Opinion ID: 2350712
Heading Depth: 4
Heading Rank: 3

Heading: 2002 to 2005: Application for disability benefits

Text: On January 31, 2002, the Director of the Division of Retirement and Benefits sent Shea a letter deferring her application for nonoccupational disability benefits because the Division's retained expert, Dr. William Cole, opined that there were still medical options available to her. Shea obtained letters from her own physicians explaining why Dr. Cole's proposed treatment options were inappropriate for her. On May 2, 2002, Shea was seen by a new physician, Dr. John Ravits, for a neurological consultation. Dr. Ravits recorded Shea's pain triggers much as her other care providers described them. [3] He concluded that her neurological examination results were normal and that Shea should focus her attention on chronic pain management and rehabilitation. Shea's counsel sent a letter to the Division of Retirement and Benefits in November 2002 requesting that it amend her application to include occupational disability benefits in addition to nonoccupational disability benefits. The letter explained: [O]ur research indicates that [Shea's] pre-existing condition was likely aggravated by her working conditions and environment. The Director of the Division of Retirement and Benefits granted Shea's claim for nonoccupational disability benefits on March 21, 2003, but the Director denied her claim for occupational disability benefits. This decision was based on Dr. Cole's recommendation, which summarized Shea's doctors' reports and concluded that [t]here is not evidence from the record that the pain was caused by her occupation. [4] On August 22, 2003 Shea sought a medical opinion from Dr. Michael Gevaert on whether her pain was caused by her work for the State of Alaska. Dr. Gevaert's records show that Shea reported that her pain is worse with standing and prolonged sitting. Sitting with a good posture, stress, physical activity, bathing, [lifting], squatting, cold environment, menstrual cycles, and sitting without her legs elevated aggravates her pain. Asked whether Shea's state employment substantially aggravated her condition, Dr. Gevaert responded: It is my understanding that chronic pelvic pain is aggravated by sitting. Her present condition is a chronic irritation of the nerve. Sitting at work or at the home may increase the pain and . . . substantially aggravate the pathophysiologic condition. It is therefore my opinion after careful review of the medical records, obtaining a history from the patient and a clinic examination that her present condition is not work-related. Her work did not substantially aggravate her condition. Shea challenged a number of the statements in Gevaert's report as factually inaccurate. Shea sought another medical opinion on causation from Dr. Michael Smith on February 11, 2004. In describing the history of Shea's condition, Dr. Smith wrote that Shea had pain almost all the time. She began having trouble with her menses. She missed two days of work every time she menstruated as the pain was intolerable. She also described worsening of her pain due to sitting while working. Dr. Smith concluded that Shea should avoid repetitive or prolonged bending and twisting. Squatting, stair climbing, and especially sitting for extended periods increase the symptoms and should be restricted. Shea next sought an opinion on causation from Dr. Paul Blocher, who was qualified as an expert in general medicine. Dr. Blocher evaluated whether Shea's work substantially aggravated her condition, but he did not independently examine her because he was not licensed to do so in Alaska. Instead, Dr. Blocher's conclusions were based exclusively on his conversations with Shea and his review of Shea's medical records. Dr. Blocher's opinion was that Shea's employment with the State from 1993 through 2001 exacerbated her pre-existing condition and that Shea's state employment was the only plausible medical etiology of [her] disease. In August 2005, at the Division of Retirement and Benefits' request, Dr. William Cole reviewed all the information in Shea's medical record, including the opinions and medical reports Shea had obtained since Dr. Cole's opinion in March 2003. After considering this information, Dr. Cole maintained his opinion that there is not a substantial presentation of an argument to support [Shea's] claim that her job activities were [a] significant contributing factor to this condition, no more than the rest of the activities of daily living of her life were. As a result, the Division affirmed its denial of Shea's claim for occupational disability benefits. Shea appealed to the Office of Administrative Hearings.