In re Compensation of Welborn, 011720 ORWC, 18-05829

Case DateJanuary 17, 2020
CourtOregon
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...

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