Title: KELLY & WILMORE, INC ., AS INSURED BY UNDERWRITERS SAFETY & CLAIMS V. PAUL PAYNE ; KELLY & WILMORE, INC ., AS INSURED BY CNA ; HON . DONALD SMITH, ADMINISTRATIVE LAW JUDGE ; AND WORKERS' COMPENSATION BOARD
Citation: N/A
Docket Number: 2002-SC-000396-WC
State: Kentucky
Issuer: Kentucky Supreme Court
Date: March 18, 2003

IMPORTANTNOTICE NOT7'Q BE PUBLISHED OPINION THIS OPINIONIS DESIGNATED "NOT TO BE PUBLISHED." PURSUANT TO THERULES OF CIVIL PROCEDUREPROMULGATED BY THE SUPREME COURT, CR 76.28 (4) (c), THIS OPINION IS NOT TO BE PUBLISHEDAND SHALL NOTBE CITED OR USEDASAUTHORITYINANYOTHER CASE INANYCOURTOF THIS STATE. KELLY & WILMORE, INC ., AS INSURED BY UNDERWRITERS SAFETY & CLAIMS AFFIRMING RENDERED : FEBRUAR NOT TO BE P APPEAL FROM COURT OF APPEALS V . 2001-CA-0171-WC WORKERS' COMPENSATION BOARD NO . 99-0528 MEMORANDUM OPINION OF THE COURT APPELLANT PAUL PAYNE ; KELLY & WILMORE, INC ., AS INSURED BY CNA ; HON . DONALD SMITH, ADMINISTRATIVE LAW JUDGE ; AND WORKERS' COMPENSATION BOARD APPELLEES The claimant's application alleged a work-related neck, shoulder, and left arm injury of April 21, 1997 . At the time, his employer was insured by Underwriters Safety and Claims (Underwriters) . He later amended the claim to allege a second work-related injury to the same areas of his body on September 21, 1998, at which time the employer was insured by CNA . Among other things, an Administrative Law Judge (ALJ) determined that the claimant sustained a work-related injury in 1997, that the subsequent incident was actually an exacerbation of the 1997 injury, and that Underwriters was liable for all income and medical benefits . Appealing decisions that affirmed those aspects of the award, Underwriters asserts that at least part of the claimant's condition was due to the 1998 injury and that CNA was responsible for medical benefits after the 1998 injury . We affirm . The claimant testified that on April 21, 1997, he was digging trenches and laying cable and that he experienced a "loud pop" in his neck and immediate sharp pain in both shoulders when the cable that he was pulling became stuck on the reel and jerked him forward . He reported the incident to his supervisor and saw Dr . Wahl the following day . He testified that although both shoulders were affected, at the time it was the left one that was really causing a problem in his neck . Medical treatment was conservative, and he missed no work at the time . The claimant's testimony concerning a second injury was unclear, and there was a controversy concerning when and how the alleged injury occurred . When deposed in November, 1999, he testified that a second injury occurred in July, 1998, at an RT site in Henderson, when he threw a trash bag full of paper, metal, and wood into the back of a pick-up truck . He indicated that he experienced a sharp pain in his neck . When asked whether the incident had aggravated his condition, he responded in the affirmative . He also indicated that discomfort after the 1998 incident prevented him from turning his head as much as before . At the May, 2000, hearing, the claimant testified that he did not know the date of the second injury for certain . He thought that it occurred on September 4, 1998, around Labor Day . He maintained that he completed an accident report that night and gave it to his supervisor . The supervisor testified, however, that the incident was not reported to him until November 18, 1998 . Likewise, the payroll benefits coordinator testified that the claimant was not scheduled to work on September 5, 1998, which was a Saturday, and that he failed to give notice of a September, 1998, neck injury until November 18, 1998 . The individual who was responsible for completing accident reports testified that at no time in September, 1998, did she complete an accident report regarding the second alleged neck injury . Furthermore, an individual who worked with the claimant at a Henderson RT site in September, 1998, and who was listed as a witness on the injury report testified that he did not remember the claimant ever saying that he was hurt on that job . On November 20, 1998, Dr . Cannon performed surgery on the claimant's cervical spine . He remained off work for about 6 weeks following surgery and then returned to his regular duties until July 7, 1999, when he was jerked by a trencher and hurt his back . He was off work until sometime in October, 1999, and was restricted to light duty by his physician from that time until he was laid off in December, 1999 . At the hearing, he testified that he had worked for one day for a trucking company, helping to deliver parcels, but was uncertain whether he would be hired for more than that day . Dr. Wahl first saw the claimant on April 22, 1997, at which time he reported the previous day's injury . His complaints involved the left upper back, near the shoulder, and Dr . Wahl diagnosed tendonitis and muscle strain . On the next visit, Dr . Wahl changed the diagnosis to musculoskeletal strain . Left shoulder x-rays were negative, but cervical spine x-rays revealed a loss of normal cervical lordosis with mild reversal and degenerative changes at C5-6 . Eventually, Dr . Wahl referred the claimant to Dr . Shah, a neurologist, due to ongoing symptoms that included tingling in the left arm . Dr. Wahl's records indicated that on July 6, 1998, the claimant sought treatment for right shoulder pain, which he indicated had awakened him that morning. He indicated that it hurt around the right scapula and also hurt to take a deep breath or to cough . Dr . Wahl diagnosed a muscle spasm for which he prescribed Lortab . On September 5, 1998, the claimant left a recorded message that was noted as, "hurt shoulder again" and requested medication for pain . A September 10, 1998, entry refers to a prescription for Lortab . On September 21, 1998, the claimant saw Dr . Wahl's assistant, Gary Mayfield, and reported that he had injured himself 3-4 weeks earlier, while picking up a trash bag at home . His complaints involved his neck and upper back, and there was muscle spasm in those areas . On October 7, 1998, the claimant saw Dr . Wahl for discomfort in the right shoulder that he attributed to an injury that occurred about 6 weeks earlier . Dr . Wahl referred him to Dr . Shah, who performed an MRI on October 22, 1998 . It revealed a herniated disc at C6-7 that extended into the neural foramina . There was evidence of bilateral neural foraminal stenosis at C5-6 and C6-7, greater on the right than on the left, and spondylitic changes at C4-5, C5-6, and C6-7 . Thus, Dr . Shah referred the claimant to Dr . Cannon, a neurosurgeon . Dr . Cannon saw the claimant on November 18, 1998, concerning complaints of pain in his neck, right shoulder, and arm and of right arm weakness . He received a history of the 1997 injury ; of intermittent neck, right shoulder, and arm pain and right arm weakness since being injured on April 21, 1997 ; and of markedly worse right arm pain since lifting trash some 8-10 weeks before the examination, around Labor Day. In addition to the large disc herniation at C6-7 that was found on MRI, physical examination revealed muscle weakness consistent with C7 radiculopathy . Dr . Cannon performed a discectomy on November 20, 1998, at which time he discovered that what had appeared to be a disc herniation was actually a neurofibroma, which is a benign neural tumor . In his opinion, the tumor was not caused by work, but it became symptomatic as a result of the April 21,1997, injury . On December 2, 1998, the claimant exhibited some wasting of the right pectoralis but was anxious to return to work . He had done so as of a January 14, 1999, check-up but complained of muscle spasms in the right triceps and exhibited pectoral weakness . Thereafter, he regularly complained of neck and shoulder discomfort . When deposed, Dr . Cannon stated that as of October, 1999, the claimant's actual impairment under the range of motion model was 20% and attributed it entirely to the effects of the 1997 injury . He stated that under the DRE model, the claimant's impairment rating was 15% . When cross-examining Dr . Cannon, counsel for Underwriters stated, erroneously, that the claimant had complained to Dr . Wahl of only left-sided problems until September, 1998, at which point he began to raise right-sided complaints that he indicated were a result of lifting trash . Although counsel for the claimant objected on the ground that the question was not based upon the evidence in the record, defense counsel then asked Dr . Cannon whether he would then agree that the right-sided problem became symptomatic after the 1998 injury . Dr. Cannon replied in the affirmative . Counsel then questioned whether, if he treated an individual who complained of only left-sided problems for a year and a half, had a September, 1998, injury, and then began to complain of right-sided problems, the treatment for those problems would result from the September, 1998, injury . Again, Dr . Cannon replied in the affirmative, indicating that his response was based upon the history . It was after Dr. Cannon's deposition that the claimant moved to amend his claim to include a September, 1998 injury and was permitted to do so. Dr . Goldman, an orthopedic surgeon, performed an IME on January 10, 2000 . He assigned a 15% impairment under the DRE model, apportioning 50% to pre-existing degenerative joint and disc disease . In his opinion, the 1997 injury was likely a cervical strain that had no impact on the need for surgery, and the claimant's entire impairment resulted from lifting a bag of trash at home in August or September, 1998 . Further- more, Dr . Goldman indicated that if the mass that Dr. Cannon removed from the claimant's neck was a tumor, then neither injury was the cause of his neck and shoulder condition. With respect to the matters that are presently at issue, the ALJ determined that the claimant was credible regarding the 1997 injury and noted that Dr. Cannon believed that "the [claimant's] present condition was related to the 1997 injury ." Furthermore, although determining that the claimant gave timely notice of the 1998 injury and noting that there was some question concerning whether the incident occurred at home or at work, the ALJ determined that "the 1998 injury was a mere exacerbation of the 1997 injury ." Based upon these findings, a finding that the claimant's neck and shoulder problems were related to the 1997 injury, and a finding that the claimant's impairment was 15%, the ALJ awarded income benefits and determined that medical treatment for the neck and shoulder conditions was compensable . Thus, Underwriters was liable for the entire award . Appealing, Underwriters maintains that the claimant first mentioned problems with his right shoulder on September 21, 1998, when he complained of pain that began after he lifted a bag of trash at home about 3-4 weeks earlier . It points out that the ALJ chose to rely upon Dr . Cannon . Referring to Dr . Cannon's testimony on cross- examination, Underwriters asserts that he attributed the claimant's right-sided problems to the September, 1998, injury . Emphasizing that a finding of causation requires medical testimony, Underwriters maintains that the medical evidence compelled a finding that the claimant's present complaints were due to the 1998 incident rather than to an aggravation of the 1997 injury as the ALJ concluded . Furthermore, it maintains that because the 1998 injury was the cause of the right-sided problems, CNA should have been held liable for medical benefits . Derr Construction Co . v . Bennett , Ky ., 873 S.W .2d 824 (1994) . This entire argument is based upon an erroneous premise because Dr . Wahl's records from July 6, 1998, clearly indicate that the claimant sought treatment for severe pain in his right shoulder at that time and was prescribed Lortab . Nowhere in its argument does Underwriters acknowledge this entry . Instead, it focuses on the September 21, 1998, complaints of right shoulder pain that the records relate to an incident that involved lifting trash while at home . Underwriters maintains that the ALJ's conclusion that the 1998 injury was a mere exacerbation of the 1997 injury was inconsistent with the "finding" that Dr. Cannon attributed the claimant's right-sided problems to the 1998 injury . We note, however, that the "finding" to which Underwriters refers was merely part of the summary of Dr . Cannon's testimony . Furthermore, it was elicited by Underwiters' counsel on cross- examination, after giving Dr . Cannon an erroneous history that the claimant's right-sided complaints first occurred in September, 1998, and Dr . Cannon clearly stated that the opinion was based upon that history. His testimony on direct examination was that the mass upon which he operated became symptomatic as a result of the April 21,1997, injury and that the claimant's entire impairment was due to the effects of that injury . There is no indication that the history on which that opinion was based was inaccurate . Although the ALJ summarized all of Dr . Cannon's testimony, including the opinion on which Underwriters relies, the ALJ also summarized Dr. Wahl's records and noted that the claimant began having right shoulder pain in July, 1998 . It is apparent, therefore, that the ALJ found Dr . Cannon's direct testimony to be most persuasive and reached a conclusion that was consistent with that testimony and with the claimant's actual history as found in Dr . Wahl's records . Thus, despite Underwriters' assertions to the contrary, there was substantial medical evidence to support the conclusion that the 1997 injury was the actual cause of the claimant's problems and that any incident that occurred in 1998 was not significant . See Calloway County Fiscal Court v . Winchester, Ky.App., 557 S .W.2d 216 (1977) ; see also , Arthur Larson and Lex K . Larson, Larson's Workers' Compensation Law (2000 ed .), §§ 10.01-.03 . Under those circumstances, where there was no subsequent injury of appreciable proportion, Derr Construction Co. v . Bennett , supra , did not apply, and Underwriters was responsible for any income and medical benefits . The decision of the Court of Appeals is affirmed . All concur. COUNSEL FOR APPELLANT : John C . Morton Samuel J . Bach MORTON & BACH 126 N . Main Street P.O . Box 883 Henderson, KY 42419-0883 COUNSEL FOR APPELLEE, PAUL PAYNE : Charles S . Wible CHARLES S . WIBLE LAW OFFICE, PSC 324 St . Ann Street P.O . Box 337 Owensboro, KY 42302-0337 COUNSEL FOR APPELLEE, KELLY & WILMORE, INC., AS INSURED BY CNA : John S . Harrison SHEFFER & SHEFFER 1600 National City Tower 101 S, Fifth Street Louisville, KY 40202