Court Opinion

ID: 9810867
Source: CourtListenerOpinion
Date Created: 2023-08-31 22:02:00.17658+00
Date Added: 2024-06-11T13:40:17.083683
License: Public Domain

KAPSNER, Justice,
dissenting.
[¶ 25] I respectfully dissent from the majority opinion. Based on a review of this record, I do not believe the ALJ adequately explained her reasons for disregarding the medical evidence that was favorable to Anderson, particularly in light of the job description requiring traveling “approximately 90% of the time.”
[¶ 26] The goal of vocational rehabilitation is to return the disabled employee to “substantial gainful employment with a minimum of retraining, as soon as possible after an injury occurs. ‘Substantial gainful employment’ means bona fide work, for remuneration, which is reasonably attainable in light of the individual’s injury, functional capacities, education, previous occupation, experience, and transferable skills....” N.D.C.C. § 65-05.1-01(3) (emphasis added).
[¶ 27] WSI has the burden of establishing that a vocational rehabilitation plan is appropriate for the injured worker. Shotbolt v. N.D. Workforce Safety and Ins., 2010 ND 13, ¶ 20, 777 N.W.2d 853. When determining whether the employment options identified in the rehabilitation plan present a realistic opportunity for substantial gainful employment, WSI must consider all of the claimant’s functional limitations. See id.; Genter v. Workforce Safety & Ins. Fund, 2006 ND 237, ¶ 14, 724 N.W.2d 132. “[F]unctional limitations which existed at the time the claimant was performing the job are elements of the employee as the employer ‘found’ him, and are valid factors which should be taken into consideration when the Bureau determines whether certain employment options present an opportunity for ‘substantial gainful employment.’” Svedberg v. N.D. Workers Comp. Bureau, 1999 ND 181, ¶ 14, 599 N.W.2d 323.
[¶ 28] “If the Bureau, the consultant, the medical assessment team, and the treating physician assess the claimant as a hypothetical ‘perfect’ individual with only the current work-related disability, and do not take the worker’s actual whole-person functional capacities into account, any vocational rehabilitation plan based upon that assessment will be flawed and un*518workable.” Svedberg, 1999 ND 181, ¶ 17, 599 N.W.2d 323. If a vocational rehabilitation plan is to be meaningful, common sense dictates that the injured worker’s actual functional abilities must be considered. Id. “The Legislature intended for claimants to be provided with actual rehabilitation, with a realistic opportunity to return to work, and not a theoretical rehabilitation on paper only.” Genter, 2006 ND 237, ¶ 14, 724 N.W.2d 132.
[¶ 29] As the majority notes, after Anderson appealed the ALJ’s final order to the district court, the district court remanded the case to the ALJ instructing her to make further factual determinations regarding whether WSI had accepted liability for Anderson’s neck injuries. Majority opinion at ¶ 5. Prior to a remand hearing, WSI accepted liability for Anderson’s neck injuries. Id. (emphasis added). Because WSI accepted liability for Anderson’s neck injuries, his injuries are considered work-related injuries. The ALJ made extensive findings of fact summarizing Anderson’s medical treatment in both of her orders, before and after the remand, specifically outlining Anderson’s continued complaints of neck pain from 2005 to 2010:
On October 21, 2005, Mr. Anderson saw Dr. Fair and complained of right shoulder and neck pain. He had ... normal cervical range of motion. X-rays showed a loss of normal cervical lordosis and advanced cervical disc degeneration. On October 22, October 26, November 15, November 21, 2005 and February 6, 2006, Mr. Anderson saw Dr. Fair. There was no mention of any problems driving.
... Mr. Anderson again saw Dr. Wy-man on February 13, 2006. He reported that his neck was a little stiff and achy....
On April 7, 2006, Mr. Anderson had an independent medical examination by Dr. Jeff Askew, D.C.... [Anderson] complained of neck pain which he described as a “dull ache” with an intensity of 0/10 to 2/10.... [Anderson] said driving does not aggravate the pain. He felt his neck and shoulder pain were about 60-75% improved. Dr. Askew examined Mr. Anderson and diagnosed mechanical cervical spine pain secondary to vertebral segmental dysfunction.... [W]ith the degree of pre-existing degenerative changes found in Mr. Anderson’s neck, he was likely to have some increasing level of symptoms through the years related to the natural progression of this pre-existing condition.
... [O]n October 5, 2007, Mr. Anderson saw Dr. Charles Whitney, D.C. and reported pain between the shoulder blades and that driving aggravates his pain.... [0]n December 27, 2007, Mr. Anderson ... complained of neck pain that is made worse by driving. ... He saw Dr. Whitney again on September 26, 2008 and said that his neck had been “pretty good.”
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On March 11, 2009, Mr. Anderson saw Shanna Kittleson, FNP ... for increased arm weakness, neck pain, and left hip pain.... Ms. Kittleson ordered an MRI of the cervical spine, which on March 20, 2009 showed disc spurs, severe bilateral neural foraminal stenosis, and moderate central canal stenosis (degenerative disc disease with cervical stenosis).
On March 13, 2009, Mr. Anderson began treatment with Dr. John Badinger, D.C.... complaining] of neck pain and headaches. He complained that the pain gets worse while driving and using his arms, and that he “has been getting worse over the years.” ... On March 16, 2009, Mr. Anderson ... indicated that he had extra pain while traveling *519and that his pain was gradually worsening. He ... indicated that he had moderate neck pain and that he could not drive as long as he wanted....
On March 23, 2009, Mr. Anderson saw Lori Klabunde, PA-C ... regarding his neck pain and bilateral shoulder pain. Upon examination, he had 75% normal cervical range of motion and normal upper extremity strength. Ms. Klabunde recommended physical therapy and released Mr. Anderson to work, lifting no greater than ten pounds....
On March 25, 2009, Mr. Anderson saw Dr. Wyman. He noted that Mr. Anderson had been advised that he may do better if he doesn’t do any driving “or at least he indicates that driving does bother him and has been advised by WSI if he can’t drive that potentially they could retrain him.” Dr. Wyman continued Mr. Anderson’s light duty restrictions but advised that he should avoid “reaching out such as driving at this time.” Dr. Wyman completed a Capability Assessment and indicated that Mr. Anderson ... was to avoid reaching, such as driving for greater than one hour per shift.
On March 31, 2009, Mr. Anderson reported ... “[h]e has the most difficulty after driving.” On April 1, 2009, Dr. Wyman ... released Mr. Anderson to work with lifting restrictions. No driving restrictions were noted. On April 2, 2009, Mr. Anderson reported to physical therapy ... that his neck was a little sore, and that he especially notices this when driving on rough roads. On April 6, 2009, Mr. Anderson reported that if he doesn’t drive, he actually does quite well. On April 16, 2009, Mr. Anderson reported improvement in his neck pain and that “really driving is just his aggravating activity.”
On April 20, 2009, Mr. Anderson saw Dr. Wyman and again complained that driving was very difficult. He reported driving about 1 ½ to 2 hours before he had to stop. Dr. Wyman noted tenderness in the muscles at the base of Mr. Anderson’s neck and somewhat limited range of motion because of the pain. On April 29, 2009, Mr. Anderson reported that he couldn’t hold his arms up to drive for more than 20 or 30 minutes. Dr. Wyman released Mr. Anderson to work full time and drive up to 20 or 30 minutes every 3 to 4 hours.
The same day, Mr. Anderson saw Dr. Badinger ... and reported that he could hardly drive at all because of severe neck pain.
From April to June, 2009, Mr. Anderson continued to complain that driving aggravated his neck and right shoulder pain....
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... On August 6, 2009, Mr. Anderson reported that he had done some driving “and is more aggravated with neck discomfort than anything.”
On September 22, 2009, Mr. Anderson saw Coleen Staloch, FNP, P.A.-C.... She noted that Mr. Anderson’s job “involves driving and when he does drive, he feels that it really has been bothering his neck, i.e., when he drove up here today.” ... “I strongly suspect his neck concerns are going to limit him and not allow him to do that anyway as he is probably having trouble with repetitively just turning his neck even with driving and with his lifting up to four ■pounds. We are going to allow him to follow up with Lori Klabunde, P.A.-C, to start the evaluation on his neck.”
On October 2, 2009, Mr. Anderson saw Lori Klabunde regarding his neck pain. Ms. Klabunde noted mild cervical range *520of motion deficits and significant steno-sis at C5-6 and more mildly at C6-7.
On October 27, 2009, Mr. Anderson saw Dr. Steven Kraljic, neurosurgeon, regarding neck pain shooting into his arms bilaterally. Dr. Kraljic noted that an MRI from March 2009 showed significant dis[c] degeneration at C5-6 and C6-7 and that the changes were causing significant compression of the C6 and C7 nerve roots bilaterally “and I do believe are contributing significantly] to his symptoms.” Dr. Kraljic recommended surgery and fusion of C5-6 and C6-7 or steroid injection.
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On December 3, 2009, WSI requested vocational rehabilitation services from Corvel Corporation.... The vocational consultant noted Mr. Anderson’s complaints of neck and hip pain and that when driving, he has good and bad days “and it depends on the road and weather.” On May 5, 2010, Mr. Anderson called the rehabilitation consultant and reported that he had traveled to Fargo recently and “had pain in his neck at about Jamestown.”
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On December 23, 2009, Coleen Staloch returned Mr. Anderson to work with a few restrictions.... She imposed no driving restrictions.
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On January 13, 2010, Mr. Anderson ... reported worsening left hip pain and persistent neck pain aggravated with jarring movement to the spine, especially when driving over rough surfaces. Mr. Anderson reported being able to tolerate sitting/driving for 45 to 60 minutes ....
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On April 29, 2010, Mr. Anderson followed up with Dr. Kraljic.... Dr. Kral-jic ... stated that “he has no restrictions.”
On May 11, 2010 ... [Anderson] reported chronic neck and right arm pain, “especially neck.” He complained of moderate pain with driving longer than one to two hours and said that he “is a traveling engineer, currently not working due to inability to tolerate longer periods of sitting/driving secondary to aggravation, especially neck and left hip pain.”
(Citations omitted.)
[¶ 30] All of Anderson’s complaints of neck pain, spanning from 2005 to 2010, that were outlined in the ALJ’s orders were made before he was released by Dr. Kraljic “without restrictions.” In the ALJ’s order after the remand, the ALJ noted:
The greater weight of the evidence shows that the first appropriate rehabilitation option for Mr. Anderson is return to the same occupation with any employer. The greater weight of the evidence shows that at the time of the vocational rehabilitation plan, Mr. Anderson was physically capable of performing the job of inspector/tester. He was released to work with restrictions that did not prevent him from performing this light duty work. Mr. Anderson complains that he is unable to do the job because he cannot tolerate driving. Over the years, Mr. Anderson has attributed his problem driving to neck pain. But Dr. Kral-jic, who treated Mr. Anderson’s neck pain, was aware of Mr. Anderson’s complaints about driving and released Mr. Anderson to do that job. Dr. Kraljic was provided with a Field Inspector Job Description that advised that the worker must have a valid driver’s license, that most assignments are performed at a job site, and that travel was required “approximately 90% of the time.” Dr. *521Krause limited Mr. Anderson’s driving to 10 to 15 minutes, but she did so based on Mr. Anderson’s subjective complaints made years after the work injury and after the vocational consultant’s report.
[¶ 31] In the ALJ’s order after the remand, the ALJ noted:
[WSI’s counsel] conceded that there was sufficient evidence in the record upon which the ALJ could determine that WSI had accepted liability for Mr. Anderson’s neck condition and that it had liability after June 16, 2010, the date Dr. Kraljie released Mr. Anderson to return to work without restrictions. [WSI’s counsel] also conceded that WSI was required to consider Mr. Anderson’s neck condition when it determined the first appropriate rehabilitation option. Accordingly, the parties agreed that the sole issue for hearing was “what effect, if any, did Mr. Anderson’s neck condition have on the validity of WSI’s vocational rehabilitation plan.”
WSI conceded it was hable for Anderson’s neck injuries, and the ALJ made extensive findings of fact regarding Anderson’s neck pain. However, upon reviewing the ALJ’s order after the remand, the ALJ appears to have classified Anderson’s neck pain as a separate injury, referring to Ms neck injuries as “subjective complaints made years after the work injury.” The ALJ did not consider Anderson’s neck pain a “work-related injury,” and she discounted Dr. Krause’s medical opinions and driving restrictions for Anderson because they were “based on Mr. Anderson’s subjective complaints ... and [made] after the vocational consultant’s report.”
[¶ 32] This Court has previously held the Bureau need not consider any medical limitations a claimant suffers from subsequent non-work-related injuries. See Holtz v. N.D. Workers Comp. Bureau, 479 N.W.2d 469, 471 (N.D.1992). In Bjerke v. N.D. Workers Comp. Bureau, 1999 ND 180, ¶¶ 21-22, 599 N.W.2d 329, this Court also held a claimant whose work-related disability has resolved, but who remains disabled due to a subsequent non-work-related disability, is not entitled to continued disability benefits. Here, unlike in Holtz and Bjerke, WSI conceded it was hable for Anderson’s neck injuries, and the purpose of the hearing on remand was to determine “what effect, if any, did Mr. Anderson’s neck condition have on the validity of WSI’s vocational rehabilitation plan.” The ALJ attempted to distance Anderson’s neck injuries from his “work injury” and discounted medical evidence from Dr. Krause that was favorable to Anderson.
[¶ 33] I do not beheve the ALJ adequately explained her reasons for disregarding the medical evidence that was favorable to Anderson, particularly in light of the job description requiring traveling “approximately 90% of the time.” See Bergum v. N.D. Workforce Safety and Ins., 2009 ND 52, ¶ 17, 764 N.W.2d 178 (“WSI must consider the entire record, clarify inconsistencies, and adequately explain its reasons for disregarding medical evidence favorable to the claimant.”) (citation omitted).
[¶ 34] In the ALJ’s conclusions of law section in her order after the remand, the ALJ stated, “Mr. Anderson had no driving limitations at the time of the injury or on the date of the rehabilitation consultant’s report.” The ALJ acknowledged Anderson’s argument that his rehabilitation option was inappropriate because Dr. Krause subsequently put driving restrictions on Anderson; however, she cited Hoffman v. N.D. Workers Comp. Bureau, 1999 ND 66, ¶ 12, 592 N.W.2d 533, for support, stating “the Bureau’s assessment of a rehabilitation program’s viability is judged by evidence the Bureau has before *522it at the time it makes the decision.” In Stenvold v. Workforce Safety and Ins., 2006 ND 197, ¶¶ 5-6, 9, 722 N.W.2d 365, new medical evidence was obtained after WSI had entered a final order terminating disability benefits, and the claimant’s doctor’s recommendation was also not before the ALJ when the ALJ issued his decision. This Court held that evidence not before the ALJ or WSI could not be considered on appeal. Id. at ¶ 14. In this cáse, like in Stenvold, Anderson’s new medical evidence with Dr. Krause was not before WSI when Anderson’s vocational rehabilitation plan was issued; however, unlike in Sten-vold, the ALJ did have such evidence before her. ■
[¶ 35] I would remand for. further explanation of the ALJ’s findings.
[¶ 36] CAROL RONNING KAPSNER.