Court Opinion

ID: 9390307
Source: CourtListenerOpinion
Date Created: 2023-04-27 15:05:28.920632+00
Date Added: 2024-06-11T17:18:32.810105
License: Public Domain

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                                         RENDERED: APRIL 27, 2023
                                            NOT TO BE PUBLISHED

            Supreme Court of Kentucky
                       2021-SC-0566-WC

KELLOGG’S                                APPELLANT/CROSS-APPELLEE

V.            ON APPEAL FROM COURT OF APPEALS
                         2020-CA-0709
               WORKERS’ COMPENSATION BOARD
                         WC-14-90651

LESLIE LAWRENCE                          APPELLEE/CROSS-APPELLANT

HONORABLE CHRIS DAVIS,                                  APPELLEES
ADMINISTRATIVE LAW JUDGE; AND
WORKERS’ COMPENSATION BOARD

                       2022-SC-0010-WC

LESLIE LAWRENCE                          APPELLANT/CROSS-APPELLEE

V.            ON APPEAL FROM COURT OF APPEALS
                         2020-CA-0709
               WORKERS’ COMPENSATION BOARD
                         WC-14-90651

KELLOGG’S                                APPELLEE/CROSS-APPELLANT

HONORABLE CHRIS DAVIS,                                  APPELLEES
ADMINISTRATIVE LAW JUDGE; AND
WORKERS’ COMPENSATION BOARD

             MEMORANDUM OPINION OF THE COURT

      AFFIRMING IN PART, REVERSING IN PART & REMANDING
      This case is before the Court on appeal as a matter of right.1 Kellogg’s

argues the ALJ did not comply with the requirements laid down in City of

Ashland v. Stumbo, 461 S.W.3d 392 (Ky. 2015), when he ruled that Leslie

Lawrence was permanently, totally disabled. Lawrence, on the other hand,

appeals from the ALJ’s ruling, arguing for “an award of Permanent Partial

Disability benefits based on the 8% Whole person impairment beginning with

the date of injury, offset by periods of temporary total disability benefits, until

the date he became permanently totally disabled.” The Worker’s Compensation

Board reversed the ALJ as to the issue of compliance with City of Ashland but

affirmed the ALJ’s refusal to grant PPD payments. The Court of Appeals

reversed the Board as to compliance with City of Ashland but affirmed the

refusal to grant PPD payments. For the following reasons, we affirm in part,

reverse in part, and remand to the ALJ for further consideration.

                                       I.       Facts
      Lawrence worked for Kellogg’s from 1977 to April 9, 2016, the day he

retired. In 1999, he was transferred to the shipping and receiving department

where he loaded orders using a forklift. On March 11, 2014, he was struck by a

co-worker operating a forklift, injuring his right foot underneath the vehicle. As

recounted by the Court of Appeals,

      As a result of the accident, Lawrence sustained significant injuries
      to his right ankle. Lawrence sought treatment from Dr. Kevin
      Harreld, who diagnosed Lawrence with a fractured right ankle and
      initially placed his ankle in a cast. Dr. Harreld subsequently
      performed an open reduction and internal fixation procedure to

      1   Ky. Const. § 115.
                                            2
      repair Lawrence's injured ankle. On May 5, 2014, Dr. Harreld
      noted that Lawrence could return to work with restrictions of sit-
      down duty only and the ability to elevate his right leg and take
      breaks as necessary. In September of 2014, Lawrence returned to
      work for Kellogg's on full duty. Lawrence testified that upon
      returning to regular duty, his ankle swelled and his back hurt from
      standing for long periods of time while working.

      Lawrence was on full-duty work release until November of 2015
      when he returned to Dr. Harreld with complaints of continued
      ankle pain. At that time, Dr. Harreld gave Lawrence work
      restrictions to allow him to take breaks at work every two hours as
      needed to elevate his right leg, ice his ankle, and limit forklift use
      to two hours at a time. On January 20, 2016,
      at Lawrence's request, Dr. Harreld performed an operation to
      remove the surgically placed hardware from Lawrence's right
      ankle. Thereafter, on March 1, 2016, Dr. Harreld
      released Lawrence to return to work at full duty, with the
      restriction that he could take breaks every two hours to elevate
      and ice his right ankle. Lawrence testified that he returned to work
      for two days following the hardware removal surgery but ultimately
      decided to retire in the spring of 2016[.]
      The Court of Appeals further summarized the medical evidence in this

case related to Lawrence’s ankle injury,2

      On November 4, 2014, Dr. Harreld stated Lawrence had reached
      maximum medical improvement (MMI) for his right ankle fracture.
      At this point, Dr. Harreld assigned a 3% impairment rating
      pursuant to the American Medical Association, Guides to the
      Evaluation of Permanent Impairment (5th ed. 2000). Dr. Harreld
      believed Lawrence required no further restrictions and could
      return to work for Kellogg's on full duty. The ALJ considered all of
      the above-mentioned medical treatment by Dr. Harreld, including
      the work restrictions he assigned Lawrence on March 1, 2016.

      Dr. Guarnaschelli performed an independent medical evaluation
      (IME) on September 7, 2016. Dr. Guarnaschelli
      diagnosed Lawrence with a right ankle fracture caused by a work-
      related injury. He assigned Lawrence a 21% total impairment

       2 Lawrence’s original claim had also sought compensation for a psychological

condition, lower back condition, and left knee condition. The ALJ ruled against all
three claims. Lawrence did not appeal those rulings to the Court of Appeals nor this
Court so we will not discuss the evidence related to those claims.
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      rating and believed Lawrence would experience difficulty returning
      to full-time employment without significant ability to sit, rest, and
      take frequent breaks. Dr. Guarnaschelli further observed that
      persistent standing or walking would exacerbate the healing
      process of Lawrence's right ankle fracture.
      Lawrence was examined by Dr. Roberts on February 14, 2018 as
      part of an additional IME. Dr. Roberts diagnosed a fractured right
      ankle and noted that he believed the injury was the result of the
      forklift incident. Dr. Roberts noted that he
      believed Lawrence reached MMI on October 11, 2014 and assigned
      him an 8% impairment rating due to his right ankle injury.
      Further, Dr. Roberts acknowledged that he did not
      believe Lawrence was capable of returning to any competitive
      employment on a regular and sustained basis.
      Dr. Larkin conducted an IME on Lawrence on April 4, 2018. The
      physical examination of Lawrence's right ankle showed a reduced
      range of motion. Dr. Larkin assigned an 8% impairment rating and
      indicated that he believed Lawrence reached MMI on March 2,
      2016. Dr. Larkin further opined that Lawrence could return to the
      type of work done at the time of his injury.
      [Robert] Tiell conducted a vocational evaluation of Lawrence on
      December 17, 2016. Tiell reported that Lawrence was considered
      an older adult and that his ankle injury was a significant deterrent
      for employability. Tiell defined Lawrence's work for Kellogg's from
      1977 through April 2016 as semi-skilled in nature and requiring at
      least medium exertion. Finally, Tiell noted that he
      believed Lawrence had a 100% occupational loss due to his ankle
      injury, and “did not believe Lawrence had skills to transfer into
      other jobs such as clerical.”
      Dr. Conte conducted a vocational evaluation of Lawrence on April
      12, 2018 in which he performed a review of Lawrence's medical
      records and administered to Lawrence various vocational skills
      tests. Dr. Conte reported that Lawrence's test scores indicated the
      capacity to perform a variety of occupations in the “semi-skilled
      and unskilled labor market” and that he believed Lawrence has the
      capacity to acquire additional vocational skills.
      The ALJ also made note of this evidence in his Opinion, Award and

Order. The ALJ made findings of fact that Lawrence was “permanently and

totally disabled as a result of the work injury[,]” and that he “is totally disabled

solely as a result of his work-related right ankle injury.” The ALJ adopted an

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impairment rating of 8% based on Dr. Roberts’ report. Opining further on the

permanent, total disability, the ALJ wrote,

      I have the FCE from Rick Pounds, which states the Plaintiff can
      work as a lift truck operator. I have the restrictions from Dr.
      Larkin, which are that the Plaintiff can work in medium duty
      seated position with some weight bearing and ambulation. These
      would seem to indicate that the Plaintiff could find jobs within in
      [sic] abilities, maybe even return to the type of work done on the
      date of injury. However, I do not adopt these restrictions.
      Rather I adopt the restrictions assigned by the treating physician
      an surgeon, Dr. Harreld. When Dr. Harreld did finally discharge
      the Plaintiff after a long course of treatment, including two
      surgeries, he said that the Plaintiff would need to ice and elevate
      his right ankle periodically throughout the day.
      This restriction alone would render most people totally disabled.
      Much less a man who has spent his entire professional life, almost
      40 years, in factories and shipping departments. It is doubtful that
      many employers would tolerate this for an extended period. The
      Plaintiff’s high school education does not create sufficient
      opportunities to overtime this severe restriction nor does his work
      experience.
      While some may seek a more detailed explanation, I doubt many
      people could envision hiring, on a permanent basis, a 58-year-old
      man with factor [sic] and shipping experience, and a high school
      education, who had to elevate and ice his ankle every so often.
      The ALJ determined the award for permanent, total disability should be

retroactive to March 14, 2014, excluding periods Lawrence actually worked. He

also gave a credit to Kellogg’s “against any past due benefits for overpayment of

TTD as to rate.” The parties stipulated that TTD payments were made between

March 12, 2014 through May 11, 2014, and January 2, 2016 through March 1,

2016. The ALJ’s original opinion did not discuss the PPD benefits Lawrence

had requested. Both parties filed petitions for reconsideration, arguing

substantially the same arguments presented on this appeal. The ALJ rejected

both, stating that Kellogg’s was not entitled to an opinion which analyzed

                                        5
evidence the ALJ had reviewed and rejected. He also stated that he found Dr.

Conte to be “entirely uncredible[.]” Finally, he rejected Lawrence’s claim for

PPD benefits, stating

      While I understand the Plaintiff was working with some pain I do
      not believe he was solely out of necessity. It was light duty, but not
      made up work. He was paid equal or greater wages. He hoped to
      make a full recovery. His actual disability began as outlined in the
      Opinion.

      Both parties appealed to the Worker’s Compensation Board. The Board

concluded the ALJ’s analysis regarding the permanent, total disability was not

in compliance with the requirements of City of Ashland v. Stumbo, 461 S.W.3d

392, 396-97 (Ky. 2015). The Board wrote, “The ALJ’s opinion does not

sufficiently set forth a detailed analysis, properly weighing the evidence of

record in determining whether Lawrence will be able to earn income by

providing services on a regular and sustained basis in a competitive economy.”

As to the PPD payments, the Board wrote, “Lawrence has not cited to any

authority authorizing an award of PPD prior to the award of PTD.” Despite that,

the Board went on to reason that Lawrence’s

      condition was not at MMI until after his recovery from the second
      surgery for hardware removal. Lawrence received TTD benefits, or
      earned equal or greater wages until he recovered from his second
      surgery. Because the condition was not at MMI during his return
      to work, Lawrence would not be entitled to PTD benefits while
      earning full wages.

It is unclear if the reference to PTD (as opposed to PPD) benefits in the last

sentence was a typographical error.

                                         6
      The Court of Appeals reversed the Board as to compliance with City of

Ashland but affirmed the Board as to the denial of PPD benefits. Further

analysis of the Court of Appeals decision will be discussed below.

                              II.   Standard of Review
      The ALJ is the sole fact-finder and has “discretion to determine the

quality, character, and substance of the evidence and to draw reasonable

inferences from the evidence.” City of Ashland, 461 S.W.3d at 396 (quoting

Magic Coal Co. v. Fox, 19 S.W.3d 88, 96 (Ky. 2000)). “[T]he ALJ ‘may reject any

testimony and believe or disbelieve various parts of the evidence, regardless of

whether it comes from the same witness or the same adversary party's total

proof.’” Id. On appeal,

      The function of further review of the WCB in the Court of Appeals
      is to correct the Board only where the the [sic] Court perceives the
      Board has overlooked or misconstrued controlling statutes or
      precedent, or committed an error in assessing the evidence so
      flagrant as to cause gross injustice. The function of further review
      in our Court is to address new or novel questions of statutory
      construction, or to reconsider precedent when such appears
      necessary, or to review a question of constitutional magnitude.

Western Baptist Hosp. v. Kelly, 827 S.W.2d 685, 687-88 (Ky. 1992). The party

with the burden of proof before the ALJ, and is successful, need only show that

the decision is supported by substantial evidence. French v. Rev-A-Shelf, 641

S.W.3d 172, 178 (Ky. 2022). If the party with the burden of proof loses before

the ALJ, then “the test is whether the evidence compelled a finding in his

favor[.]” Special Fund v. Francis, 708 S.W.2d 641, 643 (Ky. 1986).

                                        7
                                     III.       Analysis

      A. The ALJ Complied with City of Ashland
      City of Ashland delineates five-steps the ALJ must take prior to making

an award for total disability. The ALJ must “determine if the claimant suffered

a work-related injury[;]” “determine what, if any, impairment rating the

claimant has[;]” determine the “permanent disability rating[;]” “determine that

the claimant is unable to perform any type of work;” and finally, “determine

that the total disability is the result of the work injury.” City of Ashland, 461

S.W.3d at 396-97.

      The Court of Appeals noted that only the fourth requirement is at issue

in this case. Thus, regarding that particular step,

      An ALJ cannot simply state that he or she has reviewed the
      evidence and concluded that a claimant lacks the capacity to
      perform any type of work. The ALJ must set forth, with some
      specificity, what factors he or she considered and how those
      factors led to the conclusion that the claimant is totally and
      permanently disabled.

Id. The factors which have previously been identified by this Court to consider

include,

      the worker's post-injury physical, emotional, intellectual, and
      vocational status and how those factors interact. It also includes a
      consideration of the likelihood that the particular worker would be
      able to find work consistently under normal employment
      conditions. A worker's ability to do so is affected by factors such as
      whether the individual will be able to work dependably and
      whether the worker's physical restrictions will interfere with
      vocational capabilities.

Ira A. Watson Dep’t Store v. Hamilton, 34 S.W.3d 48, 51 (Ky. 2000).

                                            8
      The ALJ’s analysis in this case was pithy, and perhaps something more

could have been said in order to clarify his reasoning to the parties and better

facilitate review on appeal. But editorial preferences are one thing; legal

sufficiency is another. We agree with the Court of Appeals’ analysis below and

adopt it as our own.

      The ALJ properly determined based on the medical proof that
      Lawrence would have to spend part of his day seated, would need
      breaks, and would need the opportunity to ice his ankle
      throughout the day. The ALJ next determined that Lawrence's age
      (fifty-eight), work experience (factory and shipping work), and
      education (a high school diploma) were not sufficient to create
      other work opportunities for him within his restrictions. The ALJ
      then determined that it was not realistic to believe that an
      employer would want to hire an employee for a factory job where
      the employee had to take multiple breaks throughout the day to ice
      his ankle.

      This analysis comports with [City of Ashland v.] Stumbo. It is clear
      from the ALJ's opinion that he determined that Lawrence would
      not be a good candidate for a more sedentary position that would
      fit within his restrictions due to his limited work history, age, and
      education, and the prospect of Lawrence finding factory work
      within his restriction was bleak. More extensive findings were not
      necessary. Therefore, the Board misconstrued what was necessary
      under Stumbo and erred in vacating and remanding for additional
      findings on this matter because there was evidence of sufficient
      probative value to support the ALJ's opinion.
      Of particular note, the evidence in this case, though not cited by the ALJ,

which supports the decision are Dr. Harreld’s medical reports and restrictions,

as well as Robert Tiell’s vocational evaluation that determined Lawrence was

100% occupationally disabled. Even if it could be argued that Dr. Harreld’s

restrictions do not foreclose the proposition that Lawrence could work in some

capacity, it is the ALJ’s prerogative “to translate the lay and medical evidence

into a finding of occupational disability.” Id. at 52. There was substantial

                                         9
evidence in the record to support the ALJ’s decision. The Court of Appeals is

affirmed.

      B. Error as to PPD Benefits
      In his original Opinion, Award, and Order, the ALJ failed to mention PPD

benefits at all. In his Order subsequent to Lawrence’s petition for

reconsideration on that issue, the ALJ opined,

      While I understand the Plaintiff was working with some pain I do
      not believe he was solely out of necessity. It was light duty, but not
      made up work. He was paid equal or greater wages. He hoped to
      make a full recovery. His actual disability began as outlined in the
      Opinion.

      We are at a loss to understand why the ALJ, the Board, and the Court of

Appeals found this analysis sufficient, but it is not sufficient. The Worker’s

Compensation statute states, “If an employee returns to work at a weekly wage

equal to or greater than the average weekly wage at the time of injury, the

weekly benefit for permanent partial disability shall be determined under

paragraph (b) of this subsection for each week during which that employment

is sustained.” KRS 342.730(1)(c)(2). Obviously then, the return of Lawrence to

work at equal or greater wages cannot preclude an award of PPD. Moreover, the

ALJ stated Lawrence’s “disability began as outlined in the Opinion.” But we

have previously stated that “an award of permanent partial disability

under KRS 342.730(1)(b) is based solely on a finding that the injury resulted in

a particular AMA impairment rating, with the amount of disability being

determined by statute.” Roberts Bros. Coal Co. v. Robinson, 113 S.W.3d 181,

183 (Ky. 2003). “Impairment and disability are not synonymous.” Id. Thus, the

                                        10
beginning of Lawrence’s disability is irrelevant to whether he was entitled to

PPD benefits. The issue is impairment; and while the ALJ did make a finding

for an impairment rating of 8%, he nowhere makes a finding of fact as to the

date this impairment became effective. The ALJ never made a finding of fact of

the date Lawrence reached MMI. And, because impairment and disability are

not synonymous, the 8% impairment rating the ALJ did find for the award of

PTD benefits may not even be applicable to an award for PPD benefits. Id.

Finally, before the ALJ, Lawrence “had to establish three elements to be

entitled to PPD benefits . . . including: a statutory injury; an impairment rating

pursuant to the Guides; and the ability to work, albeit with restrictions.”

Greene v. Paschall Truck Lines, 239 S.W.3d 94, 108 (Ky. App. 2007); KRS

342.0011(11)(b). Hence, the motivating factor for a worker’s return to work—

not solely out of necessity, as noted by the ALJ—is likewise irrelevant. The

motivation for a worker’s return to work is not mentioned in either KRS

342.0011(11)(b) nor in KRS 342.730(1)(b). Because the ALJ’s reasoning, so far

as this Court can discern, is based on several reasons not actually relevant as

a matter of law to an award of PPD benefits, the ALJ’s refusal to grant PPD

benefits was clearly erroneous for overlooking and misconstruing controlling

statutes. Western Baptist, 827 S.W.2d at 687.

      What is available in the record does not allow for meaningful review of

the particular question of PPD benefits, thus the Board ought to have

remanded back to the ALJ for more specific findings of fact on that issue. Tyron

Trucking, Inc. v. Medlin, 586 S.W.3d 233, 238 (Ky. 2019). Instead, the Board

                                        11
noted first, that no judicial authority exists authorizing the award of PPD

benefits before PTD benefits; and second, it conducted its own analysis of the

merits of the question based on when Lawrence reached MMI. But the Board is

not a fact-finder. KRS 342.285(2). The failure of the ALJ to assign a date as to

when MMI was reached, and to even explicitly adopt or decline to adopt an

impairment rating for PPD benefits, precluded the Board from analyzing the

question further. We consider the question of whether the Worker’s

Compensation statute authorizes an award of PPD benefits prior to an award of

PTD benefits to be unripe at this time for adjudication. We note, however, that

Lawrence has cited two cases from the Worker’s Compensation Board

approving of an award of PPD benefits followed by an award of PTD benefits,

and we see no reason why the Board should not look to its own decisions for

guidance when the courts have as yet been silent.

      To be clear, if an appellate court has not definitively spoken on a

particular question, then the proper analysis for an ALJ and the Board to

conduct is to refer to the statutory text and determine whether the statute

authorizes or precludes that which is being contended for. There is a hint of

arbitrariness in an ALJ or the Board refusing an award simply by saying the

courts have not spoken, we are helpless. Clearly, it is the job of an ALJ and the

Board to apply the Worker’s Compensation statute to the particular facts of a

claimant’s case. The lack of judicial authority on a particular question,

standing alone, is not a sufficient reason to approve or deny an award. There

must be an analysis of the statutory text and application of the text to the facts

                                       12
of the claimant’s case, as determined by the ALJ. The Court of Appeals is

reversed.

                                  IV.     Conclusion
      For the following reasons, we affirm in part, reverse in part, and remand

to the ALJ for further consideration consistent with this opinion.

      VanMeter, C.J.; Bisig, Conley, Keller, Lambert, and Nickell, JJ., sitting.

All concur. Thompson, J., not sitting.

COUNSEL FOR KELLOGG’S:

Mark R. Bush
Samantha Steelman
Reminger Co., L.P.A.

COUNSEL FOR LESLIE LAWRENCE:

Stephanie Nicole Wolfinbarger
Cotton Wolfinbarger & Associates, PLLC

ADMINISTRATIVE LAW JUDGE:
Hon. Chris Davis

WORKER’S COMPENSATION BOARD:
Michael Wayne Alvey
Chairman

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