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...