THERESA SCHMIT, Employee/Appellant,
v.
FINGERHUT CORP. and TRAVELERS INS. CO., Employer-Insurer,
and
AMALGAMATED COTTON GARMENT & ALLIED INDUS. FUND, ST. CLOUD HOSP., and REGIONAL DIAGNOSTIC RADIOLOGY, Intervenors.
Minnesota Workers Compensation
Workers' Compensation Court of Appeals
April 23, 1999
HEADNOTES
MEDICAL
TREATMENT & EXPENSE - SURGERY. Where the employer
and insurer's doctor opined that employee's 1997
fusion surgery was not reasonable and necessary because
conservative treatment was not attempted, the compensation
judge is supported by substantial evidence and is not clearly
erroneous in finding such surgery to be unreasonable and
unnecessary.
MEDICAL
TREATMENT & EXPENSE - SURGERY. Where the employer
and insurer's doctor opined that fusion surgery performed
in 1998 was not reasonable and necessary because certain
diagnostic tests had not been performed to isolate the source
of the employee's pain, and where such tests may have
been performed, the basis for the compensation judge's
decision to deny payment is called into question and the
matter should be remanded for further consideration.
TEMPORARY
TOTAL DISABILITY. Temporary total disability benefits
may be awarded after unreasonable and unnecessary
surgery. Matter remanded to compensation judge for
reanalysis.
Affirmed
in part and remanded in part.
Determined by: Wheeler, C.J., Wilson, J., and Pederson, J.
Compensation Judge: Jeanne E. Knight.
OPINION
STEVEN
D. WHEELER, Judge
The
employee appeals from the compensation judge's
determination that the surgical procedures performed on April
23, 1997 and April 16, 1998 were not reasonable or necessary
to cure or relieve the employee from the effects of her
January 15, 1997 work injury and did not meet the treatment
parameters. We affirm the compensation judge's
determination with respect to the 1997 surgery, but remand
the issue concerning the compensability of the surgery
performed on April 16, 1998.
BACKGROUND
The
employee, Theresa Schmit, was first employed by Fingerhut
Corporation, the employer, on July 31, 1989, as a
shipper. Thereafter, until her Gillette
injury1 of January 15, 1997, she served in a
number of different capacities for the employer. At the
time of her injury the employee was 40 years of age and had a
weekly wage of $353.63.
From
the time of her initial employment until her injury in
January of 1997 the employee had several instances of
treatment for low back pain. She was first treated in
August 1990, when she complained of pain radiating into both
legs. She testified that the pain was the result of
positioning during surgery for her Crohn's disease, a
gastrointestinal disorder. She indicated that her
symptoms resolved within 24 hours of receiving pain
medication.
The
employee was next treated in November 1991 at the Cold Spring
Medical Clinic for a four to six-week history of back
pain. She indicated that she had never had back pain
before and that there was no radiation into her buttocks or
legs. She was advised by her physician that there was
nothing wrong with her and she did not seek any further
treatment. (Joint Ex. 9.)
The
employee apparently experienced some low back symptoms while
at home in the early part of 1993. She received physical
therapy during February 1993 with resolution of her symptoms
by March 1 of that year. From 1993 through the end of
1996 the employee had no complaints of low back pain, except
those associated with her Crohn's disease. She had
no restrictions on her activities. She did receive some
physical therapy in December 1995 and January 1996 following
colon surgery. On that occasion she complained of a
constant low back ache but with no symptoms in her
legs. This physical therapy treatment was successful in
relieving her symptoms.
In
January 1997, the employee began to develop low back symptoms
which she associated with the bending and lifting required in
her job as a "picker." The progression of her
symptoms increased and the employee consulted with her
gastroenterologist, Dr. Brad E. Currier. From February
27 through April 1997 the employee was on leave of
absence. Dr. Currier requested that an MRI be performed
on the employee's lumbar spine, which was completed on
March 19, 1997. The results of the MRI indicated that
the employee had degenerative disc disease at L4-5 and L5-S1
with a small annular tear and central disc bulge at L4-5 with
no nerve root impingement or stenosis. At the L3-4 level
there was a suggestion of a "far left lateral disc
bulge" but there was no indication of disc herniation,
degeneration or nerve root impingement. The report
indicated that there was no disc abnormality noted at the
upper lumbar levels. (Joint Ex. 4.)
Following
the...
