Lawson v. Addus Healthcare, Inc., 011916 IDWC, IC 2012-024774

Case DateJanuary 19, 2016
CourtIdaho
AMBER M. LAWSON, Claimant,
v.
ADDUS HEALTHCARE, INC., Employer,
and
LIBERTY INSURANCE CORPORATION, Surety, Defendants.
Nos. IC 2012-024774, 2013-031337
Idaho Workers Compensation
Before the Industrial Commission of the State of Idaho
January 19, 2016
          FINDINGS OF FACT, CONCLUSIONS OF LAW, AND RECOMMENDATION           R.D. Maynard, Chairman.          INTRODUCTION AND BACKGROUND          Pursuant to Idaho Code § 72-506, the Idaho Industrial Commission assigned the above-entitled matter to Referee Brian Harper, who conducted a hearing in Coeur D'Alene, Idaho, on July 18, 2014. Claimant was represented by Starr Kelso, of Coeur D'Alene. Joseph M. Wager, of Boise, represented Addus Healthcare, Inc., ("Employer") and Liberty Insurance Corporation ("Surety"), Defendants. The matter came under advisement, and in due course the Referee issued his Findings of Fact and Conclusions of Law (FOF). The Commission adopted the Referee's FOF and issued their Order on March 24, 2015.          As noted in the FOF, a primary issue in the previous decision (Lawson I) was whether Claimant had proven she was entitled to a repeat MRI. The Referee concluded, and Commission affirmed, that Claimant had, at the time of the decision, failed to submit sufficient evidence to prove her entitlement to the MRI. The main problem with Claimant's case at the time of hearing was that her physician, John McNulty, M.D., testified that he could not attribute the need for the repeat MRI to a particular accident or event unless and until he could compare Claimant's original MRI with the contemplated repeat MRI. Since Claimant submitted no medical testimony to provide the causative link for the repeat MRI, she did not prevail in Lawson I.          On or about April 11, 2015, Claimant obtained a repeat MRI, which Dr. McNulty reviewed. She then moved the Commission to re-open the matter for the introduction of additional medical evidence, since she felt she now had the required medical testimony linking her condition to an industrial accident. On October 22, 2015, the Commission granted the motion under the "manifest injustice" provision of Idaho Code § 72-719(3), and allowed the parties sixty days in which to present additional evidence relating to the compensability of the repeat MRI, and the impact of that study on Claimant's claim for additional medical care. The parties submitted such evidence, and on December 22, 2015, the matter came under advisement.          ISSUES          By order of the Commission, the issues to be decided are:
1. The compensability of the April 11, 2015 MRI; and
2. Claimant's entitlement to additional medical care.
         CONTENTIONS OF THE PARTIES          Claimant argues she injured her back in August 2012 in an accident arising out of and in the course of her employment with Employer. Her claim was accepted, and she received medical attention. On January 2, 2013, Claimant fell while working for          Employer, exacerbating her symptoms from the August incident. Soon after her second accident, Claimant's treating physician determined she was at MMI based solely upon the August 2012 injury, while discounting Claimant's complaints from the January accident.          Claimant's personal physician, after reviewing Claimant's April 11, 2015 MRI, opined that Claimant's January 2, 2013 fall resulted in a new compensable injury. Claimant is entitled to further reasonable medical care under Idaho Code § 72-432. In addition, Defendants are liable for the cost of the April 2015 MRI, which they wrongfully refused to obtain.          Defendants argue Claimant's latest MRI does not show any compensable injury. Defendants are not liable for the cost of the April 2015 MRI, and further have no obligation to provide Claimant with additional medical benefits.          EVIDENCE CONSIDERED          The record in this matter consists of the following:
1. The Industrial Commission legal file, which includes the previous hearing's exhibits, documents, and depositions, as well as the original decision in the instant matter;
2. The deposition transcript of John McNulty, M.D., taken on December 1, 2015, together with his deposition Exhibit 1; and
3. Defendants' Exhibit A.
         Claimant's objection posed during Dr. McNulty's deposition is overruled. Claimant also filed an objection to Defendants' proposed Exhibit B on numerous grounds. Defendants responded to the objection. The ruling on the objection will be made via separate order.          Having considered the above evidence, the Referee submits the following findings of fact and conclusions of law for review by the Commission.          FINDINGS OF FACT          1. Findings 1 through 27 contained in the Findings of Fact and...

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