VALERIE D COLLINS Applicant
WHEATON FRANCISCAN SERVICES I Employer
XL SPECIALTY INSURANCE COMPANY Insurer
Claim No. 2014-014399
Arkansas Workers Compensation
State of Wisconsin Labor and Industry Review Commission
July 26, 2019
Attorney Martin D. Stein
Attorney Russell J. Fenton
WORKER’S COMPENSATION DECISION
[1]
MICHAEL H. GILLICK, CHAIRPERSON
Order
The
commission reverses the decision of the
administrative law judge (ALJ) issued in this matter on
October 25, 2018.
Wheaton
Franciscan Services and XL Specialty Insurance Company
(respondents) are liable for payment or reimbursement of
medical expense reasonably required by the effects of the
applicant's chest wall strain injury sustained on April
24, 2014. This includes medical expense incurred for this
injury from April 24, 2014, through June 24, 2014.
Within
30 days from the date of this decision, the applicant shall
submit to XL Specialty Insurance Company an accounting of any
unpaid or unreimbursed medical expense claim reasonably
required by her chest wall strain injury. Within 30 days from
applicant's submission to XL Specialty Insurance Company,
that insurer shall make the payments/reimbursements claimed,
unless a dispute arises with respect to the necessity or
reasonableness of any such claim. In case of such dispute,
the matter shall proceed to dispute resolution in accordance
with the procedure set forth in Wis. Stat. §102.16. If
the applicant does not submit an accounting to the insurer
within 30 days from this decision, the matter shall be ended.
No
temporary or permanent disability is due for the upper chest
strain injury, and this order is final.
By the
Commission:
David
B. Falstad, Commissioner, Georgia E. Maxwell, Commissioner
Procedural
Posture
On June
13, 2016, the applicant submitted a hearing application
claiming that she sustained a compensable lumbar spine injury
while performing work duties for the employer on April 24,
2014. On July 11, 2018, a hearing was held before an ALJ of
the Department of Administration, Division of Hearings and
Appeals, Office of Worker's Compensation Hearings. On
October 25, 2018, the ALJ issued a decision finding that the
applicant sustained a compensable occupational lumbar spine
injury, and additionally finding that as a consequence of
this injury the applicant was permanently and totally
disabled. Respondents timely submitted a petition for
commission review alleging error in the ALJ's decision,
and briefs were submitted by the parties.
The
commission has reviewed the evidence submitted at the
hearing, and it has considered the petition and the positions
of the parties. It has also consulted with the ALJ with
respect to the credibility and demeanor of the applicant at
the hearing. Based upon its review and analysis the
commission makes the following:
Findings
of Fact and Conclusions of Law
1. The
applicant, whose birthdate is February 23, 1961, began
working for the employer in 2012 as a housekeeper in
environmental services. Her duties mainly involved dusting,
vacuuming, trash removal, and bed making. She was also called
upon to lift bags of laundry, although other than indicating
that such lifting was a "normal activity"
[2] in her job,
there is no indication of how often she performed this work
task. In the early morning hours of April 24, 2014, the
applicant lifted a linen bag weighing approximately 50 lbs.
and tossed it into a bin. As she was doing this she
experienced upper chest pain. She reported the injury to her
supervisor but finished her shift.
2. A
written incident report was completed and dated April 24,
2014.
[3] The report was written by the
applicant's manager as the applicant described the
incident to him. The report reads (with grammatical and
spelling errors included):
Around 1:30 am thrusday morning I was picking up a Linen Bag
To Take down To the Dock Dirty Linen. I had Pull a musho
[inferred to be the word "muscle"] by my left
chest. I didn't go to ER will by Doctor on the 5-5-2015
Back.
The
report also contains a box asking for identification of any
body part affected, and in that box "Left Upper Chest
Pain" is written. The report contains no mention of back
symptoms or a back injury, unless the last word of the
report, "Back," is taken to refer to one or the
other.
3. The
applicant sought treatment at Wheaton Franciscan Healthcare
with Al P. Baltrusaitis, D.O., at 11:44 a.m. on April 25,
2014. Dr. Baltrusaitis took a history of the applicant
lifting heavy linen bags from the floor up over her head to
place them into a linen basket, and that as she was doing
this she "felt a sharp pain to the left anterior chest
wall."
[4] No complaint of back pain related to
the work incident is found in the clinic note, but Dr.
Baltrusaitis did write: "She admitted to me that she had
some chest pain and back pain last year but this was in an
unrelated area of the back." The only other mention of
the applicant's back is found in Dr. Baltrusaits'
physical examination notes where he wrote: "Her back
range of motion is normal." Dr. Baltrusaitis diagnosed
"Left chest wall and pectoralis strain," and
prescribed conservative treatment with a return to light-duty
work.
4. The
applicant saw Dr. Baltrusaitis again on May 5, 2014. Nothing
concerning back pain was recounted in the clinic note of that
date, and again Dr. Baltrusaitis noted that applicant's
back range of motion was normal.
[5] He indicated that the applicant
was "doing better," but he referred her to physical
therapy and continued a light-duty restriction. His diagnosis
was "Left chest wall and pectoralis strain
improving."
5. On
May 21, 2014, the applicant saw Dr. Baltrusaitis and he
indicated she...
