Title: RUTH WALKER V. CABINET FOR HEALTH SERVICES, 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IMPORTANT NOTICE NOT TO BE PUBLISHED OPINION THIS OPINION IS DESIGNATED "NOT TO BE PUBLISHED." PURSUANT TO THE RULES OF CIVIL PROCEDURE PROMULGATED BY THE SUPREME COURT, CR 76.28(4)(C), THIS OPINION IS NOT TO BE PUBLISHED AND SHALL NOT BE CITED OR USED AS BINDING PRECEDENT IN ANY OTHER CASE IN ANY COURT OF THIS STATE ; HOWEVER, UNPUBLISHED KENTUCKY APPELLATE DECISIONS, RENDERED AFTER JANUARY 1, 2003, MAY BE CITED FOR CONSIDERATION BY THE COURT IF THERE IS NO PUBLISHED OPINION THAT WOULD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 OPINIONS CITED FOR CONSIDERATION BY THE COURT SHALL BE SET OUT AS AN UNPUBLISHED DECISION IN THE FILED DOCUMENT AND A COPY OF THE ENTIRE DECISION SHALL BE TENDERED ALONG WITH THE DOCUMENT TO THE COURT AND ALL PARTIES TO THE ACTION . ,SttPrme gourf of ~R' 2006-SC-0360-WC AFFIRMING RENDERED : February 22, 2007 NOT TO BE PUBLISHED RUTH WALKER APPELLANT APPEAL FROM COURT OF APPEALS V . 2005-CA-001965-WC WORKERS' COMPENSATION NO . 02-96864 CABINET FOR HEALTH SERVICES ; HON . JAMES L . KERR, ADMINISTRATIVE LAW JUDGE ; AND WORKERS' COMPENSATION BOARD APPELLEES MEMORANDUM OPINION OF THE COURT An Administrative Law Judge (ALJ) determined that the claimant failed to meet her burden of proving that her occupational disease was work-related, and the Workers' Compensation Board and the Court of Appeals affirmed . Appealing pro-se, the claimant raises numerous arguments . Among other things, she asserts that the ALJ's conclusion that her condition arose from a pre-existing occupational disease was unreasonable, not supported by substantial evidence, and contrary to the relevant probative evidence. Having reviewed the evidence and concluded that it did not compel a decision in her favor, we affirm . From April, 1995, until November, 2001, the claimant worked for the defendant- employer as a research nurse. She also worked concurrently for the Frankfort Regional Medical Center . Her application for benefits alleged that frequent exposure to mold, solvent, chemicals, and printer ink while working resulted in an occupational disease. The claimant became a registered nurse in 1973 . She had worked for numerous employers, primarily in critical care, and was exposed to latex and normal hospital chemicals . In about 1990, wearing latex gloves began to make her hands itch, her eyes water, her nose run, and her eyes swell . In 1998, she had root canal surgery, and a latex drain was placed in her mouth for several months . After emergency room treatment for swelling on her face, lips, jaws, and angioedema, testing by Dr. Greisner revealed a systemic latex allergy. Later, she developed shortness of breath, nausea diarrhea, itching on the scalp, and headaches . In December, 1998, she consulted Dr. Smith, also an allergist . He diagnosed asthma and allergies to many foods, pollen, mold, printer ink, and numerous other substances . The claimant testified that in1998 the building in which she worked was cleaned and renovated due to mold contamination . She stated that she was moved from the third floor to the sixth floor, the two floors were where most of the renovation occurred . She was told that the materials being used did not contain latex, but general maintenance in the area where she worked, cigarette smoke, balloons, greenery, and printer ink seemed to produce symptoms . In mid-2001, she "started really every day having problems at state government with my throat, my nose, my eyes, and my voice becoming hoarse." She also experienced dermatitis on her scalp and hair loss . At the time, she thought that cross-reactivity from latex had resulted in her numerous allergies . She first saw Dr. Rea on October 29, 2001 . He performed tests that had not been done previously and informed her that many of her symptoms were not typical of common allergies . He diagnosed a toxic brain injury caused by mold and chemicals in her blood and recommended a treatment plan to rid her body of the toxins . She quit both of her jobs due to the severity of her symptoms in November, 2001, but when deposed in April, 2003, she worked at Ridge Behavioral Health Hospital . In July, 1997, NIOSH investigators evaluated the building in which the claimant worked for health hazards . They noted evidence of a musty odor and fungal growth on the third floor, and samples collected from the sixth floor by a concerned building occupant revealed some stachybotrys atra (black mold) . Recommendations included the elimination of moisture, removal of water-damaged material, renovation of the building when unoccupied, avoidance of automatic deodorizers, and elimination or restriction of tobacco smoke . The report noted that the sixth floor was presently vacant and that remediation was underway there . The report also noted that air monitoring conducted in June, 1997, revealed low bacterial and fungal counts. Donald Jones was the mechanical maintenance supervisor for the building . He testified that in about 1993 or 1994 some fungus and mold spores were found on the third floor, and the janitorial staff used Lysol and a bleach solution to remove them . At about the same time, Millie Noonan, the building's nurse, had informed him that some workers had allergy problems . In about 1996, the presence of mold or fungus was confirmed, and corrective measures began on the third and sixth floors . An indoor air quality report from Taylor and Associates after the corrective measures indicated that the building's air quality was clean and good . After the Taylor study, a major building renovation included stripping paper, painting, and carpeting . A negative air machine was used during the process to minimize fumes, dust, and other particles . A subsequent study indicated that the air quality was safe . To the best of his knowledge, no mold or spores were found after the initial removal in 1996 . Millie Noonan testified that three individuals who worked on the sixth floor -3- complained of allergic symptoms before the mold and fungal contamination was identified . Two of them were already allergy patients . She stated that the mold was found primarily on the sixth floor, and she thought that a bleach solution was used to clean it . Wallpaper and carpeting were also removed . She was unaware of any problems thereafter . Although she knew that the claimant complained of latex allergies, she was unaware of her complaints due to molds or cleaning substances . Jerry Taylor testified that his company was hired in 1993 to survey the building's indoor air quality, particularly related to mold contamination . He stated that there was a moderate degree of mold contamination from a roof leak, primarily on the sixth floor of the main building but also on the third floor of a connected three-story building . Remedial action was recommended and taken at that time . Later, his firm conducted an extensive survey and administered the abatement portion of the contract for the state . Work began in September, 1998 . Procedures exceeded what was normally considered acceptable in order to alleviate employees' concerns about mold exposure . They included sealing the spaces undergoing abatement, using negative airflow with hepa filtration to prevent contaminating other parts of the building, and hepa-vacuuming after removing contaminated materials as well as after using a biocide to kill mold spores. Renovations, including the use of mold-inhibiting paint, were also performed under containment. One year after the abatement, testing indicated that mold levels remained substantially lower than in the outside air . An October, 1998, letter from Dr. Greisner indicated that the claimant had a ten- year history of complaints due to latex exposure, including periorbital swelling and rhinorrhea . A December 8, 1998, letter from Dr. Smith, addressed "To Whom It May Concern," indicated that the claimant was under his care for a latex allergy . She had been diagnosed with the condition by a history of contact, positive testing, and systemic/anaphylactic reactions . The letter explained steps to be taken to assure a latex-free environment throughout a medical facility ; recommended a laboratory to conduct air quality testing ; recommended that the claimant wear a filtering dust mask, take benadryl, carry epinephrine, and wear a medic-alert bracelet ; and suggested various modifications to her home to prevent exposure to latex adhesives and latex dust from motor vehicle tires . A report by Drs . Collins and Garrett indicated that the claimant self-referred to the University of Kentucky Preventive and Occupational Medicine clinic on October 26, 2001, for the evaluation of allergies to ink . The report noted a history of breathing problems that began with the use of latex gloves in 1994 and that was exacerbated by the use of a latex dental drain in 1998 . Dr. Collins diagnosed chemical sensitivity, multiple extrinsic allergies including latex, multiple food allergies, and asthma . He recommended that she avoid exposure to printer ink . The report notes that paint on the walls and ceiling of the claimant's home had to be stripped because black mold was found. It also notes that her drinking water came from the city but that she occasionally purchased bottled water . The claimant later took issue with both statements . The record contains numerous reports from Dr. Rea of the Environmental Health Center in Dallas, Texas, beginning on October 29, 2001 . A July 16, 2002, report indicated that skin testing was positive for approximately 30 types of mold and provoked symptoms of chest tightness, throat irritation, hoarseness, dyspnea, rhinitis, heart pounding, nausea, fatigue, itching, headaches, and indigestion . It revealed sensitivity to numerous chemicals, which provoked a number of her symptoms . Dr . Rea concluded that she suffered from the toxic effects of petrochemicals and solvents, -5- immune deregulation, mold sensitivity, chemical sensitivity, chronic fatigue, and fibromyalgia . Her condition was directly related to chronic and cumulative exposure to mold, mold toxins, and chemicals in the workplace. An April 24, 2002, report noted that exposure to carpeting, particle board, cleaning chemicals, perfumes, deodorizers, dusts and mites, photocopier chemicals and supplies, vinyl and upholstered furniture, foam padding, cigarette smoke, pesticides and insecticides, minimal variations in heat and cold, clothing and fabrics, unfiltered air, and unfiltered water all caused the claimant's severe and disabling hypersensitivity reactions . Dr. Rea stated in a May, 2003, report and his subsequent deposition that the claimant had various allergies but was also diagnosed with toxic encephalopathy, which was due to her exposure to chemicals and perhaps molds . The condition was unrelated to her allergic problem, which was hereditary . He explained that "the massive exposure she got from these substances [is] more of a toxic type exposure." It caused memory loss as well as dizziness, chronic fatigue, shortness of breath and immune deregulation and warranted a 15% permanent impairment rating . The claimant also suffered from asthma, which was due mostly to her sensitivity to chemicals and warranted a 15% permanent impairment rating . They yielded a combined permanent impairment rating of 28% . Dr. Rea stated that when an individual's susceptibility to chemicals and mold toxins develops, "it tends to persist and to spread until it may involve a wide variety of other incitants commonly found in the environment." He thought that the claimant's condition had not been treated properly and recommended a comprehensive treatment plan to control her exposure to substances inciting her symptoms and treat their effects . He stated that some of the treatment available at his clinic was unavailable in Kentucky. Dr. Powell, a pulmonologist, performed an independent medical evaluation in February, 2002, noting the claimant's history of a latex allergy, followed by an increasing number of food and environmental allergies . He attributed her present difficulties to the fact that she was an atopic individual who developed multiple allergies . Atopy is a probably hereditary hypersensitivity that produces symptoms (respiratory symptoms, fainting, itching, hives) upon exposure to the inciting antigen, especially by inhalation. Dr. Powell noted among other things that the claimant was not symptom- free when away from printer ink, for example, because she had multiple allergies . On the day of her examination, she had no measurable pulmonary impairment, which indicated that her present treatment was successful . In his opinion, she should be treated for her underlying condition and symptoms anywhere that there were appropriately-trained allergists and immunologists . Her present treatment was "certainly appropriate and quite adequate," and the treatment provided in Texas added nothing . In July, 2002, Dr. Branch saw the claimant for a follow-up of her allergic and nonallergic rhinitis, reactive airway disease, and multiple food allergies . She complained of frequent abdominal symptoms, increasing shortness of breath, and nasal congestion . She reported a mild increase in symptoms during and after a rain . She was unable to tolerate the strict allergy elimination diet and discontinued it after several days . Dr. Branch thought that she was doing fairly well regarding her allergies but did restart a nasal spray and recommend that she continue her allergy injections . At the hearing, the claimant stated that her current complaints included joint pain, fibromyalgia, and chronic fatigue syndrome . She continued to work at Ridge on an as-needed basis . She kept oxygen in her car because she was sensitive to petroleum-based products and stated that anything affecting the quality of the air that she breathes affects her. She took issue with the reports from Drs. Collins and Garrett, stating that she did not have breathing difficulties in 1994 ; that she did not have systemic problems until 1998 ; and that there was no mold in her house as they described . The claimant acknowledged that she had received a settlement in a class action regarding the latex allergy . Her responses to a questionnaire during litigation listed complaints of asthma, allergies to pollens and grass, nausea, diarrhea, headache, weakness, tiredness, and heaviness in the chest . They indicated that she had smoked a pack of cigarettes per week until 1987 ; complained of hives due to eating certain foods in 1992-1994 ; and experienced difficulty breathing at the beginning of her shift at a hospice in August, 1994, due to dust or mold in the facility . Convinced that the claimant failed to prove a causal connection between her work for the defendant-employer and the conditions that she alleged, the AU explained that the case centered on Dr. Rea's testimony because no other physician related the cause of her conditions to her work. Although Dr . Rea testified that the claimant's workplace exposure to mold and various chemicals caused her to develop neurotoxicity and chemical sensitivity, the AU found him not to be credible . His reports consistently stated that the claimant's symptoms began in 1998 . Although he was aware that she worked concurrently in a hospital, nothing in his report indicated that he considered whether she was exposed to any chemicals there that led to her conditions. Yet, the history that the claimant prepared for Drs . Garrett and Collins acknowledged that she was exposed to printer ink and latex whenever she entered the hospital or went anywhere but the intensive care unit . Moreover, Dr . Rea seemed to think that her exposures were rampant while she worked for the defendant-employer . He also had a financial interest in establishing that the condition was work-related and, therefore, in providing treatment that was unavailable locally. Finally, the AU noted that in the questionnaire prepared for her civil suit, the claimant had related all of her symptoms to allergies resulting from her increased sensitivity after developing the latex allergy . As explained in 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 . 1979), the burden is on an injured worker to prove every element of a claim, including work-related causation . KRS 342 .285 designates the AU as the finder of fact . The court determined in Paramount Foods. Inc . v. Burkhardt , 695 S.W.2d 418 (Ky. 1985), that the finder of fact has the sole discretion to determine the quality, character, and substance of evidence . Special Fund v. Francis, 708 S.W .2d 641, 643 (Ky . 1986), explains that if the party with the burden of proof fails to convince the finder of fact, that party's burden on appeal is to show that the favorable evidence was so overwhelming as to compel a favorable finding . In other words, to show that no reasonable person would have reached the same conclusion as the finder of fact . Having reviewed the evidence and the arguments of the parties, we have concluded that the favorable evidence was not so overwhelming as to compel a finding that the claimant's work for the defendant-employer was a substantial cause of her condition . The decision of the Court of Appeals is affirmed . All concur . COUNSEL FOR APPELLANT : RUTH WALKER, PRO SE 100 HAYDEN DRIVE LAWRENCEBURG, KY 40342 COUNSEL FOR APPELLEE : CABINET FOR HEALTH SERVICES : KENNETH LANCE LUCAS SUTTON, HICKS, LUCAS, GRAYSON & BRADEN 130 DUDLEY ROAD SUITE 250 EDGEWOOD, KY 41017