Opinion ID: 1368115
Heading Depth: 1
Heading Rank: 3

Heading: Summary of medical reports

Text: The parties filed the reports of four physicians with the board. [1] These reports stated that petitioner incurred an injury to his back on June 26, 1967, but disagreed as to whether he injured the lumbar (lower) back or reinjured the thoracic (upper) spine. [2] Only two reports indicated that petitioner's condition was sufficiently stable to be ratable. Dr. Lattin apportioned petitioner's disability at least 75 per cent due to the pre-existing thoracic disc disease; but Dr. Bolles, the neurosurgeon who performed the operation in June 1968, implied that the aggravation caused by petitioner's fall was primarily responsible for his disability. The referee then wrote the parties, stating that in view of the conflicting medical reports he would normally appoint an independent medical examiner, but was unable to do so because petitioner was living in Colorado. The parties then arranged for Dr. Freed of Denver to serve as an independent medical examiner. Although all of the previous medical reports agreed that petitioner's fall of June 26, 1967, had in part caused the injury to his back, and although the only pending question had been one of apportionment between that injury and the earlier difficulties of 1963, Dr. Freed stated that petitioner's fall worked no injury to the back whatsoever. His report, dated January 20, 1969, concludes that It would seem to me that, if the ruptured thoracic disc for which the patient underwent surgery was caused or aggravated by the injury of June 26, 1967, the patient would have sought medical attention before August 18, 1967. In other words, I would think that he should have had some symptoms immediately at the onset which would have led him to seek medical attention. Ruptured thoracic discs are a very rare entity, and here is a man who had apparently had two operations for ruptured thoracic disc. I believe the possibility of some other neurological disease must be seriously entertained; in view of this man's history, I think multiple sclerosis or some demyelinizing disease of the nervous system has to be considered. The block apparently apparent in his myelography at the V.A. Hospital in Denver could, of course, be secondary to adhesions from his first operation. After receiving Dr. Freed's report, the referee found that petitioner's injury resulted in no ratable permanent disability. Petitioner petitioned for reconsideration, submitting a report of Dr. Black, chief surgeon at the Grand Junction Veteran's Administration Hospital. Dr. Black's report asserted that the diagnosis that petitioner's problems stemmed from thoracic disc injury had been substantiated beyond reasonable doubt, that after three years of employment applicant fell and injured his back and thereafter sustained progressive symptoms, and concludes that it would seem reasonable to assume a sequential relationship of the symptoms to the injury. Noting Dr. Freed's argument that petitioner should have sought medical treatment earlier, Dr. Black asserted, erroneously, that petitioner had received physical therapy during the period June-August 1967. Turning to Dr. Freed's suggestion that petitioner suffered from a coincidental disease of the nervous system, Dr. Black noted that neither he nor any of the other physicians who examined petitioner could establish such a diagnosis. Dr. Black concluded that, following the operation, petitioner's original condition had attained a static status which in my opinion was altered as a consequence of the fall to such a point that further surgery was required, and there is a resulting permanent partial disability which approaches total disability.