Castro v. College of Southern Idaho, 040919 IDWC, IC 2016-033930

Docket Nº:IC 2016-033930, IC 2017-009800
Case Date:April 09, 2019
ROSA CASTRO, Claimant,
Nos. IC 2016-033930, IC 2017-009800
Idaho Workers Compensation
Before the Industrial Commission of the State of Idaho
April 9, 2019
          FINDINGS OF FACT, CONCLUSIONS OF LAW, AND RECOMMENDATION           Thomas P. Baskin, Chairman.          INTRODUCTION          Pursuant to Idaho Code § 72-506, the Idaho Industrial Commission assigned the above-entitled matter to Referee Brian Harper, who conducted a hearing in Twin Falls, Idaho, on July 17, 2018. Dennis Petersen of Idaho Falls represented Claimant. Paul Augustine of Boise represented Defendants. The parties produced oral and documentary evidence at the hearing, took post-hearing depositions, and submitted briefs. The matter came under advisement on January 22, 2019.          ISSUES          The issues noticed for resolution at hearing were:
1. Whether Claimant’s low back condition for which she seeks additional benefits was caused by either or both of her industrial accidents;
2. Whether and to what extent Claimant is entitled to the following benefits:
a. Medical care;
b. Temporary disability benefits1 ; and
3. Whether Claimant is entitled to a change of physician to Dr. Benjamin Blair.
         All other issues are reserved.          CONTENTIONS OF THE PARTIES          Claimant contends she suffered injury to her low back as the result of one or two falling accidents while in the course and scope of her employment. These accidents occurred on November 14 and December 22, 2016. After Surety declared Claimant at MMI, she saw Dr. Benjamin Blair for her continuing low back complaints. Dr. Blair recommended lumbar surgery, and attributed the need for such surgery entirely to Claimant’s industrial accidents. Defendants denied the surgery. Claimant is entitled to continuing medical care as proposed by Dr. Blair, including surgery. Claimant also asserts Dr. Blair should be designated as Claimant’s treating physician moving forward.          Defendants argue that Claimant has not proven she suffered an injury to her low back that requires lumbar surgery from either or both of her industrial accidents. Claimant had preexisting low back arthritis, and at most strained her back in the work accidents, which strain has resolved. Claimant’s ongoing symptomatology is due to conditions unrelated to her work accident. Her radicular leg pain is subjective, and not correlated by objective MRI findings. Furthermore, Dr. Blair’s opinions are based on Claimant’s unreliable, inaccurate history.          EVIDENCE CONSIDERED          The record in this matter consists of the following:
1. The testimony of Claimant taken at hearing;
2. Joint exhibits (JE) A through X admitted at hearing; and
3. The post-hearing deposition transcripts of Benjamin Blair, M.D., and Paul Montalbano, M.D., taken on September 5, and October 17, 2018, respectively.
         FINDINGS OF FACT          1. At the time of hearing Claimant was a 54 year old married woman living in Rupert, Idaho.          November Accident          2. In November 2016 Claimant worked for Employer as a teacher’s assistant helping teach children in the classroom and performing home visits with families. During one such home visit on November 14, 2016, Claimant tripped over something protruding from the ground as she approached the house. Claimant fell forward to the ground. Claimant testified she experienced pain in her neck, left shoulder, and left knee2 immediately after her fall.          3. Claimant sought medical treatment at Minidoka Medical Center. Claimant was prescribed a muscle relaxant for her neck spasm. Claimant soon began complaining of right hand pain as well. She was referred to Burley orthopedist Gilbert Crane, M.D., for her left shoulder, right hand and left knee pain. Dr. Crane treated those complaints, but did not address Claimant’s neck problems because he “[didn’t] do spine[s].” JE G, p. 27. Dr. Crane’s treatment was considerable, including left shoulder and right carpal tunnel surgeries, but such treatment is not germane to this decision, and therefore not set forth in detail.[3]          December Accident          4. On December 22, 2016, Claimant slipped on ice while at work. At hearing Claimant testified she landed “on [her] butt.” Tr. p. 43. In her deposition she claimed she fell forward during this second accident, landing on “all fours.” JE T, p. 330. Her first office visit notes from this accident also mention a fall onto her hands and knees. All subsequent medical notes describing the incident indicate Claimant fell onto her hands and knees, or “all fours.”          5. After falling on the ice, Claimant presented at Minidoka Medical Center, complaining of low and upper back pain, and left ankle pain. While low back pain was mentioned on this visit, it appears the initial treatment focused on Claimant’s ankle. At the time she fell in December, Claimant was still under Dr. Crane’s care for her right hand and left knee and shoulder complaints, all of which were still symptomatic.          6. On her followup visit of December 29, 2016, Claimant did not mention back pain; instead she focused on her left shoulder, left ankle, left knee, neck, and right hand. Low back pain was noted under the heading “Current Problems,” but not actively examined or treated.          7. While the office notes of Claimant’s January 12, 2017 visit to the Center again do not mention ongoing low back complaints, Claimant was referred to Southern Idaho Physical Therapy for “evaluation of neck, right wrist and hand, left knee, left ankle, and low back pain.” JE N, p. 250. Notes from the physical therapist do not include any treatment for low back complaints. Claimant did mention back pain on a few occasions, such as on January 26, 2017, the day after she had a shoulder MRI, and on June 22, 2017, when she stated her bed might be causing her to have a back ache.          8. On July 21, 2017, Surety sent Claimant to Keith Holley, M.D., for an orthopedic IME. At that time Claimant reported central low back pain without radicular symptoms, but with occasional tingling in her toes. She also reported tenderness to palpation at L4 to S1 without paraspinal muscle tenderness.          9. Dr. Holley diagnosed a myofascial lumbar strain from Claimant’s November industrial accident. Findings which were unrelated to either work accident included Claimant’s lumbar spondylosis and degenerative disc changes. Dr. Holley felt Claimant’s ongoing low back symptoms were age related and “primarily due to her morbid truncal obesity.”4 JE O, p. 269. He found Claimant was medically stable from her two industrial accidents.          10. Subsequently Dr. Crane agreed with Dr. Holley’s findings in a “check the box” format letter from Surety.          11. After the IME report was prepared, Claimant saw Benjamin Blair, M.D. a Pocatello orthopedic surgeon with OrthoIdaho on August 15, 2017. On this initial visit, Claimant indicated in writing that she had injured her neck, left shoulder, left knee, and right hand in the November accident, and her right knee, left ankle, and right shoulder in the December accident. However, she complained of low back pain to Dr. Blair, which she orally related to her November accident. Dr. Blair’s notes of that date state that Claimant had no previous history of low back pain until her November accident, at which time she noted “sudden onset…low back pain radiating to the lower extremity.” JE P, p. 282. Claimant’s December accident aggravated her ongoing symptoms according to Dr. Blair’s notes. Dr. Blair felt Claimant was of “average weight” at 283 pounds with a BMI of 48.6. JE O, p. 283.          12. Dr. Blair examined Claimant. All mechanical testing was negative. Claimant walked without abnormal gait. X-rays taken that day showed disc narrowing at L5-S1 with grade 1 spondylolisthesis as interpreted by the doctor. MRIs were ordered.          13. Dr. Blair interpreted the lumbar MRI as showing degenerative disc disease, central disc bulge with significant disc space...

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