Opinion ID: 2307576
Heading Depth: 2
Heading Rank: 2

Heading: S1 Radiculopathy.

Text: Olson maintains that, while her Achilles tendinitis and S1 radiculopathy may have overlapped between September and December 1996, the S1 radiculopathy has existed independently from September 1996 to the present and has prevented her from returning to her former employment, either as an intensive care nurse or as a medical auditor. Because the agency narrowly framed the issue as whether Olson's 1996 bout of Achilles tendinitis was causally related to the 1993 work injury, the compensation order does not independently address Olson's claim that her current disability, the ongoing S1 radiculopathy, is causally related to the 1993 work injury. The agency failed to examine the nature and extent of petitioner's S1 radiculopathy, apparently based on the assumption that if the Achilles tendinitis is not work-related, the ongoing S1 radiculopathy also cannot be work-related. In short, the compensation order suggests that Olson's post-September 1996 S1 radiculopathy is attributable to the Achilles tendinitis rather than to the original work injury. However, because the agency failed to support this conclusion with the required findings of fact, we are unable to conduct a substantial evidence review. An agency is required to make basic findings of fact on all material issues. Brown, supra note 21, 700 A.2d at 792 (citing Dupont Circle Citizens Ass'n v. District of Columbia Zoning Comm'n, 426 A.2d 327, 334 (D.C.1981)). Otherwise, this court cannot determine whether the agency's findings are supported by substantial evidence and whether those findings lead rationally to its conclusions of law. Id. (citations omitted). While the agency discounted Olson's testimony that her present disability is related to the original work injury, [22] it made no findings of fact on several important issues, namely whether Olson suffers from S1 radiculopathy and, if so, whether and to what extent she is disabled due to this condition. In addition, the agency did not expressly decide whether, if Olson is disabled, her disability relates back to the 1993 work injury or whether the Achilles tendinitis was in fact an intervening cause. [23] Because the agency failed to treat the S1 radiculopathy as a separate issue in the case, the findings of fact on this material issue are insufficient. The intervenors contend that, because the agency found that Olson was not disabled from her job as a medical auditor as a result of the S1 radiculopathy, it was not required to reach the causation question. This argument is flawed. Even if Olson had returned to her job as a medical auditor after December 31, 1996, the date Dr. Ammerman determined she was no longer disabled from light-duty work, she still would have been entitled to permanent partial disability benefits if it was determined that her continued S1 radiculopathy related back to her work injury because the medical auditor job was part-time and paid less than her nursing job. Here, Georgetown discontinued payment of all worker's compensation benefits after September 16, 1996, the date Olson's Achilles tendinitis was diagnosed. The agency made an explicit finding that the Achilles tendinitis was not attributable to the original work injury after a review of pertinent evidence, but it bootstrapped a second conclusion onto the firstthat Olson's lingering S1 radiculopathy was also not attributable to the work injurywithout making any findings of fact on this issue. [24] As the compensation order inadequately explores whether petitioner's S1 radiculopathy is a disability and, if so, whether this medical condition is causally related to the 1993 work injury, we remand to the agency to make the required findings of fact. See D.C.Code § 1-1509(e) (1999) (every decision rendered by an agency in a contested case must state findings of fact consisting of a concise statement of the conclusions upon each contested issue of fact); George Hyman Constr. Co., supra, 498 A.2d at 566 (noting that a hearing examiner's order must `state findings of fact on each material, contested factual issue') (quoting Perkins v. District of Columbia Dep't of Employment Servs., 482 A.2d 401, 402 (D.C.1984)). In addition, the agency must not only make adequate findings of fact on whether Olson is disabled by S1 radiculopathy, but must also indicate whether the S1 radiculopathy is related to the work injury and what, if any, evidence supports this conclusion. As noted by Olson, a Workers' Compensation claimant is entitled to a presumption that the claim comes within the provisions of the Act. D.C.Code § 36-321(1). [25] To benefit from this presumption, a petitioner must provide some evidence of 1) a disability and 2) a work-related event which could have resulted in or contributed to the disability. See Whittaker, supra, 668 A.2d at 845. Petitioner provided ample evidence to support the presumption through the opinions of Drs. Spiegel and Michaels. Since December 19, 1996, Dr. Spiegel has issued disability slips reflection Olson's continued problems with S1 radiculopathy. Additionally, Dr. Michaels stated that within a reasonable degree of medical certainty, Olson's continuing disability was work related. Although the agency recognized the presumption of compensability in the compensation order, it never explicitly applied this presumption to Olson's S1 radiculopathy claim. [26] On remand, the agency should give Olson the benefit of the presumption of compensability for her S1 radiculopathy claim and conduct a more focused inquiry as to whether Georgetown offered evidence specific and comprehensive enough to rebut the presumption. [27] Whittaker, supra, 668 A.2d at 845 (`Absent employer evidence specific and comprehensive enough to sever the potential connection between a particular injury and a job-related event, the compensation claim will be deemed to fall within the purview of the statute.') (quoting Parodi, supra, 560 A.2d at 526) (internal quotation & citation omitted). In the compensation order, the examiner discredits Olson's testimony regarding the causal relationship of her present disability to the original work injury... because he finds that Olson failed to fully inform Dr. Spiegel or Dr. Ammerman [28] of her past medical history and concealed this past history in her preheating deposition. [29] See Teal, supra, 580 A.2d at 651 n. 7 (explaining that [c]redibility determinations of a hearing examiner are accorded special deference by this court); George Hyman Constr. Co., supra, 498 A.2d at 566 (hearing examiner's decisions especially weighty when they involve credibility determinations). The agency also dismisses the opinion of Dr. Spiegel, the main treating physician, because it finds that Dr. Spiegel did not have Olson's complete medical history, namely information regarding her intermittent back and leg problems prior to the June 1993 injury. Although the opinion of a treating physician is ordinarily entitled to significant weight, see Stewart v. District of Columbia Dep't of Employment Servs., 606 A.2d 1350, 1353 (D.C.1992), a hearing examiner may discount a treating physician's opinion if the examiner sets forth specific and legitimate reasons for doing so. See Canlas, supra note 20, 723 A.2d at 1211-12. In this case, the agency offered a specific reason for discounting Dr. Spiegel's opinion which is supported by the record. After discounting Olson's testimony and Dr. Spiegel's opinion, the agency relied on Dr. Ammerman's opinion that Olson's Achilles tendinitis is not related to the June 1993 accident, but this statement does not go to the question of whether Olson's ongoing S1 radiculopathy is attributable to her work injury. [30] The examiner also referred to Dr. Rosenberg's treatment notes detailing Olson's prior history of back and leg problems; however, [t]he presumption of compensability cannot be overcome merely by some isolated evidence. Whittaker, supra, 668 A.2d at 847 (internal quotation and citation omitted). Moreover, the agency failed to consider Dr. Rosenberg's opinion that, despite this prior history, the S1 radiculopathy is work related. Although Dr. Rosenberg's opinion would be moot should the agency find that the 1996 Achilles tendinitis severed any connection between the June 1993 injury and the current S1 radiculopathy, [31] Dr. Michaels' opinion would not. [32] The agency makes no mention of Dr. Michaels' opinion that within a reasonable degree of medical certainty[,] Olson's S1 radiculopathy symptoms are directly related to her work accident on 6-14-93. This opinion, from one of Olson's treating physicians, see Stewart, supra, 606 A.2d at 1353 (treating physician's opinion entitled to significant weight), was rendered with full knowledge of Olson's complete medical history. Based on this record, we remand to the agency with specific instructions to consider the evidence as a whole, including the opinions of Drs. Rosenberg and Michaels regarding the connection between Olson's 1993 work injury and her ongoing S1 radiculopathy. [33] For the foregoing reasons, the agency's denial of Olson's benefits claim stemming from the 1996 Achilles tendinitis is affirmed, but we remand the case to the agency for further findings of fact regarding the S1 radiculopathy claim. So ordered.