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...