12-0011. NANNETTE GIROUX Employee v. FRED MEYER STORES INC Employer and FRED MEYER STORES INC. Insurer Defendant(s).
Court | Alaska |
Alaska Workers Compensation Decisions
2012.
Workers' Compensation Board
12-0011.
NANNETTE GIROUX Employee v. FRED MEYER STORES INC Employer and FRED MEYER STORES INC. Insurer Defendant(s)
Alaska Workers'
Compensation Appeals Commission
NANNETTE GIROUX, Employee, Applicant v. FRED MEYER STORES INC, Employer, and
FRED MEYER STORES, INC., Insurer, Defendant(s).AWCB Decision No. 12-0011Filed with AWCB Anchorage, Alaska on
January 12, 2012AWCB Case No. 200905952INTERLOCUTORY DECISION AND ORDERNannette Giroux's (Claimant) appeal of the reemployment
benefits administrator (RBA) designee's January 19, 2011 denial of reemployment
benefits eligibility was heard on November 16, 2011, in Anchorage, Alaska.
Claimant represented herself, appeared and testified. Attorney Michelle Meshke
represented Fred Meyer Stores, Inc. (Employer or Fred Meyer). Rehabilitation
specialist Carol Jacobsen testified for Employer. The record closed on December
19, 2011, when the panel completed deliberation.
As a preliminary matter, Employer's October 25, 2011 petition
for hearing officer recusal was addressed. After hearing Employer's arguments
for recusal, the hearing officer declined to recuse herself. After privately
deliberating, the panel's lay members declined to recuse the hearing officer,
and the underlying matter proceeded as scheduled. The hearing officer's refusal
to recuse herself and the panel's lay members' oral order declining to recuse
the hearing officer are examined and memorialized below.
ISSUES
Employer contends the board's April 26, 2011 letter denying the
parties' proposed Compromise and Release Agreement (C and R) demonstrates
either bias, or the appearance of bias on the assigned hearing officer's part,
and Claimant's actions after receiving the C and R denial letter support
Employer's contention. Employer contends the hearing officer should recuse
herself, or be disqualified by the lay panel members, and another hearing
officer assigned to this case.
Claimant contends her decision to forego a C and R hearing
after receiving the denial letter was motivated by her persisting medical
issues, including a referral by her treating physician to a neurosurgeon for a
surgical evaluation, not by the C and R denial letter.
1. Does the C and R denial letter demonstrate bias or the
appearance of bias on the part of the hearing officer, and thereby require her
recusal?
Claimant contends the RBA designee erred when she determined
Claimant was ineligible for reemployment benefits because she does not have the
physical abilities to perform the physical demands of jobs within her 10-year
work history.
Employer contends the RBA designee's decision was supported by
substantial evidence, and the designee did not abuse her discretion when she
found Claimant ineligible for reemployment benefits.
2. Did the RBA designee apply controlling law and exercise
sound legal discretion when she found Claimant ineligible for reemployment
benefits?
3. Was the RBA designee's decision denying Claimant's
eligibility for reemployment benefits supported by substantial evidence?
FINDINGS OF FACT
Evaluation of the record as a whole establishes the following
facts and factual conclusions by a preponderance of the evidence:
1) On May 2, 2009, Claimant injured her low back while
"STACKING FREIGHT IN BAKERY FREEZER." (Employer description of events contained
in Report of Injury, May 3, 2009).
2) At the time of the 2009 work injury, Claimant had been
employed since July 1, 2000 under several of Employer's job titles.
(Reemployment Benefits Eligibility Report, March 26, 2010; Reemployment
Benefits Eligibility Report Addendum 4, January 3, 2011).
3) Employer accepted the claim and paid medical, indemnity and
permanent partial impairment (PPI) benefits. (Compensation Reports dated May 5,
2009, December 22, 2009).
4) From May 5, 2009, through September 10, 2009, Claimant was
treated conservatively, first by family medicine physician J.C. Cates, D.O. Dr.
Cates prescribed, and Claimant attended physical therapy (PT) with United
Physical Therapy. Dr. Cates referred Claimant to Alaska Spine Institute (ASI)
for a pain consultation and work hardening program, and to Maury Oswald, D.O.
for follow-up care. (Dr. Cates chart notes; United PT chart notes; Dr. Oswald
Progress Note, September 17, 2009; Dr. Gevaert letter to Dr. Cates, July 16,
2009).
5) At ASI, on or about July 16, 2009, Claimant saw physical and
rehabilitation medicine physician Michel L. Gevaert, M.D. (Dr. Gevaert letter
to Dr. Cates, July 16, 2009; Dr. Cates chart note, September 2, 2009).
6) Dr. Gevaert prescribed Neurontin and Mobic for Claimant's
pain, recommended a repeat epidural steroid injection with a left L5-S1
transforaminal approach, and referred her to ASI's PT program for a structured
work hardening program and physical capacities evaluation (PCE). (Dr. Gevaert
letter to Cates, July 16, 2009; chart notes through December 1, 2009).
7) From September 23, 2009, to November 19, 2009, Claimant
participated in a work hardening program and PCE conducted by ASI occupational
therapist John DeCarlo, OTR. Mr. DeCarlo reported Claimant exerted maximal
effort, exhibiting no symptom magnification. He noted he had received
Employer's job description for its job title "Bakery Clerk" from Sedgwick
Claims Management Services, Employer's adjusting firm. He opined Claimant was
unable to lift and carry up to 50 pounds occasionally, one of the physical
demands for Employer's bakery clerks. (Work hardening chart notes
September-November 2009; PCE, November 19, 2009).
8) On December 1, 2009, Claimant last treated with Dr. Gevaert,
who conducted a PPI evaluation. Dr. Gevaert noted Claimant completed the work
hardening program, and could perform in the "light-medium physical demand
classification." He recorded Claimant's continuing complaints of moderate low
back pain in the lumbosacral junction at L4-L5 radiating into both buttocks,
with episodic pain radiating into the left calf and into the right poplitea,
with mild tingling sensation in the left foot, symptoms worse with coughing and
standing, alleviated with rest in a seated or supine position. His impression
was "HNP (herniated nucleus pulposus) L5-S1, and Nonfocal neurologic
examination." He rated Claimant with a 5% whole person permanent impairment
under the 6th edition of the American Medical Association (AMA) Guides
to Evaluation of Permanent Impairment. Dr. Gevaert imposed a permanent
lifting restriction of 35 pounds occasionally and 25 pounds frequently. (PPI
Evaluation Report, December 1, 2009).
9) On September 17, 2009, Claimant began treating with Dr.
Oswald, also on referral from Dr. Cates. Dr. Oswald referred her to Integrative
Physical and Spine Treatment Center for VAX-D PT, which she received from
December 3, 2009, through at least March 17, 2010. (Chart note, September, 17,
2009; Integrative PT progress notes).
10) On December 29, 2009, Dr. Gevaert responded to an inquiry
from Sedgwick. He too was provided with Fred Meyer's job description for its
job titled "Bakery Clerk," and asked if Claimant could perform as a "Bakery
Clerk" without restriction. Dr. Gevaert responded in the negative, re-iterating
she could lift no more than 35 pounds occasionally, and no more than 25 pounds
frequently. (Dr. Gevaert response, December 29, 2009, to Sedgwick CMS inquiry
of December 1, 2009).
11) On January 14, 2010, Dr. Oswald conducted an
electrodiagnostic study, and concluded Claimant suffered left L5 peroneal nerve
pathology - moderate, and left L1 upper lumbar nerve irritation. He continued
decompression treatments at Integrative PT, but noted if there was no
improvement he would refer Claimant for surgical evaluation. (Progress note,
January 14, 2010).
12) On January 29, 2010, Employer's claims manager wrote the
RBA requesting a vocational eligibility evaluation be conducted. (Letter from
Laurie Amidon to Mark Kemberling, RBA, January 29, 2010).
13) On March 5, 2010, rehabilitation specialist (RS) Carol
Jacobsen was assigned to conduct an evaluation to assist the office of the RBA
in its determination of Claimant's eligibility for reemployment benefits.
(Letter from Debra Reed to Jacobsen, March 5, 2010).
14) On March 26, 2010, the RS filed her first report with the
RBA designee. She stated she interviewed Claimant on March 19, 2010. The RS
reported Claimant's work history as:
9/95-7/1/00
Employer: Safeway-Anchorage, Alaska
Job Title: Bakery (5 years)
SCODRDOTs:(fn1) Packager, Hand (DOT Code
920.587-018) - 50% and Cake Decorator (DOT Code 524.381-010) - 50% --
Combo
7/1/00-9/27/09
Employer: Fred Meyer-Eagle River, Alaska
Job Title: Cake Decorator (3 years) Bakery
Manager (4 years) Food Manager Trainee (1 years)
SCODRDOTs: Cake Decorator (DOT Code
524.381-010)/Packager, Hand (DOT Code 920.587-018) - Combo; Manager, Bakery,
(DOT Code 189.117-046); Management Trainee (DOT Code 189.167-018).
(Reemployment Benefits Eligibility Evaluation, March 26, 2010).
15) The rehabilitation specialist reported Claimant worked from
September 1995, through July 1, 2000, in the Carrs-Safeway bakery department,
and her job title, "Bakery," was comprised of 50% Cake Decorator (SCORDROT
524.381-010), and 50% Packager, Hand (SCODRDOT 920.587-018) duties. There is no
evidence the RS obtained any information from Carrs-Safeway documenting
Claimant's job titles or duties while employed there. Nor did the RS explain
why she was reporting Claimant's work from September 1995, almost fourteen
years prior to the work...
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