Workman v. Wellspring Meadows, Inc., 010719 IDWC, IC 2013-002663

• Case Date: January 07, 2019
• Court: Idaho

AMY WORKMAN, Claimant, v. WELLSPRING MEADOWS, INC., Employer, and IDAHO STATE INSURANCE FUND, Surety, Defendants. No. IC 2013-002663 Idaho Workers Compensation Before The Industrial Commission of The State of Idaho January 7, 2019           FINDINGS OF FACT, CONCLUSIONS OF LAW, AND RECOMMENDATION           THOMAS E. LIMBAUGH, CHAIRMAN.          INTRODUCTION          Pursuant to Idaho Code § 72-506, the Idaho Industrial Commission assigned the above-entitled matter to Referee Brian Harper, who conducted a hearing in Boise, Idaho, on January 20, 2016. Claimant was represented at hearing by Nathan Gamel. James Ford represented Wellspring Meadows (“Employer”), and Idaho State Insurance Fund (“Surety”), Defendants. Oral and documentary evidence was admitted. Post-hearing depositions were taken and the parties submitted post-hearing briefs. The matter originally came under advisement on September 13, 2016.^[1]          ISSUES          The issues to be decided are:

1. Whether the conditions for which Claimant seeks additional benefits were caused by the industrial accident at issue; and

2. Whether and to what extent Claimant is entitled to the following benefits:

a. Medical care; and

b. Temporary disability benefits.

         CONTENTIONS OF THE PARTIES          On January 14, 2013, Claimant sustained injury while acting within the course and scope of her duties for Employer in Coeur d’Alene. Defendants accepted Claimant’s lumbar spine claim, and surgery was performed on her low back. Claimant was declared to be at MMI in August 2013. Her low back continued to be symptomatic thereafter, and she sought additional medical care.          In addition to the lumbar spine injury, Claimant asserts she also injured her neck, which led to a cervical fusion surgery. Defendants refused to pay for the cervical surgery, or any care after Claimant was declared at MMI. Claimant continues to suffer pain and limitations post surgeries. She denies she has reached MMI. Claimant is entitled to all unpaid past and future medical costs associated with her lumbar and cervical injuries. She is also entitled to temporary disability benefits.          Defendants argue Claimant suffered a work-related injury to her low back, but not her neck. She received all the reasonable and necessary medical treatment to which she is entitled. Claimant needs no further medical treatment related to her industrial accident. Her cervical surgery was not causally connected to the industrial accident at issue.          EVIDENCE CONSIDERED          The record in this matter consists of the following:

1. Claimant’s testimony, taken telephonically at hearing^[2];

2. Claimant’s Exhibits (CE) 1 through 13, admitted at hearing;

3. Defendants’ Exhibits (DE) 1 through 38, admitted at hearing;

4. Claimant’s deposition transcript, taken on December 15, 2015, submitted as a free-standing document and also as Defendants’ Exhibit 31;

5. The post-hearing deposition transcript of Gary Cook, M.D., taken on January 29, 2016;

6. The post-hearing deposition transcript of Dennis Chong, M.D., taken on March 9, 2016; and

7. The post-hearing deposition transcript of Jeffrey McDonald, M.D., taken on April 28, 2016.

         The objections made during the deposition of Gary Cook, M.D., at page 51, line 23, page 52, at lines 6 and 17, and page 53, line 3 are all sustained. All other objections preserved during the depositions are overruled.          FINDINGS OF FACT          1. As part of her duties for Employer, Claimant provided in-home care to a twelve-year old boy with cerebral palsy in Coeur d’Alene. On January 14, 2013, Claimant was assisting this patient into the bathtub when he went rigid as the result of his condition. As Claimant was attempting to hold on to the patient, she injured her back, (without dispute) and additionally claims she injured her neck in this same accident (disputed).          2. Claimant immediately informed her supervisor by telephone, and was eventually instructed to seek medical care at Premier Urgent Care, which was near the accident site.^[3] Claimant does not recall if she told her supervisor about her neck injury at that time, but admittedly her low back pain was much more severe than any neck pain she was experiencing at the time.          Premier Urgent Care          3. Claimant presented to Henry Downs, M.D., at Premier Urgent Care (Premier) on January 14, 2013, complaining of right-sided lumbar back pain. The physician’s office notes of that visit state that while lifting an 80 pound child Claimant felt right lower back pain which extended into her buttocks. Claimant complained of increased pain with walking, and described pain over her SI joint. Claimant denied previous back injury, or other complaints.          4. Dr. Downs diagnosed acute sacroiliitis (right SI joint strain). He ordered x-rays which were negative for fracture, but revealed moderate disc space narrowing at L5-S1, with mild osteophyte spurring at that level. Claimant was given medications and work restrictions. Dr. Downs scheduled Claimant for a follow up examination in ten days with John Swanson, M.D.          5. At Claimant’s initial examination with Dr. Swanson, two sets of records were generated. One set, handwritten, perhaps by a nurse (based on the signature line), indicated Claimant was presenting for lumbar pain and pain at the base of her neck, as well as pain into Claimant’s right leg. The other set of notes, typewritten, for Dr. Swanson’s signature (although not signed or dated), include a notation of chief complaint of low back pain radiating into Claimant’s right leg. Under the heading “History of Present Illness” the doctor stated, “[Claimant] denies the presence of any previous history of injury in that [low back] region of the body and there were no other injuries associated with this particular event.” DE 7 p. 284. Under the “Physical Examination” heading, Dr. Swanson’s notes indicated that Claimant’s neck “is nontender, no pain with full range of motion.” Id. p. 285. Dr. Swanson ordered an MRI for Claimant’s lumbar spine to include SI joints. Dr. Swanson scheduled a follow up examination two weeks hence, and started Claimant on physical therapy.          6. Claimant next presented unscheduled to Premier and was seen by Dr. Downs on February 4, 2013, complaining of increased radicular pain to her right foot. Based on her symptoms and MRI findings, Dr. Downs referred Claimant to a neurosurgeon for further evaluation. He suggested Claimant keep her scheduled appointment with Dr. Swanson on February 7, 2013.          7. There was no mention of neck pain in any notes taken in conjunction with Claimant’s February 7 office visit to Dr. Swanson, although the hand written notes indicated Claimant was complaining of left arm pain in addition to her lumbar and right leg complaints. However, the examination and treatment for that date focused, as always, on Claimant’s low back. Dr. Swanson again noted nontender cervical spine to palpation, and continuing tenderness to palpation of the paraspinous musculature on the right with appreciable muscular spasm. Dr. Swanson noted Claimant had been referred to neurosurgeon Jeffrey McDonald, M.D.          8. On February 17, 2013, Claimant presented at Premier complaining of neck pain with nausea and vomiting. She was seen by Morgan Ford, M.D. Dr. Ford noted Claimant’s subjective history as including her assertion that her neck pain began “essentially” from the date of the industrial accident, although initial treatments focused on her low back. Claimant described her neck pain as fairly constant, dull, but sharp pain with movement. Claimant denied any prior neck problems. She claimed her neck pain became much worse without a triggering event two days prior, and the pain radiated bilaterally into her shoulders and arms, with associated tingling and numbness periodically. The pain was so severe it made her nauseous with vomiting. She was unable to keep any food, water, or medications down. She was looking for symptom control. Dr. Ford prescribed Zofran to reduce nausea and vomiting. Claimant was also given a shot of Toradol. On April 14, 2013, Claimant again presented with complaints of neck pain flair ups with associated radiculopathy, and was again provided with a Toradol injection.          Ironwood Drive Physical Therapy          9. As noted previously, Claimant was prescribed physical therapy after her industrial accident. She presented on January 28, 2013 to Ironwood Drive Physical Therapy...