72 Van Natta 67 (2020)
In the Matter of the Compensation of LORI WELBORN, Claimant
WCB No. 18-05829
Oregon Worker Compensation
January 17, 2020
Elmer
& Brunot PC Law Offices, Claimant Attorneys
Gress,
Clark, Young, & Schoepper, Defense Attorneys
Reviewing Panel: Members Woodford and Ousey.
ORDER
ON REVIEW
Claimant
requests review of Administrative Law Judge (ALJ)
Ilias’s order that upheld the self-insured
employer’s denials of her new/omitted medical condition
claims for L5-S1 disc herniation and L5-S1 disc protrusion.
On review, the issue is compensability. We reverse.
FINDINGS
OF FACT
We
adopt the ALJ’s “Findings of Fact,” with
the following summary and supplementation.
On
February 9, 2016, claimant sustained a compensable back
injury. (Exs. 1, 2, 3, 4).
On
February 12, 2016, claimant began treating with Dr. Puscas,
reporting low back pain with radiation down the left leg.
(Ex. 5). She also reported a history of a previous back
surgery. (Id.)
On
February 20, 2016, Dr. Fitzgerald noted claimant’s past
medical history, including an L4-5 lumbar laminectomy. (Ex.
7). Claimant reported low back and radiating pain to her left
posterior thigh. (Id.)
In
April 2016, the employer accepted a lumbar strain and a right
shoulder strain. (Ex. 11).
A May
2016 lumbar MRI was interpreted as showing an L5-S1
broad-based disc bulge with a tiny residual and/or recurrent
left paracentral disc protrusion. (Ex. 12).
In June
2016, Dr. Buza, a neurosurgeon, performed an examination at
the employer’s request. (Ex. 15). He diagnosed L5-S1
radiculopathy with residuals secondary to the work event.
(Id.)
[72 Van
Natta 68] In February 2017, Dr. Buza performed a second
examination, noting claimant’s ongoing symptoms. (Ex.
17).
An
April 2017 lumbar MRI was reported as showing an unchanged
appearance of a rudimentary broad-based disc bulge with a
tiny residual/recurrent left paracentral disc protrusion.
(Ex. 20).
In May
2017, Dr. Buza authored an addendum, stating that claimant
was medically stationary, but that the last chart note
available for his review was from August 2016. (Ex. 21).
On
August 9, 2017, Dr. York, a neurosurgeon, diagnosed a
lumbosacral disc herniation with radiculopathy, and
recommended a “redo” left L5-S1 microdiscectomy.
(Ex. 23). On review of the April 2017 MRI, she noted that
claimant had a “residual versus recurrent disc”
on the left. (Ex. 23-2).
In
September 2017, Dr. York authored an addendum, noting Dr.
Buza’s review of claimant’s most recent MRI,
which he found was similar to the May 2016 MRI. (Ex. 25). Dr.
York stated that Dr. Buza’s review of that MRI
demonstrated that claimant had a “superimposed
paracentral disc bulge” as well as a “recurrent
disc protrusion possibly displacing the root at L5-S1.”
(Id.) Dr. York agreed that claimant had a recurrent
disc protrusion, which compressed the left S1 nerve root, and
S1 radiculopathy, and recommended a redo left L5-S1
microdiscectomy. (Id.)
On
October 17, 2017, Dr. Buza opined that, based on
claimant’s ongoing symptoms and unchanged MRI scan, it
was reasonable to perform a decompressive laminectomy, which
he determined would be a direct result of the February 2016
work incident. (Ex. 26-1).
On
October 31, 2017, Dr. York performed a “redo left L5-S1
microdiscectomy,” and diagnosed a recurrent left L5-S1
herniated nucleus pulposus. (Ex. 27-1). In doing so, she
noted that the S1 nerve root was densely adherent to the disk
and annulus. (Ex. 27-2).
A
February 2018 lumbar MRI was reported as showing postsurgical
changes compatible with a previous laminectomy, enhancing
granulation tissue filling the laminectomy defect, suspected
small residual left paracentral disc protrusion resulting in
displacement of the left S1 nerve root in the lateral recess,
and enhancing granulation tissue surrounding the left S1
nerve root. (Ex. 29).
[72 Van
Natta 69] In early April 2018, Dr. Buza performed an
examination concerning claimant’s medically stationary
status. (Ex. 31). In summarizing the October 2017 surgical
report, Dr. Buza stated that claimant was found to have a
recurrent left L5-S1 herniated ruptured disc, and that Dr.
York had performed a discectomy, decompressing the nerve
root. (Ex. 31-2, -3). On review of the imaging studies, Dr.
Buza noted that the May 2016 MRI showed disc material
appearing to protrude and partly impinge on the descending S1
nerve root, and that the April 2017 MRI showed a small left
superimposed protrusion on the S1 nerve root. (Ex. 31-5, -6).
On review of the February 2018 MRI, Dr. Buza stated that it
showed L5-S1 changes with distortion of the soft
tissues/granulation tissue in the laminectomy void, and
suspicion of a residual left disc protrusion on the left at
the S1 nerve root. (Ex. 31-6).
Dr.
Buza ultimately diagnosed, among other conditions, S1
radiculopathy, L5-S1 spondylosis, L5-S1 foraminal narrowing...