IN THE MATTER OF THE CLAIM OF: AUDRA FAHRION, Claimant,
THE JONES FINANCIAL COMPANY LLC, Employer,
PROPERTY CASUALTY INSURANCE COMPANY OF HARTFORD, Insurer, Respondents.
W.C. No. 5-094-870
Colorado Workers Compensation
Industrial Claim Appeals Office
October 7, 2020
& TEJADA PC, Attn: BETHIAH BEALE ESQ, (For Claimant)
& EVANS LLC, Attn: DOUGLAS J KOTAREK ESQ, C/O: PAUL R
POPOVIC ESQ, (For Respondents)
seek review of an order of Administrative Law Judge Mottram
(ALJ) dated April 20, 2020, that determined claimant had
proven that a surgery recommended by Dr. Youssef was
reasonable and necessary medical treatment and awarded
temporary total disability (TTD) benefits to the claimant We
affirm the decision of the ALJ.
sustained an admitted injury on December 6, 2018, when she
slipped and fell in the parking lot at work. She fell on her
right side, striking her right shoulder and right hip,
snapping her neck, and hitting her head on concrete.
to this injury, claimant had a slip and fall in May 2018
while hiking. Claimant was treated for this incident by Dr.
Rosenbaugh, a chiropractor. Claimant injured her right
shoulder at that time. Claimant testified that the hiking
incident led to pain radiating down her hand to her little
also sought chiropractic treatment with Dr. Rosenbaugh on
October 31, 2018. The chiropractor noted restricted motion
“in the left C1 . . . and “bilateral C7.”
The chiropractor recommended physical therapy (PT).
physical therapist noted complaints of increased pain and
discomfort through the right shoulder. Claimant did not
remember a mechanism of injury, but reported increased pain.
McLaughlin first evaluated the claimant on November 16, 2018.
He noted complaints of right sided cervical pain and right
shoulder pain. The cervical pain radiated into her trapezius
and down to the lateral arm. The claimant complained of
numbness and tingling in the 4th and
5th digits of her right hand. Bowling worsened her
symptoms in the upper extremity and neck. Lumbar spine
symptoms were also reported from sitting at her desk for
periods of time. Dr. McLaughlin performed a diagnostic and
therapeutic subacromial injection to the right shoulder.
attended a previously scheduled PT appointment on December 7,
2018. She reported she slipped on ice the day before and had
increased pain on her right side through her back and
McLaughlin again evaluated the claimant on December 12, 2018.
Claimant reported worsening right sided cervical pain, upper
right extremity numbness, and right shoulder pain. She also
reported a new right sided lumbosacral pain. Dr. McLaughlin
noted imaging studies of the cervical spine from November 26,
2018, prior to claimant’s fall. Claimant complained of
tenderness with palpation of the SI joint with a bruise over
her lateral hip. The doctor diagnosed an exacerbation of her
cervical pain and right shoulder and arm pain with a new
lumbar strain, SI joint strain and trochanteric bursitis. Dr.
McLaughlin noted that claimant reported that prior to her
fall, she had significantly improved after a shoulder
injection, but continued to experience deep achiness in the
returned to Dr. McLaughlin on January 24, 2019. Claimant
complained of worsening right sided cervical pain. The doctor
recommended a right C7-T1 epidural steroid injection (ESI)
and such was performed on January 31, 2019.
April 26, 2019, claimant returned to Dr. McLaughlin and
reported that the November shoulder injection had provided
significant improvement up until her fall on ice. The January
ESI gave good relief for the first day but was not sustained
and her symptoms gradually returned. Claimant continued to
complain of shoulder pain and right upper extremity weakness,
both of which were improved with PT. The MRI and x-rays from
November 26, 2018, were reviewed. Claimant had a positive
Sperling’s maneuver on the right that radiated into the
trapezius and down the arm. Dermatomal testing showed
decreased sensation to light touch over C5-6 and C8. Dr.
McLaughlin recommended a repeat ESI in the cervical spine and
referred claimant for an electrodiagnostic study. The ESI was
performed on May 23, 2019.
underwent electromyography (EMG) of the right upper extremity
on June 4, 2019. The EMG showed evidence of insertional
activity in a C5 and C6 distribution, suggesting nerve root
irritation, but without frank denervation.
returned to Dr. McLaughlin on June 12, 2019. The doctor noted
claimant’s report of temporary relief of 50% of her
symptoms following the ESI. Surgical options were discussed
but claimant elected to hold off on surgery at that time.
Jernigan evaluated the claimant on June 26, 2019. He noted
claimant’s course of care with Dr. McLaughlin. Dr.
Jernigan diagnosed a sprain of ligaments in the cervical
spine with right arm radiculopathy and right shoulder
contusion and strain. Dr. Jernigan opined that Dr.
McLaughlin’s care was appropriate and was causally
related to claimant’s work. Claimant returned to Dr.
Jernigan on July 19, 2019, and was referred for an MRI of her
cervical spine. The MRI was performed on August 5, 2019 and
revealed moderate degenerative disc disease, spondylosis and
asymmetric uncovertebral joint degenerative changes, left
greater than right at C5-6 producing mild spinal canal and
moderate left-sided neuroforaminal stenosis. The MRI also
showed central broad based C4-5 osteophyte disc complex
producing mild deformity of the ventral aspect of the thecal
sac, but no significant stenosis that would be new compared...