5439 CRB-4-09-2 (2010). Volmut v. General Electric Company.

• Court: Connecticut

Connecticut Workers Compensation 2010. 5439 CRB-4-09-2 (2010). Volmut v. General Electric Company CASE NO. 5439 CRB-4-09-2COMPENSATION REVIEW BOARD WORKERS' COMPENSATION COMMISSIONAPRIL 7, 2010VINCENT C. VOLMUT CLAIMANT-APPELLEE CROSS-APPELLANT v. GENERAL ELECTRIC COMPANY EMPLOYER and SEDGWICK CMS, INC. INSURER and ELECTRIC INSURANCE COMPANY INSURER RESPONDENTS-APPELLANTS CROSS-APPELLEES APPEARANCES: The claimant was represented by Robert F. Carter, Esq., Carter and Civitello, One Bradley Road, Suite 301, Woodbridge, CT 06525. The respondents were represented by Nicholas W. Francis, Esq., Law Offices of Jonathan M. Zajac, LLC, 152 Simsbury Road, P.O. Box 699, Avon, CT 06001. This Petition for Review from the February 20, 2009 Finding and Approval/Finding and Dismissal of the Commissioner acting for the Fourth District was heard on September 25, 2009 before a Compensation Review Board panel consisting of the Commission Chairman John A. Mastropietro and Commissioners Ernie R. Walker and Christine L. Engel. OPINIONJOHN A. MASTROPIETRO, CHAIRMAN. Both parties to this claim have petitioned for review from the February 20, 2009 Finding and Approval/Finding and Dismissal of the Commissioner acting for the Fourth District. Having reviewed the merits of both petitions, we affirm the decision of the Commissioner.(fn1) The trial commissioner made the following factual findings which are pertinent to our review. On March 9, 1999, the claimant, who was employed by the respondent as a videocommunications specialist, sustained an injury to his lumbar spine while attempting to maneuver a cart holding a large television through a set of doorways. In October 1999, James Sabshin, M.D., performed a L4-5 discectomy, and in March 2006, the claimant underwent a four-level fusion with Jeffrey Sumner, M.D. Dr. Sumner performed a second fusion in June 2007. The claimant ultimately came under the care of Rakesh Patel, M.D. for pain management. The claimant has been totally disabled since the date of the injury. Following routine blood work done on March 15, 2006, Dr. Patel discovered the claimant's testosterone count had fallen well below the normal range of 350-850, and referred the claimant to Adam Mayerson, M.D., an endocrinologist. Dr. Mayerson diagnosed the claimant as suffering from hypogonadism secondary to a combination of a partially empty sella and the chronic use of narcotic pain medication. Claimant's Exhibit B (Report of September 15, 2006). In his report of April 24, 2006, Dr. Mayerson stated that the claimant's "medical history include[d] a condition known as gynecomastia (male breast enlargement caused by an imbalance of the hormones estrogen and testosterone) that began in the claimant's early teens."(fn2) Findings, ¶ 10. See also Claimant's Exhibit B. Noting that laboratory results from March 15, 2006 had revealed a total testosterone count of 19, Dr. Mayerson opined that "[w]hile chronic narcotic use can lead to secondary hypogonadism, the levels are not typically this low." Claimant's Exhibit B (Report of April 24, 2006). A subsequent head/cranial MRI performed on April 28, 2006 revealed a "[p]artially empty sella with a thin pituitary gland along floor of the sella." Claimant's Exhibit B. In his RME report dated October 3, 2008, William Druckemiller, M.D., opined that it was "not absolutely clear how much the chronic narcotic use contributes to [the claimant's] low testosterone level. If he did not have an empty sella it would be the causative factor." Respondents' Exhibit 5, p. 3. On June 4, 2008, Dr. Patel issued an office note in which he indicated the claimant was depressed and that he had discussed with the claimant a referral to a psychiatrist. Claimant's Exhibit H. In his correspondence of October 2, 2008 to the claimant's physician, Dr. Patel opined that the claimant's back pain was a substantial contributing factor for treatment with a psychiatrist. Claimant's Exhibit M. The claimant testified he had never been formally diagnosed with depression prior to 2005, when Eric Liben, M.D., a former treating physician, tried to give him some sample medications for depression. September 4, 2008 Transcript, p. 46. The evidentiary record also contains a discharge summary pertaining to the March 2006 surgery which indicates the claimant had a prior medical history of depression.(fn3) Respondents' Exhibit 4. The claimant testified that he did not know where the diagnosis came from, September 4, 2006 Transcript, p. 47, given that Dr. Liben's notes are silent relative to a possible diagnosis of depression because the claimant told him he didn't want a reference to depression in his records in light of the "stigmata in our society for people who have mental problems." Id., at 46. The claimant testified that when he awoke following his second fusion surgery of June 27, 2007, he experienced numbness, aching and shooting pain in three fingers of his left hand. Id., at 23. Although the claimant testified that he told Dr. Sumner about the hand symptoms at several office visits following the surgery, the doctor "never noted the problem and his complaints fell on deaf ears."(fn4) Findings, ¶ 24. See also September 4, 2008 Transcript, pp. 54-55. In his office note of October 1, 2007, Dr. Sumner indicated he had "inadvertently omitted" to mention the claimant's left-hand symptoms at the claimant's office visit of September 14, 2007 and noted the claimant believed it was "a function of positioning." Claimant's Exhibit D. The claimant also testified that he informed Dr. Patel of the hand symptoms right after the June 27, 2007 surgery, and Dr. Patel opined that he had probably not been positioned correctly during surgery. September 4, 2008 Transcript, pp. 23-24. Dr. Patel's notes for the claimant's office visits of August 1, 2007 and October 9, 2007 - the first two office visits following the claimant's surgery - do not contain a reference to any hand symptoms. Similarly, Dr. Druckemiller, in his RME report of October 3, 2008, stated that "[t]he exact etiology of the ulnar nerve symptoms is not documented in the medical records." Respondents' Exhibit 5, p. 2. Dr. Druckemiller also observed that "[t]here is no history of onset of numbness in the arm at the time of surgery. When this happens, it is noted immediately in the hospital and there is never a question regarding this." Id. On November 13, 2007, the claimant consulted Mark Altman, M.D., who diagnosed the claimant with "ulnar nerve neuropathy arising from the elbow and probably secondary to compression" and performed ulnar nerve surgery some time in December 2007. Claimant's Exhibit G. However, on August 29, 2006, the claimant had apparently consulted an associate of Dr. Altman regarding bilateral shoulder pain, who reported that "the claimant has had intermittent numbness in both hands approximately two times each week and that he had been diagnosed years earlier with carpal tunnel syndrome."(fn5) Findings, ¶ 28. See also Respondents' Exhibit 2. The claimant submitted an exhibit documenting...