12-0027. CYNTHIA MOULTON Employee v. FAIRBANKS MEMORIAL HOSPITAL Employer and SENTRY MUTUAL INSURANCE CO. Insurer Defendants.
Alaska Workers Compensation Decisions 2012. Workers' Compensation Board 12-0027. CYNTHIA MOULTON Employee v. FAIRBANKS MEMORIAL HOSPITAL Employer and SENTRY MUTUAL INSURANCE CO. Insurer Defendants CYNTHIA MOULTON, Employee, Applicant, v. FAIRBANKS MEMORIAL HOSPITAL, Employer, and SENTRY MUTUAL INSURANCE CO., Insurer, Defendants.AWCB Decision No. 12-0027Filed with AWCB Fairbanks, Alaskaon February 15, 2012AWCB Case No. 200707707INTERLOCUTORY DECISION AND ORDERCynthia Moulton's (Employee) July 22, 2011 Petition for a second independent medical examination (SIME) with a pain management specialist was heard in Fairbanks, Alaska on January 19, 2012. Employee represented herself and appeared in person and testified. Attorney Dennis Cook represented Fairbanks Memorial Hospital and Sentry Mutual Insurance Co. (Employer). This matter was heard before a two member panel, a quorum under AS 23.30.005(f). The record closed at the hearing's conclusion on January 19, 2012. ISSUE Employee contends an SIME with a pain management specialist should be ordered because the SIME physician, John Lipon, M.D., an orthopedic surgeon, opined Employee has low back pain related to the work injury, but Dr. Lipon's report did not address ongoing pain management. She further contends Dr. Lipon disregarded objective evidence in the record, specifically Employee's reduced pain upon receiving epidural steroid injections. Employee also contends she was unaware "there were options available" concerning the SIME physician's medical specialty. Employer contends Dr. Lipon's SIME was thorough and fully addressed the disputed issues in Employee's claim. Employer concedes Employee experiences significant back pain, but notes Dr. Lipon agrees with Dr. Ballard the work injury is not the substantial cause of Employee's pain or need for treatment. Employer contends Employee is dissatisfied with the SIME report and should not be permitted to "doctor shop" for a more favorable medical opinion. Shall an SIME with a pain management specialist be ordered? FINDINGS OF FACT A review of the entire record established the following relevant facts and conclusions by a preponderance of the evidence: 1) On June 6, 2007, Employee, a computerized tomography (CT) technologist, was assisting a patient from his wheelchair to the CT table when she "twisted [her] back and hip." (Report of Occupational Injury or Illness, June 7, 2007). 2) On June 8, 2007, Employee saw Libby Silberling, PA-C. PA-C Silberling diagnosed low back pain/strain and prescribed a muscle relaxant and anti-inflammatory medication. (PA-C Silberling report, June 8, 2007). 3) Employer accepted liability for the injury and began paying temporary partial disability and medical benefits. (Compensation report, November 12, 2007). 4) On November 15, 2007, Thad Stanford, M.D. conducted an employer's medical examination (EME). Dr. Stanford diagnosed low back strain, preexisting T12-L1 degeneration, and thoracic rotoscoliosis. Dr. Stanford opined the work injury was the substantial cause of Employee's disability and need for medical treatment and recommended a consultation with an orthopedist and physical therapy. He opined anti-inflammatory medication may be helpful, but did not recommend injections. (Dr. Stanford EME, November 15, 2007). 5) Employee underwent a course of physical therapy and massage, which did not significantly improve her pain symptoms. (Physical therapy records, February - November 2008). 6) On January 24, 2009, Dr. Stanford conducted a second EME. Dr. Stanford diagnosed left SI strain, pain of undetermined etiology in the left leg and intermittent tingling in both legs. He opined the work injury was the substantial cause of Employee's need for medical treatment. He opined Employee was not medically stable and recommended nerve conduction studies and possible joint injection. (Dr. Stanford EME, January 24, 2009). 7) On March 23, 2009, Employee saw Janice Onorato, M.D., for a neurological consultation and nerve conduction studies. Dr. Onorato noted no electrophysiological evidence of lumbar radiculopathy on either side. Reviewing magnetic resonance imaging (MRI) studies, Dr. Onorato diagnosed lumbago and modest facet degeneration at L4-L5. She recommended injections into the L4-L5 facet joint and continued physical therapy and massage. (Dr. Onorato report, March 23, 2009). 8) Mark Weber, PA-C, performed a series of three soft tissue injections, which reduced Employee's pain symptoms. (PA-C Weber reports, October 2009 - January 2010). 9) On February 22, 2010, Employee underwent an MRI, which revealed progressive...
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