Frykman v. St. Mary's Medical Ctr., 022399 MNWC,

Case DateFebruary 23, 1999
CourtMinnesota
LINDA L. FRYKMAN, Employee,
v.
ST. MARY'S MEDICAL CTR., SELF-INSURED, Employer/Appellant,
and
COMPREHENSIVE CARE SERVS., INC., Intervenor.
Minnesota Workers Compensation
Workers' Compensation Court of Appeals
February 23, 1999
         HEADNOTES          CAUSATION - GILLETTE INJURY. Substantial evidence, including the employee's testimony and medical and chiropractic treatment records, support the compensation judge's finding that the employee's work activities as critical care nurse for the employer aggravated her low back and left leg problems, and that the employee sustained a Gillette injury to her low back culminating in disability on November 6, 1996.          PERMANENT PARTIAL DISABILITY - BACK. Substantial evidence supports the compensation judge's award of a 7% permanent partial disability. The decision is modified, however, to reflect permanency due to a lumbar pain syndrome pursuant to Minn. R. 5223.0390, subp. 3.C.(1), rather than a radicular syndrome pursuant to Minn. R. 5223.0390, subp. 4.C.(1).          Affirmed as modified.           Determined by Johnson, J., Wilson, J. and Wheeler, C.J.           Compensation Judge: Donald C. Erickson           OPINION           THOMAS L. JOHNSON, Judge          The self-insured employer appeals from the compensation judge's finding that the employee sustained a Gillette1 injury to her low back culminating in disability on November 6, 1996, and from the judge's award to the employee of a 7% permanent partial disability. We affirm as modified.          BACKGROUND          The employee, Linda L. Frykman, was 51 years old at the time of the hearing. She began working as a registered nurse (RN) for the self-insured employer, St. Mary's Medical Center, Duluth, Minnesota, on February 1, 1993. She initially worked in the post-coronary care unit; then in November 1995, transferred to the intensive care unit (ICU) float pool. The employee normally worked the night shift.          The employee initially sought treatment for low back pain on July 20, 1994. She had worked a full shift on the post-coronary care unit the previous night. The employee testified that she left work between 7:30 and 8:00 a.m., then "puttered around" at home, bending and squatting to remove small pieces of dirt or sod from her back walkway. Afterward, she sat awhile, experiencing low back pain when she got up. (Finding 8; T. 45-47.) She was seen on July 20th by Dr. Christine Swensen, reporting lower lumbar pain without radiating symptoms. The doctor noted tenderness and spasm in the mid-lumbosacral area, limited range of motion, and a normal neurological examination. Dr. Swensen diagnosed musculoskeletal low back pain and prescribed Flexeril and Darvocet.          About a month later, on August 19, 1994, the employee developed sharp shooting pain down her left leg while at work. The employee was seen in the emergency room at St. Mary's after completing her night shift. The chart note relates "back pain radiates to left leg, started 8 pm 8/18." The employee was given medication and placed on bed rest for several days. She was off work for about two weeks, returning to full-duty work by September 6, 1994. The employee also received physical therapy, prescribed by Dr. Swensen, between August 23 and October 7, 1994, resulting in temporary improvement of her symptoms. An x-ray taken September 15, 1994, showed degenerative changes in the lumbar spine from L3 through S1.          In mid-October 1995, the employee began treating with Mary Cooley, D.C., reporting low back and intermittent left leg pain for the past six to nine months. The chiropractor's notes reflect "insidious" onset of left leg sciatica "one night at work, went to ER next am," as well as the incident "throwing small clumps of sod." (Ex. 7.) Dr. Cooley diagnosed acute lumbosacral strain/sprain with left leg sciatica. The employee continued to treat with Dr. Swensen and Dr. Cooley for periodic exacerbations of her low back and left leg pain.          On January 8, 1996, Dr. Swensen ordered an MRI scan, noting complaints of persistent and worsening low back pain and left leg sciatica. The MRI scan showed disc degeneration from L3-4 to L5-S1, including a small prolapsed disc at L3-4 to the left, possibly deviating the L4 nerve rootlet slightly, but "of equivocal significance," and a prolapsed disc on the right at L5-S1, without nerve root compression.          On August 7, 1996, the employee was seen by Dr. Michael J. DeBevec, an orthopedist, at the request of Dr. Swensen. The employee reported no specific injury, but stated her symptoms were exacerbated by the combination of...

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