17-11WC. Enoch Rowell v. Northeast Kingdom Community Action.

• Court: Vermont

Vermont Workers Compensation 2011. 17-11WC. Enoch Rowell v. Northeast Kingdom Community Action Enoch Rowell v. Northeast Kingdom Community Action(July 6, 2011)Opinion No. 17-11WCBy: Phyllis Phillips, Esq. Hearing OfficerFor: Anne M. Noonan CommissionerState File No. Y-58698OPINION AND ORDERATTORNEYS: Heidi Groff, Esq., for Claimant Robert Mabey, Esq., for DefendantISSUES PRESENTED:

1. Is Claimant permanently and totally disabled as a consequence of his February 4, 2007 compensable work injury?

2. If not, what is the extent, if any, of Claimant's permanent partial disability causally related to his February 4, 2007 compensable work injury?

3. Is Defendant obligated to pay for a special lift chair as a reasonable and necessary medical supply causally related to Claimant's February 4, 2007 compensable work injury?

EXHIBITS: Joint Exhibit I: Medical records Claimant's Exhibit 1: Service Contract Claimant's Exhibit 2: Hours and wages for 2010 work at NCJC Claimant's Exhibit 3: Vocational Rehabilitation Plan, December 14, 2010 Claimant's Exhibit 4: Resume with handwritten corrections Claimant's Exhibit 5: Dr. White report, January 12, 2009 Claimant's Exhibit 6: Dr. Harris letter, May 8, 2009 Claimant's Exhibit 7: Functional Capacity Evaluation, May 28, 2009 Claimant's Exhibit 8: Special lift chair prescription, July 8, 2008 Claimant's Exhibit 9: James Parker vocational assessment, January 7, 2011 Claimant's Exhibit 10: Fran Plaisted vocational evaluation, January 5, 2011 Defendant's Exhibit A: NCJC employment records Defendant's Exhibit B: Cover letter and resume, March 23, 2004 Defendant's Exhibit C: Newport Daily Express, January 8, 2008 Defendant's Exhibit D: Meeting attendance records, July 2009-May 2010 Defendant's Exhibit E: COSA Activity Log Defendant's Exhibit F: Curriculum vitae, Fran Plaisted CLAIM: Permanent total disability benefits pursuant to 21 V.S.A. §645 Permanent partial disability benefits pursuant to 21 V.S.A. §648 Medical benefits pursuant to 21 V.S.A. §640 Interest, costs and attorney fees pursuant to 21 V.S.A. §§664 and 678 FINDINGS OF FACT: 1. At all times relevant to these proceedings, Claimant was an employee and Defendant was his employer as those terms are defined in Vermont's Workers' Compensation Act. 2. Judicial notice is taken of all relevant forms contained in the Department's file relating to this claim. 3. Claimant worked as an Integrated Housing Specialist at a halfway house operated by Defendant for recently released correctional center inmates. His job involved counseling and assisting the residents with such community integration skills as finding permanent housing and securing employment. Claimant did not live at the house, but was frequently there, as his duties included checking up on both the residents and the house itself. Claimant's February 2007 Work Injury, Subsequent Medical Course and Prior Medical History 4. On February 4, 2007 Claimant was at the halfway house, checking for frozen pipes in the basement. He tripped as he ascended the stairs and fell forward. Claimant heard a pop in his lower back and felt immediate pain both there and in his right shoulder. 5. Defendant accepted Claimant's injury as compensable and began paying workers' compensation benefits accordingly. 6. From the beginning Claimant treated conservatively for his low back pain, principally with Dr. Harris, his primary care provider. None of the treatments prescribed, including physical therapy, aqua therapy and injections, provided effective long-term relief. 7. As for his right shoulder injury, initially Claimant experienced pain, limited range of motion and decreased function. A September 2007 MRI revealed findings suspicious for a labral tear, which was to be surgically repaired in January 2008. The night before the scheduled surgery, however, Claimant awoke to a vision of an angel and the Lord hovering over his bed. By the next morning his symptoms had completely resolved and the surgery was cancelled. Claimant described this experience as a "divine intervention." Upon reexamining the shoulder in February 2008, Claimant's primary care provider found no evidence of shoulder pathology, and offered no medical explanation for the resolution of Claimant's symptoms. 8. With the Department's approval, Defendant discontinued Claimant's temporary total disability benefits on end medical result grounds effective October 29, 2007. 9. Even after having been determined to be at end medical result, in October 2008 Claimant was evaluated for entry into a functional restoration program for treatment of his chronic low back pain, but due to both high blood pressure and a limited exercise tolerance he was determined not to be a suitable candidate. Also in October 2008 Claimant was referred for cognitive behavioral therapy to assist with chronic pain management. Claimant did not feel capable of making the weekly trip to Burlington for group sessions, however, and therefore did not participate. 10. Currently Claimant experiences constant intractable low back pain radiating into his right buttock. The pain is hot, deep and intense. It is inadequately controlled with narcotic pain medications, deep breathing, meditation and prayer. Claimant can sit or stand for only brief periods without having to alternate his position due to increased pain. With a cane, he is able to take short walks up and down his road from time to time throughout the day. Climbing stairs causes severe pain, and as a result Claimant can no longer access his bedroom, which is on the second floor of his house. He now sleeps downstairs in his living room. His sleep is often interrupted by pain. 11. Claimant is most comfortable sitting in a reclining chair with his knees bent, which takes the pressure off of his lower back. At home he uses a special reclining lift chair that his primary care provider, Dr. Harris, prescribed in July 2008. The chair is equipped with a mechanism that lifts him to a standing position, thus decreasing the pain he otherwise experiences when moving from sitting to standing. After Defendant refused to pay for the chair, Claimant purchased it himself at a cost of $1,040.00. 12. Prior to the February 2007 injury Claimant enjoyed hunting, fishing, playing outside with his grandchildren and attending family gatherings. Since the injury Claimant has been limited by pain from engaging in these activities. 13. Claimant acknowledged, and the medical records reflect, that he had suffered from episodes of chronic low back pain at times prior to February 2007, but these always resolved, never interfered with his ability to work and required only occasional use of narcotic pain medications. Claimant testified credibly that since the February 2007 injury his pain has been significantly more severe, more constant and more intractable than anything he had experienced previously. 14. Claimant's medical history has been complicated by numerous medical conditions unrelated to his February 2007 injury. He had been plagued by knee pain for some years prior, as treatment for which he underwent bilateral knee replacement surgeries in June and July 2007. In August 2007 he underwent carpal tunnel release surgery. Claimant also suffers from obesity, sleep apnea, diabetes and high blood pressure. He was hospitalized in June 2010 for congestive heart failure, and again in August 2010 for gall bladder surgery. Claimant's wife testified credibly that since the latter two hospitalizations Claimant's overall function has improved. He has lost weight, is walking more and has decreased his use of pain medications. Expert Medical Opinions 15. Drs. Harris, White and Backus all expressed opinions as to (1) the causal relationship between Claimant's current condition and his February 2007 work injury; (2) the extent of the permanent impairment referable to that injury; and/or (3) Claimant's current work capacity. (a) Dr. Harris 16. Dr. Harris is board certified in internal medicine and has been Claimant's primary care provider since 2004. He is well-positioned, therefore, to evaluate and compare Claimant's low back condition both before and after the February 2007 work injury. 17. Dr. Harris acknowledged that prior to February 2007 Claimant had some documented degenerative disc disease in his lumbar spine, and also that he experienced intermittent episodes of low back pain. In Dr. Harris' opinion, the February 2007 injury aggravated Claimant's underlying disc disease to the point where it became chronic, increased in...