Opinion ID: 2070871
Heading Depth: 1
Heading Rank: 1

Heading: basis of claim

Text: OMP employed Mendoza as a meatcutter, which involved cutting pieces of meat weighing 60 ... up to 80 pounds. While a carcass is being moved on a conveyor belt, a cutter pulls and sometimes lifts the conveyed meat, which is then cut and trimmed of fat. Occasionally, when a carcass was too heavy for the conveyor system, a meatcutter, with the aid of a meathook, would pull the meat to get the belt going again. On November 7, 1983, Mendoza, trimming meat, was beside the conveyor when he reached for a piece of meat and the meat ... hook ripped off the meat, causing Mendoza to fall backward against a wall. Mendoza immediately experienced a sharp pain in his back, but continued working that day. Tower was the insurance carrier for OMP's workers' compensation coverage on November 7. On November 11, 1983, Mendoza went to his family physician, Dr. Donald Gammel, and complained about sharp back pain, radiating into his legs. Dr. Gammel prescribed medication and physical therapy for Mendoza and ordered Mendoza not to return to work. When Mendoza's back pain persisted, Dr. Gammel, on November 28, reexamined Mendoza and found a tenderness to palpation over both paralumbar musculature and [p]oint tenderness over the third lumbar spinous process and the right sciatic notch. Based on examination and x rays of Mendoza, Dr. Gammel diagnosed Mendoza's condition as an [a]cute lumbar strain and admitted Mendoza to the hospital later on November 28. While in the hospital, Mendoza was examined by Dr. R.C. Pitner, an orthopedic surgeon, to whom Mendoza had been referred by Dr. Gammel. Dr. Pitner found that Mendoza experienced some pain with flexion and dorsiflexion of the lumbosacral spine [and] tenderness to palpation over L4-5 and over L5-S1 and diagnosed Mendoza's injury as a back strain. On December 3, Mendoza was discharged from the hospital and returned to work on December 19, but again experienced sharp pains, down the sides of his legs. During an examination on January 4, 1984, Dr. Pitner found that Mendoza ha[d] pain with dorsiflexion and some with flexion, as well as discomfort with lateral bending, particularly to the right and [tlenderness over L3-4, L4-5, and L5-S1. Dr. Pinter concluded that Mendoza should not return to work, and prescribed a chair-back brace for Mendoza, as well as an exercise program, including daily physical therapy and ultrasound treatment. Dr. Pitner again saw Mendoza on January 19, 1984, when Mendoza indicated that his back pain was not as severe as it had been, but there was still some tenderness in his low back. Dr. Pitner authorized Mendoza's return to work on January 30. After he had gone back to work, Mendoza returned to Dr. Pitner on April 12 and complained of numbness and soreness in the low back and in his legs. Dr. Pitner suggested that Mendoza find a lighter type of job which did not require lifting heavy objects. When Mendoza's leg pain and soreness in his low back persisted, Dr. Pitner directed that Mendoza permanently refrain from heavy lifting and ordered a CAT Scan to ascertain whether Mendoza had a herniated disk. The CAT scan on May 2 disclosed a protrusion and mild diffuse posterior bulge regarding Mendoza's lumbar vertebrae. Dr. Pitner informed Mendoza about the prospects of a myelogram and possible chemical dissolution of the problem disk. However, Mendoza, who had been absent from work since May 8 for medical reasons but without further treatment from Dr. Pitner, returned to his OMP job on May 29 and, because there was no light duty work, resumed heavy lifting involving carcasses on the conveyor. In the fall of 1984, when Mendoza was reexamined on account of his continuing back pain, Dr. Pitner viewed Mendoza's x rays and recommended surgical intervention with diskectomy. When Mendoza's back problem persisted, in February of 1985 Dr. Pitner referred Mendoza to Dr. Patrick Bowman, another orthopedic surgeon, for a second opinion regarding back surgery for Mendoza. Dr. Bowman, on the basis of Mendoza's history, a copy of a report on the CAT scan (May 2, 1984), and his examination of Mendoza, reached a diagnostic impression on February 25, 1985; namely, Mendoza suffered from a [l]umbar disc syndrome. Dr. Bowman did not recommend surgery on Mendoza, and Mendoza continued working for OMP. In June 1985, Mendoza filed a petition in the Nebraska Workers' Compensation Court, alleging that he had suffered a herniated disk which had resulted from the accident of November 7, 1983. On August 1, 1985, Mendoza was involved in a second accident at OMP and sustained bodily injury when he attempted to replace a carcass on the conveyor, twisted his back, and experienced intensified back pain and a previously unexperienced burning sensation in his legs. Mendoza, on August 8, returned to Dr. Bowman for another examination regarding the back problem. During that examination, Mendoza did not mention anything concerning the August 1 accident but complained about increased pain in his back and right leg. Dr. Bowman prescribed medication for Mendoza and authorized Mendoza's return to light duty work, subject to reexamination on August 19. Because no light duty work was available at OMP, Mendoza did not return to employment with OMP, and reappeared for examination by Dr. Bowman on August 19. A CAT scan on August 23 disclosed Mendoza's mild herniation of the central portion of the disc at L4-5, but, when Mendoza indicated that his condition had improved, Dr. Bowman authorized Mendoza's return to work, effective September 16, on a trial basis. However, Mendoza did not return to work, and was reexamined by Dr. Bowman on September 23. In the September 23 examination, Mendoza told Dr. Bowman about the back pain's getting worse after Mendoza had moved furniture into his family's new residence shortly before the return to work authorized for September 16. After the examination on September 23, Dr. Bowman, considering the physical rigors of employment at OMP, instructed Mendoza that he should not return to work. Dr. Bowman last examined Mendoza on February 25, 1986, when Mendoza stated he was still experiencing pain in his right leg and low back and also informed Dr. Bowman that he had recently driven to Mexico, an automobile trip which had caused major symptoms for him. Based on his various examinations of Mendoza, including the examination of February 25, 1986, and the CAT scans, Dr. Bowman concluded that Mendoza's basic problem was a herniated disk and disease process caused by the basic insult (accident) which had occurred in November 1983. On August 1, 1985, which was the date of Mendoza's second industrial accident, Wausau Insurance Companies (Wausau) provided workers' compensation coverage for OMP, and was permitted to intervene in the proceedings before the Nebraska Workers' Compensation Court. Wausau claimed that Tower was liable for compensation and benefits payable to Mendoza because Mendoza's accident in November 1983 was the direct and proximate cause of the alleged August 1, 1985 injury. On August 30, 1985, Mendoza filed an amended petition, alleging that, as a result of the accidents in 1983 and 1985, he had sustained a herniated disc and aggravation of a herniated disc.