Opinion ID: 1309099
Heading Depth: 1
Heading Rank: 2

Heading: CLAIM OF JANET SUE McCALLISTER

Text: The claimant Janet Sue McCallister suffered a low back sprain on October 13, 1977, in the course of and as a result of her employment with Southern Appalachian Coal Company. The Workmen's Compensation Commissioner concluded that the injury was compensable on a temporary total basis and ordered that the claimant be paid temporary total disability benefits. The claimant was treated by Dr. D.S. Raja, who, in a report dated July 27, 1979, released her to return to work. That report apparently was not received by the commissioner until September 4, 1979. After learning of Dr. Raja's report, the employer wrote the commissioner and requested that the claimant's temporary total disability benefits be terminated under Mitchell. Upon receiving the employer's letter, the commissioner on November 8, 1979, sent the claimant a Notice of Termination indicating that the commissioner was considering terminating her temporary total disability benefits because Dr. Raja had released her to return to work. The notice informed the claimant that she had thirty days from receipt of the notice or until the termination date to provide medical or other evidence, in writing, to show just cause why her claim on a temporary total disability basis should not be closed. [4] Following receipt of the commissioner's order-notice, the claimant transmitted a report from Dr. Raja dated December 10, 1979, which stated: This is to certify that Mrs. Janet McCallister is under my care and is being treated for ruptured disc with right side sciatica. She will be disabled for an approximate period of 8 weeks. After receiving Dr. Raja's December 10, 1979, report, the commissioner concluded that it was insufficient to justify the continued payment of temporary total disability benefits, and by order dated December 13, 1979, terminated such benefits. The claimant protested, and a hearing was scheduled. At the hearing conducted on April 17, 1980, the claimant testified that in July 1979 Dr. Raja had released her to return to work on a trial basis and that after the trial release she remained under his care. When she approached the employer about resuming work, the employer sent her to a clinic for a physical examination. She testified that the doctor at the clinic concluded that because of her back she was in no condition to return to work, and consequently the employer refused to take her back. At a further hearing conducted on August 19, 1980, Dr. Raja, the claimant's treating physician, testified that although the claimant had a minor backache on July 27, 1979, she demonstrated considerable improvement over her prior condition, and since she expressed a desire to return to work, he released her to return. When he examined her on December 10, 1979, she had a recurrence of severe low back pain radiating to the back of the right hip and thigh and knee. This was consistent with the physical findings. At that time, Dr. Raja concluded that the claimant was definitely unable to work because of a recurrence of her symptoms. Dr. Raja also stated that at his May 5, 1980, examination of the claimant, she had been experiencing severe low backache and she had marked objective restrictions in her range of movements and tenderness at the right side of the lumbo-sacrioliac. On June 30, 1980, Dr. Raja noted that the claimant had persistent low backache and that physical findings relating to condition were unchanged from his previous examination. On July 7, 1980, she again was suffering from low backache. Finally, on August 5, 1980, Dr. Raja concluded that the claimant was unlikely to improve further, that in effect, she had reached maximum improvement. After Dr. Raja testified on August 19, 1980, the claimant's attorney wrote the commissioner on October 23, 1980, and petitioned that the claim be reopened on a temporary total disability basis. In support of his petition, he referred to the testimony of Dr. Raja at the hearing. Under the foregoing facts, we believe the commissioner erred in terminating the claimant's temporary total disability benefits. The claimant had supplied an additional report from the treating physician, Dr. Raja, prior to the date set for termination of the temporary total disability benefits, which showed that she was still temporarily disabled. This was in accordance with the procedures which we outlined in Mitchell and have discussed earlier in the Honaker case. We also note that the claimant's position that she had not actually reached maximum improvement was amply borne out at the subsequent hearings, and we believe that her temporary total disability condition existed until August 5, 1980. Under the status of the evidence, both the commissioner and Appeal Board were clearly wrong in holding that claimant's temporary total disability benefits were properly terminated. Our view is that she was entitled to such benefits through August 5, 1980. As a further procedural matter, we conclude that it was not necessary for the claimant's attorney to petition to reopen the claim at the conclusion of the hearings. He had already protested the commissioner's order of December 13, 1979, which terminated the temporary total disability benefits. We also observe that while we had no occasion in Mitchell to speak to all of the administrative procedures that the commissioner might adopt, we believe that once the claimant supplies additional medical evidence in support of continued temporary total disability, if the commissioner rejects such evidence, such rejection should be done by an order. By such an order the commissioner will enable the claimant to protest the decision to terminate the temporary total disability benefits and thereby afford the claimant a right to an evidentiary hearing. This was the procedure followed in the McCallister claim. For the reasons stated, the decision of the Workmen's Compensation Appeal Board in the Honaker case is affirmed, and the decision in the McCallister case is reversed with directions that the claimant in that case be awarded temporary total disability benefits through August 5, 1980. Case No. 15615Affirmed. Case No. 15587Reversed and Remanded with Directions.