Court Opinion

ID: 9381615
Source: CourtListenerOpinion
Date Created: 2023-03-23 15:05:56.178874+00
Date Added: 2024-06-11T17:17:33.599388
License: Public Domain

RENDERED: MARCH 23, 2023
                                                        TO BE PUBLISHED

              Supreme Court of Kentucky
                              2022-SC-0119-WC

PERRY COUNTY BOARD OF EDUCATION                                     APPELLANT

                ON APPEAL FROM COURT OF APPEALS
V.                      NO. 2021-CA-0605
          WORKERS’ COMPENSATION BOARD NO. 2018-WC-86442

MARK CAMPBELL; HAZARD ARH; DR.                                      APPELLEES
MUKUT SHARMA; WORKERS’
COMPENSATION BOARD; AND HON.
GRANT S. ROARK, ADMINISTRATIVE LAW
JUDGE

               OPINION OF THE COURT BY JUSTICE KELLER

                                  AFFIRMING

      Mark Campbell injured his knee while at work in 2018. Campbell

received workers’ compensation benefits for the injury’s treatment. After

surgery to correct the injury, Campbell continued to experience knee pain. He

ultimately received a total knee replacement, about which his employer, Perry

County Board of Education (Perry County School Board), filed a medical fee

dispute. An Administrative Law Judge (ALJ) found that the total knee

replacement was compensable. The Workers’ Compensation Board (the Board)

affirmed the ALJ. The Court of Appeals, in turn, affirmed the Board. For the

reasons stated below, we affirm the Court of Appeals.
                                I.     BACKGROUND

      On April 11, 2018, while working for Perry County Schools, Mark

Campbell was in the gymnasium of Perry County High School to hang a banner

when he hit his head on a duct and fell. The fall injured his head, shoulder,1

and knee. He first saw the school nurse, then went to a hospital for assessment

and treatment that same day. There, medical staff closed the open wound on

his head. They also performed preliminary scans on his shoulder and knee.

The radiology report from that hospital visit indicated that Campbell’s knee had

mild changes from arthritis, as well as a possible fracture. At a follow-up

appointment just over a month later, on May 30, 2018, another radiology

report indicated a softening of the cartilage of the patella and a partial

dislocation of the patella. It also indicated that Campbell’s patellar tendon was

strained or torn.

      Campbell’s primary care physician referred him to Dr. Mukut Sharma.

Following his injury, Campbell tried non-surgical treatment under Dr.

Sharma’s direction to resolve his knee pain. When that was unsuccessful, Dr.

Sharma referred Campbell to Dr. Darren Johnson for a right knee arthroscopy

with partial meniscectomy. At Campbell’s pre-operation appointment with Dr.

Johnson on October 22, 2018, an x-ray demonstrated a small amount of early

      1  Campbell’s head and shoulder injuries are not at issue in this case. His
shoulder ultimately required surgery to fix his injuries, and many of his medical
reports include notes regarding the status of his shoulder in addition to their
comments regarding his knee injury. We discuss only the notes relevant to Campbell’s
knee.

                                         2
osteoarthritis in the knee, mild patellofemoral narrowing, and an osseous

fragment inferior to the patella. These are typical of osteoarthritis, which is a

degenerative disease occurring when the cartilage within a joint breaks down

over time.2 On November 6, Dr. Johnson performed surgery. He stated that the

surgery was successful, and that Campbell could return to work without

restrictions by December 17, 2018.

      Despite Dr. Johnson’s statement, Campbell’s pain persisted. Dr. Sharma

noted this continued pain and directed Campbell to receive additional

conservative treatment, including corticosteroid injections, physical therapy,

and at-home exercises to treat his pain. On March 21, 2019, four months after

his surgery, Dr. Sharma indicated that Campbell still had localized swelling

around his knee, pain throughout range of motion, and clicking in the knee

joint indicative of a meniscal injury. Dr. Sharma diagnosed an acute meniscal

tear, contusion, knee sprain, osteoarthritis, and internal derangement of

medial meniscus. An x-ray indicated again that Campbell’s joint was narrowing

at his knee. Dr. Sharma prescribed continued physical therapy, an anti-

inflammatory medication, and home exercises. However, he also noted that

Campbell’s physical therapy, medicine, and injections had been ineffective on

his knee (despite being effective for his shoulder recovery).

      Six months later, on September 16, 2019, Dr. Sharma again recorded

that Campbell suffered from an acute meniscus tear, a contusion, a knee

       2 Osteoarthritis (OA), CENTERS FOR DISEASE CONTROL & PREVENTION (July 27,

2020), www.cdc.gov/arthritis/basics/osteoarthritis.htm.

                                         3
sprain, and osteoarthritis in the knee. He noted that Campbell’s right knee was

still in pain and only getting worse, even after his arthroscopy surgery with Dr.

Johnson and subsequent treatment. In his notes, Dr. Sharma wrote that

Campbell’s knee pain was caused by the April 11, 2018 incident. Campbell

would later testify that at this appointment, he and Dr. Sharma discussed his

options for treatment. Dr. Sharma and Campbell ultimately determined that a

total knee replacement would be the best treatment for Campbell given the

ineffectiveness of prior treatment to relieve his pain. Soon after this

appointment, Dr. Sharma requested approval for the total knee replacement

surgery from Campbell’s workers’ compensation benefits provider, which had

covered his medical fees up to that point.

      To determine whether the knee replacement was necessary, the

Bluegrass Health Network (the group managing Campbell’s workers’

compensation benefits) sought the opinion of Dr. David Muffly, an orthopedic

surgeon. Dr. Muffly met with Campbell for an assessment. Additionally, he did

a full review of Campbell’s medical history. Dr. Muffly’s report is thorough and

complete. Amongst other things, Dr. Muffly noted that Campbell had a right

knee medial meniscus tear related to his April 11, 2018 work injury, and that

the same knee had osteoarthritis with chronic complaints of right knee pain.

He also noted that Campbell had no pre-existing active impairment, despite

identifying Campbell’s osteoarthritis. Dr. Muffly concluded that Campbell did

not need a knee replacement at that time. Instead, Dr. Muffly recommended

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“self-directed exercise and non-prescription medications.” In a follow-up email,

Dr. Muffly reiterated this conclusion, stating,

      Mark Campbell does not need a right knee replacement because x-
      rays made on 10-8-2019 show early arthritis that can be
      adequately treated without knee replacement. It is not reasonable
      or necessary that knee replacement be done for the work injury on
      4-11-2018. Treatment for the right knee would include self-
      directed exercise, non-prescription medications and weight loss.

      Following Dr. Muffly’s report, Dr. Kirsch of Bluegrass Health Network

issued a utilization review notice of denial. Campbell’s request was officially

denied on November 15, 2019. In that denial, Dr. Kirsch wrote,

      [Campbell] had degenerative changes in the right knee noted at
      surgery which were in my opinion existing and not due to the
      04/11/18 events based on the information in the chart. I do not
      support the request as necessary for the 04/11/18 event and I
      agree with Dr. Muffly’s [opinion].

      Following the denial, Dr. Sharma met again with Campbell. At this

appointment, Dr. Sharma made note of several of Campbell’s right knee

symptoms, including the following: kneecap feels out of place; kneecap is

swollen; leg suddenly “locked up” at the knee; knee catches when walking;

inability to sleep due to pain; clicking/grating sensation in the knee; knee

buckles suddenly; and knee pain is not improved by medication, stretches,

rest, heat, ice, walking aids, braces, or physical therapy. Another x-ray

indicated narrowing of knee joint space, this time described as “bone on bone.”

Dr. Sharma noted again Campbell’s prior ineffective treatments. He also noted

explicitly that Campbell “had no problem [with right] knee pain prior to work

related injury.” Dr. Sharma indicated in Campbell’s treatment plan that Dr.

Sharma would perform total knee replacement on December 4, 2019.
                                         5
      Dr. Sharma ultimately did perform Campbell’s total knee replacement.

Campbell again sought approval for workers’ compensation benefits to cover

the surgery. His employer, Perry County School Board, filed a Form 112

medical fee dispute regarding the surgery. Perry County School Board

contested the causation of the injury, as well as the reasonableness and

necessity of the total knee replacement. In support of their position, the Perry

County School Board requested an Independent Medical Examination from Dr.

David Jenkinson. Dr. Jenkinson met with Campbell and reviewed his medical

records, as well as the report from Dr. Muffly. Dr. Jenkinson agreed with Dr.

Muffly regarding the lack of necessity or reasonableness for the total knee

replacement. Dr. Jenkinson reported that Campbell’s knee was allegedly worse

after his meniscal repair, that he had shooting pain, and a slow recovery after

his knee replacement. Dr. Jenkinson also reported that Campbell averred he

felt better after the knee replacement than he had before it.

      Although no one had previously disputed the legitimacy and work-

relatedness of Campbell’s original injury necessitating his first meniscal

surgery, Dr. Jenkinson stated in his report that “[t]here is no evidence that

[Campbell] had a significant acute injury to his right knee on 4/11/2018.”

Instead, Dr. Jenkinson believed the complete cause of all of Campbell’s

“abnormalities” was “pre-existing degenerative change.” Despite this

assessment, Dr. Jenkinson agreed with Drs. Johnson and Muffly that

Campbell reached Maximum Medical Improvement (MMI) on December 17,

2018, following his meniscus repair.

                                        6
      Campbell, in response, provided an IME from Dr. Jared Madden, dated

June 3, 2020. Dr. Madden diagnosed Campbell with “Right Knee Meniscal

Tears/Osteoarthritis, S/P Surgical Repair with Right TKA[,] Chronic Right Knee

Pain” and “Degenerative Joint Disease,” amongst other things. On the following

question, which asked, “Within reasonable medical probability, was plaintiff’s

injury the cause of his/her complaints?”, Dr. Madden checked “yes.” This alone

is unequivocal evidence from Dr. Madden that Campbell’s current knee pain

was caused by his workplace injury. In the explanation section for causation,

he wrote,

      Mr. Campbell suffered an injury to the right shoulder and knee
      during the course of a normal workday. His injuries required
      surgical repair. Though successful, scar tissue is never as strong
      as original tissue and as such the patient will always be at an
      increased risk for future reinjury . . . . Though Mr. Campbell has
      received treatment from an orthopedic specialist, his right knee
      injuries have not completely resolved and continue to progressively
      worsen. He continues to suffer from pain, swelling, and instability
      of the right knee. . . . Failure to provide additional treatment as
      recommended could expose the patient to unnecessary
      degenerative changes within the joints of the lower extremity and
      the exacerbation or worsening of other problems. In other words,
      without appropriate management, the problem will significantly
      and rapidly worsen resulting in advanced degenerative changes
      and increasing pain.

Dr. Madden’s report can be read to suggest that the total knee surgery was

inevitable and therefore compensable. By contrast, as noted above, the other

three doctors (Drs. Muffly, Kirsch, and Jenkinson) who reviewed Campbell’s

case opined that a total knee replacement would neither be necessary nor

reasonable due to Campbell’s workplace injury.

                                       7
      Campbell and the Perry County School Board appeared before an ALJ to

resolve the dispute over medical fees. After a full hearing, the ALJ determined

that Campbell was entitled to workers’ compensation benefits for the total knee

replacement. The ALJ relied on Dr. Madden’s findings to reach his conclusion,

about which he wrote,

      . . . Dr. Madden . . . concluded the right total knee replacement
      surgery would be causally related to the April 11, 2018 incident
      and that plaintiff continued to have right knee pain even after Dr.
      Johnson’s meniscectomy and that he had right knee osteoarthritis
      which was not remedied by Dr. Johnson’s surgery.

             Having reviewed the evidence of record, the ALJ notes this is
      not the kind of case where a claimant with a knee injury undergoes
      a successful meniscal repair surgery and several years later, after
      virtually complete recovery, requires a total knee replacement
      surgery for osteoarthritis which he then tries to relate back to the
      original meniscal repair surgery. In the present case, the ALJ is
      persuaded from the fact that plaintiff’s April 11, 2018 work injury
      caused the meniscal damage which Dr. Johnson repaired, but that
      it also made plaintiff’s underlying right knee osteoarthritis
      symptomatic, [and] this condition was never remedied by Dr.
      Johnson’s surgery. Support for this conclusion comes from the fact
      that plaintiff credibly testified he continued to have right knee pain
      even after Dr. Johnson’s surgery and the fact that he was referred
      to Dr. Sharma for treatment within just a few months of being
      released by Dr. Johnson.

      Following Perry County School Board’s Petition for Reconsideration, the

ALJ provided additional findings. The ALJ addressed Perry County School

Board’s argument that Dr. Madden never specifically stated that the total knee

replacement was necessitated by the April 11, 2018 accident. In so doing, he

stated that although Dr. Madden “did not explicitly say plaintiff’s osteoarthritis

or need for total knee replacement surgery were causally related to plaintiff’s

April 11, 2018” work injury, his diagnoses included the total knee replacement

                                        8
surgery and chronic knee pain, and he indicated that the issues he diagnosed

were work-related. The ALJ also gave weight to the “temporal relationship”

between the two surgeries and the injury, as well as to Dr. Madden’s and

Campbell’s assertions regarding Campbell’s continued pain despite earlier

treatment.

      The Perry County School Board appealed the ALJ’s decision to the

Workers’ Compensation Board. To the Board, the Perry County School Board

argued that the ALJ improperly relied on inferences to reach his conclusions on

causation, and that even if the further injury had been caused by Campbell’s

initial work injury, the total knee replacement was neither reasonable nor

necessary as treatment.

      The Board was unpersuaded by the Perry County School Board’s

arguments. The unanimous Board affirmed the ALJ, concluding that there was

substantial evidence to support his conclusions and that his inferences were

proper. The Perry County School Board appealed the Board’s decision to the

Court of Appeals, which affirmed the Board. The Perry County School Board

now appeals to this Court.

                                 II.    ANALYSIS

      To this Court, Perry County School Board makes two arguments for

reversal. First, it argues that the ALJ improperly relied upon inferences instead

of medical opinion evidence in reaching his conclusions on causation. Second,

it argues that the ALJ similarly erred by relying on inferences instead of

                                        9
medical opinion evidence to determine that the total knee replacement was

reasonable and necessary. We address each argument in turn.

      Our standard of review in workers’ compensation cases is well-settled.

Regarding questions of fact, “[t]he ALJ as fact finder has the sole authority to

judge the weight, credibility, substance, and inferences to be drawn from the

evidence.” Ford Motor Co. v. Jobe, 544 S.W.3d 628, 631 (Ky. 2018) (citations

omitted) (emphasis added). The 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 party’s total proof. Khani v. Alliance Chiropractic, 456

S.W.3d 802, 806 (Ky. 2015) (citations omitted). In front of the ALJ, Campbell

bore the burden of proving that he was entitled to the reimbursement of his

medical fees. KRS 342.735(3). Campbell was successful. Thus, if the ALJ’s

conclusions are supported by substantial evidence, he must be affirmed.

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

      Before an in-depth review, we must determine the true controversy at the

heart of this case. In his conclusion, the ALJ wrote that the April 11, 2018

injury “made plaintiff’s underlying right knee osteoarthritis symptomatic.” In

essence, the ALJ described a workplace injury that brought a dormant

preexisting condition into disabling reality. Such injuries are compensable if

they satisfy Finley v. DBM Technologies, 217 S.W.3d 261 (Ky. App. 2007).

Although the ALJ did not make findings specifically with reference to Finley’s

requirements, his findings allow us to determine on review if the requirements

                                        10
were nonetheless satisfied. Accordingly, we review the Perry County School

Board’s arguments within a reframing of the case under Finley.

A. Dormant Condition Aroused into Disabling Reality

      Under Finley, “[A] pre-existing condition that is both asymptomatic and

produces no impairment prior to the work-related injury constitutes a pre-

existing dormant condition. When a pre-existing dormant condition is aroused

into disabling reality by a work-related injury, any impairment or medical

expense related solely to the pre-existing condition is compensable.” Id. at

265.3 In short, for Campbell’s medical expenses related to his osteoarthritis to

be compensable, his condition must have been asymptomatic and producing

no impairment prior to his April 11, 2018 injury.

      In Finley, an injured worker suffering from scoliosis sought workers’

compensation benefits after her condition became symptomatic. Id. at 263.

Before her workplace injury, the worker had never been treated for her

scoliosis. Id. Because her scoliosis was only symptomatic after her workplace

injury (and was not impairment ratable prior to the injury), the treatment for

her condition was held compensable. Id. at 266. Thus,

      where the underlying pre-existing disease or condition is shown to
      have been asymptomatic immediately prior to the work-related
      traumatic event and all of the employee’s permanent impairment is
      medically determined to have arisen after that event . . . then as a

      3   Finley also, in most cases, requires findings regarding whether the condition
was temporarily or permanently aroused. Id. at 266 (“[T]he ALJ erroneously failed to
make an essential finding of fact upon whether Finley’s pre-existing dormant scoliosis
was temporarily or permanently aroused by the work-related back injury. As a
reviewing body, neither we nor the Board should attempt to supplant such a finding of
fact.”) (citations omitted). However, because this case comes to us on review of a
medical fee dispute, the issue of the disability’s permanency is irrelevant.

                                          11
      matter of law the underlying condition must be viewed as
      previously dormant and aroused into disabling reality by the
      injury.

Id. at 265.

      Here, as in Finley, there was no evidence that Campbell had ever been

treated for his osteoarthritic knee. The ALJ wrote, “Prior to the work injury,

there is no evidence of symptomatic right knee osteoarthritis.” As noted above,

Drs. Sharma, Johnson, and Muffly all recorded that Campbell had no problems

with his right knee prior to his injury. The ALJ therefore had substantial

evidence to support his finding that Campbell’s osteoarthritis was not

previously symptomatic. The first Finley factor is thus satisfied.

      The second Finley requirement—that there be no impairment related to

the condition pre-injury—is also satisfied. In support of this, Dr. Muffly wrote

in his report explicitly that Campbell had no pre-existing active impairment.

This, too, constitutes substantial evidence in support of the ALJ’s finding

regarding no pre-existing impairment relating to the osteoarthritis. The second

Finley factor is thus also satisfied.

B. Causation, Reasonableness, and Necessity

      Holding that the ALJ did not err in finding that Campbell had a pre-

existing dormant condition, we must determine whether he had substantial

evidence to support his conclusions regarding causation (i.e., that the

workplace injury actually aroused the condition into disabling reality),

reasonableness, and necessity. The ALJ determined that Campbell’s workplace

injury was the cause of the onset of his osteoarthritis symptoms, and that the

                                        12
total knee replacement was reasonable and necessary to treat it. He did this

using a patchwork of evidence (including Dr. Sharma’s notes, Campbell’s own

testimony, and the timeline of events in the case) and relying on inferences

from Dr. Madden’s medical opinion evidence. The Perry County School Board

argues that these inferences were improperly made under Kingery v. Sumitomo

Electric Wiring, 481 S.W.3d 492 (Ky. 2015).

      In Kingery, an injured worker, Sheila Kingery, was awarded workers’

compensation for lifetime medical benefits to treat her workplace injury. Id. at

494. The injury—a spinal strain or sprain—occurred in 1989. Id. Twenty-three

years later, Kingery continued to be treated for an increasing number of issues.

Id. Her employer filed a medical fee dispute regarding the compensability of her

use of the prescriptions Lorcet (a pain reliever), Skelaxin (used to treat muscle

spasms), Xanax (used to treat panic disorders), and Celexa (an anti-

depressant). Id. Kingery’s employer filed an evaluation report from Dr.

Randolph, who wrote that Kingery’s “current subjective complaints of pain are

unrelated to the mild sprain or strain injury caused by her work.” Id. at 495.

By contrast, “Kingery filed no medical evidence to rebut Dr. Randolph’s

opinions. Instead, she testified about her original work injury, work history,

medical history, and current medical condition.” Id. The ALJ nonetheless relied

on Kingery’s testimony over Dr. Randolph’s to conclude that her conditions

requiring treatment were caused by the 1989 workplace injury, and therefore

were compensable. Id. This Court reversed the decision of the ALJ. Id. at 496.

In so doing, we wrote, “ALJs are not permitted to rely on lay testimony,

                                        13
personal experience, and inference to make findings that directly conflict with

the medical evidence.” Id.

      Although this Court decidedly determined that “the ALJ’s findings . . .

were not based on substantial evidence and were insufficient to justify rejection

of the medical evidence” in Kingery, we recognized that “it would not have

required much medical evidence to support the ALJ’s decision to disregard Dr.

Randolph’s opinions here. Some contrary report from Kingery’s treating

physician, for example, likely would have sufficed.” Id. at 499, 500. Indeed, we

indicated in Kingery that any differing medical opinion would have sufficed to

support findings otherwise bolstered by non-medical evidence and inference.

See id. (noting that absent uncontroverted medical evidence, the ALJ enjoys

“immense discretion” to determine the weight of evidence for causation).

      This Court considered the sufficiency of evidence again in Parker v.

Webster County Coal, LLC (Dotiki Mine), 529 S.W.3d 759 (Ky. 2017), superseded

by statute on other grounds as noted by Cates v. Kroger, 627 S.W.3d 864 (Ky.

2021). There, as here, an ALJ found that an injured worker had a pre-existing

dormant condition aroused into disabling reality by a workplace injury. Id. at

764. The evidence in Parker was internally inconsistent: “although Dr. Eggers

referred to an injury as being the cause of Parker’s back condition in his Form

107, he did not specify which injury.” Id. at 765. In his first office note,

however, Dr. Eggers “related Parker’s back condition to the work injury.” Id.

Another doctor on whom the ALJ relied had conflicting reports regarding the

injury’s work-relatedness. Id. No single document contained the specific

                                         14
findings of the ALJ, and there were internal inconsistencies within the records

themselves. See id. Nevertheless, the ALJ “was free to consider” the totality of

the proof together, believing or disbelieving the individual aspects of each

record alongside Parker’s testimony. Id. Although he relied on Dr. Eggers’s

nonspecific opinion, office notes, and Parker’s testimony, this Court determined

that the ALJ had sufficient evidence to support his conclusion that the injury

must be compensated. Id. at 765–66.

       Here, the ALJ made inferences based upon Dr. Madden’s medical

opinion. While Dr. Madden did not specify which surgery was reasonable and

necessary or caused by the workplace injury, much like the doctor in Parker,

he instead opined that Campbell’s “injuries required surgical repair.” Dr.

Madden explicitly noted that the injury at issue in his report was work-related,

as noted above, and he assessed a Whole Person Impairment that included no

preexisting condition impairment rating in its calculation for the total knee

replacement. The ALJ took this evidence, along with Dr. Sharma’s office notes,

Campbell’s testimony, and the timeline of events, and he inferred that the total

knee replacement was both caused by the workplace injury and was reasonable

and necessary to treat it. Under Kingery, even Dr. Sharma’s notes alone would

have provided sufficient evidence to support the ALJ’s determination. See id. at

500.

       Although the ALJ relied in part on inferences to inform his ultimate

determination, he did so in a reasonable manner and in light of medical

evidence. ALJs are permitted to make inferences from the evidence and have

                                        15
the sole discretion to determine the weight of evidence. Jobe, 544 S.W.3d at

631 (citations omitted). As we held in Parker, the ALJ’s use of the evidence

before him was appropriately within his power, even if, as Perry County argues,

that evidence (in the narrative form) might be less than specific. To the

contrary, it is clear to this Court from the record that although Dr. Madden’s

proffered “explanation” section may not include the exact verbiage demanded

by Perry County, he does clearly indicate both causation and reasonableness

within his report. Our holding is consistent with Kingery, since the ALJ relied

on far more medical evidence than simply an office note to reach his

conclusions (which this Court wrote would have likely been enough to

constitute substantial evidence). Kingery, 481 S.W.3d at 500.

                                III.    CONCLUSION

      In the various reports, testimony, and medical evidence before him, the

ALJ had sufficient evidence to conclude that Campbell’s total knee replacement

was reasonable and necessary. He also had sufficient evidence to conclude that

Campbell’s osteoarthritis which required a total knee replacement was a pre-

existing condition brought into a disabling reality by his workplace injury.

Because he relied on medical evidence, the ALJ was within his discretion to

make inferences. Accordingly, we affirm the Court of Appeals.

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

All concur. Lambert, J., not sitting.

                                        16
COUNSEL FOR APPELLANT, PERRY COUNTY BOARD OF EDUCATION:

Barry Lewis
Lewis and Lewis Law Offices

COUNSEL FOR APPELLEE, MARK CAMPBELL:

McKinnley Morgan
Wiley Gerald Vanover, Jr.
Morgan, Collins, Yeast & Salyer

COUNSEL FOR APPELLEES, HAZARD ARH AND DR. MUKUT SHARMA:

Denise Moore Davidson
Davidson & Associates

ADMINISTRATIVE LAW JUDGE:

Hon. Grant Stewart Roark

WORKERS’ COMPENSATION BOARD:

Michael Wayne Alvey
Chairman

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