Mirela Pasic
v.
University of Vermont Medical Center
Opinion No. 15-20WC
Vermont Workers Compensation Decisions
State of Vermont Department of Labor
September 15, 2020
Hearing held in Montpelier on May 21, 2020
Record
closed on June 24, 2020
State
File Nos. DD-60134 and FF-55020
Christopher McVeigh, Esq., for Claimant
Jennifer K. Moore, Esq., for Defendant
Stephen W. Brown, Administrative Law Judge.
OPINION
AND ORDER
Michael A. Harrington, Commissioner.
ISSUE
PRESENTED:
What,
if any, permanent impairment rating is attributable to
Claimant’s accepted neck injury that she sustained on
February 11, 2012?
EXHIBITS:
Joint
Exhibit 1: Joint Medical Exhibit (“JME”)
Defendant’s
Exhibit A: Curriculum Vitae of Nancy Binter, M.D.
Defendant’s
Exhibit B: Correspondence from Claimant’s attorney to
Karen Huyck, M.D. dated April 22, 2016
Defendant’s
Exhibit C: Independent Medical Examination Intake Form dated
May 28, 2016
Defendant’s
Exhibit D: Service Agreement between Claimant’s
attorney and Karen Huyck, M.D. dated November 10, 2016
FINDINGS
OF FACT:
1. I
take judicial notice of all relevant forms and correspondence
in the Department’s file for this claim, and of the AMA
Guides to the Evaluation of Permanent Impairment, 5th ed.
(the “AMA Guides”).1
2.
Claimant is a 38-year-old woman residing in Milton, Vermont.
As of February 2012, Defendant employed her as a licensed
nursing assistant.
3. On
February 11, 2012, while Claimant was working at
Defendant’s hospital, she helped a heavy patient move
between her bed and the bathroom. The patient’s feet
moved out from under her, and Claimant tried to help her up
with both arms but was unable to support her weight. Claimant
sustained injuries to her lower back, left hip, and cervical
spine. Defendant accepted this incident as compensable and
paid some benefits accordingly. However, the parties
presently dispute whether Claimant’s cervical spinal
injury resulted in any permanent impairment, and if so, then
to what extent.
4. The
day after her injury, Claimant presented to Defendant’s
emergency room with a primary complaint of back pain. (JME
1-3). The next month, she was evaluated at Concentra, where
her provider assessed her back, shoulder, and neck pain as
“nearly resolved,” and released her to work half
shifts with a 40-pound lifting restriction. (JME 25-26).
5.
Claimant again reported trapezius and back pain during a
follow-up visit at Concentra in September 2012, (JME 101),
but there is no record of any neck, shoulder, or trapezius
complaints during the next roughly seventeen months.
6. In
March 2014, Claimant again reported neck stiffness to a
physical therapist during a visit that was primarily for her
left hip. (JME 230).2 She credibly acknowledged at the formal
hearing that it was “fair to assume” that she was
not experiencing neck-related symptoms between September 2012
and March 2014.
7.
Claimant’s treatment records from the spring of 2014
also reflect stressful changes in her life, including the
recent loss of her job with Defendant. (E.g., JME 229). She
credibly testified at the formal hearing that she tends to
carry her stress in her neck and shoulders and that she has
discussed this with multiple healthcare providers, who have
recommended stretching and strengthening exercises and to
improve her posture.
8. By
March 2015, Claimant was taking college courses, cleaning
houses part-time, and working as a substitute teacher. That
month, she also began a Functional Restoration Program (FRP),
a three-week intensive bootcamp-like exercise program. (JME
273).
9. Her
FRP records identify the chief complaint requiring
rehabilitation as “left groin, left buttock, low back,
and left lower extremity pain with crepitus in the left hip,
sensory loss affecting the left lateral hip and weakness in
the left lower extremity.” (JME 276). They also
identify the relevant anatomic diagnoses as labral tear,
degenerative disc, and arthritis. (Id.). While her FRP
records contain multiple references to Claimant's back
and hip complaints, they do not reflect any then-current
complaints about her neck, shoulders, or trapezius muscles.
(See generally JME 273-358).3
10. In
April 2015, during a follow-up visit after completing the
FRP, Claimant reported an onset of left shoulder pain during
the prior week. On physical examination, however, her
provider found her cervical range of motion to be “full
and pain free.” (JME 370-374).
11.
During the next nine months, Claimant experienced a flare of
back and hip pain, which she attributed at least in part to
increased hours cleaning houses. (See JME 389). In November
2015, after several conservative treatments had failed to
resolve her persistent hip pain, she underwent left hip
surgery to repair a labral tear. (JME 408-409).
12.
Claimant began another physical therapy program after that
hip surgery. In...
