Opinion ID: 2824994
Heading Depth: 2
Heading Rank: 1

Heading: I snap, I crack, I pop, I get stuck, I go

Text: through it all. Q. When you say you get stuck, what do you mean? What happens when you get stuck? A. If I sit too long, I mean, I can’t - - if I stand up, I can’t walk. I have to stand for a while [sic] and then like try to walk it off. But my [leg] is just - - it gives out on me. I go through everything with my legs. ... Q. What types of trouble do you have with stairs? A. I try not to go up them. I go up - - I have two flights of steps. I go up, I stay up; not unless I have a reason to come back down. I try to stay away from steps. Q. Okay. Why do you try to stay away from 6 steps? A. Because I hurt. Gentle Touch Senior Care submitted as exhibits, inter alia, medical records from Howard University Hospital and the 2012 DOES Compensation Order; these exhibits were related to the 2011 right knee sprain that Bowles suffered while employed at WNF. Gentle Touch Senior Care attempted to show that Bowles’s PPD was a result of the intervening knee sprain, so that it would not be responsible for paying Bowles additional disability compensation. The ALJ first found that Bowles’s PPD was causally related to the 2008 work incident that occurred while she was employed by Gentle Touch Senior Care. The 2012 DOES Compensation Order referenced Dr. Slater’s report that Bowles “had not suffered any additional significant [right knee] injury as a result of the June 7, 2011 fall,” and thus weighed against Gentle Touch Senior Care’s argument that Bowles’s 2011 injury severed the causal connection between her 2008 injury and her resulting PPD. The ALJ concluded that Gentle Touch Senior Care’s evidence was not “specific or comprehensive enough to sever the existing causal connection between claimant’s alleged PPD and the 2008 injury.” Next, the ALJ determined that Bowles suffered only a 10% PPD to her right 7 leg, despite her claim of 42% PPD. The ALJ consulted the AMA Guides to discredit Dr. Phillips’s 42% disability rating because a “[r]eview of Table 17.5 reveals that the Guides suggest a maximum of 7% for mild antalgic gait.” The ALJ also mentioned that “Dr. Meyer found only a very mild effusion and a mildly right antalgic gait” and “Dr. Phillips 42% impairment rating is also inconstant with [Bowles’s] testimony.” In addition, the ALJ did “find it reasonable that [Bowles] still has pain in her knee while climbing or descending stairs and cannot question Dr. Phillips’ minor atrophy finding.” Ultimately, the ALJ explained its 10% PPD calculation as follows: In sum, it is concluded that based on a complex of factors, taking into account the amount of physical impairment caused by the surgical procedure and zero potential for future wage loss, claimant has sustained some permanent partial impairment of the right leg based on her pain and atrophy and is entitled to a 10% permanent partial disability rating to the right leg. 2014 CRB Decision and Order. Bowles petitioned the CRB for review of the ALJ’s Compensation Order on the grounds that, inter alia, the ALJ erroneously relied on facts not within the record to discredit Dr. Phillips’s medical report. The CRB agreed that the ALJ erred when it “reached a medical opinion by taking official notice of the AMA Guides without affording the parties an opportunity to 8 rebut any fact officially noticed in the documents.” However, the CRB ultimately affirmed the ALJ Compensation Order—“Because the ALJ relied on sufficient evidence in the record to discount Dr. Phillips’ impairment rating, the error in going beyond the record to do so is harmless.” Bowles petitioned this court for review of the 2014 CRB Decision and Order.