Court Opinion

ID: 9699666
Source: CourtListenerOpinion
Date Created: 2023-08-25 20:44:28.888958+00
Date Added: 2024-06-11T18:20:55.266098
License: Public Domain

DISSENTING OPINION BY
Judge LEAVITT.
I respectfully dissent. I agree with the WCJ and the Board that Dr. Steel’s testimony supports a finding that Claimant fully recovered from her accepted work injury, which is undisputedly a herniated nucleus pulposus at L4-5.1
Dr. Steel is a board certified orthopedic surgeon who actually writes the board examinations and was the chief surgeon at Shriners Hospital for twenty-five years. In conjunction with Claimant’s independent medical examination (IME), Dr. Steel took a history from Claimant regarding how her injury occurred and he reviewed Claimant’s medical records including her injury report. Dr. Steel also noted that according to an MRI, Claimant had a herniated nucleus pulposus.
Claimant’s physical examination was normal, with excellent motion of her back, normal reflexes and no signs of radiculopa-thy. Claimant voiced subjective complaints that were inconsistent with any known physiologic cause, and Dr. Steel could find no abnormality and nothing objective to substantiate Claimant’s subjective complaints. In short, there was “nothing wrong” with Claimant. Steel Deposition, October 11, 2004, at 61 (Steel dep. _); Reproduced Record at 92a (R.R. _). Dr. Steel explained that Claimant had MRIs done in 2001 and 2002. The 2001 MRI showed a herniated disc at L5-S1 and the 2002 MRI showed that the herniated disc had gone away.2 Dr. Steel *1201specified that upon physical examination, he found no clinical evidence of a herniated disc.
As to full recovery, the following exchange took place:
[Employer’s Counsel:] ... do you have an opinion as to whether this lady was fully recovered from whatever happened to her on March 17, 2001?
[Dr. Steel:] I couldn’t find any evidence of any orthopedic or neurologic disease when I saw her, the day that I saw her.
[Employer’s counsel:] Did you find that she was fully recovered from that work incident?
[Dr. Steel:] Since I couldn’t find any abnormality, I would have to say she had gotten better, yes.
[Employer’s counsel:] Let me ask you this: What did you understand her work injury to be?
[Dr. Steel:] I understood — I knew how it occurred. I didn’t know what her work injury was. But I would infer from what I saw her, when I saw her, that she had a sprain or strain of her back. And I could find no evidence or any residual thereof or anything to suggest a herniated disc.
Steel dep. 88 — 39; R.R. 69a-70a (emphasis added).
Later in the deposition, Dr. Steel specifically testified as to the condition of Claimant’s L4-5 disc, saying “[b]ut again, there were no symptoms at L4-5 at all and nothing subjective to show a disc any place.” Steel dep. 69; R.R. 100a. On cross-examination, Dr. Steel was asked again about Claimant’s full recovery:
[Claimant’s counsel:] ... is it still your testimony that this lady is fully recovered from what happened in August (sic) of 2001?
[Dr. Steel:] When I saw her, I could find no evidence of any orthopedic or neurologic disease at all.
Steel dep. 73; R.R. 104a (emphasis added).
The majority concludes that Dr. Steel’s medical opinion is insufficient to support a termination because he stated that he did not know what her work injury was but “inferred” that it was a lumbar strain. In support, the majority relies on GA & FC Wagman, Inc. v. Workers’ Compensation Appeal Board (Aucker), 785 A.2d 1087 (Pa.Cmwlth.2001) and Gillyard v. Workers’ Compensation Appeal Board (Pennsylvania Liquor Control Board), 865 A.2d 991 (Pa.Cmwlth.2005). Both of these are distinguishable from the instant case.
In Wagman, the employer’s medical expert failed to testify that the claimant was fully recovered from an exacerbation of pseudoarthrosis, which was the accepted work injury. In Gillyard, the employer’s doctor stated that the work injury was only a lumbar strain/sprain when in reality the work injury also included chronic sciatica with disc bulging at L4r-5 and L5-S1. Further, the employer’s doctor specifically testified that he was not opining that the claimant was recovered from anything other than the lumbar strain/sprain. In Wag-man and Gillyard, the testimony of the employers’ medical experts was properly held insufficient to support a finding of recovery because their testimony was too limited in scope to include the claimant’s accepted work-related injury. That is not the situation with Dr. Steel.
This case is more akin to To v. Workers’ Compensation Appeal Board (Insaco, Inc.), 819 A.2d 1222 (Pa.Cmwlth.2003), in which the IME doctor was unable to understand, based on the claimant’s complaints and description of the mechanism of injury, how a work injury could have occurred. Nevertheless, the employer’s *1202doctor testified that there was no connection between the claimant’s current complaints and the work incident; no evidence of medical impairment; and therefore, the claimant had fully recovered from any work injury he may have sustained. This Court found that the testimony was competent and supported a finding of full recovery. Id. at 1225.
This case presents a similar situation. Although Dr. Steel inferred that Claimant had a lumbar strain or sprain based on what he saw during the IME, he never stated that his opinion of full recovery was limited to a lumbar strain/sprain. He never disputed but, rather, acknowledged that Claimant had sustained a herniated nucleus pulposus. Dr. Steel performed a thorough examination and reviewed diagnostic test results of the entire spine. He specifically looked for evidence of a herniated disc and testified that he found none. In fact, Dr. Steel found no objective evidence to support Claimant’s subjective complaints and no evidence of any orthopedic or neurologic disease at all. He also specifically opined that Claimant fully recovered from any work-related injury to her back. This supports a finding of full recovery.
The majority holds that “the expert must know what the accepted work-related injury was to be competent to testify that a claimant has fully recovered from a work-related injury.” Slip Opinion at 8. In other words, the majority would find that in any case where the IME physician is unsure of the accepted work injury, the doctor’s testimony cannot support a finding of full recovery. I disagree with that broad assertion. A reading of Dr. Steel’s entire testimony overwhelmingly reveals that he gave an opinion as to the current status of ■ Claimant’s lumbar discs, including specifically the L4-5 disc, and found nothing orthopedically or neurologically wrong with Claimant. This testimony is sufficient to find a full recovery from a herniated disc at L4-5.
I would affirm the WCJ and the Board.3

. Nucleus pulposus is defined as "the soft fibrocartilage central portion of the interver-tebral disk.” Stedman’s Medical Dictionary at 1240 (27th ed.2000).

. Dr. Steel explained that the diagnostic tests covered Claimant’s spine "from the top to bottom.” Steel dep. 41; R.R. 72a.

. I recognize that Claimant also argues that a termination is not warranted because Dr. Steel placed restrictions on her ability to work. However, because the majority did not address this argument, I will not discuss it further.