12-0086. LAWRENCE J. CAMERON Employee v. WHITE EAGLE INC Employer and AMERICAN INTERSTATE INSURANCE CO. Insurer Defendants.

Court:Alaska
 
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Alaska Workers Compensation Decisions 2012. Workers' Compensation Board 12-0086. LAWRENCE J. CAMERON Employee v. WHITE EAGLE INC Employer and AMERICAN INTERSTATE INSURANCE CO. Insurer Defendants ALASKA WORKERS' COMPENSATION BOARDP.O. Box 115512 Juneau, Alaska 99811-5512LAWRENCE J. CAMERON, Employee, Applicant V. WHITE EAGLE INC, Employer, and AMERICAN INTERSTATE INSURANCE CO., Insurer, Defendants.AWCB Case No. 200915446AWCB Decision No. 12-0086Filed with AWCB Fairbanks, Alaskaon May 11, 2012FINAL DECISION AND ORDERLawrence Cameron's (Employee) October 26, 2009 claim for benefits under the Alaska Workers' Compensation Act (Act) was heard on April 12, 2012, in Fairbanks, Alaska. Employee represented himself and testified. Attorney Robert Bredesen appeared and represented White Eagle, Inc. and American Interstate Insurance Co. (Employer). The record closed at the conclusion of the hearing, on April 12, 2012. ISSUES Employee contends Employer is liable for past and ongoing medical benefits related to his back condition, as his current pain is in the same area of his back as his original work injury. Employer contends Employee's work-related back injury was resolved no later than August 2010. 1) Is Employee entitled to past and ongoing medical benefits from Employer for treatment for his back condition? Employee contends he is entitled to temporary total disability (TTD) benefits ongoing from the date of injury. Employer contends all TTD payments owed have been paid. 2)Is Employee entitled to temporary total disability (TTD) benefits? Employee asserts he is entitled to reemployment benefits, as he is no longer "as employable as I was before the incident because they don't want someone who filed a workers' comp. claim." Employer contends Employee does not meet the eligibility requirements under AS 23.30.041(e) and is not entitled to reemployment benefits. 3)Is Employee entitled to reemployment benefits? Employee asserts he is entitled to a penalty on late-paid benefits. Employer contends because Employee is not entitled to the benefits he claims, he is not entitled to a penalty. 4)Is Employee entitled to a penalty? Employee contends he is entitled to interest on past-due benefits. Employer contends because Employee is not entitled to the benefits he claims, he is not entitled to interest. 5)Is Employee entitled to interest? 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 October 1, 2009, while working for Employer, Employee suffered a concussion, scalp laceration and injury to his ribs and spine when he "fell off a ladder, off a roof into a man basket positioned on the ground". (Report of Occupational Injury or Illness, October 12, 2009). 2)Employee was taken to Fairbanks Memorial Hospital (FMH). He received staples to close a 10-centimeter scalp laceration and medication for pain. X-rays of his thoracic spine were normal. (FMH Emergency Department report, October 1, 2009). 3)On October 14, 2009, Eric Meffley, PA-C prescribed pain medication and wrote a work restriction, noting Employee could return to work on November 2, 2009. (PA-C Meffley letter, October 14, 2009). 4)On October 26, 2009, Employee filed a workers' compensation claim seeking TTD from October 1, 2009 forward, medical costs, transportation costs, reemployment benefits, penalty, and interest. (Employee's Workers' Compensation Claim, October 26, 2009). 5)On October 29, 2009, Employee reported his pain was improving, and while he was not working, he had been "doing some labor around the house without much trouble other than occasional thoracic pain and spasm." PA-C Meffley released Employee to work "with slightly restricted capacity on solid ground x 2 weeks" and referred Employee for physical therapy. (PA-C Meffley report, October 29, 2009). 6)On November 20, 2009, Employer filed its answer to Employee's claim, admitting TTD from October 1, 2009 until Employee was released to work or medically stable, reasonable and necessary medical benefits related to the work injury, and transportation expenses. Employer noted Employee had not yet been off work for 90 days and so reemployment benefits were not yet at issue, and there were no unpaid benefits, and therefore no penalty or interest was due. Employer noted, "I have no idea why claimant filed a WCC." (Employer's Answer, November 18, 2009). 7)On November 30, 2009, Employee sought treatment with orthopedic surgeon Daniel Johnson, D.O. A review of thoracic spine films taken October 1, 2009 revealed a "possible compression fracture of T-10." Dr. Johnson noted:
I reassured [Employee] that he looks like he is doing fine from his injury. If he had a small compresion (sic) fracture at t-10 it is healed by now. I think he can return to work with no restrictions. He thought that was a good idea. He is discharged from our care.
(Dr. Johnson report, November 30, 2009). 8) On December 4, 2009, Employee complained of continued pain and muscle tension in his mid and upper back. Employee requested a referral to a spine specialist. PA-C Meffley released Employee to work without restriction and recommended he finish his physical therapy regimen. (PA-C Meffley report, December 4, 2009). 9)Employer made TTD benefit payments to Employee from October 1, 2009 through December 4, 2009, the date PA-C Meffley released Employee to work without restriction. (Compensation report, December 14, 2009). 10)On January 4, 2010, Employee reported "everything seems to be improving" and he experienced only "infrequent periodic [left] lateral rib discomfort." (PA-C Meffley report, January 4, 2010). 11)On August 2, 2010, Employee sought treatment for low back pain with Dr. Raymond. Employee reported "this is similar to an episode he had last October when he fell off a roof. This episode began 2 days ago with arising from bed. Felt a sharp spasm in left CVA area." Dr. Raymond prescribed medication for pain and referred Employee for physical therapy. (Dr. Raymond report, August 2, 2010). 12)On August 10, 2010, Employee reported his pain was improving but still occurred intermittently. PA-C Chapa noted, "Patient thinks this problem is redisual (sic) to an injury in Oct 2009 although he was asymptomatic from Dec 2009 til Jul 2010." (PA-C Chapa report, August 10, 2010). 13)On September 12, 2010, Jeremy Biggs, M.D., performed an Employer's Medical Evaluation (EME). Dr. Biggs opined:
It appears from the record that the back pain resolved between January 2010 and July 2010. Mr. Cameron had left sided low back pain after his original injury. I do not have any information on prior back history, assessment of impairment of a history of any other back injury. As the pain in his low back described in 8-2-10 is in a similar location and is described as similar to his prior pain, it is my opinion based on the available information that the recent medical care is related to the original injury.
(Dr. Biggs EME Report, September 12, 2010). 14)On October 20, 2010, Employee saw PA-C Chapa for persistent upper back pain after a "hard fall" "while in the street" on October 18, 2010. Employee noted he had a "similar injury a year ago at work that resolved." Nursing comments in the chart note from that date indicate Employee complained of back pain "that initally (sic) occurred 1 year ago when he fell off a roof. [Employee] states he slipped and fell on ice 2 days ago and re-injured his back."(PA-C Chapa report, October 20, 2010). 15)On November 4, 2010, Employer filed a controversion notice denying payment for medical treatment Employee received with PA-C Chapa on October 20, 2010, noting "Claimant re-injured his back on 10-18-10 while cossing (sic) an intersection. This new injury and care is unrelated to our injury dated 10-1-09." (Controversion Notice, November 2, 2010). 16)On October 31, 2011, Employee filed an affidavit of readiness...

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