Opinion ID: 2778155
Heading Depth: 2
Heading Rank: 1

Heading: … So, to answer your question, he had a

Text: myelogram of his neck February 16th of 2010. And this new myelogram, April 18th, 2011, to me, does not look that different. But it’s not the highest quality because of his size. It’s hard to get imaging on him, because he is 5-10 and 274 pounds, and he’s a very large upper trunk. So it’s very hard to get images on him. But I don’t see that it looks appreciably different April 18th to February 16th of 2010. .... Q. It does not appear that whatever happened to him in February when he slipped at work has caused his cervical condition? A. I would agree with that. I don’t think there’s any evidence of that. I agree with that. .... [Mr. Bailey] does have, based on his x-ray reports both on February of ’10 and April of ’11, large disk bone spurs at C5-6 and C6-7. And I’ll – I can read - although I interpret these myself, I can read the April CT myelogram. It states that he had a central disk osteophyte complex effacing the ventral thecal sac, contacting the ventral aspect of the spinal cord which is being flattened. The same thing at C6-7. Effaces the ventral thecal sac. So although there’s no stenosis, he has bony spurs pushed into his spinal cord at C5-6 and C6-7. And it would be in his best interest because of pain in his neck to have those bone spurs removed. Q. What causes the bony spurs, Doctor? A. I don’t have any idea, and I don’t think anyone can say definitively. It is theorized in some patients they are the residual of disk ruptures that have not resolved and they have gone on to calcification. Q. Something that happens over a relatively long period of time, then? A. Yes, sir. Recently long, relatively. Months to years, yes sir. [¶19] About Dr. Kopitnik’s testimony, the Medical Commission said, “[t]he most persuasive opinion in this matter is that put forth by Dr. Kopitnik, who actually requested preapproval from the Division of the cervical procedure, but indicated upon questioning that Mr. Bailey’s pre and post February 7, 2011 condition was not ‘appreciably different.’” The credibility of Dr. Kopitnik’s testimony was bolstered by Dr. Ritterbusch, 7 who said it was his opinion that the documentation failed to establish an acute injury or an aggravation or exacerbation to the cervical spine after the accident. [¶20] Mr. Bailey argues that the testimony by Dr. Kopitnik and Dr. Ritterbusch, along with the rest of the record, does not amount to substantial evidence enough to support the Medical Commission’s decision. Instead, Mr. Bailey relies entirely upon the testimony of Dr. Schubert and encourages this Court to do so as well. Mr. Bailey contends that through Dr. Schubert’s testimony he satisfied the burden of proof required to show that he materially aggravated his condition. Mr. Bailey’s argument is not consistent with our standard of review. As we stated earlier, in reviewing an agency’s determination that the burdened party failed to meet his burden of proof, we decide whether there is substantial evidence to support the agency’s decision to reject the evidence offered by the burdened party. In cases like this one, we consider whether the agency’s rejection of the claimant’s evidence was contrary to the overwhelming weight of the evidence in the record as a whole. Mr. Bailey only relies upon the portions of Dr. Schubert’s testimony that support his claim. In actuality, when asked the cause of Mr. Bailey’s need for surgery, Dr. Schubert stated, “[i]t would be conjecture on my part.” Importantly, Dr. Schubert also responded that it “would be conjecture” on his part when specifically asked if the February 7, 2011 workplace fall caused his need for surgery. Dr. Schubert testified as follows: I think it’s possible that Mr. Bailey had aggravation of a preexisting condition which became symptomatic once he had his fall. .... I think the fall is what is likely causing his current symptoms that surgery is a consideration for elective surgery to treat his symptoms which haven’t responded well to other therapies.” However, when Dr. Schubert was pressed about stating his opinion to a reasonable degree of medical probability, he stated for a third time: “… that would be conjecture on my part.” Dr. Schubert also testified that he based his opinion on Mr. Bailey’s assertions that he did not have any cervical spine symptoms before his workplace fall in 2011. However, the record clearly indicates that Mr. Bailey’s cervical spine problems began prior to the accident. [¶21] The Medical Commission summarized Dr. Schubert’s testimony as follows: Dr. Schubert indicated that the fall may have aggravated the preexisting condition in his cervical spine, but we find that Dr. Schubert was equivocal in his opinion, and confirmed that his opinion was based largely on the subjective reporting of 8 Mr. Bailey, and any opinion on that issue by Dr. Schubert would be speculative. The Medical Commission based its credibility determinations on the record and explained its reason as to why it accepted Dr. Kopitnik’s testimony and rejected Dr. Schubert’s testimony. If, in the course of its decision making process, the agency disregards certain evidence and explains its reasons for doing so based upon determinations of credibility or other factors contained in the record, its decision will be sustainable under the substantial evidence test. Along with Dr. Kopitnik’s testimony, the medical records and independent medical examination supported the Medical Commission’s decision to deny Mr. Bailey benefits for his cervical spine injury. [¶22] Under these circumstances, we cannot say that the Medical Commission was wrong to discount the medical opinions proffered by Dr. Schubert. The Medical Commission’s rejection of Mr. Bailey’s evidence and its determination that Mr. Bailey failed to meet his burden of proving his preexisting cervical spine injury was materially aggravated by his fall at work on February 7, 2011 was not contrary to the great weight of the evidence. Consequently, substantial evidence existed to support the Medical Commission’s decision.