Opinion ID: 3159718
Heading Depth: 1
Heading Rank: 1

Heading: facts

Text: In the fall of 1989, Sheila Woosley Kingery developed a repetitive-use injury during her employment with Sumitomo Electric Wiring. Kingery testified that her job there required her to reach overhead to hang coils of wire on pegs. She hung about three coils per minute. She testified that she had to strain to loop the coils around the pegs because of her height (she is four feet, eight inches tall). She had worked for Sumitomo for about one month when she developed pain in her neck and upper back. After she filed a workers' compensation claim, ALJ Dwight T. Lovan awarded benefits, including future medical benefits, for a cervical and thoracic spine strain or sprain superimposed upon pre-existing degenerative changes. ALJ Lovan further found that the occupational impact of Kingery's injury was minimal and that the effects of the injury did not prevent her from returning to her work activities with Sumitomo, with the possible exception of the one job she did hanging subassemblies as that activity had led to the work injury. Thereafter, Kingery returned to work for Sumitomo and was assigned to a seated position inspecting wire connectors. But, she testified, because this still involved moving back and forth a lot while her neck and back were messed up, she only did this for about two hours before she stopped working for Sumitomo altogether. She testified that she subsequently had one other job with another employer involving counting and packaging items into boxes, which she quit after only a few months because she couldn't do it either. She has not worked since. On February 15, 2012, Sumitomo filed this medical-fee dispute to contest the reasonableness and necessity of the treatment being provided by Kingery's treating physician, Dr. Todd Douglas, as well as the relatedness of that treatment to the 1989 work injury. Specifically, Sumitomo contested the compensability of Kingery's use of Lorcet, 1 Skelaxin,2 Xanax, 3 and Celexa, 4 whic Dr. ouglasw prescibngathetimeofilngofthismedicaldispute. But after this dispute was filed; Dr. Douglas stopped treating Kingery for the alleged effects of her work injury (while continuing to provide treatment for her other unrelated medical concerns). 5 The parties and the ALJ, however, agreed to proceed with resolving the dispute as filed as if the medications at issue were still being prescribed by Dr. Douglas. Sumitomo also agreed to assist Kingery in finding a new physician to take over her treatment. In support of its medical dispute, Sumitomo filed the evaluation report of Dr. David Randolph, 6 who evaluated Kingery at Sumitomo's request on Lorcet 10/650 is a combination medication containing the narcotic pain 1 reliever hydrocodone and the non-narcotic pain reliever acetaminophen. 2 Skelaxin is the trade name for the generic drug metaxalone and is used to treat muscle spasms. 3 Xanax is the trade name for the generic drug alprazolam, which is a benzodiazepine commonly used to treat anxiety and panic disorders. 4 Celexa is the trade name for the generic drug citalopram, which is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). 5 Indeed, in his final visit note regarding the treatment at issue, Dr. Douglas documented that he had recommended that [Kingery] consider getting another opinion from a specialist, as she may lose her Worker's Comp coverage soon, and that such a specialist `Imlay be able to help better with her pain. 6 Dr. Randolph is board-certified in occupational medicine. At the time of his deposition, he testified that he was also close to obtaining his PhD in epidemiology and biostatistics. 3 December 29, 2011. He also testified via deposition on August 27, 2012. Based on the history Kingery provided, his review of the available medical records, and his own physical examination of Kingery, Dr. Randolph concluded that her current subjective complaints of pain are unrelated to the mild sprain or strain injury caused by her work for Sumitomo in 1989 and that the drugs being prescribed are not reasonable and necessary to treat those complaints, whatever their cause. Aside from Dr. Randolph's report and deposition, the post-award medical evidence in this case is quite sparse. The record contains two treatment notes from Dr. Douglas, dated February 1 and February 29, 2012, which were her final two visits with him related to the work injury. Dr. Randolph also reviewed and summarized in his report more than 50 medical records documenting Kingery's treatment with Dr. Douglas from 1999 through 2011. According to those notes, Dr. Douglas's treatment had been directed, in relevant part, toward Kingery's complaints of pain—in her low, middle, and upper back, and neck—as well as stress, anxiety, and depression. This treatment exclusively involved prescribing various narcotics and other drugs. No objective abnormalities are noted. Kingery filed no medical evidence to rebut Dr. Randolph's opinions. Instead, she testified about her original work injury, work history, medical history, and current medical condition. As noted above, she testified that she has been unable to work over the past two decades due to her medical condition. She testified that pain in her neck and upper back has persisted and worsened since her 1989 work injury and that it now involves everything from 4 her low back, to her mid-back and ribs, and up to her neck. She confirmed that she has never had surgery for her complaints and that surgery has never been recommended. She testified that her low-back pain first began as a result of a fall in 2011, and she disputed the accuracy of Dr. Douglas's treatment notes prior to 2011 referencing low-back pain as her primary complaint. She testified that the drugs prescribed by Dr. Douglas would dull the pain, but that it never completely went away. Despite the absence of any medical evidence to the contrary, the ALT disregarded Dr. Randolph's opinions and instead relied solely on Kingery's lay testimony to find that her current complaints were related to the 1989 work injury and that the drugs being prescribed for those complaints were reasonable and necessary. Sumitomo filed a petition for reconsideration, arguing that it was inappropriate for the ALT to disregard the only expert medical evidence in the record—the report and testimony of Dr. Randolph—in favor of Kingery's lay testimony. The ALT overruled the petition, and the Board affirmed. Sumitomo appealed to the Court of Appeals, which reversed, holding that Kingery had failed to produce medical evidence to sustain her burden of proving that the treatment by Dr. Douglas was causally related to her 1989 work injury or a condition caused by it. More specifically, the Court of Appeals concluded that, under the circumstances, the medical cause of Kingery's complaints of pain would not be apparent to a lay person and, thus, that it was impermissible for the ALJ to disregard the medical evidence in favor of 5 Kingery's lay testimony to find that her current condition and complaints of pain .were medically caused by the 1989 work injury. Kingery now appeals that decision as a matter of right. Additional facts will be developed as necessary in the discussion below.