATIVE LAW JUDGE; AND WORKERS' COMPENSATION BOARD

State: kentucky

Issuer: Kentucky Supreme Court

Document:

IMPORTANTNOTICE NOT TO BE PUBLISHEDOPINION THIS OPINIONISDESIGNATED "NOT TO BE PUBLISHED." PURSUANT TO THERULES OF CIVIL PROCEDURE PROMULGATED BYTHE SUPREME COURT, CR 76.28 (4) (e), THIS OPINION IS NOT TO BE PUBLISHEDAND SHALL NOTBE CITED OR USED AS AUTHORITYINANY OTHER CASE INANY COURTOF THIS STATE. EAGLE CARRIERS V ,*uyrrmr (fourf of TROY GREGORY ; HON . J . KEVIN KING, ADMINISTRATIVE LAW JUDGE ; AND WORKERS' COMPENSATION BOARD 2002-SC-0823-WC AFFIRMING RENDERED : August 21 NOT TO BE APPEAL FROM COURT OF APPEALS 2002-CA-0744-WC WORKERS' COMPENSATION BOARD NO . 00-58420 MEMORANDUM OPINION OF THE COURT APPELLANT APPELLEES The claimant's award of income and medical benefits for work-related physical and psychological injuries has been affirmed by the Workers' Compensation Board (Board) and the Court of Appeals . Appealing, the employer maintains : 1 .) that the Administrative Law Judge (ALJ) erred by relying on medical testimony that assigned both a DRE impairment rating for the claimant's physical injury and a separate rating for pain ; 2.) that the claimant was being treated for a psychological condition immediately before his accident and, therefore, the ALJ erred by relying upon a medical witness who was not given a history of the treatment ; and 3.) that the ALJ erred by ordering the employer to pay for medications and treatment that the claimant received on a regular and continuous basis before the accident . The claimant maintains, however, that the award was proper, that the appeal is frivolous, and that sanctions are warranted under KRS 342 .310 . The claimant's medical history included treatment for scoliosis and, in 1979 or 1980, the implantation of Harrington rods in his lower back . One of the rods later broke and required treatment from 1983-87 but no additional surgery . Following the treatment, he was under no restrictions and returned to full-time employment as well as to activities such as hunting, fishing, playing golf and softball, and coaching . He testified that he suffered from occasional pain for which Dr . Patton, his family doctor, had prescribed Oxycontin, Demerol, and Percodan . On September 27, 2000, the truck that he was driving was rear-ended by another truck, and he sought benefits for both physical and psychiatric problems . The claimant testified to significant pain in his neck, back, and shoulders, daily headaches, depression, and difficulty sleeping . He indicated that Dr . Patton was treating his conditions with increased pain medication and antidepressants . Dr . Bean treated the claimant following the accident . His records indicate that the claimant had a cervical sprain and pre-existing cervical degenerative disc disease . He indicated that the diagnosis was based upon subjective symptoms and that there were no objective findings upon which to rely. Similarly, although he assigned restrictions, he noted that there were no objective changes to verify that they were necessary . Dr . Patton's records indicated that he had treated the claimant for back pain since October 3, 1998, prescribed medications including OxyContin and Percodan, and continued to see him intermittently up until the accident . A May, 1999, office note suggests that the claimant was referred to a pain clinic, and an August, 1999, note lists anxiety as a complaint . Notes from December 2, 1999, indicate that the claimant was not coping and contain a diagnosis of depression . Notes from visits as late as July 26, 2000, refer to prescriptions for Desyrel, an antidepressant . After the accident, Dr . Patton increased the claimant's dose of Oxycontin from twenty milligrams to forty milligrams and prescribed psychotropic medication . A note from October 21, 2000, indicates that the dose of Desyrel was increased . Dr . Templin's exam notes from April 17, 2001, indicate that the history the claimant gave was appropriate to his complaints . After performing a physical exam and reviewing medical records, he diagnosed chronic low back pain, degenerative disc disease, chronic lumbosacral musculoligamentous strain, Harrington rod placement from T2 through L4, history of severe thoracic scoliosis, history of cervical disc herniation, chronic cervical pain syndrome, chronic musculoligamentous strain, degenerative cervical disc disease, chronic thoracic pain syndrome, and chronic headaches . In his opinion, the claimant did not have an active impairment before the accident . Dr. Templin assigned impairments of 5% to the lumbar spine injury, 5% to the cervical injury, and 6% to pain . He explained that the rating for pain was based upon a formal pain assessment that yielded a score of 36 and, therefore, warranted a 6% impairment under Table 18-7 of the Guides . Using the Combined Values Chart, the claimant's overall impairment rating was 15% . Dr . Snider examined the claimant on June 20, 2001, and received an appropriate history of the accident as well as a medical and social history . He diagnosed cervical strain, pre-existing cervical arthritis, low back pain, scoliosis, status post-Harrington rod placement, pre-existing Harrington rod breakage, and obesity, none of which he thought required further medical treatment . Furthermore, he noted that the claimant had chronic back pain, took Oxycontin, and was treated for depression before the work-related accident . Noting that Dr. Stevens placed the Harrington rod and assessed a 20% impairment in 1985 based on a thoracolumbar diagnosis, Dr. Snider thought that no additional impairment was warranted . He did assign a Cervicthoracic Category II (5%) DIRE impairment but thought it inappropriate to assign an additional impairment for pain . His explanation was that pages 20 and 570 of the 5th Edition indicate that the DIRE table takes the effects of pain into account . Furthermore, he stated : In my opinion, Mr. Gregory's case does not warrant additional impairment for the simple fact that but for complaints of pain he would receive no impairment rating whatsoever due to neck or low back problems . Therefore, I think the anatomic impairment determination should suffice . (Emphasis original.) Dr. Mohler performed a psychological evaluation on August 30, 2001, at which time he interviewed the claimant, received an appropriate history, and performed various standardized psychological tests . His diagnosis was pain disorder that was associated with both psychological factors and the claimant's medical condition . Using the criteria from Chapter 18 of the Guides , he reported a pain-related impairment score of 49, which placed the claimant in the moderately severe category of impairment . In Dr . Mohler's opinion, the claimant came within the criteria for a Class II or mild psychological impairment . Although recognizing that the present edition of the Guides did not assign percentage impairments to mental disorders, his opinion was that the claimant's whole-body impairment was 10% of which half was due to his injury and half to "pre-existing factors and/or circumstances unrelated to his work injury ." Dr. Shraberg, a psychiatrist, evaluated the claimant on September 7, 2001, and received an appropriate history of depression and chronic pain due to "very severe congenital dextroscoliosis." Emphasizing that the claimant was taking powerful pain medication, was being treated with an anti-depressant, and had been treated for pain and depression before the accident, his opinion was that the accident caused no significant depression and caused a 0% impairment. Furthermore, he indicated that Dr. Templin's numerous diagnoses could be reduced to "progressive chronic pain due to degenerative disc disease with a simple cervical sprain, resolved ." Choosing to rely upon Drs. Templin and Mohler, the AU determined that the claimant's physical (15%) and psychological (5%) impairments yielded an overall impairment of 19% according to the Combined Values Table . Furthermore, the AU determined that the claimant was incapable of returning to his former work and, therefore, was entitled to a triple benefit under KRS 342.730(1)(c)1 : Although recognizing that the claimant was being treated with prescription medication at the time of the accident, the AU pointed to undisputed evidence that his use of medication increased after the accident . Noting that pain medication was not specific to any one body part, the ALJ determined that it was compensable but that any treatment that was specifically and solely related to the scoliosis was not compensable . Persuaded that the claimant's psychological problems would not have required treatment had the injury not occurred, the AU determined that psychological treatment also was compensable . In support of its argument that an additional impairment rating for pain was inappropriate, the employer relies upon Dr . Snider's testimony and also upon Chapter 18 of the Guides, page 570, which notes that pain commonly accompanies many disorders and that impairment ratings take pain into account. An example explains that when a cervical spine disorder causes radiating arm pain, that pain is included in the cervical spine impairment rating . We note, however, that in rejecting the argument and determining that different opinions concerning an individual's proper impairment under the Guides amount to no more than conflicting medical evidence, the Board observed that the Guides provided for the rating of pain-related impairment and permitted the addition of a 3% rating if pain-related impairment substantially increases the individual's burden . See Guides , Figure 18-1, page 574 . Dr. Templin's addition of a 3% impairment to the cervical and thoracic ratings was based upon a formal pain assessment, and Dr . Snider's testimony did not conclusively establish that a rating for pain was inappropriate on these particular facts . We conclude, therefore, that the ALJ's reliance on Dr . Templin was supported by the evidence and was properly affirmed on appeal . Arguing that Dr . Mohler did not have the benefit of Dr. Patton's records, which contained his prior diagnosis of depression, and that the claimant did not report a history of depression, the employer maintains that Dr . Mohler's opinion concerning work-related causation should have been disregarded . Osborne v. Pepsi Cola Co. , Ky., 816 S .W.2d 643 (1991) . We note, however, that a pre-existing diagnosis of depression and/or treatment for depression would not necessarily compel a conclusion that the condition was severe enough to warrant an AMA impairment rating at that time . Furthermore, during the course of his evaluation, Dr . Mohler became aware of significant pre-existing psychological stressors that were unrelated to the claimant's work and attributed half of the impairment to those factors . It is apparent, therefore, that although Dr. Mohler may have received a defective history from the claimant, his opinion of causation was based on the results of his evaluation and constituted substantial evidence from which the AU could reasonably conclude that the injury caused a 5% psychological impairment . KRS 342.020 requires an employer to pay reasonable and necessary medical expenses for the cure and relief of a work-related injury . Thus, where there was a properly supported finding that the claimant's work-related harmful changes required medical treatment, the employer was properly held liable for that treatment despite the existence of a pre-existing condition that required similar treatment. Likewise, the ALJ properly determined that any treatment that was exclusively for scoliosis was not compensable because the condition was not work-related . Finally, KRS 342.310 permits the imposition of certain sanctions against a party who brings, prosecutes, or defends an action "without reasonable ground." Relying on this provision, the claimant maintains that the ALJ's decision was supported by substantial evidence and that the appeal to this Court is frivolous . Nonetheless, having reviewed the record and the arguments of the parties, we are not persuaded that the appeal was so lacking in merit that the imposition of sanctions is warranted . The decision of the Court of Appeals is affirmed . All concur . COUNSEL FOR APPELLANT : Charles Ernest Lowther Mitchell, Joiner, Hardesty & Lowther P.O. Drawer 659 113 E . Center Street Madisonville, KY 42431 COUNSEL FOR APPELLEE : Timothy J . Wilson 200 W . Vine Street, Suite 610 Lexington, KY 40507