In re Claim of Nielsen, 040120 COWC, 5-103-366-001

Case DateApril 01, 2020
CourtColorado
IN THE MATTER OF THE CLAIM OF: MARCUS (MARK) NIELSEN, Claimant,
v.
TRI STATE GENERATION AND TRANSMISSION, Self-Insured Employer, Respondent.
W.C. No. 5-103-366-001
Colorado Workers Compensation
Industrial Claim Appeals Office
April 1, 2020
          WITHERS SEIDMAN RICE MUELLER GOODBODY PC, Attn: SEAN P GOODBODY ESQ, (For Claimant)           LAW OFFICE OF STEVEN J PICARDI PC, Attn: STEVEN J PICARDI ESQ, (For Respondents)          FINAL ORDER          The claimant seeks review of an order of Administrative Law Judge Sidanycz (ALJ) dated November 14, 2019, that denied and dismissed his claim for workers’ compensation benefits. We affirm.          This matter went to hearing on whether the claimant demonstrated he sustained a work-related injury on March 22 2019. After the hearing, the ALJ entered her order, making the following pertinent factual findings that are summarized below.          The employer operates a coal fired electric plant. The claimant has worked for the employer for more than 28 years. The claimant’s primary position is that of a mechanic and welder in the operations department, and his job duties include maintaining equipment at the power plant.          The claimant testified that at approximately noon on March 21, 2019, he informed his mechanic supervisor, Dwayne Zimmerman (Zimmerman), that moving the plywood had hurt him and he asked to no longer work on his knees. Nevertheless the claimant returned to his job duties and worked the remainder of his shift.          The claimant returned to work on March 22, 2019, and worked until approximately 5:30 p.m. He testified that he worked slower on that date and it was a struggle to perform his job duties. He explained that over the course of his shifts on March 21 and 22, 2019, he spent approximately 12 hours working on his knees.          At approximately 5:30 p.m. on March 22, 2019, the claimant informed Zimmerman that he needed to leave. He explained that he was in so much pain that he was unable to fully change out of his work clothes and needed assistance to walk. The claimant called his wife to pick him up from work, and he eventually was taken to the emergency department at The Memorial Hospital at Craig. The March 22, 2019, emergency department medical record indicates that the claimant reported pain in his right buttock that radiated into his bilateral thighs, and that the onset of his symptoms had been gradual over the prior two hours. Dr. Huyn noted the MRI of the claimant’s spine from September 22, 2014, showed diffuse degenerative changes without spinal compression. Dr. Huyn opined that the claimant had a possible musculoskeletal strain and diagnosed right sided sciatica. He prescribed medications.          The claimant subsequently sought treatment from his primary care physician, Dr. Hamilton. At his appointment, the claimant was using crutches to ambulate. The claimant reported that his symptoms developed gradually after working on his knees for several hours. He described pain in his hips and low back. Dr. Hamilton prescribed medications and referred the claimant to a specialist and physical therapy.          Thereafter, on March 28, 2019, the claimant was seen at UC Health at the direction of the employer. The claimant saw nurse practitioner, Greg Holm (NP Holm), and reported that he worked for 10 hours on March 22, 2019, and experienced “gradually worsening burning pain in his lower back into his buttocks and hips.” NP Holm noted that the recent MRI of the claimant’s lumbar spine was normal. He also noted some concern regarding the possible diagnosis of piriformis syndrome and referred the claimant to Dr. Tracy.          The claimant saw Dr. Tracy on April 1, 2019, and described severe hip, low back, and leg pain after working on his knees for 12 to 14 hours. The claimant reported his pain as 10 out of 10. Dr. Tracy noted the claimant’s x-rays and MRI results were normal. Dr. Tracy recommended a CT angiogram of the claimant’s abdomen and pelvis.          The claimant returned to Dr. Hamilton and reported continuing symptoms, including numbness into his entire foot from his right buttock region. In his report, Dr. Hamilton noted that the MRI did not identify the claimant’s pain generator. He also noted that the claimant reported right leg numbness when he palpated the claimant’s left lower lumbar region. However, Dr. Hamilton noted that such a reaction “was not possible.”          On April 2, 2019, the claimant returned to NP Holm and reported some improvement in his symptoms. However, he also reported muscle twitching in the right proximal anterior thigh, which NP Holm noted was a new symptom. NP Holm agreed with the recommendation that the claimant undergo a CT angiogram. NP Holm opined that the claimant’s symptoms may not be work-related.[1]          The CT angiogram of the claimant’s abdomen, pelvis, and bilateral lower extremities was normal.          At the recommendation of Dr. Hamilton, the claimant began physical therapy on April 22, 2019. The claimant reported to John Pearson, PT, that his symptoms were “[m]uch better with prescription of medicine for anxiety, and spasms.”          Dr. Hamilton subsequently opined that there could be an anxiety component to the claimant’s symptoms. In his medical report dated May 2, 2019, Dr. Hamilton noted the claimant seemed better. On May 22, 2019, the claimant returned to Dr. Hamilton and reported he was doing much better and had completed physical therapy. Dr. Hamilton released the claimant to return to full duty on this date.          The claimant returned to NP Holm on May 24, 2019, and reported that he believed he was injured from moving plywood sheets. However, NP Holm noted that the mechanism of injury reported at their first appointment related to a long period of working on his knees...

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