12-0085. JAMES R. MACRAE Employee v. FRED MEYER INC Self-Insured Employer.

Court:Alaska
 
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Alaska Workers Compensation Decisions 2012. Workers' Compensation Board 12-0085. JAMES R. MACRAE Employee v. FRED MEYER INC Self-Insured Employer ALASKA WORKERS' COMPENSATION BOARDP.O. Box 115512 Juneau, Alaska 99811-5512 JAMES R. MACRAE, Employee, Applicant v. FRED MEYER INC, Self-Insured EmployerAWCB Case No. 199923006AWCB Decision No. 12-0085Filed with AWCB Anchorage, Alaska on May 10, 2012FINAL DECISION AND ORDERJames MacRae's (Employee) workers' compensation claim (WCC) was heard on March 28, 2012, in Anchorage, Alaska. Dianne MacRae, Employee's spouse, was his non-attorney representative. Attorney Michelle M. Meshke represented Fred Meyer, Inc. (Employer). The record remained open until April 11, 2012, to allow Employer time to ascertain if it wished to exercise its right to cross-examine Lavern Davidhizar, D.O. The record closed on April 11, 2012. ISSUES Employee contends he is entitled to ongoing medical benefits, including prescriptions for Oxymorphone Hydrochloride, Opana, Piroxicam, Zanaflex, lumbar x-rays, lumbar magnetic resonance imaging (MRI), physical therapy, and epidural steroid injections, as a result of his low back injury in December 1999. Employee contends the State of Alaska has been paying for his medical treatment since Employer controverted his benefits in 2005 and the State should be reimbursed. Employee further asserts the 1999 work injury is still a substantial factor in his need for medications and ongoing medical treatment. Employer contends Employee's work injury resolved by 2000, or at least in 2004, and any ongoing medical treatment and prescriptions are related to Employee's pre-existing and progressive degenerative disc disease and somatoform disorder, which is the result of Employee's pre-existing bipolar disease. Employer asserts the 1999 work injury is no longer a substantial factor in the need for either medical treatment or prescriptions. Employer further contends the medical treatment now sought by Employee is no longer reasonable and necessary as a result of the 1999 work injury. Is Employee entitled to medical treatment after 2005 as a result of the 1999 work injury? FINDINGS OF FACT A review of the entire record established the following facts and factual conclusions by a preponderance of the evidence: 1) Employee sustained an injury to right side of his mid-low back on December 29, 1999, while working as a cashier for Employer (Report of Occupational Injury or Illness (ROI), January 4, 2000). 2) Employee was paid temporary total disability and temporary partial disability benefits through April 2000. On May 25, 2000, Employee was paid permanent partial disability benefits in a lump sum of $6,750 based on a 5% rating by his treating doctor (Compensation Report, May 22, 2000). 3) On March 1, 1988, Employee saw Thomas Vasileff, M.D., for a knee cyst. Dr. Vasileff noted Employee's long history of back problems for which he was taking Percodan and Flexeril (Vasileff report, March 1, 1988). 4) On December 23, 1994, Employee saw Aron S. Wolf, M.D., at Langdon Clinic, for of depression. Dr. Wolfs impressions included Employee's history of alcohol and cocaine dependence, history of depression and panic attacks, and personality disorder NOS (not otherwise specified). Employee was being treated with Paxil and Klonopin (Wolf report, December 23, 1994). 5) On December 30, 1999, Employee saw Robert R. Artwohl, M.D., for back pain and pain in the right leg. His past medical history was notable for depression. Dr. Artwohl's impression was lower back strain, with possible herniated disc. He recommended bed rest, heat, Flexeril, Vicoprofen and referral to an orthopedic surgeon (Artwohl report, December 30, 1999). 6) On January 10, 2000, Employee saw Declan R. Nolan, M.D., on referral for low back pain. Dr. Nolan's assessment was acute lumbar disc syndrome with probably resolving right lumbar radiculopathy. Dr. Nolan recommended bed rest of five to seven days followed by a physical therapy program. Employee was to stay off work for two weeks (Nolan report, January 10, 2000). 7) On January 26, 2000, Employee saw Dr. Nolan complaining about his upper back and neck more than his low back. Employee's leg pain was less and he had no new weakness or numbness. Employee's objective examination showed improvement. Dr. Nolan recommended Employee be off work for two more weeks and then return to work without restriction (Nolan report, January 26, 2000). 8) On February 9, 2000, Employee reported to Dr. Nolan his back was worse although he had no radiation, no weakness, and no numbness. Employee showed markedly restricted motion with guarding and very little flexion. Dr. Nolan recommended an MRI and gave Employee a prescription for DarvocetN-100 (Nolan report, February 9, 2000). 9) On February 10, 2000, Employee had an MRI without contrast which showed a mild L2-L3 disc bulge but no evidence of a herniated nucleus pulposus (FDNP) or neural impingement (MRI report, February 10, 2000). 10) On February 14, 2000, Employee saw Dr. Nolan for the results of the MRI. Dr. Nolan opined Employee would improve with time and released Employee to light duty work. Employee had no instability or radiculopathy. Dr. Nolan referred Employee to Susan Klimow, M.D., for a rehabilitation consultation (Nolan report, February 14, 2000). 11) On February 21, 2000, Employee saw Dr. Klimow who noted Employee had been to physical therapy and had a home stretching program. She noted Employee worked seasonally for Employer and ran a commercial fishing boat in the summers. She stated Employee was in the care of Greg McCarthy, M.D., psychiatrist. Her impression was lumbosacral back pain with L2-L3 degenerative disc disease and evidence on examination of right SI involvement inconsistent with symptoms and MRI. She recommended Motrin 800 mg and a release to work 6 hours per day with lifting up to 50 pounds occasionally, and increasing to 8 hours per day over the next three weeks with no prolonged walking. Employee was to continue with a home exercise program (Klimow report, February 21, 2000). 12) On March 1, 2000, Employee underwent an electrodiagnostic study with Dr. Klimow. The electrodiagnostic study was normal as was the SI nerve function of the bilateral lower extremities. She noted he had completed routine physical therapy and was referred to a work reconditioning program. He was released to work light duty for four hours a day initially. He was also referred to biofeedback to help him learn to relax his neck muscles. Her impression remained lumbosacral back pain with L2-L3 degenerative disc disease (Klimow report, March 1, 2000). 13) On April 11, 2000, Employee saw Dr. Klimow and reported he was doing better overall. Employee was to complete the BEAR work hardening program and then have a physical capacities evaluation. Employee was to continue with a home exercise program (Klimow report, April 11, 2000). 14) On April 19, 2000, Dr. Klimow found Employee to be medically stable and rated him for permanent partial impairment (PPI) under the AMA Guides to Evaluation of Permanent Impairment, 4th Edition, with a 5% whole person rating. She noted Employee had recurrent lumbosacral back pain which was intermittent in nature, a negative neurological exam, L2-L3 degenerative disc disease, and bipolar disorder. Employee was released to medium capacity work for lifting but was limited to standing for 30 minutes at a time. He was not precluded from commercial fishing but was limited to cashier work to be performed while sitting. Employee was advised to take Motrin as needed and was given a prescription for Anexsia for severe pain (Klimow report, April 19, 2000). 15)On November 2, 2000, Employee again saw Dr. Klimow for recurrent low back pain. He had returned to work for Employer after working as a commercial fisherman during the "on"...

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