Title: SCHNEIDER TRANSPORT, INC. V. ROGER EACRET, 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IMPORTANT NOTICE NOT TO BE PUBLISHED OPINION THIS OPINION IS DESIGNATED "NOT TO BE PUBLISHED." PURSUANT TO THE RULES OF CIVIL PROCEDURE PROMULGATED BY THE SUPREME COURT, CR 76 .28(4)(C), THIS OPINION IS NOT TO BE PUBLISHED AND SHALL NOT BE CITED OR USED AS BINDING PRECEDENT IN ANY OTHER CASE IN ANY COURT OF THIS STATE ; HOWEVER, UNPUBLISHED KENTUCKY APPELLATE DECISIONS, RENDERED AFTER JANUARY 1, 2003, MAY BE CITED FOR CONSIDERATION BY THE COURT IF THERE IS NO PUBLISHED OPINION THAT WOULD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 OPINIONS CITED FOR CONSIDERATION BY THE COURT SHALL BE SET OUT AS AN UNPUBLISHED DECISION IN THE FILED DOCUMENT AND A COPY OF THE ENTIRE DECISION SHALL BE TENDERED ALONG WITH THE DOCUMENT TO THE COURT AND ALL PARTIES TO THE ACTION . a six~c~e f~murf Of 2007-SC-000938-WC RENDERED : SEPTEMBER 18, 2008 NOT TO BE PUBLISHED SCHNEIDER TRANSPORT, INC . APPELLANT ON APPEAL FROM COURT OF APPEALS V . 2007-CA-001229-WC WORKERS' COMPENSATION BOARD NO . 83-27626 ROGER EACRET ; HONORABLE R. SCOTT BORDERS, ADMINISTRATIVE LAW JUDGE ; AND WORKERS' COMPENSATION BOARD APPELLEES MEMORANDUM OPINION OF THE COURT AFFIRMING An Administrative Law Judge (ALJ) found a university evaluator's opinion regarding causation to be inconclusive and relied on testimony from the treating nephrologist, who stated that the claimant's end-stage renal failure resulted from his work-related back injury. The Workers' Compensation Board and the Court of Appeals affirmed . Appealing, the employer continues to assert that the ALJ erred by failing to rely on the university evaluator's testimony and by finding for the claimant . We affirm . Not only did the ALJ comply with KRS 342 .315(2) by stating a reasonable basis for rejecting the university evaluator's opinion, the ultimate finding was reasonable . The claimant sustained a ruptured herniated disc while working on August 5, 1985, and underwent back surgeries . The parties settled the claim based on a permanent total disability, with the employer agreeing to pay future medical expenses . At some point the claimant had a spinal cord stimulator implanted . Surgery to replace the battery pack on October 25, 2000, resulted in a large hematoma, after which he developed severe anemia, pulmonary edema, respiratory failure, and was placed on dialysis for acute renal failure . He underwent a kidney transplant in 2003 . The employer refused to pay for treatment of the renal condition based on a utilization review report that indicated the condition did not result from the injury . Thus, the claimant moved to reopen to compel the employer to pay for the treatment . Dr. Woo, a nephrologist, based his utilization review report on medical records . He noted that the claimant had a history of alcohol and substance abuse, was a heavy smoker, developed chronic obstructive pulmonary disease, and had a long history of poorly-controlled hypertension . Dr . Woo viewed a slightly-elevated creatinine level of 1 .5 in 1998 as being evidence of chronic renal insufficiency and noted that the claimant was treated by a urologist in 1999 for bladder outlet obstruction . He also noted that the claimant had a spinal cord stimulator implanted subsequently and developed hypoxemia, adult respiratory distress syndrome, bleeding, and kidney failure . He stated that acute kidney failure is not unusual with adult respiratory distress syndrome and did not think that it resulted from the back injury and use of analgesics . Dr. Crowe, the claimant's treating nephrologist, reported in May 2002 that the claimant presently received hemodialysis for end-stage renal disease . Noting the history of the back injury, numerous surgeries, and pain medications (narcotics, anti inflammatories, and over-the-counter analgesics), he concluded that the chronic renal failure was related to the back injury and resulting pain . He also stated that the claimant had normal renal function before the surgery to replace the battery pack and subsequent bleeding episode. The evidence included records from Dr. Atkinson, director of the transplant center where the claimant received a kidney in May 2003 . They did not address the relationship between treatment for renal failure and the work-related injury. The record contains a May 2005 report from Dr . Griffith, the claimant's pain management specialist since 2002 . The report indicates that the claimant underwent multiple back surgeries, physical therapy, trigger point injections, epidural steroid injections, and he was treated with several pain medications, muscle relaxers, and anti- inflammatories . He had a spinal cord stimulator implanted eventually, which resulted in complications that included a massive epidural hematoma . Dr. Waid, a professor of internal medicine and kidney transplant physician, performed a university evaluation in September 2006 for the purpose of addressing causation . He noted the claimant's longstanding history of hypertension that was not well-controlled but noted that he had normal renal function in 1998 . Dr. Waid also noted that the claimant took an undetermined amount of non-steroidal anti- inflammatory medication after the injury and that he stated that he took high doses of ibuprophen for a long period of time . Dr. Waid observed that analgesic abuse nephropathy could have contributed to the hypertension which, in turn, worsened his nephropathy . He noted that there was evidence of microscopic hematuria in 1999, a condition that can occur with analgesic abuse nephropathy. He also noted that the claimant had severe complications after the surgery concerning the spinal cord stimulator, including the hematoma, acute respiratory failure, and acute renal failure . He concluded : Based on prior records, what we can say at this time is that he had chronic kidney disease which could be secondary to uncontrolled hypertension for many years and/or possibly analgesic abuse . Then, the patient developed acute on [sic] chronic renal failure and did not recover. Most of the cases of acute tubular necrosis in the ICU setting do recover function but probably since this patient had an already abnormal renal function this could have played a role in his renal function not recovering . The ALJ refused to afford Dr . Waid's opinion presumptive weight on the ground that he failed to specify whether the claimant's renal condition resulted from the injury, which was the sole matter at issue. Persuaded by Dr . Crowe's testimony, the ALJ determined that the back injury and subsequent treatment caused the end-stage renal failure . Thus, the employer bore liability far the related medical expenses . The employer argues that the ALJ erred by failing to give the university evaluator's opinion presumptive weight, that the claimant failed to follow competent medical advice, and that the evidence compelled a decision in its favor. We disagree . The claimant had the burden to prove every element of his claim, including causation.' KRS 342 .285 designates the ALJ as the finder of fact, which gives the ALJ the sole discretion to determine the quality, character, and substance of evidence and to determine whom and what to believe . Special Fund v. Francis , 708 S.W.2d 641, 643 (Ky . 1986), explains that if the party with the burden of proof prevails, that party's burden on appeal is to show that the decision was reasonable because substantial evidence supported it. Magic Coal Co. v . Fox, 19 S .W.3d 88, 95-97 (Ky. 2000), explains that KRS 1 Roark v . Alva Coal Corporation , 371 S.W.2d 856 (Ky. 1963); Wolf Creek Collieries v. Crum, 673 S.W .2d 735 (Ky. App . 1984) ; Snawder v. Stice , 576 S.W.2d 276 (Ky . App . 4 342.315(2) requires a designated university evaluator's clinical findings and opinions to be given presumptive weight unless the AU specifically states a reasonable basis for rejecting them . Dr . Waid concluded that the kidney condition "could be secondary to uncontrolled hypertension for many years and/or possibly analgesic abuse." The ALJ determined reasonably that Dr. Waid failed to state'a definitive opinion regarding causation . The decision complied with KRS 342.315(2) and permitted the AU to rely on a different medical expert . The AU found Dr . Crowe's testimony to be more convincing than Dr. Woo's. Although the employer asserts that the claimant abused analgesics and traveled out of state after surgery against medical advice, it failed to raise a defense under KRS 342.035(3) for an alleged failure to comply with competent medical advice . Nor did it petition for reconsideration and request specific findings under the statute . In any event, no physician testified that travel against medical advice contributed to causing the renal failure . Dr . Woo stated that the claimant traveled against medical advice after surgery but did not relate the travel to the cause of the renal condition . Although he referred to the abuse of analgesics, he found no connection between such abuse and the renal failure . Dr. Crowe viewed the renal failure as being a complication of the surgery to replace the spinal cord stimulator's battery pack and, therefore, as being a consequence of the work-related injury . The testimony provided substantial evidence to support the award . Although other evidence would have permitted a different conclusion, it was not so overwhelming as to compel a different conclusion .2 1979) . 2 McCloud v. Beth-Elkhorn Corp ., 514 S.W . 2d 46 (Ky. 1974) . 5 The decision of the Court of Appeals is affirmed . All sitting . All concur . COUNSEL FOR APPELLANT, SCHNEIDER TRANSPORT, INC.: LAURIE GOETZ KEMP WOODWARD, HOBSON & FULTON, LLP 101 SOUTH FIFTH STREET 2500 NATIONAL CITY TOWER LOUISVILLE, KY 40202-3175 COUNSEL FOR APPELLEE, ROGER EACRET : ROGER EACRET 2510 TINCHTOWN ROAD JAMESTOWN, TN 38556